Atopic Dermatitis in SOC

CE / CME

Addressing the Disproportionate Burden of Moderate to Severe Atopic Dermatitis in Patients With Skin of Color: Expert Perspectives for NPs and PAs

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: January 15, 2025

Expiration: January 14, 2026

Victoria Garcia-Albea
Victoria Garcia-Albea, PNP, DCNP

Activity

Progress
1 2
Course Completed

References

  1. Silverberg JI, Barbarot S, Gadkari A, et al. Atopic dermatitis in the pediatric population: A cross-sectional, international epidemiologic study. Ann Allergy Asthma Immunol. 2021;126:417-428 e412.
  2. Rudikoff D, Lebwohl M. Atopic dermatitis. Lancet. 1998;351:1715-1721.
  3. Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019;80:1526-1532 e1527.
  4. Paul C, Griffiths CEM, Costanzo A, et al. Factors predicting quality of life impairment in adult patients with atopic dermatitis: Results from a patient survey and machine learning analysis. Dermatol Ther (Heidelb). 2023;13:981-995.
  5. Wei W, Ghorayeb E, Andria M, et al. A real-world study evaluating adeQUacy of Existing Systemic Treatments for patients with moderate-to-severe Atopic Dermatitis (QUEST-AD): Baseline treatment patterns and unmet needs assessment. Ann Allergy Asthma Immunol. 2019;123:381-388 e382.
  6. National Eczema Association. Eczema facts. nationaleczema.org/research/eczema-facts/. Accessed January 7, 2025.
  7. Davis CM, Apter AJ, Casillas A, et al. Health disparities in allergic and immunologic conditions in racial and ethnic underserved populations: A Work Group Report of the AAAAI Committee on the Underserved. J Allergy Clin Immunol. 2021;147:1579-1593.
  8. McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019;123:173-178 e171.
  9. Artiga S, Hinton E. Beyond health care: The role of social determinants in promoting health and health equity. files.kff.org/attachment/issue-brief-beyond-health-care. Accessed January 7, 2025.
  10. Harvard Gazette. Money, quality health care, longer life. news.harvard.edu/gazette/story/2016/02/money-quality-health-care-longer-life/. Accessed January 7, 2025.
  11. Poladian K, De Souza B, McMichael AJ. Atopic dermatitis in adolescents with skin of color. Cutis. 2019;104:164-168.
  12. Tackett KJ, Jenkins F, Morrell DS, McShane DB, Burkhart CN. Structural racism and its influence on the severity of atopic dermatitis in African American children. Pediatr Dermatol. 2020;37:142-146.
  13. Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017;13:15-26.
  14. Luschkova D, Zeiser K, Ludwig A, Traidl-Hoffmann C. Atopic eczema is an environmental disease. Allergol Select. 2021;5:244-250.
  15. Chovatiya R, Begolka WS, Thibau IJ, Silverberg JI. Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among black individuals in the United States. Arch Dermatol Res. 2022;314:739-747.
  16. Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70:338-351.
  17. Sugerman DT. JAMA patient page. Atopic eczema. JAMA. 2014;311:636.
  18. Ricci G, Bellini F, Dondi A, Patrizi A, Pession A. Atopic dermatitis in adolescence. Dermatol Reports. 2012;4:e1.
  19. Kaufman BP, Guttman-Yassky E, Alexis AF. Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment. Exp Dermatol. 2018;27:340-357.
  20. Lopez Carrera YI, Al Hammadi A, Huang YH, Llamado LJ, Mahgoub E, Tallman AM. Epidemiology, diagnosis, and treatment of atopic dermatitis in the developing countries of Asia, Africa, Latin America, and the Middle East: A review. Dermatol Ther (Heidelb). 2019;9:685-705.
  21. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396:345-360.
  22. Noda S, Suarez-Farinas M, Ungar B, et al. The Asian atopic dermatitis phenotype combines features of atopic dermatitis and psoriasis with increased TH17 polarization. J Allergy Clin Immunol. 2015;136:1254-1264.
  23. Chan TC, Sanyal RD, Pavel AB, et al. Atopic dermatitis in Chinese patients shows T(H)2/T(H)17 skewing with psoriasiform features. J Allergy Clin Immunol. 2018;142:1013-1017.
  24. Davis DMR, Drucker AM, Alikhan A, et al. American Academy of Dermatology Guidelines: Awareness of comorbidities associated with atopic dermatitis in adults. J Am Acad Dermatol. 2022;86:1335-1336 e1318.
  25. Hanifin JM, Baghoomian W, Grinich E, Leshem YA, Jacobson M, Simpson EL. The eczema area and severity index-A practical guide. Dermatitis. 2022;33:187-192.
  26. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186:23-31.
  27. Charman CR, Venn AJ, Williams HC. The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients' perspective. Arch Dermatol. 2004;140:1513-1519.
  28. Pariser DM, Simpson EL, Gadkari A, et al. Evaluating patient-perceived control of atopic dermatitis: design, validation, and scoring of the Atopic Dermatitis Control Tool (ADCT). Curr Med Res Opin. 2020;36:367-376.
  29. Simpson E, Eckert L, Gadkari A, et al. Validation of the atopic dermatitis control tool (ADCT(c)) using a longitudinal survey of biologic-treated patients with atopic dermatitis. BMC Dermatol. 2019;19:15.
  30. Davis DMR, Drucker AM, Alikhan A, et al. Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies. J Am Acad Dermatol. 2024;90:e43-e56.
  31. Tralokinumab-idrm [prescribing information]. Madison, NJ: Leo Pharma, Inc; 2023.
  32. Lebrikizumab-ibkz [prescribing information]. Indianapolis, IN: Eli Lilly and Company; 2024.
  33. Upadacitinib [prescribing information]. North Chicago, IL: AbbVie, Inc; 2024.
  34. Alexis AF, Rendon M, Silverberg JI, et al. Efficacy of dupilumab in different racial subgroups of adults with moderate-to-severe atopic dermatitis in three randomized, placebo-controlled phase 3 trials. J Drugs Dermatol. 2019;18:804-813.
  35. Guttman-Yassky E, Blauvelt A, Eichenfield LF, et al. Efficacy and safety of lebrikizumab, a high-affinity interleukin 13 inhibitor, in adults with moderate to severe atopic dermatitis: A phase 2b randomized clinical trial. JAMA Dermatol. 2020;156:411-420.
  36. Armstrong A, Schlesinger TE, Gopalan R, et al. Lebrikizumab, a high-affinity interleukin-13 inhibitor, improves moderate-to-severe atopic dermatitis regardless of patient race: post hoc analysis from a phase IIb study. Br J Dermatol. 2020;183:e113‐e114.
  37. Mayo T, Armstrong A, Kircik L, et al. Efficacy and safety of up to two years of tralokinumab treatment in adults of different racial subgroups with moderate-to-severe atopic dermatitis. SKIN J Cutan Med. 2023;7(2):s144. doi:10.25251/skin.7.supp.144. Skin J Cutaneous Med. 2023;7:s144.
  38. Alexis AF, Silverberg JI, Rice ZP, et al. Abrocitinib efficacy and safety in moderate-to-severe atopic dermatitis by race, ethnicity, and Fitzpatrick skin type. Ann Allergy Asthma Immunol. 2024;132:383-389 e383.
  39. Thyssen JP, Thaci D, Bieber T, et al. Upadacitinib for moderate-to-severe atopic dermatitis: Stratified analysis from three randomized phase 3 trials by key baseline characteristics. J Eur Acad Dermatol Venereol. 2023;37:1871-1880.
  40. American College of Allergy AI. Black and Hispanic children in the U.S. have more severe eczema than White children. acaai.org/news/black-and-hispanic-children-in-the-u-s-have-more-severe-eczema-than-white-children/. Accessed January 7, 2025.
  41. Egede LE. Race, ethnicity, culture, and disparities in health care. J Gen Intern Med. 2006;21:667-669.
  42. Stanford FC. The importance of diversity and inclusion in the healthcare workforce. J Natl Med Assoc. 2020;112:247-249.
  43. Foster E, Loiselle AR, Thibau IJ, Smith Begolka W. Factors facilitating shared decision making in eczema: Met and unmet needs from the patient perspective. JAAD Int. 2023;11:95-102.
  44. Vermeulen FM, van der Kraaij GE, Tupker RA, et al. Towards more shared decision making in dermatology: Development of evidence-based decision cards for psoriasis and atopic eczema treatments. Acta Derm Venereol. 2020;100:adv00337.
  45. MGH Institute for Technology Assessment. Tools & training. mghdecisionsciences.org/tools-training/. Accessed January 7, 2025.
  46. National Eczema Association. EczemaWise. eczemawise.org/. Accessed January 7, 2025.
  47. National Institute on Alcohol Abuse and Alcoholism. Matching alcoholism treatments to client heterogeneity: Project MATCH hypotheses. niaaa.nih.gov/sites/default/files/match02.pdf. Accessed January 7, 2025.