A review of biological agents and small molecules in the management of atopic dermatitis

Abstract

Atopic dermatitis (AD) is a recurrent, chronic, and non-infectious inflammatory dermatoses characterized by persistent itching of the skin. It has multifactorial causes characterized by a tetrad of a (i) genetic predisposition, (ii) disturbed epidermal barrier, (iii) immune dysregulation, and (iv) deranged skin microbiome. At present, treatment is aimed at maintaining the epidermal barrier function by the use of emollients, sedative, and non-sedative antihistamines targeting the itch pathway, immunosuppressants in the form of steroids as well as steroid sparing agents to control the chronic persistent inflammatory response. However, newer emerging therapy in the form of biologics gives a promising approach to control the chronic, persistent inflammatory response by targeting the specific cytokines involved in pathogenesis of AD.