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Adult vs child atopic dermatitis


Dr. Jonathan Silverberg offers tips at AAD 2019 for diagnosing and managing atopic dermatitis in adults.

Atopic Dermatitis arm

Dr. Jonathan Silverberg offers tips at AAD 2019 for diagnosing and managing atopic dermatitis in adults. (©TYlim/Shutterstock.com)

Dr. Silverberg

Atopic dermatitis can present very differently in adults than in children, according to Jonathan Silverberg, M.D., Ph.D., M.P.H., who presented “Atopic Dermatitis in Adults: Not Just Big Kids,” Friday, March 1, at the 2019 American Academy of Dermatology Annual Meeting in Washington, DC.

“In addition, the differential diagnosis of atopic dermatitis is much broader in adults,” according to Dr. Silverberg, director of the Northwestern Medicine Eczema Center and Contact Dermatitis Clinic, Northwestern Memorial Hospital, Chicago. “Together, these two issues can make atopic dermatitis very challenging to diagnose in adults.”

Key differences in the presentation of atopic dermatitis in adults versus in children include that adult atopic dermatitis often has fewer flexural lesions and more involvement of the head, neck and hands. Adults also may have more nummular, or coin-shaped, lesions, according to Dr. Silverberg.

Dr. Silverberg says it’s important that dermatologists:

  • Pay attention to mental health comorbidities in their adult atopic dermatitis patients, such as anxiety and depression. Symptoms of anxiety and depression are very common in adults with atopic dermatitis, and often can be improved with adequate treatment of atopic dermatitis signs and symptoms.

  • Understand that atopic dermatitis patients commonly report adult-onset of their skin disease.

  • Know that dupilumab has been a game-changer in the management of moderate-to-severe atopic dermatitis, and there are many more treatments in development for atopic dermatitis.

“These agents will ultimately revolutionize the management of atopic dermatitis,” he says.


Dr. Silverberg has consulting, research, advisory and/or speaking roles with AbbVie, AnaptysBio, Asana Biosciences, Eli Lilly and Company, Galderma Research and Development, GlaxoSmithKline, Glenmark Generics, Kiniksa Pharmaceuticals, Leo Pharma, Medimmune, Menlo Therapeutics, Pfizer, PuriCore, Regeneron and Sanofi.

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