Atopic Dermatitis in Adults: Focus on Topical Therapy

Objective To review the topical therapies for adults, including older adults, with atopic dermatitis. A background on atopic dermatitis in adults, overview of treatment recommendations, and the pharmacists' role for care is included. Data Sources Articles indexed in PubMed, Cochrane Reviews, and Google Scholar in the past 10 years using the search terms atopic dermatitis, atopic dermatitis and treatment, and atopic dermatitis and adults were reviewed. Current guidelines and manufacturers' prescribing information were reviewed. Primary sources were used to locate additional resources. Study Selection/Data Extraction Forty-five publications were reviewed and criteria supporting the objectives identified useful resources. Data Synthesis Selected literature included practice guidelines, review articles, research articles, product prescribing information, and drug information databases. Conclusion Atopic dermatitis is a common chronic inflammatory cutaneous disease that may present at any age. Atopic dermatitis has a relapsing course with active disease followed by periods of remission. Atopic dermatitis is not curable, but available and recommended regimens can control patient symptoms. Topical therapies are the preferred treatment and are able to control atopic dermatitis in most adults. Topical moisturizers are the mainstay of therapy. Despite regular use of a moisturizer, most patients will need a topical anti-inflammatory agent to control disease flares. The Food and Drug Administration-approved topical anti-inflammatory agents include the corticosteroids, calcineurin inhibitors, a phosphodiesterase-4 enzyme inhibitor, and a Janus Kinase inhibitor. Pharmacists are in a unique position to counsel patients about the appropriate use and benefits and risks of atopic dermatitis therapies.