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Atopic Dermatitis News to Use

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Article
Dermatology TimesDermatology Times, December 2023 (Vol. 44 No. 12)
Volume 44
Issue 12

Review a rundown of our top articles and resources for patients inspired by National Eczema Awareness Month.

wladimir1804/AdobeStock

wladimir1804/AdobeStock

Dermatology Times spotlights research and advancements about atopic dermatitis (AD) year-round, especially during eczema awareness campaigns in the fall. Here is a rundown of our top articles and resources for patients inspired by National Eczema Awareness Month.

Systemic Therapies in AD Patients

A recent study conducted as part of the Adelphi AD Disease Specific Programme explored the clinical characteristics and treatments of AD patients seen by nurse practitioners and physician assistants. The research, based on real-world data from 874 surveyed patients in the US, reveals that 51% received systemic therapies either in combination with topicals or as stand-alone treatments, with 12% exclusively on systemic therapies. Notably, patients exclusively on systemics displayed more mild disease severity and fewer current flares. Nurse practitioners and physician assistants expressed high satisfaction levels with AD control in patients treated with systemics only (90%) and those under combined systemic and topical therapies (77%). The study emphasizes the positive impact of systemic therapies, highlighting their role in optimizing therapeutic strategies for moderate to severe AD patients and enhancing their overall quality of life.

Strategies to Improve Psychologic Outcomes

AD has a profound impact on the quality of life (QOL) and mental health of affected individuals, extending to caregivers of children with AD. The distressing symptom of pruritus is a significant contributor to decreased QOL, leading to heightened rates of psychiatric comorbidities, including anxiety, depression, attention-deficit/hyperactivity disorder, and suicidal ideation. A recent review examines a comprehensive range of interventions to address health-related QOL and psychological outcomes in childhood AD. Pharmacological interventions, such as emollients, topical therapies, and systemic treatments, prove effective in improving disease severity and psychological well-being. Nonpharmacological approaches, including phototherapy, patient education, eczema action plans, bleach baths, and allergen immunotherapy, are considered essential adjuncts to medical management. There are also promising psychological interventions, such as hypnotherapy and mindfulness therapy for parents, emphasizing the need for a holistic approach to AD treatment that not only alleviates physical symptoms but also enhances psychological well-being for patients and their caregivers.

Considering Laundry Care and Skin Care

In an interview, Lindsey Zubritsky, MD, FAAD, a board-certified dermatologist at Premier Dermatology and Skin Cancer Center in Ocean Springs, Mississippi, discusses her experience treating eczema, highlighting its prevalence and the various types she encounters, including AD and allergic contact dermatitis. She emphasizes the significance of awareness campaigns to educate the public about this common yet stigmatized condition. Zubritsky collaborates with All Free Clear to raise awareness and mitigate flare-ups, emphasizing the importance of using hypoallergenic detergents for sensitive skin. Regarding stress-induced eczema,she advises gentle skin care and recommends stress-reducing activities like mindfulness and exercise. For pediatric patients, Zubritsky encourages collaboration with dermatologists, including keeping a diary of triggers and following consistent treatment regimens. She closes by stressing the need to destigmatize eczema, highlighting both professional treatments and at-home strategies for managing the condition effectively.

The Power of the Microbiome in Inflammatory Diseases

Renata Block, MMS, PA-C, delves into the critical role of the microbiome in maintaining skin health and preventing inflammatory skin diseases, particularly AD. Emphasizing the significance of a balanced microbiome in promoting overall health, dysbiosis can adversely affect the immune system, contributing to the severity of conditions such as AD, psoriasis, and acne. According to research on the gut-skin axis, a healthy microbiome developed in early life, possibly in the womb, can protect against allergic sensitization and prevent the onset of skin diseases. The importance of microbial diversity; pH balance; and the influence of genetics, environment, and diet on the skin microbiome is continually being explored. There is a multifaceted approach to managing inflammatory skin diseases, including the potential benefits of prebiotics, probiotics, and dietary modifications in restoring microbiota balance and mitigating skin conditions.

Advances in Diagnosing and Treating AD in the Elderly

The aging population has given rise to a distinct clinical subtype of AD among the elderly, presenting unique challenges for clinicians. A recent study addresses the epidemiology, clinical characteristics, diagnosis, and treatment of AD in this age group, where prevalence rates range from 1% to 4%. The complex pathogenesis of AD in the elderly is linked to epidermal barrier dysfunction, chronic inflammation, and pruritus. Diagnosis is complicated by the presence of other pruritic skin diseases and concurrent systemic conditions, making accurate identification challenging. Basic treatments, including moisturizers and anti-inflammatory measures, form the foundation for managing elderly AD. Systemic treatments, such as corticosteroids, immunosuppressants, biologics like dupilumab, and Janus kinase 1 inhibitors, are considered, with a focus on balancing efficacy and safety, especially given the unique characteristics of the elderly population. The study emphasizes the need for specialized attention, early initiation of tailored systemic therapy, and ongoing research to optimize therapeutic approaches for this vulnerable population.

Give the Gift of Patient Resources

AltogetherEczema

A global network for eczema and AD resources, AltogetherEczema provides patients with descriptions of eczema and its subtypes, self-management tips, available treatment options, how to schedule a physician visit, information about eczema-related conditions, and more. Additionally, patients interested in sharing their story with others to promote awareness can upload and share their story directly on the website.

American Academy of Dermatology (AAD)

The AAD’s Eczema Resource Center features a collection of dermatologist-reviewed information and guides. Patients can look through content on eczema types and treatments, childhood eczema, adult eczema, and insider secrets. The unique insiders-only page offers informative videos and write-ups by board-certified dermatologists discussing the difference between eczema and psoriasis, relieving severe AD, managing eczema in the summer, how to use moisturizers, and how to avoid nickel reactions.

Allergy & Asthma Network

One of the main focuses of the Allergy & Asthma Network’s Eczema Resources for Patients page is teaching individuals about eczema and AD in patients with skin of color and how these conditions can present differently among varying skin tones. The Allergy & Asthma Network’s Learning Pathways include educational videos on understanding AD in skin of color, the role of nurses in AD management, shared decision-making in AD, eczema medications for skin of all colors, treating and managing eczema in skin of all colors, and more. There are free eczema podcasts featuring board-certified allergist Payel Gupta, MD, and Kortney Kwong Hing, an eczema patient.

Asthma and Allergy Foundation of America (AAFA)

The AAFA provides a comprehensive guideline on eczema and its most common subtype, AD. Common triggers of eczema listed by the AAFA include allergens, soaps and household cleaners, metals such as nickel, rubber products, perfumes and other fragrances, dyes, and formaldehyde. To prepare patients for their appointments, the AAFA lists possible events that may have triggered a flare, including going hiking, wearing a new necklace, or using a new laundry detergent.

Boston Children’s Hospital

The “Atopic Dermatitis: A Guide for Your Family” booklet from the Boston Children’s Hospital is a 40-page resource for patients that includes in-depth chapters on understanding, treating, and managing AD. Specific topics covered include recommended moisturizers, fighting infections, managing the itch-scratch cycle, teaching children about skin care, and more.

Eczema Exposed

“Taking proactive steps to learn more can help you feel confident that you’re doing everything you can for yourself or your child to cope with the disease” is the clear message of Eczema Exposed. To further promote beneficial conversations between patients and health care providers, Eczema Exposed created 3 guides for patients to take to their next appointment: Infant Caregiver Doctor Discussion Guide (6 months to 5 years); Child Caregivers Doctor Discussion Guide (6-17 years); and Adult Doctor Discussion Guide (18+ years). Each guide has sections to fill out about symptoms, quality of life, life activities that are impacted, and observed triggers.

Eczema Sample Store

The Eczema Sample Store was created by founder Stephanie Philpot, who has had eczema since she was only a few months old. While trying to find the best products that worked for her sensitive skin, she would waste significant amounts of money on full-size products that did not work for her skin. Now, the Eczema Sample Store provides subscription boxes of sample-sized eczema products to help patients find the best product for their skin. Subscription options from the Eczema Sample Store include seasonal eczema product boxes; an annual plan; a 6-month plan; a seasonal plan; individual seasonal boxes for fall, winter, spring, and summer; an Eczema Awareness Month mystery box; a mini mystery sample box; and more.

EczemaWise – National Eczema Association

The National Eczema Association’s EczemaWise app helps patients keep track of their triggers, symptoms, and treatments. With physician-provided science and input, the app can then reveal trends and highlights in patients’ flares to share with their physician. Data recording includes skin, itch, pain, sleep, stress, treatments, triggers, diet, and weather. Patients are also able to print their health data to bring to their next appointment.

Global Parents for Eczema Research (GPER)

GPER is a “grassroots, parent-led nonprofit organization that advances research and policy changes that lead to better treatments and prevention strategies for moderate to severe eczema in children.” GPER’s core programs include support for eczema caregivers, the Eczema Breakthrough Podcast, patient- and family-centered research, and a global effort to improve eczema care worldwide. GPER’s newest resource for families managing eczema is the Treatment Navigator, which highlights treatments currently available or in clinical trials and then categorizes them by topicals, orals, and injectables.

Grahams Natural Alternatives

Grahams Natural was founded by Geoff and Shannon Graham after Geoff had experienced severe eczema as a child and then watched his son develop severe eczema. Geoff and Shannon began mixing various natural ingredients together until they developed their first C+ Eczema and Dermatitis Cream. Then they learned the cream needed to be paired with a 100% oil formula for best results, and eventually they developed their Body and Bath Oil, which worked for their son. Now, patients can shop for a variety of eczema products, including products for the face and eyelids, scalp relief cream, rosacea cream, and more.

International Eczema Council

The International Eczema Council is an online hub of eczema content for both clinicians and patients. In the patient portal, patients can participate in an AD virtual program, created in collaboration with Medscape Education. Patients will learn more about the impacts of eczema as well as how to explain their concerns to clinicians. Other resources from the International Eczema Council include understanding eczema, signs of eczema, an explanation of what causes eczema, understanding whether there is a cure for eczema, and the relationship between eczema and allergies.

Schweiger Dermatology Group

For patients local to a Schweiger Dermatology Group office or for those looking for online resources, numerous dermatology experts are available. On its website, Schweiger Dermatology Group published a “How to Soothe Eczema With 7 Home Remedies” piece for patients. To help treat flares and lessen symptoms, Schweiger Dermatology Group recommends the following: consistent moisturizing, shorter and cooler showers, reducing stress levels, humidifying your space, wearing loose-fitting clothing, avoiding harsh soaps, and vacuuming dust and pet dander more often.

The Eczema Company

The Eczema Company was founded by a mother who was watching her child struggle with severe eczema and extreme itching. Jennifer Roberge focused her efforts on healing her son’s skin from within by closely monitoring foods that increased his flares and incorporating supplements into his diet. Now, the Eczema Company provides patients with natural skin care options and gentle clothing to help stop extreme itching.

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