Patient preferences for treatment of atopic dermatitis: findings from the Danish Skin Cohort.

Attrition of topical calcineurin inhibitor use over time in patients with atopic dermatitis

Atopic dermatitis: Therapeutic concepts evolving from new pathophysiologic insights

Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report

Report of the Topical Calcineurin Inhibitor Task Force of the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology

Atopic dermatitis

Pityrosporum species as a cause of allergy and infection.

Atopic dermatitis (AD) is a systemic, multifactorial disease that causes significant morbidity and health care burden in Latin America (LA). Data on AD are scarce in LA. Lack of disease registries and non-standardized study methodologies, coupled with region-specific genetic, immunological, and environmental factors, hamper data collection. A panel of LA experts in AD was given a series of relevant questions to address before a conference. Each narrative was discussed and edited through numerous rounds of deliberation until achieving consensus. Identified knowledge gaps in AD research were updated prevalence, adult-disease epidemiology, local phenotypes and endotypes, severe-disease prevalence, specialist distribution, and AD public health policy. Underlying reasons for these gaps include limited funding for AD research, from epidemiology and public policy to clinical and translational studies. Regional heterogeneity requires that complex interactions between race, ethnicity, and environmental factors be further studied. Informed awareness, education, and decision making should be encouraged.

T‐cell responses in atopic eczema

Bleach baths for atopic dermatitis: Evidence of efficacy but more data are needed

Tacrolimus: A new topical immunomodulatory therapy for atopic dermatitis

Are biologics safe in the treatment of atopic dermatitis? A review with a focus on immediate hypersensitivity reactions

Expression patterns of atopic eczema and respiratory illnesses in a high-risk birth cohort

Atopic dermatitis (AD) is a chronically recurrent inflammatory skin disorder characterized by pruritus, a specific distribution, and a family history. It has recently been reported that the incidence of AD has increased in Korea.1,2 Pruritus, sleep loss, dietary restrictions, and psychosocial factors significantly decrease the quality of life for AD patients.3,4 Recently, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma, and Immunology published the PRACTALL consensus report for the diagnosis and treatment of AD in children and adults.5 The report suggests a stepwise management that includes the addition of multiple therapeutic agents on the basis of the disease severity. The PRACTALL consensus report defines severe or recalcitrant AD as AD that cannot be controlled with topical treatment.6 In the 2009 Korean Work Group Report on the treatment of severe/recalcitrant AD, severe AD is defined as AD with a SCORAD index higher than 50 and that cannot be controlled with conventional treatment,7 while the 2008 Guideline of Atopic Dermatitis in Korean Children defines severe AD by a SCORAD index higher than 40.8 Specific criteria for the definition of recalcitrant and severe AD are necessary. For the management of severe AD, the PRACTALL consensus report recommends systemic therapy such as antimicrobial treatment, systemic corticosteroids, cyclosporin A, azathioprine, anti-histamines, phototherapy, and immunotherapy. Several reports, including the 2009 Korean Work Group Report, have described intravenous immunoglobulin (IVIg) treatment as one of various immunoregulatory treatments. Nevertheless, this treatment was not included in the PRACTALL report.7,9,10 IVIg treatment displays immunomodulatory and anti-inflammatory properties, and its effectiveness in several immune-mediated conditions such as Kawasaki disease and idiopathic thrombocytopenic purpura has been demonstrated.11 IVIg is considered a candidate for the treatment of AD because of its ability to downregulate T-cell function, particularly interleukin-4 production.12,13 A small number of observations on the efficiency of IVIg in AD have been reported, but prospective and randomized studies for its clinical efficiency in childhood AD are sparse. A randomized, placebo-controlled prospective study in childhood AD patients is therefore required.14 Jee et al.14 recently reported therapeutic effects of IVIg in childhood AD; however, this study involved moderate to severe AD patients, and it did not include severe AD patients because the disease severity might have affected the treatment results. Further randomized studies with strict criteria for recalcitrant/severe AD are warranted. In addition, the IVIg effective dose, the dosing interval for initiation and maintenance, the identification of biomarkers (e.g., ECP, ICAM-1, and IL-5/INF-gamma) to determine efficiency, and clear criteria for IVIg indications all require consideration. Currently, we lack evidence-based data supporting the use of IVIg and other immunomodulators in childhood AD. Before IVIg can be recommended, its cost-benefit ratio, course, duration, and adverse reactions compared with alternative therapeutic options must be determined. The effects of novel therapies such as IVIg for recalcitrant/severe AD patients should be verified through repeated research and numerous research discussions.

Introduction and aim: Atopic dermatitis (AD) is a chronic inflammatory skin disease. It is characterised by periods of exacerbation and remission of symptoms such as pruritus, dry skin and eczematous lesions with characteristic morphology. The aim of this study is to present the current state of knowledge on new treatments for atopic dermatitis. Review methods: The review was based on publicly available PubMed and Google Scholar databases from 2020 to 2024 using the following phrases: atopic dermatitis, treatment of atopic dermatitis, diagnosis of atopic dermatitis, epidemiology, biological treatment of atopic dermatitis, JAK inhibitors, stem cells, dermatitis. Brief description of the state of the art: Atopic dermatitis is a disease whose mechanism of origin is incompletely understood.It involves interactions between genotype, environment, and the immune system, and is largely related to the T-cell response. The main symptom is pruritus and dry skin leading to lichenification or exfoliation of the epidermis, which characterise the chronic form. Diagnosis is confirmed by clinical criteria such as skin lesions characteristic of AD, a family predisposition to allergic disease and a full history and skin tests. Treatment focuses on managing the symptoms associated with the disease and improving the patient's quality of life using mainly corticosteroids, calcineurin inhibitors and antihistamines. Recent studies show positive effects of treatment with biologic drugs, JAK inhibitors, stem cells and provide great hope towards the development of treatments for atopic dermatitis. Summary: The authors emphasise the need for further research towards the development of promising, innovative treatments for atopic dermatitis in order to significantly improve patients' quality of life.

Despite preliminary evidence, the role of probiotic and synbiotic in treatment of the atopic dermatitis has shown varying results. We aimed to evaluate whether synbiotic supplementation decrease severity of atopic dermatitis (AD) in childhood. In a randomized double blind-placebo controlled trial, we evaluated the synbiotic supplementation efficiency on the treatment of atopic dermatitis. Infants aged 1-36 months with moderate to severe atopic dermatitis were randomized (n=41) and received either synbiotic (probiotic plus prebiotic) (n=20) or placebo (n=21) daily as a powder for two months. Emollient (Eucerin) and topical corticosteroid (Hydrocortisone) were permitted. Children were scored for severity of atopic dermatitis (SCORAD). Also allergen Skin Prick Tests (SPT), IgE blood level and eosinophil count were measured at first visit. Patients' SCORAD were reevaluated at the end of intervention. We followed 36 out of 41 subjects for two months (drop out rate = 9%). In the whole group, the mean Total SCORAD (at base line 40.93) decreased by 56% (p=0.00). The mean Objective SCORAD (at base line 31.29) decreased by 53% (p=0.00). There was no significant difference in the mean decrease of total SCORAD between placebo (22.3) and synbiotic groups (24.2). There was also no difference between two intervention groups in the mean decrease of total SCORAD regarding to different demographic, clinical and para clinical subgroups. This study could not confirm synbiotic as an effective treatment for childhood atopic dermatitis and further studies are needed. These findings challenge the role of synbiotics in the treatment of childhood atopic dermatitis.