Atopic Dermatitis Flashcards
Atopic Dermatitis
- Presentation
- Dry skin
- Itch
- Hyper/Hypopigmentation
Calcineurin
Crisaborole
Indication: Mild-moderate atopic dermatitis over 2 years old
MOA: Inhibits PDE4
Counseling:
- Do not use on mucous membranes
- 2 years of use
Roflumilast
Indication:
- Seborrheic Dermatitis older than 9 years old
MOA: PDE4 Inhibitors
Counseling:
- Weight Loss
- Diarrhea and Headache
Phototherapy
MOA:
- Kills inflammatory cells
Indication:
- AD not responding to topical therapy
Counseling:
- Ensure patient is not on sun sensitivity drugs
Corticosteroids
MOA:
- Suppresses inflammatory genes
Indication:
- Short term treatment of flares in AD
Counseling:
- Bridge therapy
- A/E: Cushings, Glucose intolerance
- Skin lesions may worsen upon stopping therapy
Dupilumab
MOA:
- Inhibits IL4 and IL13
Indication:
- 6 months or older
Counseling:
- Oral herpes, gastritis, arthralgia
- NO Pregnancy
Tralokinumab
MOA:
- Inhibits IL13
Indication:
- 12 or older
Counseling:
- Injection site reaction, allergic conjunctivitis, URTIs
- NO Pregnancy
Lebrikizumab
MOA:
- Inhibits IL13
Indication:
- Older than 12 for Moderate-Severe AD
Counseling:
- Dry eye, Shingles
- NO Pregnancy
Upadacitinib
MOA:
- Inhibits Janus Kinase
Indication:
- 12 or older
Counseling:
- URTI, Acne, Lymphoma, Herpes Zoster
- Routine monitoring
- NO pregnancy
Abrocitinib
MOA:
- Inhibits Janus Kinase
Indication:
- 12 or older
Counseling:
- URTI, Acne, Lymphoma, Herpes Zoster
- Routine monitoring
- NO pregnancy
Biologic vs JAK inhibitors
Biologic
- Injectable
- Every other week or monthly
- Long half life / Slow onset
- Do not require lab monitoring
JAK Inhibitors
- Oral
- Daily dosing
- Short half life / Slow onset
- Require lab monitoring before and during treatment
Biologic vs JAK inhibitors
- Adverse Effects
Biologics:
- Injection site reaction
- Conjunctivitis
- Arthralgia
- URTI
- Oral Herpes
JAK Inhibitors:
- Increases cholesterol
- Acne
- URTI
- Herpes Zoster
