PDE4 Inhibitors for Atopic Dermatitis: How Do They Work?

Experts discuss the rationale for PDE4 inhibition in atopic dermatitis treatment. Dr. Eichenfield explains its historical foundation: research showed cyclic AMP modulates inflammation, and PDE4 amplifies this in inflammatory cells. Blocking PDE4 provides an anti-inflammatory effect. After decades, this led to topical development. Early topical PDE4 inhibitors faced tolerability issues. The newer agent, roflumilast, offers different binding and greater potency. Initially approved as a 0.15% cream for ages 6+, recent studies support a 0.05% cream for pediatric patients as young as 2 years old. This evolution represents a targeted topical treatment option for managing pediatric atopic dermatitis, providing a non-steroidal alternative for long-term management and maintenance therapy.