Keeping It Simple: Treatment Choices for Atopic Dermatitis

This transcript has been edited for clarity.

Steven R. Feldman, MD, PhD: Hi. I'm Dr Steve Feldman, professor of dermatology at the Wake Forest University School of Medicine in Winston-Salem, North Carolina.

Peter Lio, MD: And I'm Dr Peter Lio. I'm a clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Chicago, Illinois.

Feldman: We're talking about atopic dermatitis. Peter, I like to think of atopic dermatitis in two buckets: a mild bucket where we use topicals, and a more extensive bucket where I've got to use systemic treatment. Let's talk about topicals first.

The guidelines are incredibly complicated. I don't think patients are going to follow them. I like to keep the treatment simple. How do you manage it?

Lio: I think you're right. And it's actually getting more complex as we get all of these new agents. I like to break it down into two phases. I like to have a rescue plan when things are flaring up. Usually, that's going to be a topical corticosteroid — mid-potency, sometimes even a little bit higher.

And then I like to have a "when better" maintenance plan: something ideally nonsteroidal, in some cases a lower-potency steroid that can be used to either maintain and prevent flare-ups, or for those patients who have really severe disease, in a proactive way, they could be doing a treatment two or three times per week to those hotspots so that we hopefully will avoid needing to use those steroids.

Authors and Disclosures

Experts

Steven R. Feldman, MD, PhD

Professor of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Disclosure: Steven R. Feldman, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Accordant; Almirall; Alvotech; Arcutis; Arena; Argenx; Biocon; BMS; Boehringer; Dermavant; Fortel; Helsinn; Janssen; Leo; Micreos; Mylan; Novartis; Ono; Pfizer; Samsung; Sanofi; Sun; UCB; vTv; Voluntis
Serve(d) as a speaker or a member of a speakers bureau for: AbbVie; Alvotech; Amgen; BMS; Janssen; Lilly; Regeneron; Sanofi; Sun
Received research grant from: AbbVie; Almirall; BMS; Galderma; Janssen; Lilly; Novartis; Pfizer; UCB
Have a 5% or greater equity interest in: Sensal Health

Peter Lio, MD

Clinical Assistant Professor, Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine; Founding Director, Chicago Integrative Eczema Center, Chicago, Illinois

Disclosure: Peter Lio, MD, has disclosed the following relevant financial relationships:
Received consultant fees from: AbbVie; Amyris, Inc; Burt's Bees; Dermira; Eli Lilly and Company; Kimberly-Clark; LEO Laboratories Ltd (LEO Pharma); Lipidor; L'Oreal USA Inc. (honoraria); MyOR Diagnostics Ltd; Sibel Health; Skinfix, Inc.; Sonica LLC; Theraplex; Unilever
Received research grant from: AbbVie; AOBiome, LLC; Eczema Foundation (formerly La Fondation pour la Dermatite Atopique); National Eczema Association; Regeneron
Received speaker fees from: AbbVie; Almirall; Arcutis Biotherapeutics; Eli Lilly and Company; Galderma USA; Hyphens Pharma; Incyte Corporation; La Roche-Posay Laboratorie Pharmaceutique (honoraria); Leo Pharma Inc; MyOR Diagnostics Ltd (honoraria); Pfizer Inc.(honoraria); Pierre Fabre Dermatologie (honoraria); Regeneron; Verrica Pharmaceuticals Inc
Received advisory board fees from: Almirall; Alphyn Biologics (honoraria); Apogee Therapeutics; Arbonne (honoraria); Arcutis, Inc; ASLAN Pharmaceuticals; Bodewell; Bristol-Myers Squibb; Castle Biosciences; Dermavant Sciences (honoraria); Galderma Laboratories, LP; Janssen Pharmaceuticals, Inc (honoraria); Johnson & Johnson Consumer Products Company (honoraria); Merck (honoraria); Regeneron; Sanofi US Services (honoraria); UCB (honoraria); Verrica Pharmaceuticals Inc (honoraria)
Serve(d) on an advisor board or board of directors for: Modernizing Medicine; National Eczema Association Received stock options from: Boston Skin Science LLC; Codex Labs; Concerto Biosciences; DermVeda; LearnHealth/LearnSkin; Medable; Micreos Human Health B.V.; Modernizing Medicine; Syncere Skin Systems; Yobee Care Inc
Received speaker patent compensation for intellectual property rights: ParentMD; Theraplex