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Background/Objectives Methods Results Conclusion Atopic dermatitis (AD) is a common chronic skin disease in the pediatric population; however, rates of admissions for flares in patients established with dermatology compared to those that are not established have not been fully assessed in prior studies.We reviewed electronic medical records of patients hospitalized (billing codes 99221–99223, 99217) with diagnoses encompassing AD, eczema, and dermatitis (ICD‐10 codes L20.8‐L20.9, L30.8‐L30.9) between January 1, 2011, and December 31, 2021, at University Hospitals (UH) in Cleveland, Ohio. Patients were considered established with dermatology if they had been seen by a dermatology provider within 6 months prior to admission. Statistical analysis was performed using chi‐square goodness of fit.A total of 95 patient encounters met criteria for inclusion. Fifteen (15.8%) patients were established with dermatology at the time of admission and 80 (84.2%) were not. The chi‐square value (x2 = 44.74) was greater than the critical value of 10.828 at one degree of freedom (p < .001). There were 8 patients who had more than one admission for atopic dermatitis flares; 2 of these patients were established with dermatology prior to their first admission, and 4 were established at the time of the second admission.The majority of patients admitted with AD flare were not established with dermatology. Many of these patients lived in a low socioeconomic area and missed follow‐up appointments. Increasing access to dermatologic care for patients with atopic dermatitis, especially in lower‐income areas, could aid in decreasing atopic dermatitis‐related hospitalizations. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion Neomycin is an aminoglycoside antibiotic that may cause contact allergy. It was withdrawn as a medicine for human use in Denmark in October 2009 but is still found in some vaccines.To identify time trends in contact allergy to neomycin in the period from 2000 to 2023.A cross‐section study of patients ≥18 years consecutively patch‐tested with neomycin sulfate (20% in pet.) at Gentofte Hospital, Denmark, during the period 2000–2023 was conducted.The overall prevalence of contact allergy to neomycin was 1.4%. The prevalence was significantly lower in the period ‘2010–2023’ (1.2%) than in ‘2000–2009’ (1.8%) (p < 0.005). Contact allergy to neomycin was significantly positively associated with facial dermatitis and age >40 years, and significantly negatively associated with occupational dermatitis and hand dermatitis. No changes in sex, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, or age > 40/≤40 (the MOAHLFA‐index) were identified when comparing neomycin contact allergic‐patients in the two periods ‘2010–2023’ and ‘2001–2009’.Neomycin is a rare cause of contact allergy in Denmark with a significantly lower prevalence following its withdrawal as a medicinal product for human use in Denmark in 2009. [ABSTRACT FROM AUTHOR]

Abstract Introduction Limited evidence is available on real-world management of atopic dermatitis (AD) among Asian adults. This cross-sectional study aimed to assess current approaches in AD diagnosis and management in Asia. Methods Practising dermatologists regularly treating patients with moderate-to-severe AD were recruited from eight Asia–Pacific territories, namely Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. A survey was administered to eligible dermatologists after screening and taking informed consent. Data from fully completed submissions were analysed using descriptive statistics. The study was reviewed by the institutional review board in each territory. Results Data from 271 dermatologists were included for analysis. About one-third (31.7%) reported that they referred to the Hanifin and Rajka criteria during diagnosis. The majority of dermatologists used clinical impression when assessing AD severity and treatment response. Reduction of eczema and pruritus was the primary treatment objective when managing both acute (98.1%) and chronic (69.1%) AD. More than half of dermatologists preferred adding systemic anti-inflammatory medication for patients who did not respond to maximized topical treatment, while 43.6% would switch to another systemic medication for those failing to respond to maximized systemic treatment. Topical corticosteroids were frequently selected by dermatologists. For systemic therapies, oral corticosteroids were most frequently used, followed by cyclosporin and dupilumab. Narrow-band ultraviolet B was the most common phototherapy reported (84.9%). There was considerable variation in estimated average and maximum durations of therapies used to treat AD. Conclusion This study has provided insights on the real-world management of moderate-to-severe AD in the Asia–Pacific region. The diverse approaches in diagnosis and treatment highlight the multifactorial nature of AD, reliance on clinical judgement, and importance of personalized care. To improve outcomes in patients with AD, it will be crucial to develop biomarkers for diagnosis, reduce subjectivity in assessment, as well as promote access to newer and effective therapies.

Abstract Introduction The burden of atopic dermatitis (AD) is significant, with a substantial impact on quality of life (QoL). This cross-sectional study aimed to ascertain the burden of AD, its impact on QoL, and associated costs. Methods Patients with moderate-to-severe AD were enrolled from eight territories, namely Hong Kong, India, Japan, Mainland China, Singapore, South Korea, Taiwan, and Thailand. After screening was performed and informed consent was obtained, eligible participants were asked to provide responses on their AD symptoms, severity, treatment, and out-of-pocket costs via an online survey. QoL was assessed using EQ-5D-5L and Dermatology Life Quality Index (DLQI), while productivity loss was quantified using the Work Productivity and Activity Impairment (WPAI) questionnaire. Data from completed submissions were analyzed using descriptive statistics. The study was reviewed by the institutional review board in each territory. Results Median age of enrolled patients (N = 1103) was 41.0 years (interquartile range, IQR 16.0). The majority of patients reported that their head/neck, trunk, upper limbs, and lower limbs were affected during a flare. Topical (74.2%) and oral steroids (58.7%) were frequently prescribed to manage AD. Common atopic comorbidities were allergic urticaria (64.2%), allergic rhinitis (61.8%), and allergic conjunctivitis (51.5%). Median DLQI score was 13.0 (IQR 11.0), while median EQ-5D-5L (based on China value set) score was 0.8 (IQR 0.4); 87.2% and 77.2% of patients reported pain/discomfort and anxiety/depression on the EQ-5D-5L domains, respectively. Median total annual costs associated with AD were USD 10,128.52 (IQR 12,963.26) per patient, with indirect costs being the largest component. Findings from WPAI indicated that presenteeism is a major contributor to productivity loss. Conclusion This multinational survey study showed that AD is associated with substantial QoL impairment and economic burden among Asian adult patients with moderate-to-severe AD. To alleviate burden of AD, clinicians should be more proactive in managing other concomitant conditions including psychological issues, and advocate for increased reimbursement for AD treatments.

Abstract Introduction Lebrikizumab is a novel monoclonal antibody with established efficacy in patients with moderate-to-severe atopic dermatitis (AD) in multiple Phase 3 trials. One of the ultimate treatment goals for patients with moderate-to-severe AD is to achieve stable disease control without concern for planning future life events. Methods In ADvocate1 and ADvocate2, lebrikizumab-treated patients meeting the protocol-defined response criteria at Week 16 were re-randomized 2:2:1 to receive lebrikizumab every 2 weeks (Q2W), lebrikizumab every 4 weeks (Q4W), or placebo Q2W (lebrikizumab withdrawal) for 36 additional weeks. In this post hoc analysis, we evaluated the proportions of patients with no or minimal fluctuations of efficacy during the 36-week maintenance period and plotted individual patient trajectories. We defined no or minimal fluctuations as achieving and maintaining the defined endpoint (≥ 75% improvement in the Eczema Area and Severity Index [EASI 75], ≥ 90% improvement in EASI, Pruritus Numeric Rating Scale [NRS] ≥ 4-point improvement, or Pruritus NRS ≥ 3-point improvement) for ≥ 80% of the study visits. If patients used rescue medication, discontinued treatment, or transferred to the escape arm, data collected at or after the event were imputed as non-response. Results The proportions of lebrikizumab responders who maintained EASI 75 with no or minimal fluctuations were 70.8% (lebrikizumab Q2W), 71.2% (lebrikizumab Q4W), and 60.0% (lebrikizumab withdrawal). Of the patients with baseline Pruritus NRS ≥ 4 and who achieved ≥ 4-point improvement at Week 16, 66.1% (lebrikizumab Q2W), 62.7% (lebrikizumab Q4W), and 55.2% (lebrikizumab withdrawal) maintained ≥ 4-point Pruritus NRS improvement with no or minimal fluctuations. Conclusions Patients who met the response criteria at Week 16 and continued treatment with lebrikizumab Q2W or Q4W demonstrated a stable response with no or minimal fluctuations of efficacy in measures of skin and itch up to Week 52. Clinical Trial Registration NCT04146363 (ADvocate1) and NCT04178967 (ADvocate2).

Abstract Introduction It remains unclear how patients with atopic dermatitis (AD) and clinicians perceive the level of patient–clinician communication and if there could be potential lapses. This cross-sectional study aims to compare perspectives between patients with AD and dermatologists regarding communication and treatment expectations in Asia. Methods Moderate-to-severe patients with AD and practicing dermatologists were recruited from eight Asia–Pacific territories, including Mainland China, Hong Kong, India, Japan, Singapore, South Korea, Taiwan, and Thailand. Patients and dermatologists completed separate surveys designed to elicit their expectations regarding AD management, and their perceived level of patient–clinician communication. Patients were also asked about their treatment satisfaction and whether they prefer additional treatment beyond what was prescribed. Demographic information and responses were analyzed using descriptive statistics. The study was reviewed by the institutional review board in each territory, and all participants provided informed consent. Results A total of 1103 patients and 271 dermatologists completed the surveys. Both patients and dermatologists were largely aligned in their top treatment goals in AD management. However, greater proportions of patients prioritized the prevention of exacerbation (78.0% versus 47.2%), minimization of treatment adverse effects (46.4% versus 9.1%), and improvement in mental health (16.0% versus 4.9%), compared with dermatologists. Although patient–clinician communication was observed to be generally good, 10.9% of patients reported dissatisfaction with communication in AD management. The majority of patients were either “very satisfied” or “satisfied” with their latest acute AD treatment, but 65.5% of patients still desired additional treatment. Conclusions This multinational study has provided insights on the perspectives of Asian patients and dermatologists in treatment goals, AD management, and communication. In general, both patients and dermatologists were aligned in treatment goals and there was satisfactory patient–clinician communication in most aspects. However, potential areas of improvement have been identified to further enhance patient-centered care.

Abstract Introduction Despite advances in atopic dermatitis (AD) treatments, many patients face challenges obtaining medications. This study aimed to determine the frequency and causes of insurance coverage delays and denials for AD prescriptions and characterize the associated wait times and extent to which patients understand what to do when faced with a coverage issue. Methods This was a cross-sectional, observational study in which adult U.S. residents (aged 18+ years) with AD or caregivers of pediatric U.S. patients with AD (aged 0–17 years) completed an online survey (3 June–16 July 2021). Results Respondents (N = 978) were primarily adults with AD (81.8%), female (67.7%), and white (70.2%). There were 645 insurance delays or denials for AD prescriptions, with 48.1% (470/978) of respondents experiencing at least one delay/denial in the past year. Most delays/denials were for topical steroids (39.2%, 253/645), the most highly used prescription treatment class (83.9%, 821/978). However, the highest rate of delay/denials was for biologics, of which 43.6% (109/250) of all prescriptions faced a delay or denial. Denials were caused primarily by step therapy (27.6%) and delays by prior authorization (55.1%). Only 56.0% of respondents said they would know what to do if they faced an issue with AD prescription coverage. Conclusions Patients with AD frequently experience insurance-related barriers to obtaining recommended therapies, and many do not know how to respond when these barriers arise. Strategies to improve timely therapeutic access are needed.

Abstract Background Loss of function mutations in the filaggrin gene (FLG) play an important role in the pathogenesis of atopic dermatitis (AD). However, FLG is structurally challenging to sequence using conventional high‐throughput techniques. Genome‐wide association studies (GWAS) chips and imputation panels are also not designed to detect most of these mutations. Furthermore, bioinformatics tools have variable sensitivity for identification of loss of function variants. Targeted sequencing is often performed for AD but requires a comprehensive list of potential variants. Objectives This study sought to compile all published FLG single nucleotide polymorphisms (SNPs) in AD and characterize the methods for assessing the associated phenotype. Methods We searched nine electronic databases for studies that reported measures of association between FLG and AD. Data regarding FLG SNPs and participant demographics were extracted. The identified SNPs were compared to those available in the National Human Genome Research Institute‐European Bioinformatics Institute (NHGRI‐EBI) GWAS Catalogue and the 1000Genomes reference panel. Results We identified 168 SNPs in FLG that have been associated with AD, with the most studied being R501X, 2282del4, R2447X, 3321delA, S3247X and p.S2554 in European and Asian ancestries. A total of 153 of these SNPs are not available from GWAS studies, and 78 are not included in the 1000Genomes reference panel. Conclusions Because FLG is a complex gene, current GWAS chips do not capture most of the polymorphisms that have been associated with AD.

Background: Atopic dermatitis (AD) is an inflammatory skin condition, often multifactorial in origin, and most commonly manifests during childhood. Although there remains a deficit in literature, current data suggest Honduras may have the highest prevalence and severity of AD among all Latin American countries. Objective: To assess the current prevalence of pediatric AD in Honduras and evaluate existing gaps in available literature to monitor disease burden. Methods: A comprehensive literature search was performed in March 2023. Articles were removed if they were published before 2007, were of the incorrect study design, or were focused on countries outside of Honduras. The articles were independently reviewed by 2 authors. Results: The initial literature search yielded 174 studies, of which 7 met inclusion criteria. AD prevalence rates in children in Honduras ranged from 0.7% to 40.0%. Limitations: Limitations include elements of study design, analytic methods, study populations, and limited articles. Conclusion: There appears to be a disproportionately higher prevalence and disease burden of pediatric AD in Honduras. Future research should acquire accurate data to further understand the prevalence, incidence, and severity of AD in Honduras.

Traditionally, patients presenting to primary care with severe eczema would be referred to a dermatology clinic for an in‐person specialist appointment. With the rise of teledermatology, dermatologists are instead dispensing tailored written advice based on information provided in the referral. However, there is currently minimal literature assessing whether this advice translates into relevant prescriptions. This clinical audit examines GP prescribing practices and how they correlate to dermatologist recommendations with the objective of assessing whether this form of teledermatology is a viable method of providing care to paediatric eczema patients. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disease clinically characterized by eczematous skin manifestations; sometimes it can manifest with non-specific clinical features, in common with other skin conditions, such as infectious and neoplastic diseases. We would like to underline the importance of accurate dermatologic examination and rigorous anamnesis in patient affected by AD, in order to avoid misdiagnosis and delayed treatments.

Abstract Introduction Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects both children and adults. AD increases the risk of developing comorbidities like asthma, allergic rhinitis and food allergies. AD patients face difficulties, including itching, lack of effective treatments, lack of funding and discomfort in seeking a diagnosis or treatment. This study aims to identify the main barriers and opportunities to improve the experience of patients with AD and provide high-quality care. Methods Patients, caregivers and healthcare professionals were recruited from the Dermatology Department at Puerta de Hierro Majadahonda University Hospital (Madrid, Spain). Interviews with patients, caregivers and professionals were performed. Participants used storyboards to depict their preferred scenarios for improving healthcare interactions and create a Patient Journey Map. Results A total of 15 participants were included in the study. Early symptoms of AD were commonly described as undefined stages. As symptoms worsened, patients and caregivers expressed uncertainty and frustration. Patients became concerned about AD after their first serious flare and started experiencing intense itching, eczema, wounds, shedding or asthma. Topical corticosteroids were used to manage flares, but their effectiveness diminished over time, causing further frustration. Because of the ineffectiveness of their initial treatments, dermatologists observed that patients tended to downplay symptoms and how they affected their quality of life. The specialized treatment of severe AD significantly changed patients' emotional states. Despite AD's chronic nature, patients strived to enjoy remission periods and cope with flares. Psychological and emotional support was crucial for patients and caregivers, a need addressed by the Patients' School initiative at HUPHM hospital. Conclusion The severity of AD has a profound impact on patients' lives. Patient and caregiver emotional and social needs can be met by adequate communication, access to effective treatments and comprehensive psychological support.

Abstract Introduction The skin of patients with atopic dermatitis (AD) is characterised by elevated pH. As a central homeostatic regulator, an increased pH accelerates desquamation and suppresses lipid processing, resulting in diminished skin barrier function. The aim of this study was to determine whether a novel zinc lactobionate emollient cream can strengthen the skin barrier by lowering skin surface pH. Methods A double-blind, forearm-controlled cohort study was undertaken in patients with AD. Participants applied the test cream to one forearm and a vehicle cream to the other (randomised allocation) twice daily for 56 days. Skin surface pH and barrier function (primary outcomes) were assessed at baseline and after 28 days and 56 days of treatment, amongst other tests. Results A total of 23 adults with AD completed the study. During and after treatment, a sustained difference in skin surface pH was observed between areas treated with the test cream and vehicle (4.50 ± 0.38 versus 5.25 ± 0.54, respectively, p

Treat‐to‐target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management. To do so, we systematically searched for peer‐reviewed publications on the T2T approach for any skin disease in the PubMed and Scopus databases up to February 2022 and conducted a survey among IEC members regarding various components to potentially include in a T2T approach in AD. We identified 21 relevant T2T‐related reports in dermatology, of which 14 were related to psoriasis, five to AD, one for juvenile dermatomyositis and one for urticaria. In the IEC member survey, respondents proposed treatable traits (with itch, disease severity and sleep problems getting the highest scores), relevant comorbidities (with asthma being selected most commonly, followed by anxiety and depression in adults), recommended specialists that should define the approach in AD (dermatologists, allergists and primary care physicians were most commonly selected in adults), and applicable assessment tools (both physician‐ and patient‐reported), in both adult and paediatric patients, for potential future utilization of the T2T approach in AD. In conclusion, while the T2T approach may become a useful tool to simplify therapeutic goals and AD management, its foundation in AD is only starting to build. A multidisciplinary approach, including a wide range of stakeholders, including patients, is needed to further define the essential components needed to utilize T2T in AD. [ABSTRACT FROM AUTHOR]

This article discusses the efficacy of skin care interventions in preventing eczema and food allergy in infants. The study found that emollients, such as moisturizers, during infancy do not significantly impact the risk of developing eczema. However, they may increase the chance of developing mild local skin infections. The study also highlights a lack of trials studying other approaches to infant skincare for preventing eczema. Further research is needed to understand whether different approaches to infant skin care might prevent eczema or food allergy. [Extracted from the article]

A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27–48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0–28) was 12 (IQR 5–19). The mean and median vIGA-ADTM scores (range 0–4) were 2 (standard deviation [SD] 2) and 3 (IQR 2–4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p

Extensive research has been published on atopic dermatitis (AD), a prevalent skin condition amongst pediatricians. To assess the pediatric representation in the most cited literature on AD, using bibliometric analysis. Web of Science citation indexing database was used to identify publications with "atopic" and "dermatitis" or "eczema" in their title. Results were ranked by their Annual citation(Ac) and refined to the 100 topmost cited articles in the non-refined pediatric category and the top five journals in the categories of general medicine, dermatology, and pediatrics, by impact factor. 28,360 publications were retrieved. The metrics were significantly higher in dermatology, compared to pediatric and general categories [(RTC = 0.899, p < .001), (RAC = 0.795, p < .001), (Rusage count = 0.639, p < .001)] and [(RTC = 0.417, p < .001), (RAC = 0.392, p < .001), (Rusage count = 0.279, p < .001)]. This analysis is the first to highlight the underrepresentation of AD publications in the pediatric literature, which might impact the clinicians' and patients' level of care and AD annual societal expenditure.

Abstract Background Patients with moderate‐to‐severe atopic dermatitis (AD) refractory to topical therapy might require treatment with systemic therapies, including biologics. Objectives To assess the efficacy and safety of abrocitinib monotherapy in patients who previously received systemic therapies. Methods This post hoc analysis included patients receiving abrocitinib (200 mg/100 mg) or placebo in the phase 2b and phase 3 JADE MONO‐1 and MONO‐2, REGIMEN (abrocitinib 200 mg; open‐label period) and EXTEND (patients enrolled from MONO‐1 and MONO‐2) trials. Patients who were systemic therapy‐naive or had received prior oral systemic or biologic therapies were assessed for Investigator's Global Assessment (IGA) response of 0 (clear) or 1 (almost clear) and ≥2‐point improvement from baseline, ≥75% or ≥90% improvement in Eczema Area and Severity Index (EASI‐75 or EASI‐90), ≥4‐point improvement in Peak Pruritus Numerical Rating Scale (PP‐NRS4), PP‐NRS score of 0 or 1 and change from baseline in Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) and Patient‐Oriented Eczema Measure (POEM) scores. Safety was assessed. Results This analysis included 1579 patients (systemic therapy‐naive, n = 997; prior exposure to oral systemic, n = 429; biologic therapies, n = 153). At Week 12, IGA 0/1 response rates (95% confidence intervals) among patients who were systemic therapy‐naive, had received prior oral systemic therapy or had received biologic therapy were 44.4% (37.5–51.4), 34.5% (22.3–46.7) and 43.5% (23.2–63.7) with abrocitinib 200 mg, 30.9% (24.2–37.5), 16.4% (7.1–25.7) and 24.1% (8.6–39.7) with abrocitinib 100 mg and 9.6% (4.2–14.9), 5.9% (0.0–13.8) and 0.0% (0.0–23.2) with placebo in the pooled monotherapy trials; and 67.0% (62.8–71.2), 62.2% (56.4–68.0) and 53.5% (42.9–64.0) in REGIMEN. Across subgroups, abrocitinib showed greater improvement in EASI‐75, PP‐NRS4, EASI‐90, PP‐NRS 0/1, PSAAD and POEM scores versus placebo. Similar results were seen at Week 48. No new safety signals were observed. Conclusions Prior use of oral systemic or biologic therapies did not seem to impact the efficacy and safety of abrocitinib in patients with moderate‐to‐severe AD.

Abstract Introduction Upadacitinib is an oral Janus kinase inhibitor approved in multiple countries for moderate-to-severe atopic dermatitis (AD). Here we present long-term data for up to 3 years of continuous upadacitinib treatment in Japanese patients with AD. Methods Rising Up was a phase 3, randomized, multicenter study in Japan investigating the safety and efficacy of upadacitinib in patients with moderate-to-severe AD. Patients aged 12–75 years (weight ≥ 40 kg if

Abstract Introduction Air pollution in North America has intensified due to wildfires in recent years. In 2023, the wildfires in the Canadian province of Quebec caused a southward spread of pollutants, negatively affecting air quality and thereby aggravating certain health conditions in northeastern USA. This study examines the impact of air pollution on atopic dermatitis (AD) and skin health and how wildfires can exacerbate the burden of disease. Methods Carbon monoxide levels measured by the U.S. Environmental Protection Agency (EPA) in the Boston region during the months following the Canadian wildfires of 2023 were collected from the U.S. EPA Outdoor Air Quality webpage. Patient records on dermatology clinic visits for dermatitis and eczema at the Mass General Brigham (MGB) hospital system, 300 miles from the wildfires, were examined, and the data compared with data from the corresponding months in 2019–2022 for historical control. No individual patient data were collected. Results A notable rise and atypical summer peak in carbon monoxide (CO) levels in the Boston region during 2023 correlated with a spike in AD, dermatitis, and eczema-related dermatology clinic visits within the MGB hospital system, as compared with the prior 4 years. Conclusion The synchronized atypical peaks of CO levels and AD-related visits during the summer of 2023 highlight the potential impact of acute air pollution events such as wildfires on air quality and the consequences for skin health. Air pollution, exacerbated by wildfires, can damage the skin through the smoke and chemicals utilized for extinguishing fires, which contain multiple potential allergens and irritants to the skin, such as CO, particulate matter (PM2.5), and ammonium phosphates, triggering airway and skin inflammation and flares of AD. This issue disproportionately affects vulnerable populations, including low-income communities and the geriatric and pediatric populations. Healthcare professionals and government agencies must work together to improve air quality and purification policies and initiatives to lower the burden of skin disease, especially for vulnerable communities.

Abstract Introduction Lebrikizumab and dupilumab are monoclonal antibodies approved for treating moderate-to-severe atopic dermatitis (AD). Both have demonstrated efficacy and safety over the 16-week SOLOs and ADvocate trials. However, AD is a chronic and relapsing inflammatory disease, and the long-term maintenance of efficacy is critical for achieving disease control from the perspective of patients, physicians, and regulatory agencies. This study aims to compare the long-term efficacy and safety of lebrikizumab every 4 weeks (Q4W) and dupilumab every week or every 2 weeks (QW/Q2W) among adult patients who have achieved treatment efficacy following the induction period of 16 weeks. Methods Lebrikizumab’s efficacy was assessed using individual patient data (IPD) from the ADvocate 1 and 2 monotherapy trials. Dupilumab’s efficacy was evaluated using aggregate data from the adult-exclusive SOLO-CONTINUE trial. Due to the absence of a common comparator trial arm, we employed an unanchored matching-adjusted indirect comparison (MAIC), a robust methodology widely accepted by health technology assessment (HTA) agencies. This re-weights ADvocate IPD to align with SOLO-CONTINUE’s prognostic factors and effect modifiers. We compared lebrikizumab’s adjusted outcomes with dupilumab outcomes at week 52, focusing on 75% improvement in the Eczema Area and Severity Index from baseline (EASI-75), Investigator’s Global Assessment (IGA) score of 0 or 1, and overall adverse event (AE) rates. Sensitivity analyses were conducted to test various combinations of matching variables. Results Adults on lebrikizumab Q4W were more likely to maintain IGA 0/1 through the 36-week maintenance period (weeks 16–52) compared with those on dupilumab QW/Q2W [risk ratio (RR) 1.334; 95% confidence interval (CI) 1.02–1.74; p = 0.035]. Both treatments demonstrated comparable efficacy in terms of EASI-75 maintenance (RR 0.937; 95% CI 0.78–1.13; p = 0.490) and similar AE rates (RR 1.052; 95% CI 0.90–1.23; p = 0.526). Sensitivity analyses substantiated these findings. Conclusions Our findings suggest that lebrikizumab Q4W may provide equal or superior long-term maintenance of efficacy measured with EASI-75 and IGA 0/1 compared with dupilumab QW/Q2W, with the advantage of requiring less frequent doses.

Niyaz Mostafa,1 Saxon D Smith2 1Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia; 2ANU Medical School, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, AustraliaCorrespondence: Niyaz Mostafa, Email nmostafa.research@gmail.comIntroduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease that usually develops in early childhood. AD has a significant impact on quality of life and psychological health outcomes in both adults and children. There are increased reported rates of psychiatric comorbidities including anxiety, depression, ADHD and suicidal ideation compared to the general population. Primary caregivers of children with pediatric eczema and their families may also have derangements in psychological health and quality of life. A number of interventions exist for AD and address wellbeing outcomes as an important aspect of effective treatment.Methods: A comprehensive literature search was conducted using PubMed/Medline, Embase, the Cochrane Central Register of Controlled Trials in February 2023. Published studies up to April 2023 were included related to interventions for childhood AD that included psychological health or quality of life outcomes. These interventions were stratified according to type and evidence quality.Results: Search strategy revealed a wide variety of interventions with demonstrated improvements in quality of life or wellbeing of patients with pediatric AD or their families. Both pharmacological and non-pharmacological interventions demonstrated effectiveness in improving disease outcomes.Conclusion: A variety of both pharmacological and non-pharmacological interventions may be employed to improve psychological health outcomes in children with AD.Keywords: eczema, atopic dermatitis, psychology, wellbeing, children, pediatric

Introduction: Eczema is a debilitating skin disorder clinically characterised by the development of itchy, dry, rough, and scaling skin caused by a series of rudimentary clinical phenotypes. Methods: This double-blind, randomised, comparator-controlled trial evaluated the effectiveness of topical application of a novel palmitoylethanolamide formulation (Levagen+) compared with a standard moisturiser (comparator) to reduce eczema severity and improve patient outcomes. Seventy-two participants aged over 18 years old with atopic eczema (symptoms including redness, dry skin, scaling, and/or itchiness) on their hands or arm were recruited. Participants were randomly allocated to one of two treatment groups (Levagen + or comparator). Treatment was applied to the affected area twice daily for 4 weeks. Outcome measures included Self-Assessed Eczema Area Severity Index (SA-EASI) scoring and Patient-Oriented Eczema Measure (POEM) from baseline to week 4. Results: Levagen+ was effective at alleviating symptom severity of eczema over 4 weeks. Levagen+ significantly reduced redness, dryness, and total POEM score compared to a comparator cream. Conclusion: Levagen+ can significantly reduce eczema symptom severity compared to a comparator product, supporting its use as a potential treatment for eczema. Trial registration: clinicaltrials.gov Identifier: NCT05003453. [ABSTRACT FROM AUTHOR]

In young children, atopic dermatitis (AD) imposes a multidimensional burden on many aspects of their quality of life (QoL) and that of their families. LIBERTY AD PRESCHOOL part B was a randomized, double- blinded, placebo-controlled phase 3 trial in 162 children (aged 6 months to 5 years) with moderate-to- severe AD receiving dupilumab or placebo, plus low-potency topical corticosteroids. Post hoc analyses were performed on the full analysis set (FAS) and a subset of patients with Investigator’s Global Assessment score > 1 at week 16. The primary outcome was the proportion of patients at week 16 achieving a composite endpoint encompassing clinically meaningful changes in AD signs, symptoms and QoL: ≥ 50% improvement in Eczema Area and Severity Index; and/or ≥ 4-point reduction in worst scratch/itch numerical rating scale; and/or ≥ 6-point reduction in Children’s Dermatology Life Quality Index/Infants’ Dermatitis Quality of Life Index. Significantly more patients receiving dupilumab vs placebo achieved the composite endpoint in both the FAS (77.7% vs 24.6%, p

Resumen: Antecedentes: Dupilumab es una nueva terapia dirigida para la dermatitis atópica (DA) grave con una evidencia en la vida real aún limitada. Objetivo: Explorar nuestra experiencia con dupilumab para la DA en práctica clínica en un centro terciario. Material y método: Estudio observacional retrospectivo y unicéntrico que incluye pacientes adultos y pediátricos con DA grave en tratamiento con dupilumab entre diciembre de 2017 y diciembre de 2021. La gravedad y la respuesta se evaluaron con las escalas Eczema Area and Severity Index (EASI), Pruritus Numerical Rating Scale y Sleep Disturbance Numerical Rating Scale. Resultados: Cincuenta y nueve pacientes recibieron dupilumab: 52, 48, 26 y 13 pacientes alcanzaron los 6, 12, 24 y 36 meses de tratamiento, respectivamente. La tasa de EASI-75 fue del 94,2; 95,8; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI-90 fue del 63,5; 72,9; 84,6 y 92,3% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI

Abstract Background For children aged 6–11 years with uncontrolled severe atopic dermatitis (AD), 16 weeks of treatment with dupilumab resulted in substantial clinical benefit compared with placebo with an acceptable safety profile. However, longer-term safety and efficacy data are important to inform longitudinal AD management. Objectives This analysis of data from an open-label extension study (LIBERTY AD PED-OLE, NCT02612454) reports the long-term safety, efficacy, and pharmacokinetics of dupilumab in children with severe AD who had participated in the pivotal dupilumab LIBERTY AD PEDS study (NCT03345914). Methods Enrolled patients initially received subcutaneous dupilumab 300 mg every 4 weeks (q4w). The q4w regimen could be uptitrated to dupilumab dose regimens of 200 or 300 mg every 2 weeks (q2w; for body weight

Abstract Background Management of paediatric atopic dermatitis (AD) remains challenging, and presents a considerable healthcare resource utilisation (HCRU) burden. Objectives To describe secondary HCRU for children and adolescents with moderate‐to‐severe AD in Ireland. Methods This was a single‐centre chart review of children (age 6–11 years) and adolescents (age 12–17 years) with clinician‐confirmed moderate‐to‐severe AD. Eligible patients were selected consecutively, starting with the most recently consulting patient, and working backwards until patient identification for the study was complete. From first secondary care appointment post 1 January 2014, at least 12 months' medical record data were abstracted, including patient demographics/clinical characteristics, treatments, HCRU, and patient‐reported outcomes. Results Data were abstracted for 31 patients (22 children). Mean (SD) duration of observation was 4.4 (1.9) years. Most patients (74.2%) had severe AD at first referral, a mean (SD) of 2.7 (1.5) comorbid conditions, 2.2 (1.1) patient‐reported flare episodes/patient/year‐of‐observation, and 18.5 (12.2) tests/scans/procedures/patient/year‐of‐observation. Patients had tried a mean (SD) of 7.9 (5.3) treatments/patient/year‐of‐observation. Topical corticosteroids (TCS; 48.5% of prescriptions) were most frequently prescribed. Mean (SD) use (duration) of TCS, nonsteroidal topicals (tacrolimus, 4.1% of prescriptions), systemic corticosteroids (prednisolone, 2.2%), and systemic immunosuppressants (10.7%, of which methotrexate was 68.2%) was 38.6 (41.1), 54.4 (41.1), 2.0 (3.1), and 27.6 (21.1) months. Mean (SD) consultations/patient/year‐of‐observation was 15.3 (6.3); 28 (5.9%) for flare. Eight (25.8%) patients were hospitalised (including six children). There were 0.03 hospitalisations/patient/year‐of‐observation, and 4.4 nights spent in hospital, mostly for flare. Earliest mean (SD) Children's Dermatology Life Quality Index score was 9.7 (6.2); latest was 6.6 (5.5). Conclusion This is the first study examining paediatric AD HCRU in an Irish healthcare setting. Moderate‐to‐severe paediatric AD results in complex treatment, with high healthcare burden in hospital outpatient care. Despite treatment and a low hospitalisation rate, patients experience flare, lengthy hospital stays, and minor changes in quality of life.

Abstract Introduction Atopic dermatitis (AD) is heterogeneous in distribution pattern and clinical features. This analysis assessed the effect of dupilumab on the extent and severity of AD across various signs (erythema, edema/papulation, excoriation, lichenification) in different anatomical regions (head and neck, trunk, upper extremities, lower extremities) in patients aged 6 months to 5 years. Methods In LIBERTY AD PRESCHOOL, a double-blind, placebo-controlled, phase III clinical trial, children aged 6 months to 5 years with moderate-to-severe AD were randomized 1:1 to subcutaneous dupilumab or placebo with concomitant low-potency topical corticosteroids (TCS) every 4 weeks for 16 weeks. Changes in AD signs across anatomical regions were assessed using unweighted Eczema Area and Severity Index (EASI) body region scores. Results Overall, 162 patients were randomized to dupilumab (n = 83) or placebo (n = 79). A significant improvement in least squares mean EASI area score was seen by week 2 in all four anatomical regions (P

Abstract Introduction Upadacitinib, an oral selective Janus kinase (JAK) inhibitor, is used to treat moderate-to-severe atopic dermatitis (AD). Acne is the most common treatment-emergent adverse event in patients with AD treated with upadacitinib. In this post hoc analysis, we describe the acne events in Japanese patients with AD who received upadacitinib during the Rising Up study. Methods In this phase 3, double-blind, 3-year trial evaluating the safety and efficacy of upadacitinib 15 mg or 30 mg in Japanese patients with moderate-to-severe AD, patients were randomized 1:1:1 to receive upadacitinib 15 mg, 30 mg, or placebo for up to 16 weeks. At week 16, placebo-treated patients were re-randomized 1:1 to receive upadacitinib 15 mg or 30 mg. The incidence, characteristics, and management of treatment-emergent acne events up to the 52-week cutoff date were summarized. Results Among 272 patients in this analysis, the incidence of acne was higher in patients receiving upadacitinib compared with patients who received placebo. The rate of acne was higher in patients receiving upadacitinib 30 mg (32.4%) compared with those taking upadacitinib 15 mg (17.3%) during the long-term treatment period. All cases of acne were mild or moderate; no cases led to study drug discontinuation. The mean (range) of acne onset was 135.4 (7–465) days after starting study drug. Most acne occurred on the face; inflammatory papules were the most common morphology. Risk factors for acne included relevant concomitant medications (e.g., corticosteroids) started before acne onset and family and personal history of acne. Acne was generally managed with topical treatments. Conclusion Mild or moderate acne reported in Japanese patients with AD receiving upadacitinib occurred in a dose-dependent manner and had a variable onset time. Acne was readily managed with topical treatments. Patients and clinicians should be aware of the risk of acne associated with upadacitinib treatment for AD. Trial Registration ClinicalTrials.gov identifier, NCT03661138.

Abstract Atopic patients, multi‐disciplinary specialists, caregivers, and experts from all over the world participated in the International Meeting of the Eczema Foundation in Malta (IMEF). During this 4‐day conference, attendants addressed the challenges pertaining to the management of atopic dermatitis by sharing their experience in the form of presentations, discussion sessions, workshops, and a plenary session. This article aims to report on what we consider to be a successful attempt to unite patients and caregivers in the quest for improved treatment of atopic dermatitis through the implementation of therapeutic patient education.

Background: Research has shown that eczema patients prefer some degree of shared control over treatment decisions, but little is known about factors perceived to be important to facilitate shared decision making (SDM). Objective: To determine factors eczema patients and caregivers consider to be important for SDM, and how often they experience them with their eczema healthcare provider (HCP). Methods: A cross-sectional survey study (64 questions) was conducted, which included factors related to SDM rated by respondents on a Likert scale for importance, and how often these factors were true with their current eczema HCP. Results: Respondents (840, response rate 62.4%) most frequently rated their health literacy and communication skills as important for SDM. Factors which indicated a strong provider-patient relationship, and HCPs who initiate treatment conversations were also deemed beneficial. Low importance was placed on concordant HCP race/ethnicity, however, of those who did rate it as important, 53/91 identified as Black (half of all Black respondents). Limitations: A high proportion of respondents were aware of the term SDM prior to the survey. Conclusions: SDM is more likely to be facilitated when patient education and empowerment are coupled with HCPs who initiate treatment discussions, maintain compassion resilience, and listen to patient perspectives.

Background: Atopic dermatitis (AD) is common across all ages. Understanding heterogeneous age-related phenotypes may improve AD management. Objective: To determine age-related clinical phenotypes of AD. Methods: A prospective, dermatology practice-based study was performed (n = 380). AD severity was evaluated using questionnaires and full-body examination. Phenotypes were determined using latent class analysis. Results: There were 23 (6.1%) pediatric patients (

Introduction: Atopic Dermatitis (AD) affects individuals from all ethnicities and backgrounds. It has the highest global disease burden of dermatoses. There is a widely held belief that the presentation of AD is not described well in individuals with non-European ancestry in peer-reviewed literature. However, to our knowledge, this has not been investigated previously Objective: To quantify the number of peer-reviewed literature describing the appearance of clinical features of AD in non-European ancestry, particularly those originating from the Asian and African continents. Methods: A systematic scoping review between December 2020 and January 2021 was performed to quantify the number of studies describing AD in individuals of African and Asian ancestry. Reuslts: Sixteen studies were identified. None of the studies provided a clear description of AD in our population groups. Two studies described features of lichen planus like-AD in African American individuals. All studies reported on observed clinical features of AD. Conclusions: The review confirmed a lack of literature describing AD in populations of non-European heritage. It should encourage authors to make a deliberate effort to describe the appearance of clinical features of AD to enable understanding of how they may differentiate in individuals originating from different parts of the globe.

Introduction: Atopic dermatitis is an inflammatory skin condition that begins in infancy, characterized by extreme skin dryness, excoriations, and erythema. A completely natural product with plant extracts and vegetable oils was developed to manage eczema and associated conditions in a mixed population including infants. Materials and Methods: An open-label, single-arm, single-center study was conducted to evaluate the safety and efficacy of the test product on eczema severity. A total of 58 subjects, including infants, children, and adults aged 0 months to 60 years, diagnosed with mild-to-moderate eczema, were included. The subjects applied a small amount of product on the affected area twice daily for 14 days. Three-Item Severity (TIS) score, Eczema Area and Severity Index (EASI) change, and symptomatic relief were assessed at various time points. Results: The TIS score in children significantly reduced from baseline at 24 h (12.22%), day 7 (52.26%), and day 14 (79.74%), (all P

Atopic dermatitis (AD) is the most common skin inflammatory disease. Dysregulation of innate and adaptive immune systems plays a major role in the pathophysiology of AD. JAKi (Janus Kinase Inhibitors) reduce the production of pro‐inflammatory cytokines and represent a promising novel treatment for AD. To assess and summarize the overall efficacy and safety of topial JAKi in the treatment of AD in adults and pediatrics, a broad search was performed on Ovid Medline, Ovid Embase, Cochrane Library, Web of Sciences, Scopus, CINAHL and Google Scholar until 14 June 2022. After screening, 19 studies remained for the final review. The current systematic review was conducted according to PRISMA, and the protocol was registered in PROSPERO (ID #CRD42022303321). Topical delgocitinib, tofacitinib, ruxolitinib, cerdulatinib and ifidancitinib are effective in treating AD and significantly improve EASI, IGA, pruritus‐NRS score and some other indexes in adults. Moreover, topical delgocitinib was observed to have a great efficacy in the treatment of AD in paediatrics. All topical JAKi showed minimal risk of mild‐to‐moderate adverse effects. Available topical JAKi are effective and safe modalities in treating AD. Nevertheless, further studies with longer duration and head‐to‐head comparative trials are necessary to find the best option with the least adverse effects. [ABSTRACT FROM AUTHOR]

Caroline Oska,1 Mio Nakamura2 1University of Michigan Medical School, Ann Arbor, MI, USA; 2Department of Dermatology, University of Michigan, Ann Arbor, MI, USACorrespondence: Mio Nakamura, 1910 Taubman Center, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA, Tel +1-734-936-4054, Fax +1 734-647-2540, Email mionak@umich.eduIntroduction: Patients with eczema suffer from high psychological burden, often caused and exacerbated by chronic pruritus, which leads to a vicious itch-scratch cycle. Although much of the literature focuses on treating the physiological factors that lead to pruritus, little attention has been given to the cognitive, behavioral, and social factors associated with the itch-scratch cycle. We conducted a literature review to investigate whether treatments aimed at psychosocial factors could be effective for patients with eczema.Methods: A systematic literature review was conducted through PubMed and EMBASE. Original investigative articles that focused on psychotherapeutic interventions for eczema and/or eczema-related psychological morbidities were reviewed.Results: Psychotherapeutic interventions alongside standard medical care are shown to be beneficial compared to conventional treatments alone, both for eczema and for eczema-associated psychological symptoms. Such interventions include meditation and mindfulness, stress-reduction, habit-reversal training, hypnotherapy, music therapy, massage therapy, and standard psychological treatments such as cognitive behavioral therapy.Conclusion: It is important to recognize the reciprocal relationship between eczema and psychosocial distress. Alternative treatment options to address psychological factors associated with eczema can improve disease trajectory and quality of life.Keywords: eczema, atopic dermatitis, psychotherapy, mindfulness, stress-reduction, habit-reversal training, hypnotherapy, music therapy, massage therapy, cognitive behavioral therapy

Abstract Background Atopic dermatitis (AD) is a common inflammatory skin disease while the economic burden of AD by severity is not adequately understood. Objective To estimate the societal economic burden and to identify cost determinants of AD. Methods In this population‐based, controlled cohort study in Sweden, patients with AD were identified through diagnosis codes in primary or secondary care or by dispensed medications using administrative healthcare registers. A reference cohort without AD was randomly selected from the general population. Healthcare costs (primary/secondary care visits and dispensed medication) and indirect costs (care for sick children and long‐term sick leave for adults) were calculated annually. AD patients were stratified by age (paediatric [age

Food allergy and food-related worsening of dermatitis can occur in patients with atopic dermatitis (AD). We reviewed the relationship of AD with food allergen hypersensitivity and the risks and benefits of food allergen testing and avoidance in patients with AD. Skin prick testing and specific immunoglobulin E to aeroallergens may identify patients with immediate hypersensitivity. Atopy patch tests may detect non–immunoglobulin E–mediated reactions but are not standardized or routinely used. Younger children with more severe AD in whom the optimal management failed may have food-triggered AD. Egg, milk, and peanut account for most food allergens. Elimination of relevant food allergens should improve AD but must be guided by appropriate allergy testing and establishing clinical relevance. Serum immunoglobulin E panels for food allergens are discouraged in the primary care setting because of their difficulty of interpretation. Empiric avoidance of foods is entirely discouraged in AD because of their risk of causing nutritional issues, food allergy, and other problems.

Background Abrocitinib, a once-daily, oral Janus kinase 1 selective inhibitor, was shown to be an effective treatment for moderate-to-severe atopic dermatitis in phase 2 b/3 monotherapy trials. Methods These analyses included data for Investigator’s Global Assessment responder (clear [0] or almost clear [] with ≥2-grade improvement) and nonresponder patients with moderate-to-severe atopic dermatitis who received abrocitinib (200 mg or 100 mg) or placebo in three abrocitinib monotherapy trials (phase 2 b, NCT02780167; two phase 3, NCT03349060/JADE MONO-1 and NCT03575871/JADE MONO-2). Outcomes measuring skin clearance, itch, and quality of life were evaluated. Results Both nonresponders (n = 548) and responders (n = 260) treated with abrocitinib had rapid and clinically meaningful improvement in skin clearance, itch, and quality of life compared with placebo. Conclusion Patients with moderate-to-severe atopic dermatitis treated with abrocitinib who did not achieve an Investigator’s Global Assessment 0/1 response at week 12 still experienced rapid, clinically meaningful improvements across several other validated measures of efficacy and quality of life. ClinicalTrials.gov NCT02780167, NCT03349060, NCT03575871

Janus kinase (JAK) inhibitors are disease-modifying agents with efficacy in treating a spectrum of burdensome dermatologic conditions. The US Food and Drug Administration (FDA) recently placed a black box warning on this class of medications due to safety concerns based on data from studies investigating tofacitinib in patients with rheumatoid arthritis. Here we provide an overview of the timeline of FDA approval of JAK inhibitors in dermatology. We also discuss the available safety profiles of approved oral JAK1 inhibitors, namely abrocitinib and upadacitinib, oral baricitinib, a JAK1/2 inhibitor, deucravacitinib, a Tyk2 inhibitor, and the topical JAK1/2 inhibitor ruxolitinib in dermatology patients. Additionally, we offer suggestions for initial screening and laboratory monitoring for patients receiving JAK inhibitors. We found that the rates of venous thromboembolism reported in trials ranged from no events to 0.1–0.5% in dermatology-specific phase 3 clinical trials compared with no events in the placebo. The rates of cardiovascular events ranged from no events to 0.4–1.2% compared with no events to 0.5–1.2% in the placebo. The rates of serious infections were 0.4–4.8% compared with no events to 0.5–1.3% in the placebo. The rates of nonmelanoma skin cancer (NMSC) ranged from no event to 0.6–0.9% compared with no events in the placebo. The rates of non-NMSC ranged from no event to 0.2–0.7% compared with no event to 0.6% in the placebo. Most patients who developed these adverse events had risk factors for the specific event. The most common adverse events of oral JAK inhibitors included upper respiratory infections, nasopharyngitis, nausea, headache, and acne. Dermatologists should consider patients' baseline risk factors for developing serious complications when prescribing oral JAK inhibitors. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a common inflammatory skin disorder characterised by recurrent eczematous lesions and intense itch. The disorder affects people of all ages and ethnicities, has a substantial psychosocial impact on patients and relatives, and is the leading cause of the global burden from skin disease. Atopic dermatitis is associated with an increased risk of multiple comorbidities, including food allergy, asthma, allergic rhinitis, and mental health disorders. The pathophysiology is complex and involves a strong genetic predisposition, epidermal dysfunction, and T-cell driven inflammation. Although type-2 mechanisms are dominant, there is increasing evidence that the disorder involves multiple immune pathways. Until recently, the management of AD rested mainly on the judicious use of emollients, topical steroids, and topical calcineurin inhibitors in the majority of patients and systemic immunosuppressants were advocated in severely diseased. However, in the last few years, new therapeutic strategies were designed and developed to target the various steps in the chain of molecular events that lead to the AD phenotype. This review highlights the recent advancements in the management of AD.

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