Derm Dispatch: Lessons From the Eczema Community

In this episode of Derm Dispatch, host Renata Block, DMSc, MMS, PA-C, speaks with Ashley Ann Lora, an eczema advocate and long-term patient living with atopic dermatitis (AD). Their discussion centers on the lifelong burden of AD, the psychosocial dimensions of chronic skin disease, and strategies clinicians can adopt to better connect with and empower their patients.

Lora was diagnosed with atopic dermatitis in infancy, describing herself as “a long timer of eczema — somebody who has been dealing with this condition day in and day out, almost every single day since I was a baby.” This early-onset presentation aligns with the chronic relapsing nature of moderate to severe AD, where symptoms often persist beyond childhood. Lora emphasized that her disease trajectory was marked by periods of remission and severe flares, reflecting the unpredictable course characteristic of AD.

From a clinical standpoint, the conversation illuminated how disease burden extends beyond skin symptoms. Lora discussed the mental and emotional exhaustion associated with chronic itching, pain, and social visibility of lesions. She highlighted that effective management requires providers to recognize these invisible dimensions: “It’s not just about the cream or the medication; it’s about how we’re supporting the person behind the skin.” This reinforces the need for holistic assessment, encompassing sleep quality, anxiety, depression, and stigma, all factors that significantly impact patient quality of life.

Another key theme throughout the discussion was the evolving treatment landscape for AD and how patient engagement plays a role in optimizing outcomes. Lora shared that navigating multiple therapies over time, from topical corticosteroids to newer systemic and biologic agents, required not only medical guidance but also education and emotional support. She emphasized that adherence often falters when patients feel dismissed or uninformed about treatment expectations, side effects, or the rationale behind stepwise escalation. For clinicians, this underscores the importance of clear communication and patient-centered education, particularly when introducing advanced therapies. As Lora articulated, “When my provider took the time to explain why a treatment mattered for me specifically, it changed how I approached my care.”

Block framed the discussion within the constraints of real-world practice, acknowledging that “we have limited time during the clinic to address all concerns at one visit.” Both she and Lora encouraged clinicians to identify what is most important for the patient ‘in the now’—prioritizing immediate symptom control while fostering ongoing, collaborative care.

The discussion concluded with Lora’s advocacy for shared decision-making and patient education, emphasizing that empathy and open communication are key drivers of adherence and trust. For clinicians, the episode underscores the importance of active listening, individualized care plans, and validating patient experiences—core tenets in optimizing outcomes for chronic dermatologic conditions like AD.