Topical corticosteroids play a major role in the treatment of many dermatologic conditions. They are FDA-approved and indicated for the use of inflammatory and pruritic presentations of dermatologic conditions. The well-known indications are for diseases such as psoriasis, limited areas of vitiligo, eczema, atopic dermatitis, phimosis, acute radiation dermatitis, lichen planus, lichen simplex chronicus, discoid lupus erythematosus, and lichen sclerosis.[1] They are effective for conditions involving hyper-proliferation, immunological, and inflammatory properties.[2]

Atopic disorders are on the rise and pose a great burden on society. A better understanding of the underlying mechanisms is required for the development of improved or novel therapeutic strategies. Here we aim to highlight recent advances in experimental allergy, with a particular focus on proposed treatment alternatives for airway disorders, atopic dermatitis, and food allergy. Furthermore, we discuss recent work focusing on molecular and cellular mechanisms that might offer candidates for future preventive or therapeutic intervention.

Although previous studies have explored racial/ethnic differences in incident atopic dermatitis (AD) in childhood, few studies have examined risk factors associated with AD persistence. As such, we sought to examine differences in incidence and persistence of childhood AD by race/ethnicity accounting for socio-demographic characteristics and perinatal vitamin D levels. Using data from Project Viva, a prospective pre-birth cohort in eastern Massachusetts, we studied 1,437 mother-child pairs with known AD status to examine the associations of race/ethnicity with maternally-reported child AD. We used multivariable logistic regression, adjusting for socio-demographic factors and maternal plasma vitamin D, to estimate adjusted odds ratios (aOR) of AD incidence at early childhood and persistence at mid-childhood. Compared to non-Hispanic whites, non-Hispanic blacks (aOR 2.71, 95% CI: 1.75, 4.19) and other non-Hispanics (aOR 1.80, 95% CI: 1.16, 2.80) were more likely to have incident AD. Non-Hispanic blacks (aOR 6.26, 95% CI: 2.32, 16.88) and Hispanics (aOR 6.42, 95% CI: 1.93, 21.41) with early childhood AD were more likely to have persistent AD. In conclusion, compared to non-Hispanic whites, AD incidence and persistence is higher among certain non-white racial/ethnic subgroups. Further research is warranted to identify environmental, socioeconomic, and genetic factors that may be responsible for the observed differences.

The present study provides the first genetic locus associated with AD in African Americans.

Atopic dermatitis (AD) is a prevalent disease worldwide associated with systemic co-morbidities, representing a significant burden on individuals, their families and society. Therapeutic options for AD remain limited, in part due to lack of well-characterised animal models. To better define pathophysiological mechanisms and to identify novel therapeutic targets and biomarkers that predict therapeutic response, there has been increasing interest in developing experimental approaches to study the pathogenesis of human AD in vivo, in vitro, and in silico. This review critically appraises a range of models including: genetic mutations relevant to AD; experimental challenge of human skin in vivo; tissue culture models; integration of "omic" datasets; and the development of predictive computational models. Whilst no one individual model recapitulates the complex AD pathophysiology, our review highlights insights gained into key elements of cutaneous biology, molecular pathways and therapeutic target identification through each approach. Recent developments in computational analysis, including the application of machine learning and a systems approach to data integration and predictive modelling, highlight the applicability of these methods to AD subclassification (endotyping), therapy development and precision medicine. Such predictive modelling will highlight knowledge gaps, further inform refinement of biological models, and support new experimental and systems approaches to AD.

We describe the clinical features of a novel complication in patients with atopic dermatitis (AD). Twenty patients, mean age 23 years, with AD who presented with staphylococcal scalded skin syndrome (SSSS)-like lesions were included between January 2008 and September 2010. Skin lesions followed a triphasic progression pattern from erythema to hyperpigmentation and then erosions. A symmetric and predominant flexural involvement was observed. Pseudomonas aeruginosa (PA) (38.9%) and Staphylococcus epidermidis (38.9%) were the most frequently cultured bacteria from skin swabs. Complete resolution was evident in all cases, and the recurrence rate was 35%. In conclusion, a unique complication characterized by triphasic progression to painful erosions was found in a cluster of AD patients. We propose the new term "dermatitis flammeus" to describe this phenomenon, with PA being one of the etiologies.