Approach to topical treatment of mild-to-moderate atopic dermatitis: A physician assistant perspective

Atopic dermatitis (AD) is an inflammatory, intensely pruritic skin disease that can significantly reduce patients’ quality of life. Epidermal barrier dysfunction and aberrant inflammation contribute to AD pathogenesis, which is exacerbated by scratching the skin. Moisturizers and topical pharmacotherapies are the mainstay of treatment. Optimal therapy should aim to reduce local inflammation and itch as well as repair the damaged skin and break the itch-scratch cycle. Mechanisms and formulations of topical therapies for AD have recently expanded, representing a growing need to continuously evaluate the current treatment landscape from the point of view of an advanced practice provider. This article identifies therapeutic targets for topical AD-directed therapy, goals of treatment, and the approach to management of mild-to-moderate AD. A summary of key information for patients is included as a supplementary patient handout (Supplemental Digital Content, http://links.lww.com/JDP/A1).