Severe atopic dermatitis in early infancy: characteristics, challenges and new perspectives in clinical practice

Area of Science:

• Pediatric Dermatology
• Immunology
• Genetics

Background:

• Atopic dermatitis (AD) is highly prevalent in infants and children, with a significant percentage experiencing severe disease.
• Infants with severe AD present unique psychosocial, neurocognitive, and morphological challenges distinct from adult presentations.
• Distinguishing severe AD from inborn errors of immunity (IEI) is critical due to overlapping phenotypes.

Purpose of the Study:

• To provide an age-specific approach for managing severe atopic dermatitis in infants.
• To guide clinicians in differentiating severe AD from IEI based on clinical and laboratory findings.
• To offer an update on current management strategies, including systemic treatments for severe infantile AD.

Main Methods:

• Review of clinical history, dermatological findings, and laboratory markers for distinguishing severe AD from IEI.
• Analysis of age-specific clinical manifestations in infants with severe AD.
• Compilation of current evidence for managing severe AD in early infancy.

Main Results:

• A practical approach is presented for identifying infants with severe AD and differentiating them from IEI.
• Key clinical and laboratory indicators are highlighted for diagnostic accuracy.
• Updated recommendations for the general and systemic management of severe infantile AD are provided.

Conclusions:

• Tailored disease management is essential for infants with severe atopic dermatitis.
• Early and accurate diagnosis, differentiating AD from IEI, is vital for preventing atopic comorbidity.
• Current systemic treatment options offer new avenues for managing severe infantile AD effectively.