Angela M Lavadia MD, Angela T Cumagun MD, Lourdes Palmero MD, Noemie Salta Ramos MD, Cindy Jao Tan MD J Drugs Dermatol. 2021;20(1):84-87. doi:10.36849/JDD.2021.5080
An ABC scheme of atopic dermatitis (AD) management entails anti-inflammatory, barrier repair and basic skin care strategies to adequately manage AD. It is an easy-to-follow model which helps lessen distress and improve the quality of life amongst patients. An expert panel composed of specialists in the field of dermatology and pediatric dermatology in the Philippines convened to review current data and management practices in order to provide key treatment recommendations and identify current gaps in the treatment of mild to moderate atopic dermatitis. This scientific expert panel, likewise, seeks to provide guidance for all healthcare professionals involved in the care and management of AD patients.
Atopic Dermatitis and the Role of the Skin Microbiome in Choosing Prevention, Treatment, and Maintenance Options
Hilary Baldwin MD, Crystal Aguh MD, Anneke Andriessen PhD, Latanya Benjamin MD FAAP FAAD, Aaron S. Ferberg MD, Deirdre Hooper MD FAAD, Joseph L. Jarizzo MD, Peter A. Lio MD, Brook Tlougan MD FAADI, Heather C. Woolery-Lloyd MD, Joshua Zeichner MD FAAD J Drugs Dermatol. 2020;19(10):935-940. doi:10.36849/JDD.2020.5393
Atopic dermatitis (AD) is a common skin condition characterized by disturbed barrier function, skin inflammation, and cutaneous dysbiosis. Clinically, it manifests as chronic-recurrent xerosis, pruritus, and erythematous lesions. Its pathophysiology is complex, making the selection of appropriate treatment options a task. Results from an expert panel were summarized and discussed to provide updated recommendations for the treatment and maintenance of atopic dermatitis. Normalization of skin microbiome diversity using a topical moisturizer containing post-biotic aqua and biomass may offer a valuable option for the treatment and maintenance of inflammatory skin diseases.
Matthew Reynolds PA-C, Joe Gorelick RN MSN FNP-C, Matthew Bruno PA-C J Drugs Dermatol. 2020;19(3): doi:10.36849/JDD.2020.4737
The objective of this review is to describe the current thinking on the clinical features of AD alongside current treatment guidelines, in order to consolidate and distill past and current criteria used in AD diagnosis, and thereby propose a more simplified set of diagnostic criteria.
Lawrence F. Eichenfield MD, Thomas Luger MD, Kim Papp MD, et al. J Drugs Dermatol. 2020;19(1):50-64. doi:10.36849/JDD.2020.4508
This review summarizes the efficacy and safety data of topical therapies including corticosteroids, calcineurin inhibitors, and crisaborole and it shows that comparison among available agents is difficult because of differing methodologies used across clinical trials and that there is considerable variability in safety reporting among AD trials.
A Global Review on the Risk Factors and Management of Early Atopic Dermatitis in Children Ages 0 to 2 Years Old
Lawrence A. Schachner MD FAAD FAAP, Adelaide A. Hebert MD FAAD, Anneke Andriessen PhD, Latanya T. Benjamin MD FAAD FAAP, et al. J Drugs Dermatol. 2019;18(10):1020-1027.
The current review aims to explore early intervention in infants and young children with eczema and AD-prone skin by improving skin barrier function and controlling inflammation at the earliest time point using a moisturizer and a proactive treatment.
Nolan J. Maloney BS,Kyle Tegtmeyer BS, Jeffrey Zhao BA, Scott Worswick MD J Drugs Dermatol. 2019;18(10):1053-1055.
Given that dupilumab is relatively well tolerated and has shown efficacy in diseases mediated by Th2 processes, a new topic of interest is whether dupilumab might prove effective in other conditions in dermatology.
Adrian Pona MD, Abigail Cline MD PhD, Sree S. Kolli BA, Steven R. Feldman MD PhD, Alan B. Fleischer Jr. MD J Drugs Dermatol. 2019;18(10):987-990.
Although pediatricians manage more AD visits than dermatologists in total visits, dermatologists manage more AD visits than pediatricians per physician. Characterizing how AD patients are currently treated may build a reference for future clinical research investigating novel standard-of-care treatment in AD.
Efficacy of Dupilumab in Different Racial Subgroups of Adults With Moderate-to-Severe Atopic Dermatitis in Three Randomized, Placebo-Controlled Phase 3 Trials
Andrew F. Alexis MD MPH, Marta Rendon MD, Jonathan I. Silverberg MD, David M. Pariser MD, et al. J Drugs Dermatol. 2019;18(8):804-813. ClinicalTrials.gov identifiers: NCT02277743, NCT02277769, NCT02260986
Significant clinical improvement and a favorable benefit-risk profile can be achieved with dupilumab treatment in patients of White, Asian, and Black/African American racial subgroups with moderate-to-severe AD inadequately controlled with topical medications.
Mark Lebwohl MD, Andrew F. Alexis MD MPH, Lisa A. Beck MD, et al. J Drugs Dermatol. 2019;18(2):122-129.
Recently published expert perspectives outlined recommendations for the diagnosis and treatment of moderate-to-severe AD in adults, reflecting evidence-based, practical recommendations to support allergists and dermatologists in selecting appropriate treatment in the era of biologic therapies. In these case studies, we demonstrate how AD severity, treatment response, and treatment failure can be assessed, and the role of emerging systemic treatments in the management of moderate-to-severe AD.
James Q. Del Rosso DO, Julie Harper MD, Leon Kircik MD, et al. J Drugs Dermatol. 2018;17(10):1070-1076.
This article provides succinct summaries of pathophysiology and medical management, and discussion of epidermal barrier dysfunction and skin microbiome shifting associated with AD. Additional emphasis is placed on adjunctive topical skin barrier approaches that may prolong disease-free remissions.
Marita Zimmermann MPH PhD, David Rind MD MSc, Rick Chapman PhD, MS, et al. J Drugs Dermatol. 2018;17(7):750-756.
Moderate-to-severe atopic dermatitis can be difficult and costly to treat. We aimed to identify the cost-effectiveness of dupilumab compared to usual care in moderate-to-severe atopic dermatitis.
Collin M. Costello MD, Melody Maarouf MHS, Vivian Y. Shi MD J Drugs Dermatol. 2018;17(12):1330-1332.
Dermatology is entering an exciting era with new, targeted immune-modulating medications for treating a variety of dermatologic conditions including psoriasis, atopic dermatitis (AD), and hidradenitis suppurativa. Our understanding of cytokine signaling cascades has grown, presenting new opportunities to target skewed immune responses. Two major classes are biologics and small molecules. Herein, we highlight the similarities and differences between these two categories of targeted medications.
Alice He BS, Steven R. Feldman MD PhD, and Alan B. Fleischer Jr. MD J Drugs Dermatol. 2018;17(2):135-140.
Atopic dermatitis (AD) is primarily treated with topical therapies, systemic immunosuppressants, or adjunctive therapies. As novel treatment approaches for AD emerge, we characterize AD treatment and examine trends in treatment over time. We update these results with more recent data to examine trends in AD management over time.
Mio Nakamura MD, Michael Abrouk MD, Henry Zhu MD, et al. J Drugs Dermatol. 2017;16(7):643-648.
This article reviews all published clinical incidence of adrenal adverse effects in the medical literature, specifically Cushing’s syndrome (CS) and pathologic adrenal suppression (PAAS), to try to ascertain a more realistic limit for the safe use of superpotent topical steroids as it pertains to its potential systemic effects.
Treatment of Atopic Dermatitis in the United States: Analysis of Data from the National Ambulatory Medical Care Survey
Sean P. McGregor DO PharmD, Michael E. Farhangian MD, Karen E. Huang MS, and Steven R. Feldman MD PhD J Drugs Dermatol. 2017;16(3):250-255.
The primary objective of this study was to determine if there is a difference between dermatologists and non-dermatology specialties with regard to treatment strategies for AD and to describe those differences. There remains a disparity between dermatologists and non-dermatology specialties with regard to evidence-based approaches to the treatment of AD.
Lyn C. Guenther MD FRCPC, Anneke Andriessen PhD, Charles W. Lynde MD FRCPC, et al. J Drugs Dermatol. 2016;15(12):1485-1494.
The purpose of this paper was to develop a practical case-based approach for the treatment and maintenance of AD, enabling translation of guidelines into clinical care. A patient focused clinical pathway with 7 cases was developed. For each case scenario, treatment for mild, moderate, and severe disease was recommended.
Jessica Payne BS, Kyle A. Habet MD, Adrian Pona MD, Steven R. Feldman MD PhD J Drugs Dermatol. 2019;18(8):756-770.
Asthma and Atopic Dermatitis: A Review of Targeted Inhibition of Interleukin-4 and Interleukin-13 As Therapy for Atopic Disease
Choosing Wisely: Capitalizing on Atopic Dermatitis Clinical Trial Data for Meaningful Selection of Topical Agents
We are finally getting what we asked for: Pharma is ponying up for head to head studies to provide us with meaningful data to help make better clinical decisions. However, these valuable projects are often with systemic agents, such as biologics, leaving topical treatments in the dust. To address this, Dr. Lawrence Eichenfield, Professor of Dermatology and Pediatrics, UCSD, and colleagues sought to make the most out of the data we do have on the litany of topical options for atopic dermatitis and provide efficacy and safety guidance (A for effort!). Tune in to hear what this dream team concocted about creams. Hear how an expert approaches new atopic dermatitis patients. Don’t miss out – this is all very topical.
Back by popular demand, Dr. Steven Feldman, Professor of Dermatology, Pathology and Public Health joins host Dr. Adam Friedman from GW School of Medicine to review his recent database dive entitled “Trends in Atopic Dermatitis Management: Comparison of 1990-1997 to 2003-2012.” What new trends, both good and bad, have emerged? What can we expect and hope for the future of AD care? What tricks of the trade do these two employ when utilizing systemic immunosuppressants? Itching for answers? Make sure to tune in…
In this edition of the JDD Podcast, Ask the Investigator, host Dr. Adam Friedman digs deep with UCSF Assistant Professor of Dermatology Dr. Tina Bhutani to powerlift the most up to date safety data on Class 1 superpotent topical steroids from her study entitled “Update on the Systemic Risks of Superpotent Topical Steroids.” Is steroid phobia valid, or does proper use of steroids properly protect from the adverse event boogeyman. Hear from the expert how to effectively use topical steroids while limiting local and systemic side effects, and how to get your patients on board, especially those nay sayers. Do not miss this clinically relevant and im-POTENT podcast ( nailed it!).
In this special edition of the JDD podcast, with consideration from La Roche-Posay, host Dr. Adam Friedman is joined by Acne guru Dr. Hilary Baldwin, Director of the Acne Research Center and Associate Professor of Dermatology at SUNY Downstate, to review the cutting edge of cutaneous microbiome research and translational applications. Yes you are covered in bacteria – accept it, own it, and love it. Learn how harmony between the >500 species on our skin keep our barrier and cutaneous immunity in check, and conversely, how dysbiosis can facilitate a broad range of cutaneous pathology. This special edition is not to be missed!
Translational Lecture Series
Dr. Jon Zippin, Assistant Attending Dermatologist and Assistant Professor of Dermatology at Weill Medical College of Cornell, elucidates the complexity of cAMP biology and the translational impact of PDE4 inhibition as it relates to chronic inflammatory skin diseases. Tune in to learn why targeting this pathway is clinically meaningful but also where more work is needed to improve outcomes.
Dr. Amy Paller, Walter J. Hamlin Professor and Chair of Dermatology & Professor of Pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois, delivers a presentation discussing the cause and treatment of pediatric Atopic Dematitis, including co-morbidities, epidermal barrier impairment, and compliance issues.
Dr. Gil Yosipovitch, Professor of Dermatology at University of Miami Miller School of Medicine, provides residents and physicians access to the latest bench research and practical pearls from a master in pruritus that will help them offer the highest quality evidence-based dermatological care.