Expert Interviews

Panelists discuss how, based on clinical observations, atopic dermatitis imposes significant physical and mental burdens. Patients experience chronic itching, pain, and sleep disruption while experiencing psychological distress, social anxiety, and reduced self-esteem. Delayed diagnosis exacerbates these burdens, allowing disease progression and worsening quality of life.

Panelists discuss recent topical atopic dermatitis therapies, which include roflumilast (PDE4 inhibitor, age ≥ 6 years), ruxolitinib (JAK inhibitor, age ≥ 12 years), and tapinarof (hydrocarbon receptor agonist, age ≥ 2 years). Treatment selection considers disease severity, age, affected areas, comorbidities, and previous therapy responses.

Panelists discuss how the newer topical agents (PDE4 inhibitors, JAK inhibitors) demonstrate comparable efficacy to midpotency corticosteroids but with improved safety profiles, lacking steroid-related adverse effects such as skin atrophy, hypothalamic-pituitary-adrenal axis suppression, and tachyphylaxis when used long term.

Shahriari, assistant clinical professor of dermatology at Yale University School of Medicine, says greater understanding of the condition has expanded the population for the diagnosis.

Panelists discuss how older topical treatments such as corticosteroids, calcineurin inhibitors, and crisaborole have limited efficacy with prolonged use. Corticosteroids cause skin thinning and systemic absorption on large body surface area (BSA). Calcineurin inhibitors and crisaborole show modest efficacy, with application site reactions.

Panelists discuss how atopic dermatitis diagnosis in primary care relies on clinical features including pruritus, characteristic distribution, and chronic/relapsing course. Severity assessment involves examining extent, intensity, impact on quality of life, and response to previous treatments.

Not all atopic dermatitis requires treatment by a specialist, says this dermatologist, and she collaborates regularly with her primary care colleagues.

Monu Khanna, MD, discusses challenges in managing pain in patients with obesity, effective pharmacological and nonpharmacological therapies, and more.

Shagun Bindlish, MD, discusses the complex interplay between obesity and mental health conditions and how sex is a potential moderating factor.

Anila Chadha, MD, highlights key preventive strategies to reduce CVD risk in patients with obesity and how to tailor them to address individual patient needs.