Atopic Dermatitis In Adolescents Research Articles

Patient and family burden in pediatric atopic dermatitis and its treatment pattern in Japan.

This study evaluated the level of burden in pediatric and adolescent atopic dermatitis (AD) patients in Japan, the associated burden on caregivers/families, and whether this burden varied with age. Data were drawn from the Adelphi Pediatric AD Disease Specific Programme (DSP)™, a cross-sectional survey of physicians and their patients conducted in Japan between July and December 2022. Physicians reported patient demographics, clinical characteristics, disease burden, and current/previous therapies. Patients and/or caregivers reported perceived disease severity and impact of AD, including the Children's Dermatology Life Quality Index (CDLQI) and Dermatitis Family Impact questionnaire (DFI). Overall, 55 physicians provided data for 537 AD patients aged ≤17. Mean (SD) overall scores for CDLQI, POEM, and DFI were 9.3 (6.3), 8.3 (6.8), and 11.7 (7.2), respectively. Age was associated with higher patient and/or caregiver-reported CDLQI scores, which increased by 0.543 points per year of age (P = 0.01). Patients with severe disease reported a more significant impact on quality of life factors compared with mild patients (P < 0.001). Age was associated with higher caregiver-reported burden, with DFI scores increasing by 0.325 per year (P = 0.01). Physician-reported impact on caregivers showed that age was significantly associated with increased burden on sleep, daily activities, work, and mood (P < 0.05), with disease severity associated with impact across all factors (P < 0.01). Both increasing age and disease severity were associated with the increased impact of AD on patients and their caregivers. Disease control/modification through appropriate therapeutic intervention at a younger age may relieve the burden of pediatric AD on patients and their families.

Tapinarof Cream 1% Once Daily for the Treatment of Extensive Atopic Dermatitis in Adolescents and Children: Outcomes from the 4-Week Maximal Usage Trial

Tapinarof Cream 1% Once Daily for the Treatment of Extensive Atopic Dermatitis in Adolescents and Children: Outcomes from the 4-Week Maximal Usage Trial

Effectiveness Of Treatment Of Tralokinumab In Treatment Of Atopic Dermatitis In Adolescents.

Respected Madam, Atopic dermatitis (AD) is a prevalent inflammatory skin condition that affects people of all ages and can cause significant distress based on the severity of the condition. Researchers have examined focussed therapies that rely on a better understanding of the underlying pathophysiology of AD. While some therapies that target specific molecules, such as IL-13, IL-31, and OX40 (CD134), have been assessed, there is still much to be done regarding narrow-acting agents which act on a single molecule only.1 Tralokinumab, targeting interleukin-13 in patients with moderate-to-severe atopic dermatitis, was found to be an effective treatment hence beneficial in enhancing health-related quality of life (QoL) in adults.2 Paller et al. recently conducted a clinical trial focussing on adolescents (aged 12-17) with moderate to severe atopic dermatitis, finding that tralokinumab was both effective and safe, showcasing its potential as a treatment option for the said age group.3 Tralokinumab is a fully human monoclonal immunoglobulin G4 antibody that binds with remarkable affinity to the IL-13 cytokine, blocking its interaction with the IL-13 receptor and thus preventing downstream signalling and its ensuing inflammatory effects.4 Atopic dermatitis can be treated with the use of Janus Kinase inhibitors; however, these treatments have shown to result in unexpected adverse effects (AEs) due to the interaction of unintended pathways as well as the target ones; the most common being acne.5 Dupilumab, another therapeutic agent for atopic dermatitis, has been observed to cause conjunctivitis in adolescent patients. The study revealed that Tralokinumab (150mg/300mg) demonstrated to be an effectual treatment for atopic dermatitis, as the primary and secondary endpoints of the trial between Tralokinumab and placebo were statistically significant (p&lt;0.05) while the frequency of conjunctivitis in adolescents was numerically lower than that reported with Dupilumab and the frequency of acne was numerically lower than that reported with Janus kinase inhibitors. As safe and efficient treatment of acute dermatitis for adolescents is already limited, Tralokinumab’s narrow focus on IL-13 molecule provides a more precise approach to treat atopic dermatitis in adolescents with fewer complications. Hence, it is imperative to look into this discovery for more effective treatment of the disease.

Algorithms to improve the EMIAS system to optimize the routing of adolescents with atopic dermatitis

Atopic dermatitis is a systemic, chronic, relapsing, inflammatory disease affecting mainly the skin. In recent decades, the incidence of atopic dermatitis has been steadily increasing. The burden of atopic dermatitis in adolescents is particularly severe because they are in a transitional and vulnerable growth phase with associated biological, cognitive, social, and emotional transformations.&#x0D; Early and correct diagnosis of atopic dermatitis, as well as the identification of adolescents with an uncontrolled course of the disease, will provide an opportunity to select/change therapy, which can lead to remission, preventing the negative effects of the disease. A number of studies have shown that the negative mental health effects of atopic dermatitis on adolescents include an increased risk for depression, attention deficit hyperactivity disorder, anxiety and behavior disorders, sleep disturbances, and suicidal ideation.&#x0D; EMIAS is a unified medical information and analytical system, which was created to improve the availability and quality of medical services provided by Moscow public health institutions. The introduction of EMIAS has led to improvements in the healthcare system.&#x0D; The article proposes validated and simple tools, the integration of which into the EMIAS system, will facilitate the verification of diagnosis and personalized (based on recommendations at the population level) management of adolescents with atopic dermatitis in the outpatient phase by pediatrician and allergist.

406 Tapinarof cream 1% once daily for the treatment of extensive atopic dermatitis in adolescents and children: outcomes from the 4-week maximal usage trial

Abstract Tapinarof is a first-in-class, nonsteroidal, topical, aryl hydrocarbon receptor agonist approved by the Food and Drug Administration for the treatment of plaque psoriasis in adults, and under investigation for the treatment of atopic dermatitis (AD) in adults and children. Tapinarof cream 1% once daily (QD) demonstrated significant efficacy vs. vehicle and was well tolerated in adults and adolescents with moderate to severe AD in a previously reported phase 2b trial. The pharmacokinetic (PK) profile of tapinarof across psoriasis and AD trials in adults is characterized by no-to-minimal systemic absorption and decreasing plasma concentrations over the course of treatment. Here, we report PK, tolerability and safety of tapinarof cream 1% QD in adolescents and children down to age 2 years with extensive AD. Adolescents and children with a Validated Investigator Global Assessment scale for Atopic Dermatitis™ (vIGA-AD™) score ≥3 (moderate or worse) and body surface area (BSA) involvement ≥25% (ages 12–17 years) or ≥35% (ages 2–11 years) were enrolled into three age cohorts (2–6, 7–11 and 12–17 years) and were treated with tapinarof cream 1% QD for 4 weeks. Primary endpoints included PK parameters, investigator-assessed Local Tolerability Scale (LTS) scores by visit (overall and for sensitive areas) and treatment-emergent adverse events (TEAEs). Overall, 36 patients (12 per cohort) were enrolled. Patients’ mean age was 8.9 years and 66.7% were male. At baseline, 66.7%, 75% and 91.7% of patients had a vIGA-AD score of 3 for cohorts 2–6, 7–11 and 12–17 years, respectively. Mean BSA (range) affected was 52.4% (36.0–90.0%), 42.0% (35.0–72.0%) and 33.9% (26.0–54.5%) for the three age cohorts, respectively. Mean Eczema Area and Severity Index scores were 30.2, 21.0 and 20.3, respectively. No-to-minimal tapinarof systemic exposure was observed, consistent with previous trials in adults. Mean tapinarof maximum plasma concentration (Cmax) at Day 1 was 2.4 ng/mL, and the median time to Cmax was approximately 3 h, for all patients. Approximately 25% of post-treatment plasma samples were below the quantifiable limit of the highly sensitive assay [&amp;lt;50 pg (10–12)/mL]. There was no correlation between tapinarof exposure (Cmax on Day 1) and baseline %BSA affected. Mean overall investigator-assessed LTS score was 0.1 (no irritation) at Weeks 1 and 4. Investigators assessed that the majority of patients had no irritation (LTS score of 0), including sensitive and intertriginous skin. The TEAEs were reported by eight patients (22%) and were all mild or moderate; one patient discontinued due to two unrelated TEAEs. One case of mild folliculitis and no contact dermatitis occurred. Most patients (87.5%) chose to enroll in the 48-week long-term extension trial. This is the first trial evaluating tapinarof in children down to 2 years of age. Tapinarof cream 1% QD demonstrated no-to-minimal systemic exposure in children with extensive AD, even when measured with a highly sensitive assay. There was a low incidence of TEAEs in patients with up to 90% BSA affected. Tapinarof cream was well tolerated, including sensitive and intertriginous skin areas.

Efficacy and safety of abrocitinib for moderate-to-severe atopic dermatitis in adolescents and adults: Meta-analysis.

Objective: This study aims to investigate the safety and efficacy of abrocitinib in treating moderate-to-severe AD in adolescents and adults. Methods: Pubmed, Cochrane, Embase, and Web of science data base were searched from inception to 9 August 2022. All randomized controlled trials (RCTs) evaluating the efficacy and safety of abrocitinib in moderate to severe AD were included in the meta-analysis. Results: This meta-analysis comprised 7 studies and found that 100mg or 200mg of abrocitinib significantly improved IGA {[RR = 2.44, 95% CI (1.93-3.08)] [RR = 3.16, 95% CI (2.52-3.96)]} and EASI-75{[RR = 2.18, 95%CI (1.78-2.67)] [RR = 3.04, 95%CI (2.22-4.16)]} responses compared to placebo. Following that, the population was divided into adolescent and adult groups. The abrocitinib improved IGA, EASI-75 responses, and it was still superior to placebo in both the adolescent and the adult groups. PP-NRS4 response index demonstrated that abrocitinib had a greater effect than placebo at 100mg [RR = 2.22, 95% CI 1.80-2.72] and 200mg [RR = 3.28, 95% CI 2.59-4.17]. Abrocitinib improved PSAAD, POEM, DLQI, CDLQI, and HADS more than a placebo. Conclusion: In conclusion, this meta-analysis preliminarily demonstrated that abrocitinib had higher efficacy and safety in the treatment of moderate-to-severe AD in adolescents and adults. In addition, abrocitinib could rapidly relieve itching, and effectively improve symptoms and signs, with a greater effect at the dosage of 200mg than 100mg.

550 Atopic dermatitis in adolescents: Role of carbonyl reductase 3 genetic risk score under constant chronic exposure to particulate matter

550 Atopic dermatitis in adolescents: Role of carbonyl reductase 3 genetic risk score under constant chronic exposure to particulate matter

Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults.

The efficacy and safety of upadacitinib in atopic dermatitis have been defined in clinical trials, but long-term real-life experience, essential for clinical decision-making, is still limited. We aimed to assess the effectiveness and tolerance of upadacitinib in a real-life cohort of adults and adolescents with severe atopic dermatitis in whom previous systemic therapies largely failed. Retrospective cohort study collecting data from adults and adolescents treated with upadacitinib 15 or 30mg per day between July 2021 to August 2022. The outcomes for effectiveness were evaluated by the percentage of patients who achieved a validated Investigator's Global Assessment for atopic dermatitis(vIGA-AD) of 0 (clear) or 1 (almost clear) and/or an improvement of at least 75% on the Eczema Area and Severity Index (EASI 75) at the end of the follow-up. All treatment-emergent adverse events were collected. A total of 29 patients were included (22 adults and 7 adolescents), with a median follow-up of 54.4weeks. At the end of the follow-up, 23 patients (79.3%) reached a vIGA-AD of 0/1, and 24 patients (82.7%) achieved EASI 75. Among patients treated with upadacitinib after initial failure of first- and/or second-line treatment with biologics or baricitinib, 5/7 patients (71.4%) reached a vIGA-AD score of 0/1. Disease control was slightly better in adults than in adolescents (81.8% vs 71.4% reached the efficacy endpoint, respectively). Response rate in patients with upadacitinib 15mg seemed better than in clinical trials or network meta-analysis. Safety data were reassuring; lipid changes were the most frequent adverse event. This real-life study confirms the effectiveness of upadacitinib, particularly for the treatment of atopic dermatitis recalcitrant to conventional systemic agents, biologics or baricitinib. Induced lipid changes require close follow-up.

Tapinarof Cream 1% Once Daily for the Treatment of Extensive Atopic Dermatitis in Adolescents and Children: 4-Week Maximal-Use Trial

Tapinarof Cream 1% Once Daily for the Treatment of Extensive Atopic Dermatitis in Adolescents and Children: 4-Week Maximal-Use Trial

301 Tapinarof cream 1% once daily for the treatment of extensive atopic dermatitis in adolescents and children: 4-week maximal use trial

Abstract There is a need for efficacious non-steroidal topical therapies for atopic dermatitis (AD) without restrictions relating to duration, the extent of use and application sites. Tapinarof (VTAMA®; Dermavant Sciences, Inc., USA) is a first-in-class, non-steroidal, topical, aryl hydrocarbon receptor agonist approved by the Food and Drug Administration for the treatment of plaque psoriasis in adults and under investigation for the treatment of psoriasis in children down to 2 years of age and for AD in adults and children down to 2 years of age. Tapinarof cream 1% once daily (QD) demonstrated significant efficacy vs. vehicle at 12 weeks and was well tolerated in adults and adolescents and with moderate to severe AD in a previously reported phase 2b trial (NCT02564055). To assess the safety, tolerability, pharmacokinetics (PK) and efficacy of tapinarof cream 1% QD in adolescents and children with extensive AD. In this open-label, maximal use, phase 2 trial (NCT05186805), adolescents and children, aged 2–17 years, with a clinical diagnosis of AD, a validated Investigator Global Assessment in Atopic Dermatitis™ (vIGA-AD™) score ≥3, and percent body surface area (%BSA) involvement of ≥ 25% for adolescents (12–17 years) or ≥35% for children (2–11 years) were assigned tapinarof cream 1% QD for 27 days. Primary endpoints include adverse events, mean investigator-assessed local tolerability scores (overall and sensitive areas) and PK parameters. Secondary endpoints include a change in vIGA-AD™, Eczema Area Severity Index (EASI), %BSA affected, and Peak Pruritus-Numeric Rating Scale scores at each trial visit. Eligible patients completing this trial have the option to enrol in an open-label, long-term extension trial (NCT05142774) to receive up to an additional 48 weeks of tapinarof cream 1% QD treatment. Overall, 36 patients aged 2–17 years were enrolled at nine sites in the US and Canada. Of these patients, equal proportions (33.3% [12/36]) were young children (2–6 years), children (7–11 years) and adolescents (12–17 years); 66.7% (24/36) were male and mean age (standard deviation [SD]) was 8.9 (4.9) years. At baseline, 77.8% (28/36) had a vIGA-AD™ score of 3 (moderate) and 8/36 (22.2%) had a score of 4 (severe). At baseline, the mean (SD) %BSA affected was 52.4% (19.1%), 42.0% (10.0%) and 33.9% (8.6%) for young children, children and adolescents, respectively. The overall mean (SD) EASI score was 23.8 (9.2). This trial will assess the safety, tolerability, PK and efficacy of tapinarof cream 1% QD in 36 adolescents and children down to 2 years of age with extensive, moderate-to-severe AD.

Tapinarof Cream 1% Once Daily for the Treatment of Extensive Atopic Dermatitis in Adolescents and Children: 4-Week Maximal-Use Trial

Tapinarof Cream 1% Once Daily for the Treatment of Extensive Atopic Dermatitis in Adolescents and Children: 4-Week Maximal-Use Trial

Moderate-to-severe atopic dermatitis in adolescents treated with dupilumab: A multicentre Italian real-world experience.

BackgroundModerate‐to‐severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side‐effects. Dupilumab was recently approved for treatment of adolescent AD.ObjectivesA multicentre, prospective, real‐world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate‐to‐severe AD was conducted. The main AD clinical phenotypes were also examined.MethodsData of adolescents with moderate‐to‐severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes.ResultsOne hundred and thirty‐nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait‐like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS‐CoV‐2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty‐eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event.ConclusionsDupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID‐19 pandemic era.

Pharmacokinetics, Safety, Efficacy, and Biomarker Profiles During Nemolizumab Treatment of Atopic Dermatitis in Adolescents.

IntroductionNemolizumab, a new monoclonal antibody that targets the receptor alpha of the neuroimmune cytokine interleukin-31 (IL-31), has shown efficacy in atopic dermatitis (AD) in adults. This study evaluated the pharmacokinetics (PK) and safety of nemolizumab in adolescents with moderate to severe AD as well as the relationship between nemolizumab concentrations and clinical efficacy and the effect of nemolizumab on protein biomarkers.MethodsOpen-label, 16-week study of nemolizumab in patients aged 12–17 years with moderate to severe AD (baseline EASI ≥ 16, IGA ≥ 3, and BSA ≥ 10%) and associated pruritus with baseline average daily peak pruritus numeric rating scale (PP-NRS) intensity of at least 4. Nemolizumab was administered subcutaneously as a loading dose of 60 mg at baseline, followed by 30 mg every 4 weeks until week 12 with background topical corticosteroids (TCS) or calcineurin inhibitors (TCI). Subsequently patients were followed for 8 weeks more. Stratum corneum (SC) and plasma samples were collected for biomarker assessments.ResultsTwenty patients participated, with a mean age of 14.8 ± 1.6 years. The PK of nemolizumab was described by a one-compartment model with linear elimination, a first-order absorption, and a mean half-life of 16.7 ± 4.1 days. Mean trough concentrations ranged from 2935 ± 1029 ng/mL to 3292 ± 2018 ng/mL over the 16-week treatment period. There was a marked improvement in rash, itch, and sleep with a decrease from baseline to week 16 in EASI by 66.5 ± 32.5%, in PP-NRS by 43.2 ± 37%, and in sleep disturbance numeric rating scale by 53.5 ± 47.8%. The popPK and PK/PD analyses confirmed that model-predicted exposure and efficacy of nemolizumab were similar in adolescents compared to adults receiving the same dosing regimens. Age did not impact PK parameters, while the main source of PK variability was body weight. Analyses of SC samples identified a panel of AD-related pro-inflammatory biomarkers that were upregulated in lesional skin (compared to non-lesional skin) and correspondingly downregulated in clinical responders to nemolizumab (based on EASI75 and PP-NRS ≥ 4). Four biomarkers (CCL20, CCL22, CCL27, and VEGF) had changes that were 1.9–3.5-fold higher in EASI responders than in EASI non-responders (all p < 0.05). Analysis showed no significant correlation between plasma biomarkers and clinical scores. Adverse events were experienced by 33.3% of subjects (n = 6) and were primarily mild or moderate in severity.ConclusionsNemolizumab PK and safety profiles in adolescents with moderate to severe AD are consistent with previous nemolizumab studies in adults. PK/PD models demonstrate similar exposure–response profiles in 12- to 17-year-old adolescents and adults for three clinical endpoints (EASI, IGA, and PP-NRS). Nemolizumab treatment reversed AD-related pro-inflammatory biomarkers in skin, indicating that the neuroimmune cytokine IL-31 is an important mediator of multiple pathways in AD.Clinical Trial RegistrationClinicaltrials.gov NCT03921411.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-021-00678-7.

Lack of Significant Association between Sex Hormone Concentrations and Atopic Dermatitis in Adolescents and Adults in Two Population-Based Studies

Atopic dermatitis (AD) is a chronic, pruritic skin disease with increasing incidence (Mathiesen and Thomsen, 2019). Although AD is classically thought of as a pediatric disease, recent studies have shown high rates of disease in adults as well, with a prevalence in Europe between 2.2% and 17.6% (Kowalska-Olędzka et al., 2019). There is a growing body of evidence that sex hormones play a role in the complex interplay of ADs pathophysiology, influencing immunological pathways and the skin (Kanda et al., 2019).

Atopic dermatitis in adolescents: Effectiveness and safety of dupilumab in a 16-week real-life experience during the COVID-19 pandemic in Italy.

Dupilumab showed significant improvement of adolescent atopic dermatitis (AD) signs and symptoms in clinical trials, with a good safety profile. Herein we report the real-word effectiveness and safety of dupilumab in adolescents with moderate to severe AD from January to October 2020, during the COVID-19 pandemic in Italy. All patients had a diagnosis of AD for a mean [SD] 12.8 [3.1] years. Baseline demographics, AD characteristics (EASI, cDLQI, NRS itch score, NRS sleep loss score) at baseline and week 16, and safety data were collected. Nineteen patients (52.6% men; mean [SD] age, 15.6 [1.4] years [range, 13-17 years]) were included in the analysis. All patients reached EASI-50 and 78.9% EASI-75, especially in those with EASI≥30 and BMI < 25 at baseline, with marked reduction for cDLQI (77.4%), NRS itch score (5.9 point), and NRS sleep loss score (87.5%). One patient contracted asymptomatic SARS-CoV-2 infection and 1 developed mild conjuntivitis, without stopping dupilumab. In this real-word experience the effectiveness of dupilumab was excellent and resulted higher than that observed in clinical trials, with a good safety profile during COVID-19 pandemic.

Safety of dupilumab in patients with atopic dermatitis: expert opinion

ABSTRACT Introduction: Dupilumab, the first biologic drug to be approved for the treatment of moderate to severe atopic dermatitis in adolescents and adults, has shown efficacy and safety in clinical trials. Data on long-term safety is limited but crucial for pharmacovigilance. Therefore, we performed this review to evaluate available real-world data on the long-term safety of dupilumab in atopic dermatitis. Areas covered: PubMed and Google Scholar databases were searched for randomized controlled clinical trials (RCTs), observational studies, case series, and case reports regarding the use of dupilumab for the treatment of atopic dermatitis. Adverse events were summarized and critically evaluated. Expert opinion: Atopic dermatitis patients receiving dupilumab reported ocular surface disease more often than patients receiving placebo. Real-world data show previously unreported adverse events (blood eosinophilia, rosacea-like skin lesions, weight gain), but their mechanistic association to dupilumab treatment still requires clarification. Cutaneous T-cell lymphomas occurring under the therapy with dupilumab might be unrelated to the drug use itself but long-term follow-up data of large patient cohorts is necessary to rule out such possibility. Real-world data show that dupilumab is well tolerated in atopic dermatitis; however, ocular adverse events are not rare. Registries are needed to monitor future adverse events.

Diagnosis and management of moderate to severe atopic dermatitis in adolescents. A Consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Italian Association of Hospital Dermatologists and Public Health (ADOI), the Italian Association of Hospital and Territorial Allergists and Immunologists (AAIITO), the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC), the Italian Society of Pediatric Allergy and

Atopic dermatitis (AD) is a chronic inflammatory disease with increasing global incidence, which has a multifactorial pathogenesis and a variable expressivity. Clinical features of AD are different in adults compared to children, but it is well recognized the substantial impact of the disease on patients' quality of life at any age. Indeed, little is known about AD in adolescence, a period of life generally associated with high psychological burden and vulnerability to depression. Guidelines for the management of AD are available for both children and adults but specific guidelines for the diagnosis and treatment of AD in adolescents are lacking. Seven Italian scientific societies of dermatologists, allergists, and pediatric allergists joined in a specific meeting to provide practical guidance for the diagnosis and management of moderate-to-severe adolescent AD suitable for the Italian clinical practice. Through a modified Delphi procedure, consensus was reached by 59 Italian experts in the management of AD on 20 statements covering five areas of interest about adolescent AD, including disease complexity, burden and social impact, diagnosis and definition of severity, current treatments, and new biologic therapies. This paper reports recommendations for the diagnosis and management of AD specifically in adolescents, pointing out some peculiar clinical features and focusing on the choice of medications. Dupilumab, the first biologic approved for the treatment of adolescents with AD, represents a useful treatment option due to its efficacy and reassuring safety profile.

Identification of oral symptoms associated with atopic dermatitis in adolescents: Results from the Korea national representative survey 2009\u20132017

The relationship between oral health and atopic dermatitis (AD) remains unclear. Here we investigated the association between oral health status and AD using data from 634,299 subjects in the Korean Youth Risk Behavior Survey (KYRBS). Participants with oral symptoms were defined as those with any of following: sensitive teeth, toothache, bleeding gums or gum pain, and dry mouth. Current AD was determined by the question if participant had been diagnosed with AD from doctor within the past 12 months. We estimated the odds ratio (OR) for AD diagnosis according to the presence of oral symptoms. The OR for current AD, which is a dependent variable, was significantly increased in participants with oral symptoms, which are independent variables, in an adjusted model (OR, 1.27; 95% confidence interval [CI], 1.26–1.29; P < 0.001). In detailed analyses, all four oral symptoms were significantly associated with AD diagnosis: sensitive teeth (OR, 1.21; CI, 1.19–1.23; P < 0.001), bad breath (OR, 1.18; CI, 1.17–1.20; P < 0.001), toothache (OR, 1.18; CI, 1.16–1.20; P < 0.001), and bleeding gums (OR, 1.14; CI, 1.12–1.16; P < 0.001). In the presence of oral symptoms, the ORs for having two or more allergic diseases (AD, allergic rhinitis, and/or asthma) were higher than that of AD alone. In this study, oral symptoms appeared to be associated with AD in Korean adolescences.

Visual racism in internet searches and dermatology textbooks

Visual racism in internet searches and dermatology textbooks

Associations of second-hand smoke exposure with hand eczema and atopic dermatitis among college students in China

Smoking has been identified as a risk factor for atopic dermatitis and hand eczema, but less is known about the association of exposure to second-hand smoke (SHS) with hand eczema. The study aimed to investigate the association of SHS exposure with hand eczema and atopic dermatitis in a group of adolescents. We conducted a cross-sectional study among first-year college students. SHS exposure was measured by a self-administered questionnaire. Skin diseases were diagnosed by dermatologists in the field survey. Mixed models were used to estimate the associations. A total of 20,129 participants that underwent skin examination and a questionnaire survey were included in the analyses. The prevalence rates of atopic dermatitis and hand eczema were 3.86% and 3.35%, respectively. Crude and adjusted estimates consistently showed that exposure to SHS was significantly associated with atopic dermatitis and hand eczema in a dose–response manner. Attention deficit/hyperactivity disorder mediated minimal or no effect of SHS on hand eczema and atopic dermatitis. Subgroup analysis by type of hand eczema, and sensitivity analysis by excluding data with center effect showed consistent results. Exposure to SHS is an independent but modifiable risk factor for hand eczema and atopic dermatitis in adolescents.