Focused update: Guidelines of care for the management of atopic dermatitis in adults

Dawn M. Davis, Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota.
Lindsy Frazer-Green, American Academy of Dermatology, Rosemont, Illinois. Electronic address: lfrazer-green@aad.org.
Ali Alikhan, Department of Dermatology, Sutter Medical Foundation, Sacramento, California.
Lionel Bercovitch, Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
David E. Cohen, The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
Jennifer M. Darr, Department of Pediatrics/Pediatric Behavioral Health, National Jewish Health, Denver, Colorado.
Aaron M. Drucker, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Lawrence F. Eichenfield, Departments of Dermatology and Pediatrics, University of California San Diego and Rady Children's Hospital San Diego, San Diego, California.
Amy S. Paller, Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Kathryn Schwarzenberger, Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
Jonathan I. Silverberg, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Anne Marie Singh, Departments of Pediatrics, Dermatology and Medical Microbiology/Immunology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Peggy A. Wu, Department of Dermatology, University of California, Davis, Sacramento, California.
Robert Sidbury, Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington.

Document Type

Journal Article

Publication Date

6-17-2025

Journal

Journal of the American Academy of Dermatology

DOI

10.1016/j.jaad.2025.05.1386

Keywords

atopic dermatitis; biologic; eczema; lebrikizumab; nemolizumab; roflumilast; tapinarof; topical agents

Abstract

BACKGROUND: In 2023 and 2024, the American Academy of Dermatology published guidelines on the use of topical and systemic therapies for the management of atopic dermatitis (AD) in adults. Since the publication of these guidelines, several novel therapies have emerged to treat AD. OBJECTIVE: To update previous guidelines on the management of AD in adults by providing evidence-based recommendations on the use of additional Food and Drug Administration-approved topical and systemic therapies. METHODS: A multidisciplinary workgroup conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS: The workgroup developed 4 new recommendations for the management of AD in adults. LIMITATIONS: This analysis is based on the best available evidence at the time it was conducted. Most randomized controlled trials of the considered therapies for AD are of short duration, limiting comparative long-term efficacy and safety conclusions. CONCLUSIONS: The workgroup developed strong recommendations for the use of tapinarof cream, roflumilast cream, lebrikizumab, and nemolizumab with concomitant topical therapy.

Department

Dermatology

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