Diagnosis and treatment of atopic dermatitis

Atopic dermatitis is among the most common and highest-impact diseases of the skin. The prevalence appears to be increasing and corticosteroids remain the only available effective agents, despite their limitations and toxicity. Research is providing a better understanding of pathogenic factors in atopic dermatitis, opening new potential targets for therapeutic intervention. For severe disease, immune modulators such as cyclosporin A, methotrexate and IFN-γ are available as reasonable alternatives to the toxicity of systemic corticosteroids. New topical agents in the form of PDE4 inhibitors and FK506 are on the near horizon and should add some flexibility in approaching the management of this difficult disease.