Practical Guidance for Systemic Treatment Selection in Pediatric Refractory Atopic Dermatitis

Severe or refractory pediatric atopic dermatitis (AD) requires systemic intervention. While severity was historically quantified using physician-administered tools, recent guidelines emphasize patient-centered impacts like pruritus, sleep disturbance, and special site involvement, which heavily affect development and quality of life. Furthermore, treatment is undergoing a paradigm shift, moving away from traditional, broad immunosuppressants (like methotrexate and cyclosporine) toward novel systemic agents. This article reviews the expanding therapeutic spectrum for managing pediatric refractory AD.