Dr Jonathan Silverberg Discusses What Future Research on AD in Children Should Include

Now that racial and ethnic disparities of atopic dermatitis prevalence among children have been confirmed, the next step in research will be to discover the reasons why those disparities exist, said Jonathan Silverberg, MD, PhD, MPH.

Now that racial and ethnic disparities of atopic dermatitis prevalence among children have been confirmed, the next step in research will be to discover the reasons why those disparities exist, said Jonathan Silverberg, MD, PhD, MPH.

Transcript:

What should physicians keep in mind when making decisions on treatments to prescribe to children with atopic dermatitis?

It's a very broad question to think about what are the different treatment considerations. There's many different aspects that come into play. I think first and foremost is properly recognizing the more severe patients and when therapy needs to be stepped up to something stronger. That is a very important conversation, particularly in skin of color, because if one is looking for shades of pinks and reds, as a clinician, you're going to miss the appropriate patients, you're going to underappreciate the severity in diverse patient populations, and you're going to have poor patient outcomes because of that. So, some of that is really just being able to properly recognize and stratify the risk of patients.

Once that's done, we need to really understand what the best practices in terms of therapy are and how to optimize topical therapy use. When is it appropriate to use systemic and biologic [agents] in patients, because there is a subset in the pediatric population that need those too? [We need to know] who those patients are, really make sure we are properly identifying them, and neither overcall nor undercall in clinical practice.

What should future research on atopic dermatitis in children focus on?

I think future research is certainly warranted. I think, we need more confirmatory research about some of these population trends and at the next step understanding what the reasons for this are. Where is this coming from? Why are there these disparities across different patient populations? Are these biologic effects? Are these genetic differences? Or is this all environmental? Or is it all due just to poor access to care? Can we remedy some of these problems and reduce the population burden by making sure that there is proper education amongst health care providers and proper access to adequate skincare for patients with atopic dermatitis? I think there's many different facets because this is a very complex and heterogeneous disease, but I think the next generation of research really needs to parse this out. In this step of the research, we identified the problems. Now, we need to figure out what are some potential solutions to really reducing that population burden.