April W. Armstrong, MD, MPH

Panelists discuss how recent clinical trials like ADmirable and DISCOVER intentionally enrolled patients with skin of color (Fitzpatrick types IV-VI), demonstrating similar efficacy and safety profiles for biologics across diverse racial populations, with more than 70% achieving a 75% or greater improvement in the Eczema Area and Severity Index (EASI-75).

Panelists discuss how historical underrepresentation of patients with darker skin tones in clinical trials has limited understanding of treatment efficacy and safety across diverse populations, hampering real-world clinical decision-making.

Panelists discuss how health care providers need coordinated multidisciplinary care teams, visual resources like databases for eczema in skin of color, peer-to-peer educational sessions, and case-based learning to better recognize and manage atopic dermatitis (AD) across diverse skin tones.

Panelists discuss how treatment access challenges require provider advocacy through peer-to-peer reviews and patient assistance programs, whereas cost-effectiveness evaluation focuses on time to specialist care, therapy duration, and quality-of-life outcomes.

Panelists discuss how biologic therapy selection depends on disease burden rather than just body surface area (BSA), with monitoring requiring objective measures, patient-reported outcomes, and specialized photography documentation for patients with darker skin tones.

Panelists discuss how patients with darker skin tones often experience delayed diagnosis due to misidentification as fungal infections or other conditions, emphasizing the importance of shared decision-making and patient education about the immune-mediated nature of the disease.

Panelists discuss how atopic dermatitis (AD) presents differently across skin tones, appearing as purple, gray, or barely visible inflammation rather than classic redness, with perifollicular prominence and postinflammatory pigmentation changes being more prominent in patients with darker skin.

Panelists discuss how atopic dermatitis (AD) extends far beyond pruritus to include pain, sleep disturbances, psychosocial stigma, and quality-of-life impacts that affect patients’ work, school, and daily functioning regardless of disease severity.

Panelists discuss how health care professionals face educational gaps in understanding atopic dermatitis (AD) immunopathogenesis, with advanced practice providers (APPS) particularly needing additional training outside standard curricula to master biologic therapy selection.

Panelists discuss how atopic dermatitis involves complex inflammatory and neuronal pathways, with IL-4, IL-13, and IL-31 cytokines driving Th2-mediated inflammation that varies across different racial populations.

This review describes the impact of nonmedical switching of biologic therapies on US patients and providers, with a focus on switching to in-class alternatives.