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- Andrea R. Waldman, MD*
- Jusleen Ahluwalia, MD*
- Jeremy Udkoff, MA*
- Jenna F. Borok, BS*
- Lawrence F. Eichenfield, MD*
- *Pediatric and Adolescent Dermatology, University of California, San Diego, and Rady Children’s Hospital, San Diego, CA
AUTHOR DISCLOSURE
Drs Waldman and Ahluwalia and Mr Udkoff have disclosed no financial relationships relevant to this article. Ms Borok has disclosed that she has authored a consensus guideline statement on atopic dermatitis. Dr Eichenfield has disclosed that he has a research grant from Regeneron/Sanofi; is on the speakers' bureaus of Anacor/Pfizer and Genentech; is a consultant for Otsuka/Medimetriks, Regeneron/Sanofi, TopMD Inc, Valeant Pharmaceuticals International Inc, and Eli Lilly & Co; and serves on the advisory board and as a speaker for Valeant Pharmaceuticals International Inc. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
- AD:
- atopic dermatitis
- ADHD:
- attention-deficit/hyperactivity disorder
- AE:
- adverse effect
- FDA:
- Food and Drug Administration
- FLG:
- filaggrin
- IgE:
- immunoglobulin E
- IL:
- interleukin
- TCI:
- topical calcineurin inhibitor
- TCS:
- topical corticosteroid
- Th:
- T helper
- WWT:
- wet wrap therapy
Education Gap
Clinicians are often challenged in the primary care setting with children who present with moderate-severe recalcitrant atopic dermatitis. Many patients present at the subspecialist level grossly undertreated with topical medications and emollients. Recently, numerous clinical investigations have evolved our understanding of the pathogenesis of atopic dermatitis, and the American Academy of Dermatology released new atopic dermatitis guidelines in 2014. Understanding the groundbreaking discoveries in disease pathogenesis and implementing up-to-date management guidelines in clinical practice are critical for pediatricians.
Objectives
After completing this article, readers should be able to:
List the age-specific clinical features of atopic dermatitis (AD).
Understand the essential, important, and associated diagnostic criteria of AD.
Recognize the atopic and nonatopic clinical comorbidities associated with AD.
Understand the cutaneous infectious complications associated with AD.
Understand the disease pathogenesis and its relationship to therapeutic management.
Understand the state-of-the-art treatment guidelines, including the recent “proactive” maintenance therapy recommendations.
Recognize the importance of multidisciplinary management and clinical indications for subspecialty referral.
Understand effective strategies of therapeutic patient education and implement them into clinical practice.
Introduction
Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease with a frequently remitting and relapsing course. It is postulated as the first manifestation of the “atopic march”—often …
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