Strategies for Successful Management of Severe Atopic Dermatitis

J Allergy Clin Immunol Pract. 2019 Jan;7(1):1-16. doi: 10.1016/j.jaip.2018.10.021.

Abstract

Patients with severe atopic dermatitis (AD) are reported to represent between 10% and 18% of all patients with AD. However, in this subgroup of patients, quality of life is significantly affected and patients may have a number of atopic and nonatopic comorbidities. Treatment of this severe population has often been reactive with inappropriate use of systemic corticosteroids and unapproved immunosuppressants. Recent insights point to the systemic nature of AD, which has important therapeutic implications. Management of severe AD requires a comprehensive approach that incorporates proper diagnosis, assessment of disease severity, and impact on patient's and caregiver's quality of life, along with education regarding the chronic relapsing nature of the disease as well as treatment options. Biologics such as dupilumab offer a novel, targeted therapeutic approach for this systemic disease.

Keywords: Atopic dermatitis; Biologics; Dupilumab; Eczema; Wet wrap therapy.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Biological Products / therapeutic use*
  • Chronic Disease
  • Dermatitis, Atopic / diagnosis*
  • Dermatitis, Atopic / drug therapy
  • Disease Progression
  • Eczema / diagnosis*
  • Eczema / drug therapy
  • Humans
  • Quality of Life
  • Recurrence
  • Severity of Illness Index

Substances

  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • dupilumab