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Treatment-resistant atopic dermatitis: challenges and solutions.

Brian B Johnson1, Abigail I Franco1, Lisa A Beck1

  • 1Department of Dermatology, University of Rochester Medical Center, Rochester, NY 14642, USA, Brianb_Johnson@urmc.rochester.edu.

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|April 10, 2019
PubMed
Summary

Atopic dermatitis (AD) management varies by severity. Severe or refractory AD presents challenges, necessitating exploration of advanced systemic therapies and biologics like dupilumab, though some patients remain inadequately responsive.

Keywords:
atopic dermatitisbiologicseczemasystemic therapytopical therapytreatment resistance

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • Atopic dermatitis (AD) is a chronic inflammatory skin condition with varying severity.
  • Mild AD is managed with skincare and topical treatments; severe AD often requires systemic therapies or phototherapy.
  • Current treatments for severe AD have limitations, including side effects and accessibility issues.

Purpose of the Study:

  • To review clinical challenges in treating moderate-to-severe refractory atopic dermatitis.
  • To discuss current and emerging treatment options for difficult-to-treat AD.
  • To highlight the need for effective therapies for patients with inadequate response to existing treatments.

Main Methods:

  • Review of existing literature on atopic dermatitis management.
  • Discussion of systemic therapies, phototherapy, and biologic treatments.
  • Focus on treatment-resistant cases and patient responses.

Main Results:

  • Topical therapies are effective for mild AD.
  • Systemic therapies and phototherapy are used for moderate-to-severe AD but have limitations.
  • Dupilumab is an approved biologic for moderate-to-severe AD, but some patients show inadequate response.

Conclusions:

  • Moderate-to-severe refractory atopic dermatitis poses significant clinical challenges.
  • While new therapies like dupilumab offer advancements, treatment gaps persist.
  • Further research into targeted pathways and novel treatments is crucial for refractory AD.