Evolving management of atopic dermatitis

Atopic dermatitis is a common, complex inflammatory skin disorder with an immunological basis, characterized by eczematous dermatitis and pruritis. The prevalence of atopic dermatitis is increasing in industrialized areas of the world, including the USA and western Europe. There is an estimated 15–20% lifetime prevalence of atopic dermatitis in young school-age children in the USA and western Europe. Evidence suggests that atopic dermatitis may represent an entry point for allergic disease, with some data supporting claims that 50–80% of children with atopic dermatitis may develop other symptoms of the atopic triad, including allergic rhinitis and asthma. There has been an evolution in the understanding of the pathogenesis and epidemiology of atopic dermatitis, leading to the introduction of new therapeutic agents and treatment options. Ongoing studies are now evaluating if early effective treatment of atopic dermatitis in an infant modifies the risk of developing other atopic disease or alleviates its impact. In the scope of this article we will discuss diagnosis, the safety and efficacy of treatments and suggest treatment algorithms.