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Special, Sensitive, and Difficult-to-Treat Areas: Clarifying the Terminology in Atopic Dermatitis
Francisco Javier Melgosa Ramos1, Virginia Sanz Motilva2, Javier Sabater Abad3
1Hospital Lluís Alcanyís, Valencia, Spain.
None:
"Special," "sensitive," and "difficult-to-treat" areas are frequently used interchangeably in atopic dermatitis despite describing distinct clinical constructs. Sensitive sites reflect disproportionate psychosocial and functional vulnerability, whereas difficult-to-treat areas denote therapeutic refractoriness. This distinction is clinically relevant because involvement of these locations may support consideration of systemic therapy independently of the Eczema Area and Severity Index (EASI) score or body surface area. Precise terminology should guide, rather than obscure, therapeutic decision-making.
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