Atopic dermatitis: Kids are not just little people

Children atopic dermatitis: Diagnosis, mimics, overlaps, and therapeutic implication

Atopic dermatitis (AD) is a chronic inflammatory, itching skin with a significant psychosocial impact on patients and relatives. In adults and adolescents besides flexural eczema, head and neck eczema, and hand eczema, which are the most frequent clinical phenotypes (84.9% and 84.2%, respectively), there are also other possible presentation such as, portrait-like dermatitis (20.1%), diffuse eczema (6.5%), eczema nummulare-like (5.8%), prurigo nodularis-like (2.1%) and erythrodermia (0.7%). Diagnosis can be easy due to the typically distributed eczematous lesions, albeit with age-related differences, However, it is also extremely heterogeneous in severity, course, and sometimes particular clinical features. Currently, there are no better diagnostic criteria than an experienced dermatologist for the diagnosis of AD. Misdiagnosis and delayed treatment will have an impact not only on the child's physical health, but also and especially on the child's psychological health. The aim of our review was to group the main differential diagnoses in pediatric age where the diagnosis can often hide many pitfalls.

An update on the topical and oral therapy options for treating pediatric atopic dermatitis

INTRODUCTION

Atopic dermatitis (AD) is one of the most common childhood skin disorders. Multiple mechanisms contribute to the pathology of AD and treatment approaches are directed at these processes.

AREAS COVERED

The purpose of this review is to discuss the chemical treatment options for pediatric atopic dermatitis, including immunomodulators and small molecule inhibitors. A systematic literature search was conducted, and publications were reviewed for applicable treatment guidelines.

EXPERT OPINION

Topical therapy is first-line for pediatric atopic dermatitis. Providers should work closely with patients and caregivers to promote the success of topical treatments. In disease refractory to topical treatments, systemic agents may be considered. Clinical trials are ongoing for the use of biologics in the treatment of pediatric AD. When choosing the most appropriate treatment, physicians should consider the drug efficacy, potential adverse effects, patient adherence, and quality of life for both patients and caregivers. Additional studies are required to determine the safest and most effective doses for systemic therapy in childhood AD.