Rethinking Pediatric Atopic Dermatitis: Impacts and Intervention

Announcer:
This is DermConsult on ReachMD. On this episode, we’ll hear from Dr. Nicole Harter, who’s an Associate Professor in the Department of Dermatology and the Pediatric Dermatology Fellowship Program Director at University of Nebraska Medical Center in Omaha. She’ll be discussing our evolving knowledge of pediatric atopic dermatitis.

Here’s Dr. Harter now.

Dr. Harter:
So our understanding of atopic dermatitis, or AD, has really changed in the sense that we—and this is truly more recent data, even in the past several years—we understand that this is not a skin-limited disease. It involves systemic inflammation. It’s not an autoimmune disease, but we know there’s an increased type of allergic inflammation in patients, especially young pediatric patients, with atopic dermatitis, and they are at greater risk for things like asthma, seasonal allergies, and food allergies, and that these things evolve over time. And usually, atopic dermatitis is the first one of this cohort of what we call atopic diseases—or atopic triad or tetrad—to develop. And if we treat the symptoms of atopic dermatitis early and aggressively, theoretically, we’re getting new data that we may actually reduce the incidence of patients developing these other types of diseases later on in life, and also that we know that if we don’t treat atopic dermatitis aggressively early in life, there’s a lot of comorbidities that go along with prolonged chronic atopic dermatitis. So  children are scratching. They’re up all night, so they’re not sleeping well. They’re not getting good rest. Could this impact learning? Could this impact growth and development in other ways?

We know that there’s a lot of psychosocial comorbidities that go along with it, meaning children that have chronic atopic dermatitis, chronic skin disease, struggle with the fact that their disease is on their skin for other people to see, and also, again, just the constant disruption of their daily life because they’re scratching; they can’t attend to their play, to their school, or to their activities, and they feel constantly distressed by it. So there’s many, many reasons that we need to target treatment early and aggressively because it’s not something we expect that at a certain age, it just turns off. It naturally improves over time in the vast majority of patients. That’s a very slow improvement over many years, and there’s no need for children to suffer while we wait for it to get better. We can treat it effectively and safely early on and, hopefully, prevent some comorbidities and other diseases that go along with AD.

Announcer:
That was Dr. Nicole Harter talking about how our understanding of pediatric atopic dermatitis has advanced. To access this and other episodes in our series, visit  DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!