Live Blog: Lecture sponsored by Anacor Pharmaceuticals: “Advances in Atopic Dermatitis: Expert Insights Into New and Emerging Therapies.” Faculty: Theodore Rosen, MD
In this live blog from the Annual Fall SDPA Conference in Orlando, FL, Theodore Rosen, MD, presented a lecture sponsored by Anacor Pharmaceuticals called, “Advances in Atopic Dermatitis: Expert Insights Into New and Emerging Therapies.” Here are some of the highlights.
Dr. Rosen began his lecture by stating that atopic dermatitis is the most chronic skin disease in young children, while affecting only 2% to 3% of adults. Notably there has been an increased prevalence of atopic dermatitis in newly industrialized countries.
Atopic dermatitis shares cross-sectional symptoms between asthma, eczema, and allergic rhinitis. Sufferers also commonly report comorbid mental health concerns (depression, autism, hypertension, ADHD), dietary concerns (obesity, poor nutrition), and sleep deprivation (especially in pediatric patients and their parents).
What is the best course of action for treating a patient suffering with atopic dermatitis? Dr. Rosen emphasized the importance of reducing itchiness (over redness reduction) as the primary goal of treatment. While treatment should also seek to control inflammation and minimize infection, Dr. Rosen argued that treating the itch first is the most important because a patient’s itching results in scratching, which will exacerbate the dermatitis.
The first line of treatment is to hydrate the skin. Locking in moisture is essential. “Soak and seal,” Dr. Rosen urged. He also encouraged that patients be proactive about their therapy. Regular, intermittent diluted bleach baths can help reduce the bacterial carriage on the skin.
Flares occur in patients, Dr. Rosen explained, when there tends to be more staph and less diversity. Decreasing S. aureus colonization tends to be helpful in reducing inflammation. Dr. Rosen recommended that a topical agent such as a topical corticosteroids (TCS) and or topical calcenurin inhibitors (TCI) depending on severity can be used to achieve control. Getting pediatric patients to apply topical agents consistently as prescribed can be challenging. Dr. Rosen suggested getting the parents email address or phone number and programming an email or text reminder to the parent to treat their children. Providers can also mail parents a monthly check-in postcard, or even schedule video check-ins. If TCSs or TCIs are not effective, systemic therapy/UV therapy is the last attempt. Dr. Rosen advised that systemic steroids are never ideal. They should be used for a short term and only for over exacerbated cases.