Newer Treatments, Treatment Selection, Pipeline Therapies, and Personalized Medicine in Atopic Dermatitis: Where Are We Now?

Atopic dermatitis (AD) is a common, genetically influenced, inflammatory skin disorder affecting children, adolescents, and adults, is markedly pruritic, and has a complex pathophysiology. The disease course is prolonged, characterized by periods of marked flaring that are separated by periods of relative remission. More recent advances in understanding the pathophysiology of AD have led to more targeted therapies, especially injectable monoclonal antibodies and Janus kinase inhibitors, although many compounds continue to be studied that are associated with a wide variety of suggested modes of action. This chapter walks the reader through the thought process regarding management of chronic and persistent atopic dermatitis. The chapter also addresses the pipeline of potential new agents, advances in understanding phenotypes and endotypes of AD, biomarkers that may assist in management and/or optimize treatment selection, and the progressive development of personalized medicine.