The recurrent course of atopic dermatitis: therapeutic options for management of disease and prolongation of remissions

Abstract

Atopic dermatitis is a common inflammatory skin disease, which is most frequently occurred in children. The disease is characterized as chronic, but only 20% of children have severe atopic dermatitis, while the other 80% achieve a long-term remission by the age of 8. The article summarizes the main details about atopic dermatitis, including statistical epidemiological data, signs of a severe course of atopic dermatitis, criteria for determining the severity of the disease and the main aspects of a stepwise approach to the therapy. The authors paid special attention to the factors worsening the course of atopic dermatitis: the role of allergens and provoking factors, secondary infection, drug hypersensitivity, concomitant diseases, breach of dermatologist’s prescriptions. Despite the large arsenal of modern therapeutic methods, the therapy of a long, persistent course of atopic dermatitis may not produce a proper effect, and this is the reason why the disease acquires a torpid course. Such clinical cases call for finding new therapeutic methods, in particular the use of Janus kinase inhibitors. In the article, the authors described a clinical case: a 17-year-old patient K. complained of widespread rashes on the skin of the trunk accompanied by intense itching; the patient had been suffering from atopic dermatitis since early childhood, the skin process had a recurrent character with alternating periods of remissions and exacerbations about 2 times a year. The case describes the successful use of Janus kinase inhibitor that was capable to reduce the signaling of many cytokines that contribute to the development of signs and symptoms of the disease, in a patient with severe relapsing atopic dermatitis, who showed insufficient efficacy of therapy with standard methods.