Atopic dermatitis (AD), the most common chronic inflammatory skin disease, affects infants as well as adults. AD is now recognized as a heterogeneous disease with different subtypes and varying clinical manifestations, which are influenced by the impairments of the skin barrier.

The severity of AD decides the level of treatment. The mainstay of the treatment remains the use of moisturizers. Further, anti-inflammatory treatments represent the second-line therapy and must always be used with moisturizers. Mild to moderate cases demands topical treatments; however, moderate to severe cases can see the addition of systemic immunosuppressive drugs. New emerging therapies, e.g., biologics, are also proven promising in treating AD.

Current AD treatment concentrates on restoring the barrier function, mainly through moisturizers and corticosteroids to control inflammation, topical calcineurin inhibitors and immunosuppressive drugs in the most severe cases. Nevertheless, targeted disease-modifying therapies are being investigated. Recent evidence on skin microbial dysbiosis is a promising future direction for developing new treatments. We still need to improve our understanding regarding the complex microbiome-host interactions, the role of autoimmunity, the comparative effectiveness of therapies and the ways to implement educational strategies appropriately.

Source: D′Auria E, Banderali G, Barberi S, et al. Atopic dermatitis: recent insight on pathogenesis and novel therapeutic target. Asian Pac J Allergy Immunol. 2016;34(2):98-108.