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Abstract
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, affecting 10 – 20% of children and 2% of adults worldwide. Preventive treatment of AD consists of daily skin hydration and emollient therapy; but the majority of patients still require symptomatic treatment with topical corticosteroids and/or topical calcineurin inhibitors, both of which may be associated with potential long-term side effects. With increasing evidence supporting the role of skin barrier defects in the pathogenesis of AD, there is also a parallel increase in medications that claim to assist barrier repair. The current review discusses some exciting results with these medications, as well as the challenges that lie ahead of them. While barrier repair treatments offer some promise, there continues to be a need for safer anti-inflammatory medications. Some of these medications under investigation are phosphodiesterase-4 inhibitors, urocanic acid oxidation products and IL-4/IL-13 receptor blockers. The review also discusses anti-staphylococcal treatments including nanocrystalline silver cream, silver- and antimicrobial-coated fabrics, and anti-itch treatments including μ-opiod receptor antagonists, chymase inhibitors and cannabinoid receptor agonists. These medications may become an integral part of AD therapy.
Acknowledgements
The author is supported in part by a grant from the Children's Hospital Los Angeles GCRC with funds provided by the National Center for Research Resources (NCRR), NIH (MO1 RR00046); the Saban Research Institute Clinical Research Award (5-MOI RR00004346); and a CReFF award from GCRC, National Center for Research Resources at the USC (MO1 RR00043). I thank Dr. Joseph Church for his support of the Atopic Dermatitis Program.