Assessment and Monitoring Challenges Among Patients With Moderate-to-Severe Atopic Dermatitis Across Fitzpatrick Skin...

Area of Science:

• Dermatology
• Immunology
• Genetics

Background:

• Atopic dermatitis (AD) is a prevalent, chronic inflammatory skin disease with diverse clinical and biological presentations.
• Current AD diagnosis and monitoring depend on clinical assessment due to the absence of definitive biomarkers.
• Variations in AD presentation across Fitzpatrick skin types, particularly in skin of color, present significant clinical evaluation challenges.

Approach:

• This review examines the phenotypic heterogeneity of AD across Fitzpatrick skin types.
• It emphasizes the diagnostic and assessment difficulties encountered in patients with darker skin tones.
• Photographic evidence from phase 3 clinical trials of upadacitinib in moderate-to-severe AD illustrates these challenges and treatment outcomes.

Key Points:

• Erythema and excoriation are challenging to assess in dark skin types.
• Lichenification is a key indicator in light skin types.
• Targeted systemic therapies can significantly alter clinical signs and symptoms of AD.

Conclusions:

• Recognizing and addressing the variations in AD presentation across diverse skin types is crucial for accurate diagnosis and effective management.
• Clinical trial data and photographic evidence underscore the need for tailored evaluation methods.
• Upadacitinib demonstrated efficacy in improving AD signs and symptoms, highlighting the potential of targeted therapies.