Atopic Dermatitis in the Real World: Cases Across Ages and Skin Tones
An expert discusses how the stage and diverse presentations of atopic dermatitis, especially in underserved and darker-skinned patients, influence treatment decisions, highlighting the promise of new nonsteroidal therapies and the importance of personalized, patient-centered care to improve quality of life.
The patient’s stage in their atopic dermatitis journey greatly influences treatment decisions. Many arrive feeling exhausted after trying multiple topical therapies without sustained relief, often feeling the disease controls their life. Systemic treatments provide an opportunity to manage the condition more proactively and improve long-term outcomes. Chronic atopic dermatitis can be particularly challenging, especially in underserved populations and patients with darker skin tones, where symptoms may present differently. For example, hypopigmentation or subtle discoloration may be more prominent than the classic bright redness, making assessment more complex.
Several patient cases highlight the diversity of presentations. One young adult exhibited rough, ill-defined patches with prominent discoloration on the hands, whereas pediatric cases showed thickened, lichenified skin with uneven pigmentation and subtle redness on the neck and face. The skin changes, such as thickening and textural alterations, may be easily overlooked if one focuses only on redness, underscoring the importance of careful examination. These examples illustrate how chronic atopic dermatitis can lead to skin changes that may appear to age patients prematurely, despite their young age.
In closing, the evolution of treatments offers hope and new options for patients beyond traditional topical steroids. There is growing excitement about 3 new nonsteroidal topical therapies that are effective on both sensitive and thicker skin areas. Educating patients and guiding them through their treatment journey remains essential, and personalized care is key to improving quality of life. As new treatments become more widely available, they provide an important opportunity to tailor therapy to each patient’s unique disease pattern and needs.
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