The evolving atopic dermatitis management landscape
Abstract
INTRODUCTION: Atopic dermatitis is a common dermatologic condition that affects millions of people worldwide, and a standardized approach to treatment was published by the American Academy of Dermatology (AAD) in 2013-14. Since 2014, new FDA-approved treatment options such as dupilumab and crisaborole have changed the landscape of AD management, and future therapies such as JAK inhibitors and anti-interleukin 13 and 31 antibodies appear effective, emphasizing the need for a comprehensive review to give clinicians an updated toolbox to aid in pharmacologic management. AREAS COVERED: In this review, the authors explore the updated efficacy and safety data on established therapeutic options for AD including topical corticosteroids, topical calcineurin inhibitors, cyclosporine, azathioprine, methotrexate, and mycophenolate mofetil. In addition, the authors also explore trial data and studies on dupilumab, crisaborole, omalizumab, tofacitinib, ruxolinitib, abrocitinib, baricitinib, upadacitinib, delgocitinib, nemoliuzumab, and tralokinumab. EXPERT OPINION: The AAD guidelines must be updated in the future to include several new treatment modalities that have revolutionized the pharmacologic management of patients with AD, including dupilumab and crisaborole. The future of AD treatment is also extremely bright, as JAK inhibitors and Il-13/31 antibodies have shown convincing results in the improvement of AD patients' lives in various trials and studies that have been examined in this paper.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Topical corticosteroids and calcineurin inhibitors remain first-line treatments for atopic dermatitis, while topical JAK inhibitors provide targeted inhibition of cytokine signaling downstream of IL-4 and IL-13.
“Topical anti-inflammatory therapies, including corticosteroids and calcineurin inhibitors, remain first-line treatments, while topical JAK inhibitors provide targeted inhibition of cytokine signaling downstream of IL-4 and IL-13.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
In moderate-to-severe atopic dermatitis, systemic immunosuppressants such as cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil can be used, alongside oral JAK inhibitors that interfere with intracellular signaling pathways central to disease pathogenesis.
“In moderate-to-severe disease, systemic immunosuppressants can be used, such as cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil, alongside oral JAK inhibitors that interfere with intracellular signaling pathways central to disease pathogenesis.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
Emollients and ceramide-based moisturizers restore lipid composition, reduce transepidermal water loss, and limit allergen and microbial penetration.
“Management includes both barrier repair options and targeted immunomodulation, with emollients and ceramide-based moisturizers, which restore lipid composition, reduce transepidermal water loss, and limit allergen and microbial penetration.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
Treatment of atopic dermatitis targets epidermal barrier dysfunction and type 2 immune dysregulation.
“Treatment of atopic dermatitis targets the epidermal barrier dysfunction and type 2 immune dysregulation.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
Recent real-world evidence supports the effectiveness of JAK inhibitors in moderate-to-severe atopic dermatitis, particularly in patients with inadequate response to biologic therapies.
“Recent real-world evidence further supports the effectiveness of JAK inhibitors in moderate-to-severe atopic dermatitis, particularly in patients with inadequate response to biologic therapies [11,16,17,18,19].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
Emerging strategies for atopic dermatitis include microbiome modulation, neuroimmune pathway targeting, and biomarker-guided treatment selection.
“Emerging strategies include microbiome modulation, neuroimmune pathway targeting, and biomarker-guided treatment selection, reflecting an evolving precision medicine approach in atopic dermatitis.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
Biologic therapies targeting type 2 inflammation, including dupilumab, lebrikizumab, and tralokinumab, have shown significant efficacy in moderate-to-severe atopic dermatitis by inhibiting IL-4 and IL-13 signaling.
“Biologic therapies targeting type 2 inflammation, including dupilumab, lebrikizumab, and tralokinumab, have shown significant efficacy in moderate-to-severe atopic dermatitis by inhibiting IL-4 and IL-13 signaling [11,12,13,14,15].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
These atopic dermatitis therapies reduce inflammation and contribute to restoration of barrier function.
“These therapies reduce inflammation and contribute to the restoration of barrier function.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [11]
The citation lists haven’t been fetched yet
References 75 · Cited by 20
- Authors
- Sahni, V. N., Balogh, E. A., Strowd, L. C., & Feldman, S. R.
- Affiliations
- Drexel University (US)
- Wake Forest University Health Sciences (US)
- University of Southern Denmark (DK)
- Corresponding author
- Sahni, Vikram N.
- Venue
- Expert Opinion on Pharmacotherapy
- Publisher
- Informa UK Limited
- Published
- 2021-11-10
- Volume
- 23
- Issue
- 4
- Pages
- 517-526
- ISSN
- 1465-6566 (ISSN-L)
- 1744-7666
- OpenAlex
- W3214049954
- Semantic Scholar
- 456a8008efe86f7441d2d8b0775b730481999c33
- Cited by
- 20
- References
- 75
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 5
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Update notices
- correction (2022-01-05)
- Open access
- closed
- Locations
- Expert Opinion on Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Funders
- not funded
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- atopic dermatitis, dupilumab, crisaborole, JAK inhibitors, topical corticosteroids, calcineurin inhibitors, systemic immunosuppressive therapy, omalizumab, tofacitinib, abrocitinib, baricitinib, upadacitinib, delgocitinib, tralokinumab, treatment efficacy and safety
- MeSH terms
- Janus Kinase Inhibitors, Dermatitis, Atopic, Dermatologic Agents, Eczema, Humans, Cyclosporine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
