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.
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 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.
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 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.
