Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection.
J Allergy Clin Immunol Pract. 2020 Jan; 8(1):91-101.JA

Abstract

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases affecting children and adults. The intense pruritus and rash can be debilitating, significantly impairing quality of life. Until recently, treatment was largely nonspecific and, in severe disease, sometimes ineffective and/or fraught with many side effects. Now, multiple agents targeting specific disease pathways are available or in development. Two new therapies, crisaborole and dupilumab, have become available since 2016, and dupilumab has dramatically improved outcomes for adults with severe AD. This article provides an overview of AD, including strategies for differential diagnosis and assessment of disease severity to guide treatment selection. Key clinical trials for crisaborole and dupilumab are reviewed, and other targeted treatments now in development are summarized. Two cases, representing childhood-onset and adult-onset AD, are discussed to provide clinical context for diagnosis, severity assessment, and treatment selection and outcomes.

Links

PMC Free PDF

Authors+Show Affiliations

Fishbein AB

Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: afishbein@luriechildrens.org.

Silverberg JI

Northwestern University Feinberg School of Medicine, Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Ill.

Wilson EJ

The France Foundation, Old Lyme, Conn.

Ong PY

Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Los Angeles, Calif; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, Calif.

MeSH

AdultAntibodies, Monoclonal, HumanizedChildDermatitis, AtopicEczemaHumansQuality of LifeSeverity of Illness IndexTreatment Outcome

Pub Type(s)

Case Reports

Journal Article

Research Support, Non-U.S. Gov't

Review

Language

eng

PubMed ID

31474543

Citation

Fishbein, Anna B., et al. "Update On Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection." The Journal of Allergy and Clinical Immunology. in Practice, vol. 8, no. 1, 2020, pp. 91-101.

Fishbein AB, Silverberg JI, Wilson EJ, et al. Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection. J Allergy Clin Immunol Pract. 2020;8(1):91-101.

Fishbein, A. B., Silverberg, J. I., Wilson, E. J., & Ong, P. Y. (2020). Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection. The Journal of Allergy and Clinical Immunology. in Practice, 8(1), 91-101. https://doi.org/10.1016/j.jaip.2019.06.044

Fishbein AB, et al. Update On Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection. J Allergy Clin Immunol Pract. 2020;8(1):91-101. PubMed PMID: 31474543.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection. AU - Fishbein,Anna B, AU - Silverberg,Jonathan I, AU - Wilson,Eve J, AU - Ong,Peck Y, Y1 - 2019/08/29/ PY - 2019/04/04/received PY - 2019/06/25/revised PY - 2019/06/26/accepted PY - 2019/9/3/pubmed PY - 2021/5/15/medline PY - 2019/9/3/entrez KW - Adult onset KW - Atopic dermatitis KW - Crisaborole KW - Differential diagnosis KW - Dupilumab KW - Eczema KW - Infant onset KW - Severity assessment SP - 91 EP - 101 JF - The journal of allergy and clinical immunology. In practice JO - J Allergy Clin Immunol Pract VL - 8 IS - 1 N2 - Atopic dermatitis (AD) is one of the most common inflammatory skin diseases affecting children and adults. The intense pruritus and rash can be debilitating, significantly impairing quality of life. Until recently, treatment was largely nonspecific and, in severe disease, sometimes ineffective and/or fraught with many side effects. Now, multiple agents targeting specific disease pathways are available or in development. Two new therapies, crisaborole and dupilumab, have become available since 2016, and dupilumab has dramatically improved outcomes for adults with severe AD. This article provides an overview of AD, including strategies for differential diagnosis and assessment of disease severity to guide treatment selection. Key clinical trials for crisaborole and dupilumab are reviewed, and other targeted treatments now in development are summarized. Two cases, representing childhood-onset and adult-onset AD, are discussed to provide clinical context for diagnosis, severity assessment, and treatment selection and outcomes. SN - 2213-2201 UR - https://www.unboundmedicine.com/medline/citation/31474543/full_citation DB - PRIME DP - Unbound Medicine ER -

Tags

Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection.J Allergy Clin Immunol Pract. 2020 Jan; 8(1):91-101.JA