Atopic Dermatitis: Overview
Atopic dermatitis (AD) is a chronic, relapsing, and pruritic disease that classically develops in early childhood. There appears to be many contributing factors in the development of this disease including both genetic and environmental interactions, which ultimately lead to impaired epidermal barrier function and immune dysregulation. AD has a variable presentation depending upon age, and the diagnosis is based on clinical history and diagnostic characteristics. When making the diagnosis of AD, it is important to exclude conditions that present with similar erythematous, scaling, and pruritic rashes. The mainstay of treatment focuses on the maintenance of the skin barrier through pharmacological and/or non-pharmacological means. In this chapter, we will review important factors in making the diagnosis and treatment options. We will also discuss common pitfalls that occur in the management of this disease.
KeywordsAtopic dermatitis Eczema Pruritus Topical corticosteroids Topical calcineurin inhibitors Antihistamines Immunosuppressants Dupilumab
- 10.Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116–32.CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Blauvelt A, de Bruin-Weller M, Gooderham M, Cather JC, Weisman J, Pariser D, et al. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet. 2017;389(10086):2287–303.CrossRefPubMedGoogle Scholar
- 25.Sidbury R, Tom WL, Bergman JN, Cooper KD, Silverman RA, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. 2014;71(6):1218–33.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Togias A, Cooper SF, Acebal ML, Assa’ad A, Baker JR, Beck LA, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. J Allergy Clin Immunol. 2017;139(1):29–44.CrossRefPubMedPubMedCentralGoogle Scholar