Diagnosis and treatment of atopic dermatitis

Abstract Atopic dermatitis (AD) is a chronic, inflammatory skin disease that affects both children and adults. It is characterized by persistent itching, redness and inflammation of the skin. The mechanisms underlying AD are intricate and include immune system dysfunction, genetic factors, skin microbiome dysfunction and skin barrier damage. The diagnosis of AD is mainly based on the Hanifin and Rajka criteria but there are also simplified and more practical guidelines developed by a team of specialists – the UK Working Party. There is a wide range of diagnostic scales elucidating the severity of AD and the treatment effectiveness, including: SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI) and Investigator’s Global Assessment (IGA). The treatment of AD involves standard local treatment, such as emollients, glucocorticosteroids and calcineurin inhibitors, but also systemic treatment, phototherapy, as well as innovative biological therapies. Biological treatments are mainly based on monoclonal antibodies, PDE-4 inhibitors and Janus kinase (JAK) inhibitors. Monoclonal antibodies are highly effective in controlling moderate and severe AD by acting on key pro-inflammatory cytokines. JAK kinase inhibitors are also gaining an interest because they constitute an effective alternative to classic immunosuppressive drugs. Novel treatment methods play a crucial role in enhancing the AD patients’ quality of life and reducing disease relapses. This systematic review confirmed that biological drugs are characterized by a favorable safety profile and high effectiveness. Therefore, they can be a potential alternative to standard systemic therapies in the treatment of severe and moderate AD. The available clinical trials indicate the need for searching for novel drugs and conducting research comparing available therapeutic methods.