Atopic dermatitis: a brief review of recent advances in its management

Abstract

Atopic dermatitis (AD) is a common inflammatory skin disorder characterized by recurrent eczematous lesions and intense itching. 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 of skin diseases. Atopic dermatitis is associated with an increased risk of multiple comorbidities, including food allergies, 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 patients. However, in the last few years, new therapeutic strategies have been 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.

Keywords: Janus kinase inhibitors; alopecia areata; atopic dermatitis; baricitinib; eczema.

Figure 1.

Typical clinical appearance and location of atopic dermatitis in infants.

Figure 2.

Close-up view of skin.

Figure 3.

Treatment pattern of atopic dermatitis.

Figure 4.

A summary of various therapeutic biologics and small molecules used to treat atopic dermatitis.