ATOPIC DERMATITIS: ADVANCES IN PATHOPHYSIOLOGY AND NEW IMMUNOLOGICAL THERAPIES.

Atopic dermatitis is a chronic inflammatory skin disease with high global prevalence, characterized by persistent itching, skin barrier dysfunction, and a high burden on quality of life.Over the last decade, it has been established as a systemic disorder mediated by the type 2 immune response, involving key cytokines such as IL-4, IL-13, IL-31, and TSLP, as well as epigenetic factors, skin dysbiosis, and neuroimmunological mechanisms.These pathophysiological advances have enabled the development of targeted immunological therapies, including monoclonal antibodies such as dupilumab, tralokinumab, lebrikizumab, and nemolizumab, as well as JAK inhibitors (baricitinib, upadacitinib, abrocitinib), which have demonstrated superior clinical efficacy to conventional treatments and significant improvement in itch control.This article reviews the main advances in understanding the pathophysiology of atopic dermatitis and analyzes the impact of new immunological therapies.It concludes that the implementation of these treatments requires not only evidence of efficacy and safety, but also strategies for equitable access and sustainability in health systems, as well as the incorporation of biomarkers that allow for a personalized medicine approach.