What is Atopic Dermatitis?

Atopic dermatitis (AD), also known as atopic eczema, is a type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thickens over time. While the condition may occur at any age, it typically starts in childhood with changing severity over the years. In children under one year of age much of the body may be affected. As children get older, the back of the knees and front of the elbows are the most common areas affected. In adults the hands and feet are the most commonly affected areas. Scratching worsens symptoms and affected people have an increased risk of skin infections. Many people with atopic dermatitis develop hay fever or asthma.

The word "atopic" indicates an association with allergies. While atopic dermatitis is not always due to an allergic reaction, it is commonly associated with other allergic disorders: up to 60 percent of people with atopic dermatitis develop asthma or hay fever (allergic rhinitis) later in life, and up to 30 percent have food allergies.

The cause is unknown but believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with the permeability of the skin. If one identical twin is affected, there is an 85% chance the other also has the condition. Those who live in cities and dry climates are more commonly affected. Exposure to certain chemicals or frequent hand washing makes symptoms worse. While emotional stress may make the symptoms worse. The disorder is not contagious. The diagnosis is typically based on the signs and symptoms.

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Atopic eczema causes the skin to become itchy, dry, cracked and sore. Some people only have small patches of dry skin, but others may experience widespread inflamed skin all over the body. Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. This can also be more difficult to see on darker skin. People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).

According to the National Eczema Association 2020: o Itch is the most burdensome symptom of AD, followed by skin redness and dryness. A recent study of adults with moderate to severe AD found that 70.5% reported severe, unbearable itch in the past two weeks, 85.8% reported daily itch, and 62.8% reported itching at least 12 hours per day.

Skin pain is a newly appreciated symptom of AD, with 61% of affected adults reporting pain, 33% experienced pain at least once per week, and 5.2% had pain daily.

More than 55% of adults with moderate-to-severe AD report inadequate disease control.

There is currently no specific test for AD, and no single symptom or feature can be used to identify the disease. Each patient has a unique combination of symptoms and rash appearance. Diagnosis of AD is based on the history and physical examination of the patient. In uncertain cases, a skin biopsy may be taken for a histopathological diagnosis of dermatitis.

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Currently, there is no cure for AD; however, it can be effectively managed with current treatment options. The pattern of the disease and its severity determine the kind of treatment the patient ought to receive. Treatment options include topical treatments like emollients, topical corticosteroids (TCS), antibiotics, topical calcineurin inhibitors (TCIs), and systemic treatment such as immunosuppressant, corticosteroids, and phototherapy. Drugs such as Eucrisa (Crisaborole), Dupixent (Dupilumab), Corectim ointment and Olumiant (baricitinib) are approved for AD.

Although seen in individuals of all ages, AD most frequently occurs in childhood. The characteristic clinical features and distribution tend to evolve based on the age of the patient. The main triggers of atopic dermatitis are dry skin, irritants, stress, allergies, infection and heat/sweating.

Atopic dermatitis (AD) is the most common type of eczema. In fact, more than 18 million American adults have atopic dermatitis which often appears as a red, itchy rash normally on the cheeks, arms and legs. AD presents different symptoms depending on the age of the person. Itching is the hallmark of AD, more than 85% of people with the condition experience this distressing symptom every day.

There is currently no reliable biomarker that can distinguish the disease from other entities.

When AD is mild, dermatologists may begin treatment by asking patients to avoid known triggers and to moisturize regularly to protect and strengthen the skin barrier. The maintenance therapy for AD consists of the liberal use of emollients and daily bathing practice with soap-free cleansers. The use of topical corticosteroids (TCS) is the first-line treatment for AD flare-ups. Pimecrolimus and tacrolimus are topical calcineurin inhibitors (TCIs) that can be used in conjunction with TCS. Ultraviolet phototherapy is a safe and effective treatment for moderate-to-severe AD when first-line treatments are not adequate. In addition to these, antistaphylococcal antibiotics are effective in treating secondary skin infections. Patients with severe sleep disturbance due to pruritus are offered a short-term, intermittent course of an oral sedating antihistamine such as Diphenhydramine (Benadryl) or Hydroxyzine; however, they are not routinely recommended because of lack of evidence that they reduce pruritus and the risk of development of contact dermatitis. Eucrisa (Crisaborole), Dupixent (Dupilumab), Corectim ointment and Olumiant (baricitinib) are approved drugs for AD.

Targeted biologic therapeutics - Anti-IL-4Ra therapy (dupilumab): Dupilumab is a monoclonal antibody that inhibits interleukin (IL)–4 and IL-13 signaling by blocking the shared IL-4Ra. It was approved by the US FDA in 2017 for adults with moderate-to-severe atopic dermatitis not adequately controlled with topical prescription therapies or when those therapies are not advisable. In 2019, this indication was expanded to include adolescents aged 12 years or older. It is a subcutaneous injection administered every two weeks.

Topical phosphodiesterase-4 (PDE-4) inhibitors: Eucrisa is a phosphodiesterase 4 inhibitor indicated for topical treatment of mild to moderate atopic dermatitis in patients 2 years of age and older. PDE-4 inhibition results in increased intracellular cyclic adenosine monophosphate (cAMP) levels. The specific mechanism(s) by which crisaborole exerts its therapeutic action for thetreatment of atopic dermatitis is not well defined.

Original Source:- Atopic Dermatitis Market Research