Diagnosis and Treatment of Atopic Dermatitis in Children and Adults

In a recent study published in Deutsches Ärzteblatt International, researchers provided valuable insights into the diagnosis and treatment of atopic dermatitis in both children and adults based on current German and European guidelines.

The study emphasized the importance of basic therapy using drug-free topical agents, which can significantly improve the skin's barrier function. For optimal results, adults are advised to apply a minimum of 250 g of topical agents per week. The review also highlighted the significance of identifying and eliminating patient-specific trigger factors, such as allergens, stress, microbial pathogens, or skin irritants. By doing so, the severity and recurrence of the disease can be reduced.

In mild to moderately severe cases, external treatment with topical glucocorticosteroids and topical calcineurin inhibitors is usually sufficient. Proactive therapy is recommended for patients who experience frequent recurrences or have a long course of the disease. In more severe cases, systemic anti-inflammatory treatments become necessary. This may involve the use of biologic agents, such as dupilumab and tralokinumab; Janus kinase inhibitors, such as baricitinib, upadacitinib, and abrocitinib; or conventional immunosuppressant drugs. The choice of treatment should be a collaborative decision, considering the patient's age and the characteristics of their skin condition.

The study also emphasized the importance of interdisciplinary patient education, which has been shown to yield long-term benefits. By actively involving patients in the choice and planning of their treatment, health care providers can achieve more successful outcomes.

“A combination of baseline therapy, reactive and proactive anti-inflammatory therapy, and systemic therapy as needed is the foundation of successful interdisciplinary treatment for atopic dermatitis,” concluded the study authors.

Reference
Wollenberg A, Werfel T, Ring J, Ott H, Gieler U, Weidinger S. Atopic dermatitis in children and adults—diagnosis and treatment. Dtsch Arztebl Int. 2023;120(13):224-234. doi:10.3238/arztebl.m2023.0011