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Atopic dermatitis
Stephan Weidinger1, Valeria Aoiki2, Sandipan Dhar3
1Department of Dermatology and Allergy, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany. sweidinger@dermatology.uni-kiel.de.
Nature Reviews. Disease Primers
|June 4, 2026
Summary
Atopic dermatitis (AD), a common itchy skin condition, significantly impacts global health and is linked to various immune-related diseases. Advances in understanding AD have led to targeted therapies, but access remains unequal worldwide.
Area of Science:
- Dermatology
- Immunology
- Public Health
Background:
- Atopic dermatitis (AD) is the most prevalent inflammatory skin condition, causing a high burden of disability-adjusted life-years globally.
- AD is characterized by severe itching and is associated with numerous comorbidities, including allergic conditions, mental health disorders, and infections, largely driven by type 2 immune responses.
- The disease often begins in early childhood but can manifest at any age, with a notable increase in late-onset cases.
Purpose of the Study:
- To review the current understanding of atopic dermatitis (AD) pathology.
- To discuss the evolution of therapeutic strategies for AD.
- To highlight the global disparities in accessing advanced AD treatments.
Main Methods:
- Review of recent scientific literature on atopic dermatitis.
- Analysis of disease mechanisms, including skin barrier function, immune pathways, microbiome, and neural networks.
- Examination of therapeutic advancements and global access to treatments.
Main Results:
- Enhanced understanding of AD pathogenesis involves the interplay of skin barrier, immune system, microbiome, and neural networks.
- Therapeutic approaches have shifted from broad immunomodulation to targeted biologics and small molecules for severe AD, and from topical corticosteroids to next-generation therapies for milder forms.
- Significant global inequities persist in the availability and accessibility of novel AD treatments.
Conclusions:
- Recent advancements have deepened the understanding of atopic dermatitis, leading to more targeted and effective therapies.
- Despite therapeutic progress, global disparities in access to these treatments remain a critical challenge.
- Future efforts should focus on addressing these inequities to ensure broader patient benefit from innovative AD management strategies.
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