Atopic Dermatitis (AD) Across Ages: Identifying and Treating Flares in Children and Adults

Now Viewing

EP: 1.Atopic Dermatitis (AD) Across Ages: Identifying and Treating Flares in Children and Adults

EP: 2.Streamlining Atopic Dermatitis (AD) Diagnosis and Treatment in Primary Care

EP: 3.Choosing the Right Topical Therapy for Patients With Atopic Dermatitis (AD): Balancing Risk and Efficacy

EP: 4.Treating Atopic Dermatitis (AD) With Topical PDE4 Inhibitors

EP: 5.Other Topical Options to Treat Atopic Dermatitis (AD): Topical JAK Inhibitors and AhR Agonists

EP: 6.Factors that Impact Therapy Decisions for Atopic Dermatitis (AD)

EP: 7.Collaborating for Better Atopic Dermatitis (AD) Care: How Primary Care and Dermatology Can Work Together

EP: 8.Summarizing Topical Options: Treating Atopic Dermatitis (AD) Across Every Age

EP: 9.Closing Thoughts with Patient Cases: Disease Control With Modern Therapies

Atopic Dermatitis (AD) Across Ages: Identifying and Treating Flares in Children and Adults

Clinical Presentation

• AD manifests differently across age groups: infantile (2-24 months), childhood (2-12 years), adolescent/adult (>12 years)
• Key features: intense pruritus, erythema, exudation, scaling, lichenification
• Distribution patterns vary by age: face/trunk in infants, flexural areas in children, hands/neck/eyelids in adults

Flare Identification

• Characterized by acute worsening of pruritus, erythema, vesiculation with weeping/oozing
• Common triggers: irritants, allergens, stress, infections, climate changes
• Early identification critical for prompt intervention

Treatment Strategies

First-Line Therapy: Optimize skin hydration, repair barrier function

• Regular emollient use (ceramide-containing preferred)
• Gentle cleansers, lukewarm water, immediate moisturization after bathing

Anti-inflammatory Treatments:

• Topical corticosteroids (TCS): Choose potency based on severity, location, patient age
• Topical calcineurin inhibitors (TCIs): Steroid-sparing, suitable for sensitive areas
• Phosphodiesterase-4 inhibitors: Newer options with favorable safety profiles

Severe/Recalcitrant Cases:

• Phototherapy (narrowband UVB, UVA1)
• Systemic immunosuppressants (cyclosporine, methotrexate, azathioprine)
• Biologics (dupilumab, tralokinumab) for moderate-to-severe disease

Age-Specific Considerations

Pediatric Patients:

• Lower potency TCS, careful monitoring for systemic absorption
• Special attention to infection risk, particularly eczema herpeticum
• Educational support for parents/caregivers on proper application techniques

Adult Patients:

• Extended maintenance therapy often required
• Occupational considerations (hand dermatitis)
• Comorbidity management (anxiety, depression, sleep disturbance)

Preventive Strategies

• Trigger avoidance: customized plans based on identified triggers
• Proactive therapy: intermittent use of anti-inflammatories on previously affected sites
• Patient education: comprehensive self-management, recognizing early signs of flares

Follow-up Care

• Regular assessment of disease control, treatment adherence
• Adjustment of treatment regimens based on response
• Multidisciplinary approach for cases with significant psychosocial impact