Atopic dermatitis: the new frontier

Med J Aust. 2017 Oct 16;207(8):351-356. doi: 10.5694/mja17.00463.

Abstract

Atopic dermatitis (AD) is the most common inflammatory skin condition in adults and children. AD is a chronic disease that has a considerable negative impact on the quality of life of patients and their families. Most cases of AD may be effectively treated with topical therapies that are directed at decreasing cutaneous inflammation and alleviating pruritus. These therapies include emollients, antihistamines, topical corticosteroids, topical calcineurin inhibitors and antimicrobial and antiseptic measures; more refractory cases may require additional oral immunosuppression (eg, cyclosporine, azathioprine, methotrexate and mycophenolate). Improved understanding of the immune pathogenesis of AD, including the role of T helper cells and the inflammatory pathways involved, has led to breakthrough translational clinical research and treatment. New targeted immunotherapies, such as inhibitors of interleukin (IL)-4, IL-13, IL-31, Janus associated kinase and phosphodiesterase, have had promising results from phase 2 and 3 trials for patients with moderate to severe AD.

Keywords: Anti-inflammatory agents; Atopy; Dermatitis; Eczema; Inflammation.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Cytokines / blood
  • Dermatitis, Atopic / complications
  • Dermatitis, Atopic / drug therapy*
  • Dermatitis, Atopic / immunology
  • Dermatologic Agents / therapeutic use*
  • Environmental Exposure
  • Humans
  • Immunologic Factors / therapeutic use
  • Pruritus / drug therapy
  • Pruritus / etiology
  • Quality of Life
  • T-Lymphocytes / metabolism

Substances

  • Cytokines
  • Dermatologic Agents
  • Immunologic Factors