Skin in the Game: Tackling Atopic Dermatitis with Topical Treatment

Omar Noor, MD, FAAD and Randy Alevi, DO, discuss the identification and management of atopic dermatitis, with a focus on topical treatment options. They discuss the importance of timely identification of atopic dermatitis in the primary care setting and explore recently approved topical treatment options for mild-to-moderate disease.

EP. 1: Diagnosing and Defining Severity of Atopic Dermatitis

February 28th 2025

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.

EP. 2: Older Approaches to Topical Treatment of Atopic Dermatitis

February 28th 2025

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.

EP. 3: New Nonsteroidal Topical Treatment Options for Atopic Dermatitis

March 4th 2025

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.

EP. 4: Long-Term Use of Topical Treatments in Atopic Dermatitis

March 4th 2025

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.

EP. 5: Addressing Itch and Quality of Life for Patients With Atopic Dermatitis

March 4th 2025

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.

EP. 6: Importance of Patient Education and Multidisciplinary Communication

March 4th 2025

Panelists discuss how proper application technique and adherence are vital for topical atopic dermatitis treatments. Effective provider communication and primary care provider/dermatologist collaboration optimize patient outcomes through education and coordinated care. Primary care providers and dermatologists should coordinate care through clear communication, shared protocols, and defined referral pathways to optimize atopic dermatitis management and improve patient outcomes.