{
  "schemaVersion": 2,
  "eyebrow": "Dermatology",
  "title": "Atopic Dermatitis",
  "summary": "A severity- and site-directed approach to atopic dermatitis prioritizes topical anti-inflammatory treatment, proactive relapse prevention, and timely systemic escalation when disease remains uncontrolled, sleep-disrupting, or extensive despite optimized topical care.",
  "seoDescription": "Physician guide to atopic dermatitis assessment, topical treatment, proactive maintenance, and selection of systemic biologics or JAK inhibitors.",
  "clinicalQuestion": "How should clinicians assess atopic dermatitis severity and escalate topical or systemic treatment for persistent disease?",
  "specialty": "Dermatology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "atopic dermatitis",
    "eczema",
    "topical corticosteroids",
    "dupilumab",
    "JAK inhibitors",
    "EASI",
    "POEM"
  ],
  "keyTakeaways": [
    "Use a reproducible clinician measure such as EASI plus a patient-reported measure such as POEM when symptom burden and visible inflammation diverge; EASI and POEM correlate only moderately. [18][19]",
    "Topical corticosteroids remain first-line anti-inflammatory treatment; an acute flare regimen of mid- to high-potency treatment once daily for 2 to 4 weeks and proactive low- to medium-potency weekend treatment are described approaches. [22]",
    "Select nonsteroidal topical agents when corticosteroid toxicity is a concern, for sensitive sites, or when repeated treatment is needed; calcineurin inhibitors, PDE-4 inhibitors, and topical JAK inhibitors are alternatives. [16]",
    "For moderate-to-severe disease uncontrolled with optimized topical therapy, systemic choices include dupilumab and oral JAK inhibitors; high-dose upadacitinib has among the greatest short-term efficacy across multiple patient-important outcomes, whereas dupilumab and IL-13 biologics have intermediate effectiveness and favorable safety profiles. [23]",
    "Avoid routine systemic corticosteroids for chronic management; contemporary reviews describe systemic corticosteroids as generally discouraged because of safety concerns. [8]"
  ],
  "sections": [
    {
      "id": "assess-severity-and-treatment-failure",
      "eyebrow": "Initial decision",
      "heading": "Document inflammatory severity and patient burden before escalating therapy",
      "intro": "Treatment escalation should follow confirmation of persistent active dermatitis, not itch alone.",
      "paragraphs": [
        "At baseline and at treatment-change visits, document extent and signs with EASI when a clinician-assessed longitudinal metric is needed. EASI scores range from 0 to 72; values of 7 or less, 8 to 21, 22 to 50, and 51 to 72 correspond to mild, moderate, severe, and very severe disease, respectively. [20] Record a patient-reported outcome such as POEM when itch, sleep loss, or day-to-day burden is driving escalation, because EASI and POEM show only moderate correlation. [18][19]",
        "Interpret change relative to baseline rather than relying only on an absolute EASI change. In an observational study, one-grade improvement in physician global assessment was associated with approximately 50% EASI reduction, while percent EASI responses had similar interpretation across mild, moderate, and severe baseline disease. [17] A patient with limited visible eczema but high POEM may require reassessment for xerosis, sleep disruption, treatment tolerability, or an alternate contributor to symptoms rather than automatic systemic escalation. [18][19]",
        "Before declaring topical treatment failure, verify the diagnosis and distribution. The United Kingdom diagnostic criteria can support probable atopic dermatitis; discordant anatomy or timing should prompt consideration of contact dermatitis, acute viral exanthem, or immune deficiency-associated dermatoses. [19] Chronic dermatitis present from birth is not the expected pattern for immune deficiency-associated skin disease in the cited diagnostic framework. [19]"
      ],
      "bullets": [
        "Use EASI when objective severity or systemic-treatment response must be tracked over time. [20]",
        "Use POEM or PO-SCORAD to quantify patient-experienced burden in routine practice; these measures are less time-consuming than EASI or SCORAD. [19]",
        "Reassess diagnostic alternatives when morphology, distribution, or chronology is atypical for atopic dermatitis. [19]"
      ],
      "subsections": [],
      "table": {
        "caption": "Severity measures support different treatment decisions. [17][18][19][20]",
        "columns": [
          "Measure",
          "What it captures",
          "Decision use",
          "Actionable interpretation"
        ],
        "rows": [
          [
            "EASI",
            "Erythema, edema/papulation, excoriation, lichenification, and affected area; total score 0-72. [20]",
            "Objective baseline and response tracking.",
            "Scores 8-21 indicate moderate, 22-50 severe, and 51-72 very severe disease. [20]"
          ],
          [
            "POEM",
            "Patient-reported eczema burden. [19]",
            "Quantify itch- and sleep-related impact that may not parallel skin findings.",
            "Do not substitute low EASI for low burden; EASI and POEM correlate only moderately. [18]"
          ],
          [
            "SCORAD",
            "Clinical signs and extent plus subjective pruritus and sleep assessment. [19]",
            "Alternative comprehensive severity assessment.",
            "Less practical than patient-reported tools or EASI for many routine visits. [19]"
          ]
        ]
      }
    },
    {
      "id": "topical-induction-and-maintenance",
      "eyebrow": "Topical management",
      "heading": "Treat active lesions, then prevent relapse at recurrent sites",
      "intro": "Persistent disease often reflects inadequate anti-inflammatory intensity, duration, or maintenance rather than treatment resistance.",
      "paragraphs": [
        "Use topical corticosteroids as first-line anti-inflammatory therapy for flares and maintenance of mild-to-moderate atopic dermatitis. [22] One described flare strategy is a mid- to high-potency topical corticosteroid once daily for 2 to 4 weeks; treatment quantity can be estimated with fingertip units, where 1 fingertip unit is approximately 0.5 g and covers about two adult hand areas, or 2% body surface area. [22] Select potency according to lesion thickness, anatomic site, age, and anticipated duration, recognizing that guideline potency recommendations vary. [24]",
        "After control of recurrent disease, use proactive therapy rather than waiting for full relapse. A cited regimen uses low- to medium-potency topical corticosteroid once daily on weekends. [22] Guidelines reviewed in a Cochrane analysis generally recommended weekend proactive topical corticosteroid use, although the evidentiary support varied by region and guideline. [24]",
        "Monitor patients requiring prolonged or extensive high-potency topical corticosteroids for local toxicity, including atrophy, striae, rosacea, perioral dermatitis, acne, and purpura. [22] Systemic adverse effects are uncommon, but prolonged high-potency exposure can suppress the hypothalamic-pituitary-adrenal axis and produce Cushing syndrome manifestations. [22] Recurrent adverse effects or need for continuous high-potency therapy should trigger transition to a steroid-sparing topical agent and consideration of systemic disease control."
      ],
      "bullets": [
        "Acute flare: mid- to high-potency topical corticosteroid once daily for 2 to 4 weeks. [22]",
        "Maintenance of recurrent sites: low- to medium-potency topical corticosteroid once daily on weekends. [22]",
        "Escalate beyond a topical-only strategy when extensive disease, repeated flares, or major itch and sleep burden persist despite an adequate topical course. [19][23]"
      ],
      "subsections": [
        {
          "heading": "When to use nonsteroidal topical therapy",
          "paragraphs": [
            "Use a topical calcineurin inhibitor, PDE-4 inhibitor, or topical JAK inhibitor when repeated treatment of sensitive skin, corticosteroid adverse effects, or a need to reduce corticosteroid exposure makes a nonsteroidal agent preferable. [16] These therapies are alternatives rather than replacements for a severity-based anti-inflammatory plan; continued objective and patient-reported outcome assessment determines whether topical therapy is sufficient. [19]"
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Topical treatment choices and escalation triggers. [16][22][24]",
        "columns": [
          "Clinical situation",
          "Preferred topical strategy",
          "Important tradeoff or next step"
        ],
        "rows": [
          [
            "Active flare requiring anti-inflammatory control",
            "Mid- to high-potency topical corticosteroid once daily for 2-4 weeks. [22]",
            "Monitor local toxicity with recurrent or prolonged use. [22]"
          ],
          [
            "Previously involved sites with frequent recurrence",
            "Low- to medium-potency topical corticosteroid once daily on weekends. [22]",
            "Proactive treatment is intended to delay relapse. [22][24]"
          ],
          [
            "Need to limit corticosteroid exposure",
            "Topical calcineurin inhibitor, PDE-4 inhibitor, or topical JAK inhibitor. [16]",
            "Reassess disease control; persistent burden warrants systemic-treatment consideration. [19][23]"
          ],
          [
            "Continuous high-potency steroid need or poor control after an adequate regimen",
            "Reevaluate diagnosis, adherence, distribution, and severity measures. [19][22]",
            "Consider phototherapy or systemic treatment for moderate-to-severe disease. [21][23]"
          ]
        ]
      }
    },
    {
      "id": "systemic-treatment-selection",
      "eyebrow": "Escalation",
      "heading": "Choose systemic therapy by efficacy priority, safety profile, and treatment constraints",
      "intro": "Systemic treatment is appropriate for moderate-to-severe disease inadequately controlled with topical therapy.",
      "paragraphs": [
        "For refractory moderate-to-severe atopic dermatitis, systemic options include biologics, oral JAK inhibitors, phototherapy, and conventional immunosuppressive agents. [1][21][23] In a network meta-analysis of 149 randomized trials involving 28,686 patients with moderate-to-severe disease, high-dose upadacitinib was among the most effective therapies for five of six patient-important outcomes; high-dose abrocitinib and low-dose upadacitinib were among the most effective for two outcomes. [23] Oral JAK inhibitors are characterized as highly effective, rapid-onset treatments for moderate-to-severe atopic dermatitis. [10]",
        "Choose a biologic when a favorable comparative safety profile is prioritized over maximal short-term efficacy. Dupilumab, lebrikizumab, and tralokinumab were of intermediate effectiveness and among the safest systemic options in the network meta-analysis. [23] Dupilumab is FDA approved down to age 6 months; upadacitinib and abrocitinib are approved for patients 12 years and older, while tralokinumab is identified as an IL-13 antagonist option. [1][6]",
        "Abrocitinib is FDA indicated for adults and patients 12 years and older with refractory moderate-to-severe atopic dermatitis that is not adequately controlled with other systemic drug products, including biologics, or when those therapies are inadvisable. [1] When considering an oral JAK inhibitor, explicitly weigh the anticipated benefit of rapid, high-level disease control against class safety considerations and the need for medication-specific prescribing review; do not use systemic corticosteroids as routine long-term management, because they are generally discouraged for safety reasons. [8][10]"
      ],
      "bullets": [
        "Prioritize rapid, high-efficacy control: an oral JAK inhibitor may be appropriate after individualized risk assessment. [10][23]",
        "Prioritize comparative safety and established biologic use: consider dupilumab or an IL-13-targeted biologic. [6][23]",
        "Consider phototherapy or conventional systemic immunosuppression when targeted agents are unsuitable, unavailable, or contraindicated. [21]",
        "Avoid making chronic oral corticosteroids the maintenance plan. [8]"
      ],
      "subsections": [
        {
          "heading": "Where phototherapy and conventional immunosuppression fit",
          "paragraphs": [
            "Phototherapy and photochemotherapy, including psoralen-ultraviolet A, are treatment options for chronic severe atopic dermatitis. [21] Conventional systemic options listed for more severe dermatitis not responding to topical therapy include cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil. [21] Their role is most practical when targeted systemic treatment is unsuitable or inaccessible and when the monitoring burden is acceptable for the individual patient."
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Systemic-treatment selection for uncontrolled moderate-to-severe atopic dermatitis. [1][6][10][21][23]",
        "columns": [
          "Clinical priority",
          "Reasonable treatment direction",
          "Evidence-based discriminator"
        ],
        "rows": [
          [
            "Fast, high-level short-term disease control",
            "Oral JAK inhibitor.",
            "High-dose upadacitinib was among the most effective interventions for five of six patient-important outcomes; oral JAK inhibitors are rapid-onset therapies. [10][23]"
          ],
          [
            "Comparative safety emphasis",
            "Dupilumab, lebrikizumab, or tralokinumab.",
            "These biologics had intermediate effectiveness and were among the safest options in the network meta-analysis. [23]"
          ],
          [
            "Refractory disease in a patient aged 12 years or older after other systemic therapy is ineffective or inadvisable",
            "Abrocitinib, within its FDA-indicated population.",
            "FDA indication includes refractory moderate-to-severe disease not adequately controlled with other systemic drugs, including biologics, or when those therapies are inadvisable. [1]"
          ],
          [
            "Targeted therapy unsuitable or unavailable",
            "Phototherapy or conventional systemic immunosuppression.",
            "Phototherapy, cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil are recognized options for more severe disease. [21]"
          ]
        ]
      }
    },
    {
      "id": "monitor-response-and-change-course",
      "eyebrow": "Follow-up",
      "heading": "Use parallel objective and patient-reported response targets to change course",
      "intro": "Visible clearance and patient experience should both determine whether therapy is continued or changed.",
      "paragraphs": [
        "At each reassessment, compare EASI and a patient-reported burden measure with baseline. An EASI reduction of approximately 50% corresponded to one-grade improvement in physician global assessment in a prospective observational study. [17] If EASI improves while itch, sleep disturbance, or POEM remains high, investigate ongoing xerosis, excoriation, treatment adverse effects, and diagnostic overlap before labeling the systemic agent ineffective. [18][19]",
        "If objective inflammation and patient burden both remain substantial after an adequate topical regimen, move beyond repeated rescue topical corticosteroid cycles. For moderate-to-severe disease, compare systemic options using the patient’s required speed of relief, age eligibility, comparative safety priorities, and feasibility of phototherapy or conventional systemic treatment. [1][6][10][21][23] If control is achieved, continue relapse prevention at historically active sites rather than discontinuing all anti-inflammatory topical treatment solely because visible lesions have cleared. [22][24]"
      ],
      "bullets": [
        "Track EASI response from baseline; percent improvement is more comparable across baseline severity strata than absolute point change. [17]",
        "Track itch and sleep burden separately because clinical extent and patient-reported burden may diverge. [18][19]",
        "Change strategy when both inflammatory signs and patient burden persist despite an adequate treatment trial. [19][23]"
      ],
      "subsections": [],
      "table": {
        "caption": "Response patterns that should alter the next clinical step. [17][18][19][22][23][24]",
        "columns": [
          "Observed response",
          "Interpretation",
          "Next action"
        ],
        "rows": [
          [
            "EASI falls by about 50% with improved patient symptoms",
            "Magnitude consistent with approximately one-grade physician global improvement. [17]",
            "Continue effective therapy and use proactive topical maintenance at recurrent sites. [22][24]"
          ],
          [
            "EASI improves but POEM, itch, or sleep burden remains high",
            "Objective signs and patient experience may be discordant. [18][19]",
            "Assess xerosis, excoriation, adverse effects, and alternate contributors before changing systemic therapy. [18][19]"
          ],
          [
            "Persistent extensive inflammation and high burden after optimized topical treatment",
            "Topical-only management is inadequate for moderate-to-severe disease. [19][23]",
            "Select systemic therapy, phototherapy, or conventional immunosuppression according to efficacy and safety priorities. [21][23]"
          ],
          [
            "Repeated need for high-potency topical corticosteroid",
            "Risk of local adverse effects rises with prolonged exposure; systemic effects are possible with prolonged high-potency use. [22]",
            "Introduce steroid-sparing topical treatment and reassess need for systemic disease control. [16][22]"
          ]
        ]
      }
    }
  ],
  "faq": [],
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      "authors": "www.cell.com",
      "host": "www.cell.com",
      "snippet": "Gooderham, Emerging systemic JAK inhibitors in the treatment of atopic dermatitis: a review of abrocitinib, baricitinib, and upadacitinib",
      "score": 0.5951402
    },
    {
      "number": 5,
      "title": "Advances in the pathophysiology of atopic dermatitis revealed by novel therapeutics and clinical trials - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0163725821000322",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Atopic dermatitis (AD) is an inflammatory skin disease arising from a complex interplay of genetic, immune, and environmental factors. This review provides a brief overview of therapeutic biologics and small molecules for moderate-to-severe AD currently in development and undergoing clinical trials ",
      "score": 0.81133276
    },
    {
      "number": 6,
      "title": "Emerging Systemic Therapeutic Biologics and Small Molecules for Atopic Dermatitis: How to Decide Which Treatment Is Right for Your Patients",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S2213219821001756",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Most have involved systemic biologics inhibiting Th2 cell function and small molecules, particularly JAK inhibitors that block T-cell and dendritic cell activity in the skin.34 Numerous systematic reviews and commentaries discussing the outcomes of these trials have been published recently.35-44 Dup",
      "score": 0.79099923
    },
    {
      "number": 7,
      "title": "Topical and systemic corticosteroids in the modern Management of Atopic Eczema: A scoping review - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1567576926003218",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "### J. Am. Acad. Dermatol.\n\n### A comparison of topical corticosteroids and topical calcineurin inhibitors for the treatment of atopic dermatitis\n\n### J. Allergy Clin. Immunol. Pract.\n\n### Short-term efficacy and safety of biologics and Janus kinase inhibitors for patients with atopic dermatitis: a ",
      "score": 0.7703443
    },
    {
      "number": 8,
      "title": "Topical and systemic corticosteroids in the modern Management of Atopic Eczema: A scoping review",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S1567576926003218",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "## Abstract\n\n### Background\n\nTopical corticosteroids remain first-line therapy for atopic eczema, while systemic corticosteroids are generally discouraged because of safety concerns. The emergence of biologics and Janus kinase (JAK) inhibitors has substantially altered the therapeutic landscape, nec",
      "score": 0.7482976
    },
    {
      "number": 9,
      "title": "How we treat atopic dermatitis now and how that will change over ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bjd/advance-article-pdf/doi/10.1093/bjd/ljac116/51919009/ljac116.pdf",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Global Guidelines in Dermatology Mapping Project (GUIDEMAP), a systematic review of atopic dermatitis clinical practice guidelines: are they.",
      "score": 0.60358196
    },
    {
      "number": 10,
      "title": "practical guide to using oral Janus kinase inhibitors for atopic ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/bjd/article/192/1/135/7754126",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Oral JAK inhibitors (JAKi) are highly effective, fast-onset medications used to treat moderate-to-severe atopic dermatitis (AD).",
      "score": 0.5683445
    },
    {
      "number": 11,
      "title": "Add-on treatments in patients with atopic dermatitis with incomplete ...",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/ced/advance-article/doi/10.1093/ced/llag062/8651691",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "Add-on treatments in patients with atopic dermatitis with incomplete response to biologic agents or systemic Janus kinase inhibitors: a review.",
      "score": 0.5402697
    },
    {
      "number": 12,
      "title": "Oral Janus Kinase Inhibitors in the Treatment of Atopic Dermatitis",
      "detail": "academic.oup.com",
      "url": "https://academic.oup.com/skinhd/article/3/1/ski2.133/7755664",
      "authors": "academic.oup.com",
      "host": "academic.oup.com",
      "snippet": "JAK inhibitors were found to be an effective treatment for AD. Upadacitinib, at 30 mg, was found to be the most efficacious oral JAK inhibitor for AD. More",
      "score": 0.51442534
    },
    {
      "number": 13,
      "title": "Assessing the current treatment of atopic dermatitis: Unmet needs - Journal of Allergy and Clinical Immunology",
      "detail": "www.jacionline.org",
      "url": "https://www.jacionline.org/article/S0091-6749(17)30150-1/fulltext",
      "authors": "www.jacionline.org",
      "host": "www.jacionline.org",
      "snippet": "Atopic dermatitis (AD) is a complex, chronic, inflammatory, pruritic skin disease managed by allergists and dermatologists. **Clinical phenotypes and endophenotypes of atopic dermatitis: where are we and where should we go?**. **Clinical phenotypes and endophenotypes of atopic dermatitis: where are ",
      "score": 0.7923522
    },
    {
      "number": 14,
      "title": "A Comparison of Topical Corticosteroids and Topical Calcineurin Inhibitors for the Treatment of Atopic Dermatitis - The Journal of Allergy and Clinical Immunology: In Practice",
      "detail": "www.jaci-inpractice.org",
      "url": "https://www.jaci-inpractice.org/article/S2213-2198(23)00356-2/pdf",
      "authors": "www.jaci-inpractice.org",
      "host": "www.jaci-inpractice.org",
      "snippet": "A Comparison of Topical Corticosteroids and Topical Calcineurin Inhibitors for the Treatment of Atopic Dermatitis00306-9/fulltext \"A Comparison of Topical Corticosteroids and Topical Calcineurin Inhibitors for the Treatment of Atopic Dermatitis\"). * A Comparison of Topical Corticosteroids and Topica",
      "score": 0.7316155
    },
    {
      "number": 15,
      "title": "A Systematic Review of the Efficacy and Safety of Probiotics in Topical Treatment of Atopic Dermatitis - Journal of Allergy and Clinical Immunology",
      "detail": "www.jacionline.org",
      "url": "https://www.jacionline.org/article/S0091-6749(19)31979-7/fulltext",
      "authors": "www.jacionline.org",
      "host": "www.jacionline.org",
      "snippet": "# A Systematic Review of the Efficacy and Safety of Probiotics in Topical Treatment of Atopic Dermatitis. * Topical treatments for atopic dermatitis (eczema): Systematic review and network meta-analysis of randomized trials01113-2/fulltext \"Topical treatments for atopic dermatitis (eczema): Systemat",
      "score": 0.59655124
    },
    {
      "number": 16,
      "title": "Atopic Dermatitis Part 2: Management | Pediatrics In Review",
      "detail": "publications.aap.org",
      "url": "https://publications.aap.org/pediatricsinreview/article/46/8/425/202963/Atopic-Dermatitis-Part-2-Management",
      "authors": "publications.aap.org",
      "host": "publications.aap.org",
      "snippet": "Effective alternative topical treatments include calcineurin inhibitors, phosphodiesterase-4 inhibitors, and Janus kinase inhibitors (JAKI).",
      "score": 0.5550741
    },
    {
      "number": 17,
      "title": "What are the best endpoints for Eczema Area and Severity Index and Scoring Atopic Dermatitis in clinical practice? A prospective observational study",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7862410",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "One-grade improvements of Physician’s Global Assessment (PGA) and Validated Investigator’s Global Assessment of AD (vIGA-AD) were associated with 50%, 35%, and 35% decreases of EASI, SCORAD and objective-SCORAD, respectively. The thresholds for % MIC of EASI (Kruskal-Wallis test, P=0.61), SCORAD (P=",
      "score": 0.7187726
    },
    {
      "number": 18,
      "title": "Relationship between EASI and SCORAD severity assessments for atopic dermatitis",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5723207",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "EASI and oSCORAD were strongly correlated with each other (rho=0.92; P<0.0001), but only moderately with POEM (rho=0.46 and 0.44; P<0.0001). There were non-linear relationships of EASI with SCORAD (r 2 linear=0.73, r 2 nonlinear=0.85) (Figure 1A), oSCORAD (r 2 linear=0.78, r 2 nonlinear=0.87) (Figur",
      "score": 0.6994397
    },
    {
      "number": 19,
      "title": "Update on Atopic Dermatitis: Diagnosis, Severity Assessment, and Treatment Selection",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7395647",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "##  injections with dupilumab (300 mg) once weekly, placebo once weekly, or dupilumab (300 mg) alternating every other week with placebo. Patients did not routinely use TCS during the trial, but if they required rescue TCS, they were allowed to continue participating. The primary outcome was a score",
      "score": 0.6786044
    },
    {
      "number": 20,
      "title": "Atopic dermatitis: diagnosis, molecular pathogenesis, and therapeutics",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12497682",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "The severity of AD can be quantified using several scoring systems, including the eczema area and severity index (EASI) and the SCORing AD (SCORAD) scale. The EASI scale evaluates the severity of skin lesions based on erythema, edema/infiltration/papulation, scaling, and lichenification, and assesse",
      "score": 0.67321366
    },
    {
      "number": 21,
      "title": "national institute for health and care excellence",
      "detail": "www.nice.org.uk",
      "url": "https://www.nice.org.uk/guidance/gid-ta10596/documents/final-scope",
      "authors": "www.nice.org.uk",
      "host": "www.nice.org.uk",
      "snippet": "to potent topical corticosteroids (TA177). People with moderate or severe dermatitis not responding to topical treatments may be referred to secondary care and treated with stronger oral medications such as oral steroids, systemic immunosuppressants (azathioprine, ciclosporin, mycophenolate mofetil,",
      "score": 0.6366926
    },
    {
      "number": 22,
      "title": "Atopic Dermatitis: A Review of Diagnosis and Treatment - PMC",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11627575",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "| Corticosteroids | The anti-inflammatory effects of corticosteroids include vasoconstriction, decreased production of prostaglandins and leukotrienes (via inhibition of phospholipase A2), decreased expression of proinflammatory genes, and increased expression of anti-inflammatory genes. Corticoster",
      "score": 0.6208291
    },
    {
      "number": 23,
      "title": "Systemic treatments for atopic dermatitis (eczema): Systematic review and network meta-analysis of randomized trials - PubMed",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "http://www.ncbi.nlm.nih.gov/pubmed/37678577",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "An official website of the United States government. Federal government websites often end in .gov or .mil. official website and that any information you provide is encrypted. ## Save citation to file. ### Add to Collections. ### Add to My Bibliography. ## Create a file for external citation managem",
      "score": 0.57837737
    },
    {
      "number": 24,
      "title": "Strategies for using topical corticosteroids in children and adults with ...",
      "detail": "www.cochranelibrary.com",
      "url": "https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013356.pub2/full",
      "authors": "www.cochranelibrary.com",
      "host": "www.cochranelibrary.com",
      "snippet": "Eight trials looked for local adverse events (Berth‐Jones 2003:1367. GlazenburgE , Graham-BrownR , HanifinJ , Berth-JonesJ , Van der MeerJ .Intermittent dosing with topical fluticasone propionate delays the time to relapse in adults and children with chronic atopic dermatitis - two randomised contro",
      "score": 0.5573882
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  ],
  "publishedAt": "2026-09-15T23:14:49.021590+00:00",
  "updatedAt": "2026-09-15T23:14:49.021590+00:00",
  "readingMinutes": 6,
  "slug": "atopic-dermatitis"
}