Personalized Management of Atopic Dermatitis: Beyond Emollients and Topical Steroids

Abstract

Atopic dermatitis (AD) is a complex and multifactorial disease which we are just beginning to understand in terms of its heterogeneous genetic and pathophysiological nature. Personalised medicine offers us the unique opportunity to tailor the management of AD based on the presence or absence of key biomarkers. For example, filaggrin mutations might be potentially useful as markers to predict the course of AD in individual patients. Other biomarkers might help us to predict the risk of developing IgE-sensitization in some patients. Thus, the genotype and other biological information located on a key set of biomarkers (the so-called endophenotype) could help us to identify those patients who would benefit most from early intervention with the aim of stopping the “atopic march”. In addition, patient stratification might eventually enable us to identify those patients who are receptive to long-term management with treatments that may reverse the “atopic march”. Thus, we are at the beginning of a new era in our understanding of the complexity of AD; an era in which established prevention strategies and new therapies might be applied in a selective manner to target the right patients more effectively at the right time.