Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease that usually starts in early infancy, but also affects a substantial number of adults, also known as atopic eczema. It is commonly associated with elevated levels of immunoglobulin E (IgE). It may be accompanies by asthma or hay fever. It commonly occurs on the eyelids and gives sign such as dennie-morganinfraorbital fold, infra-auricular fissure and periorbital pigmentation. Some other names of AD are infantile eczema, flexural eczema, prurigoBesnier, allergic eczema, and neurodermatitis.
Main symptom of AD is incessant pruritus. Some other signs and symptoms of AD are dry skin, red to brownish-gray colored patches, itching, small-raised bumps, raw-sensitive-swollen skin from scratching and thickened-cracked-scaly skin etc. there are some risk factors are family history of eczema, hay fever, allergies and asthma.
According to study, “Atopic Dermatitis (Atopic Eczema) – Pipeline Review, H2 2018” some of the major companies that are currently working in the atopic dermatitis are AbbVieInc, Abeome Corp, Accolade Pharmaceuticals LLC, Aclaris Therapeutics Inc, Allergan Plc, Almirall SA, Amgen Inc, Amor pacific Corp, Anaptys Bionic, AntibioTx AS, Asana BioSciences LLC, Aslan Pharmaceuticals Pte Ltd, Bausch Health Companies Inc, Bioleaders Corp, Blueberry Therapeutics Ltd, Celgene Corp, Chiron Wells GmbH, Chugai Pharmaceutical Co Ltd, ClevexelPharma SAS, Cutanea Life Sciences Inc, DermalaInc, DURECT Corp, Eli Lilly and Co, Evelo Biosciences Inc, Evotec AG, F. Hoffmann-La Roche Ltd, Fountain BiopharmaInc, Galapagos NV, Galderma SA, Galectin Therapeutics Inc, GlaxoSmithKline Plc, Glenmark Pharmaceuticals Ltd, Golden Biotechnology Corp, Han WhaPharma Co Ltd, Heptares Therapeutics Ltd, iCo Therapeutics Inc, and Immune Pharmaceuticals Inc, Incyte Corp.
Some features of diagnosis of AD are xerosis, IGE reactivity and early age of onset etc. Additionally, some associated features are ocular/periorbital changes, atypical vascular responses, keratosis pillaris and perifollicular accentuation etc. In diagnosis, there are some conditions are included that should be excluded such as scabies, ichthyoses, psoriasis, immune deficiency disease, cutaneous T-cell lymphoma, contact dermatitis and photosensitivity dermatoses etc. Some complications of AD are viral, sleep disturbance, food allergy, irritant reaction and bacterial etc.
There are some treatments are used for AD, which are; ultraviolet-A, ultraviolet-B, methotrexate, azathioprine, probiotics, Celestone vial, olux foam, betamethasone valerate foam, cortef, hydrocortisone, olux-E foam, antibiotics, everolimus and intranasal mupirocin ointment & diluted bleach baths etc. some agents are used to treat AD such as moisturizers, topical steroids and broad immunomodulators etc. Some non-medical measures are using soft clothing, maintaining mild temperatures, washing clothes in a mild detergent and using a humidifier in both winter and summer.
There are some therapies are also used to treatment of AD, which are dupilumab, cyclosporine, methotrexate, azathioprine and biologics etc. Dupilumab is a monoclonal antibody that inhibits IL-4 and IL-3 signaling by blocking the shared IL-4Ra: it is administered as a subcutaneous injection every two weeks and may be used with or without topical corticosteroids.
In recent years, there has been a growing movement towards the use of targeted therapies in treating AD. Currently many mechanistic actions are used for AD such as phosphodiesterase-4 inhibitors, boron molecules, Janus kinase inhibitors, cannabinoid receptors agonists, kappa-opioid receptor agonists. In 2017, dupixent was the first biologic to be launched for management of AD. The future of biologic treatment for AD may be quite diverse. In upcoming years, through extensive clinical trials will allow for more information about these targeted therapies and their potential place in the treatment algorithm of AD. Due to the success of such therapies in treating a spectrum of chronic inflammatory diseases, it is expected that the successful development of targeted therapies for AD lies ahead.
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