Internists are front-line healthcare providers who often provide the first encounter with patients with dermatological conditions, especially atopic dermatitis (AD). Thus, they need to be comfortable with managing mild-to-moderate AD in their practices. Criteria and guidelines established in dermatology literature help general practitioners diagnose and treat AD. 

AD, a systemic disease, is associated with multiple cutaneous and extracutaneous comorbidities that warrant screening by internists, especially for mental health conditions. Environmental factors also play a role in the development or worsening of AD; however, no strong evidence guide specific population- or clinic-based interventions for their avoidance. Food allergies are often seen in AD patients, but the role of food allergens as an exacerbating factor for AD remains controversial. 

Before initiating any dietary modifications, careful evaluation should be performed by an allergist. If the patient is not well-controlled despite adequate topical therapies or is experiencing severe/worsening disease, early referral to dermatology is important to rule out confusing diagnoses and/or advancement to systemic therapies. Finally, recognizing the racial disparities present in AD and addressing these when formulating treatment plans is important.

Source: Narla S, Silverberg JI. Dermatology for the internist: optimal diagnosis and management of atopic dermatitis. Ann Med. 2021;53(1):2165-77.