Children are being affected by chronic skin diseases, and atopic dermatitis is a very common one. Its diagnosis has been rising, being about 10 to 20% of the pediatric population in Europe and affecting up to 20% of children worldwide. Despite not being a life-threatening condition is an important topic to address, because it can significantly lower people’s quality of life, beyond the fact that one third of patients carry the disease into adulthood.
Atopic dermatitis is a multifactorial disease, being the result of the combination of genetic, immunologic, and environmental factors, infections causing dysfunctions of the skin barrier, and inflammation. The main symptoms of atopic dermatitis include pruritus, skin dryness and other skin lesions and it can be controlled for most of the patients with topical therapy and skin care.
The topical therapy depends on the patient’s adherence and to achieve maximum effect is necessary to individualize the treatment to the patient’s needs, for example, the skin condition.
However, there are some cases where is difficult to control the disease. These patients with severe atopic dermatitis are mainly those with generalized skin lesions and long and continuous disease course. In this case, systemic therapy must be considered, in other words, treatments using substances that travel through the bloodstream. These therapies have potential to manage the disease, however, besides cyclosporine, approved in some European countries, none of the other systemic therapies are currently approved.
Cyclosporine can be sufficient in short-term therapies but patients with severe atopic dermatitis might require long-term therapy, with an individually adjusted maintenance dose at lowest levels controlling the disease. Cyclosporine should not be combined with phototherapy because of an increased risk for skin cancer.
Despite the availability of cyclosporine, the scientific community and the affected patients are expecting new developments for this disease. There is a clear medical need that should be addressed in the future by the pharmaceutical industry.
Beyond systemic therapies, new approaches are being developed, which target the pathways involved in the pathogenesis of atopic dermatitis, which may be more effective than systemic therapy. These agents modify or block a specific cellular signal or a pro-inflammatory pathway.
To sum up, this disease has been rising in the world, but there have not been a lot of studies regarding it, being necessary more research regarding the topic.