RAD 2025: Mobile health data reveal a troubling decline in systemic treatment for moderate to severe atopic dermatitis, underscoring issues in access and clinical inertia.

Dupilumab monotherapy showed significant improvements in atopic dermatitis symptoms in patients with skin of color, according to late-breaking data presented at RAD 2025.

Panelist discusses how patient cases demonstrate the importance of considering nonsteroidal agents in patients of color (due to hypopigmentation risks) and elderly patients (due to skin thinning), concluding that effective atopic dermatitis management requires proper moisturizing, appropriate corticosteroid cycling, and proactive twice-weekly maintenance with newer nonsteroidal topicals to prevent long-term complications.

RAD 2025: Adults and adolescents treated with nemolizumab experienced rapid onset of action and robust improvements in pruritis, sleep, and quality of life up to 2 years.

Panelist discusses how referral to dermatology should occur when patients fail to reach treatment goals despite proper skincare, appropriate topical steroid and nonsteroid use, and proactive treatment, emphasizing the importance of maintaining open dialogue about systemic therapy options rather than dismissing them as “last resort” treatments.

Panelist discusses how topical treatment selection should be based on affected body areas, patient preferences for vehicle type, and disease extent, noting that patients prefer topical over systemic therapies and emphasizing the importance of using specialty pharmacies with manufacturer contracts to ensure affordable access through proper prior authorization processes.

nonsteroidal topicals including roflumilast (next-generation PDE4 inhibitor), ruxolitinib (JAK1/2 inhibitor), and tapinarof (aryl hydrocarbon receptor agonist) offer significant improvements in efficacy and tolerability compared with older agents like crisaborole, with clinical trial data showing 30% to 50% of patients achieving complete or near-complete clearance.

Panelist discusses how polling results show varied approaches to second-line atopic dermatitis treatment, emphasizing that topical corticosteroids remain the workforce but require proper usage limits of 1 to 2 weeks to avoid serious adverse effects, while highlighting growing patient concerns about steroid phobia and topical steroid withdrawal syndrome.

Panelist discusses how the current treatment guidelines include 4 classes of topical therapies, with newer nonsteroidal options like JAK inhibitors and PDE4 inhibitors providing effective alternatives to long-term corticosteroid use.

Panelist discusses how proper skin care forms the foundation of atopic dermatitis treatment and emphasizes the importance of proactive rather than reactive treatment approaches using maintenance therapy.