Atopic Dermatitis: A Review on Diagnosis and Management

Atopic Dermatitis (AD), also known as eczema, is a chronic, relapsing, and itchy inflammatory skin condition. The pathogenesis of AD including genetic, environmental, and immunologic factors. The primary biologic changes in AD are decreased skin barrier function, Filaggrin gene impairment, and Calcineurin-mediated Th2 cell activation. History taking and clinical manifestations play an essential role in ruling out common differential diagnoses because there is no specific diagnostic tool for AD. The management of AD varies in children and adults depend on the severity of cases. Successful treatment of AD requires multifocal modalities from non-pharmacologic and pharmacologic therapy as well as identification and elimination of flare factors. Managementfor AD including moisturizer, topical corticosteroid, non-steroidal immunomodulators (topical Calcineurin Inhibitors), antibiotics to treat secondary infection, systemic immunosuppressive agents (Cyclosporine, Azathioprine, Methotrexate) and targeted biologic therapeutic agent (Dupilumab). Treatment outcome also affected by the severity of the disease and concomitant atopic conditions. A physician needs to inform the patient that the treatment does not produce a cure to the disease, but it can be controlled.