Atopic dermatitis: phototherapy and systemic therapy

Semin Cutan Med Surg. 2017 Sep;36(3):118-123. doi: 10.12788/j.sder.2017.027.

Abstract

The majority of atopic dermatitis (AD) patients respond satisfactorily to gentle bathing, frequent moisturizing, and topical medications. Second-line therapies for AD should be used in recalcitrant cases or in patients with uncontrolled disease despite compliance with first-line measures and avoidance of allergens. Recommended advanced therapies include phototherapy, especially narrowband ultraviolet B, systemic immunosuppressants, and a new biologic agent. Few studies have compared head-to-head efficacy of the different immunosuppressant therapies such as cyclosporine, methotrexate, azathioprine and mycophenolate mofetil. Therefore, the agent used is based on provider and patient preferences and can be decided on a case-by-case basis.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Azathioprine / therapeutic use
  • Cyclosporine / therapeutic use
  • Dermatitis, Atopic / drug therapy*
  • Dermatitis, Atopic / therapy*
  • Dermatologic Agents / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Interleukin-13 / antagonists & inhibitors
  • Interleukin-4 / antagonists & inhibitors
  • Methotrexate / therapeutic use
  • Mycophenolic Acid / therapeutic use
  • Phototherapy* / adverse effects

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Dermatologic Agents
  • IL13 protein, human
  • IL4 protein, human
  • Immunosuppressive Agents
  • Interleukin-13
  • Interleukin-4
  • dupilumab
  • Cyclosporine
  • Mycophenolic Acid
  • Azathioprine
  • Methotrexate