From the Guidelines
Atopic dermatitis management should prioritize a multimodal approach, including emollients, topical therapies, and consideration of phototherapy or systemic therapies for severe or refractory cases, with a focus on shared decision-making and quality of life 1. The condition is characterized by intense pruritus and eczematous lesions, with a complex pathophysiology involving genetic predisposition, immune dysregulation, and skin barrier dysfunction. Key aspects of management include:
- Regular emollients to repair the skin barrier
- Topical corticosteroids as first-line therapy for flares, with potency matched to severity and body site
- Topical calcineurin inhibitors as effective steroid-sparing agents for moderate-severe disease
- Consideration of phototherapy or systemic therapies, including oral medications and injectable biologics, for severe or refractory cases 1
- Infection control and patient education on trigger avoidance, wet dressings, and addressing sleep disturbance and psychological impact. When initiating advanced therapies, clinicians should consider the severity of atopic dermatitis, its impact on the patient, and the efficacy, safety, and accessibility of available interventions, using shared decision-making between patients and clinicians 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Atopic Dermatitis Overview
- Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects 2
- It is a common, chronic pruritic condition affecting both children and adults, which has a negative impact on the quality of life 3
- AD is mainly driven by type 2 inflammation and often treated with topical agents 4
Treatment Options
- Topical corticosteroids are safe and effective treatments for AD, when used in short courses, but prolonged use is associated with skin barrier damage 2
- Topical calcineurin inhibitors are alternative immune-modulating treatments for AD purported to have no negative effects on the skin barrier 2, 3
- Emollients, mild potency topical steroids, and topical calcineurin inhibitors are recommended for mild atopic dermatitis 3
- For moderate-to-severe atopic dermatitis, the use of emollients, moderate-to-potent topical steroids, topical calcineurin inhibitors, wet dressings, antimicrobials for secondary skin infection, phototherapy, and systemic therapy may be warranted 3, 5, 6
- New, targeted, systemic therapies such as dupilumab, delgocitinib, and baricitinib have been approved for the treatment of moderate-to-severe AD 5, 6
Management Guidelines
- The management of AD should be individualized and combined with adequate patient and parental education 3
- Patients with moderate-to-severe atopic dermatitis should be managed in conjunction with a dermatologist 3
- Guidelines for the management of AD have been developed to provide doctors with information to assist in the management of their patients with AD 3, 5
- The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes 5