Atopic dermatitis

ABSTRACT: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that commonly begins in childhood and can persist or first appear in adulthood. Its burden reflects pruritus, sleep loss, pain, infection, psychosocial effects, and treatment demands rather than visible extent alone. Diagnosis is clinical and requires recognition of age- and skin tone-specific morphology and exclusion of mimics. AD management begins with moisturization, gentle bathing, topical anti-inflammatory therapy, education, and proactive maintenance. Newer nonsteroidal topical agents and targeted systemic therapies have expanded options, but treatment should be individualized according to age, disease severity and control, comorbidities, safety, access, and patient preference. Routine elimination diets, topical antimicrobials for uninfected disease, antihistamines as primary antipruritic therapy, and systemic corticosteroids are generally not recommended for AD. This review provides physician associates with a practical approach to diagnosis, severity assessment, stepwise treatment, complication recognition, and timely referral.