From the Guidelines
Recent developments in community dermatology have been significantly impacted by the introduction of new guidelines for the management of atopic dermatitis, including the use of phototherapy and systemic therapies, as outlined in the 2024 American Academy of Dermatology guidelines 1. The management of atopic dermatitis (AD) has seen significant advancements, particularly with the emergence of new systemic therapies and phototherapy modalities. Key developments include:
- The use of biologics such as dupilumab, tralokinumab, abrocitinib, baricitinib, and upadacitinib, which have shown strong evidence for efficacy in treating AD 1.
- Conditional recommendations for the use of phototherapy, azathioprine, cyclosporine, methotrexate, and mycophenolate, highlighting the need for shared decision-making between patients and clinicians 1.
- An increased focus on the importance of topical therapies, including emollients and topical anti-inflammatory medications, which are often used concomitantly with phototherapy and systemic therapies 1.
- Recognition of the need for further research, particularly in the areas of phototherapy and systemic therapies, to better understand their roles in treating AD and to improve the certainty of the evidence for various medications 1. These developments have the potential to significantly improve disease control and quality of life for individuals with AD, and the use of these new therapies should be considered in the context of shared decision-making, taking into account the severity of AD, its impact on the patient, and the efficacy, safety, and accessibility of the available interventions 1.
From the Research
New Developments in Community Dermatology
- The emergence of topical and oral Janus kinase (JAK) inhibitors has been regarded as an innovation in the treatment of atopic dermatitis, with significant improvements in symptoms and low frequency of adverse events 2.
- Crisaborole, a novel nonsteroidal topical treatment, has been shown to be effective and safe for the management of mild to moderate atopic dermatitis, with a limited adverse event profile and low systemic absorption 3, 4.
- Topical JAK inhibitors have demonstrated modest improvements in psoriasis and atopic dermatitis disease scores, patient-reported outcomes, and quality of life, providing an attractive treatment option for patients with these conditions 5.
- Crisaborole has also been used successfully in the treatment of psoriasis, although there is limited literature documenting its use for this condition 6.
Key Findings
- JAK inhibitors have been shown to improve pruritus and skin symptoms quickly, with oral JAK inhibitors having a faster onset of action 2.
- Crisaborole has been approved for the treatment of mild to moderate atopic dermatitis in patients 2 years of age and older, and is considered a second-line option for patients who are recalcitrant to or unable to use topical corticosteroids 3, 4.
- Topical JAK inhibitors have the potential to significantly affect the field of dermatology, especially with the development of topical formulations 5.