Childhood atopic dermatitis: current developments, treatment approaches, and future expectations

Abstract

Atopic dermatitis (AD) is the most common chronic inflammatory skin disorder of childhood. Underlying factors thatcontribute to AD are impaired epithelial barrier, alterations in the lipid composition of the skin, immunological imbalance includingincreased Th2/Th1 ratio, proinflammatory cytokines, decreased T regulatory cells, genetic mutations, and epigenetic alterations. Atopicdermatitis is a multifactorial disease with a particularly complicated pathophysiology. Discoveries to date may be considered the tip ofthe iceberg, and the increasing number of studies in this field indicate that there are many points to be elucidated in AD pathophysiology.In this review, we aimed to illustrate the current understanding of the underlying pathogenic mechanisms in AD, to evaluate availabletreatment options with a focus on recently discovered therapeutic agents, and to determine the personal, familial, and economic burdensof the disease, which are frequently neglected issues in AD. Currently available therapies only provide transient solutions and cannotfully cure the disease. However, advances in the understanding of the pathogenic mechanisms of the disease have led to the productionof new treatment options, while ongoing drug trials also have had promising results.