Recent Developments and Advances in Atopic Dermatitis: A Focus on Epidemiology, Pathophysiology, and Treatment in the Pediatric Setting

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects a substantial number of children and has a significant negative impact on affected patients and their caregivers/families. Recent studies have led to significant evolutions in the understanding of AD pathogenesis, epidemiology, and treatment. The first point of contact for many patients with new-onset AD is usually with their primary care provider or pediatrician. This underscores the importance for pediatricians to understand the basic pathophysiology and current standards of care for AD. This article provides up-to-date information and reviews the basic principles of AD pathophysiology, diagnosis, and management. In addition, the article highlights recent advances in scientific research regarding the mechanisms involved in the pathogenesis of atopic dermatitis that have resulted in the discovery of novel therapeutic targets and the development of targeted biologic therapies with the potential to revolutionize AD therapy.

Fig. 1

Atopic pathogenesis and mechanisms of action of approved and emerging agents. Adapted with permission from Nguyen et al. [77]. AhR aryl hydrocarbon receptor, cAMP cyclic adenosine monophosphate, CRTH2 chemoattractant receptor homologs molecule expressed on TH2 cells, H4R histamine-4 receptor, IgE immunoglobulin-E, IL interleukin, JAK/STAT Janus kinase/signal transducer and activator of transcription, KOR κ-opioid receptor, NK1R neurokinin-1 receptor, PDE4 phosphodiesterase 4, R receptor, TSLP thymic stromal lymphopoietin

Fig. 2

Comprehensive long-term approach to the management of atopic dermatitis in children. Adapted with permission from Boguniewicz et al. [71]. AD atopic dermatitis, TCI topical calcineurin inhibitor, TCS topical corticosteroids