Skill Checkup: A 32-Year-Old Man With a History of Atopic Dermatitis Presents With Worsening Itch

Diamant Thaçi, MD, PhD; Alan Irvine, MD, DSc


July 13, 2023

The topical calcineurin inhibitors pimecrolimus and tacrolimus are preferred in sensitive skin areas and for long-term use in AD in adults who are nonimmunocompromised and children ≥ 2 years of age.

Phototherapy is a possible therapeutic option for moderate to severe AD, particularly narrow-band UVB. It can be used in conjunction with emollients and topical corticosteroids to reduce flareups. However, a disadvantage of phototherapy is that it requires a major time commitment and administration by skilled personnel. Given his busy career, it is unlikely that phototherapy would be a realistic option for this patient.

Crisaborole, the only PDE-4 inhibitor available, is intended for use only for patients with mild to moderate AD. Further, this product is unavailable in the European Union.

Anti IL-33 therapy has shown promise in the treatment of AD in a small, proof-of-concept trial; however, larger randomised trials are required to fully determine safety and efficacy.


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