Topical Treatment for Atopic Dermatitis

Professor Peter A. Lio reviews atopic dermatitis topical therapies for Medscape.

Dr Peter Lio, it is great to have the opportunity to discuss with you about the topical treatments for adults with atopic dermatitis. What are the typical atopic dermatitis signs and symptoms that can help guide treatment decisions?

That is a hard question for a disease that affects up to 10% of adults and maybe as many as 20% of children with a complex etiopathogenesis.^[1,2] I would say that the typical scenario includes a patient presenting with mild or moderate disease characterized by itchy patches in the head, neck, and/or flexures. I have some patients who have not had a normal night's sleep in a decade, so the burden of atopic dermatitis can be huge. The diagnosis is made on the basis of the presence of one or more symptoms, including pruritus, erythema, scaling, xerosis, edema, excoriations, oozing, and crusting or lichenification, and exclusion of other possible diagnoses. This can be very challenging, however, because allergic contact dermatitis and other conditions can mimic atopic dermatitis.^[3,4]For example, I have had patients referred to me who actually had cutaneous T-cell lymphoma, scabies infestation, zinc deficiency, and secondary infection associated with herpes virus or