Atopic Dermatitis: New Science, Smart Strategies

At the Masterclasses in Dermatology APP Institute, David Rosmarin, MD, returned to the podium with a high-yield session titled “Atopic Dermatitis Treatment Update.” From foundational skin hygiene to breakthrough therapies, Dr Rosmarin delivered both big-picture insights and practical pearls for managing one of dermatology’s most common and complex conditions.

“Atopos is Greek for strange or unusual,” Dr Rosmarin said, reminding attendees that atopic dermatitis (AD) is more than itchy skin; it is a chronic, relapsing inflammatory disease with far-reaching impacts.

Dr Rosmarin began by reinforcing basics often overlooked. He emphasized the importance of “minimizing soap use; minimizing washing; and moisturizing, moisturizing, moisturizing,” citing that greasy emollients and consistent use (at least 25g per full-body application) are key to restoring the disrupted skin barrier.

For flares, he encouraged revisiting the “soak and smear” method and using the fingertip rule to ensure adequate topical coverage. He also stressed patient education, noting that “repeated education by a nurse” can boost compliance and reduce severity, referencing studies showing an 800% increase in emollient use after 1 session.

Rosmarin reviewed a wide spectrum of treatments, starting with topical steroids, calcineurin inhibitors, and phosphodiesterase 4 inhibitors such as crisaborole and roflumilast, and extending to Janus kinase (JAK) inhibitors like ruxolitinib cream. For severe or refractory cases, he walked through systemic options, including dupilumab, upadacitinib, and abrocitinib, explaining how JAK inhibitors offer rapid improvement but carry boxed warnings that must be discussed with patients.

“Put it in context that these side effects are rare,” he said of JAK inhibitors, “but always weigh benefits vs risks.”

Exciting pipeline agents included tapinarof, lebrikizumab, and other targeted biologics such as anti-IL-31 and anti-OX40 therapies. He highlighted new data on roflumilast cream, showing rapid itch improvement and strong Eczema Area and Severity Index-75 responses, even in children as young as 6 years old.

From bleach baths to biologics, Dr Rosmarin’s session was a comprehensive reminder that effective eczema care begins with the basics but does not stop there.

For APPs managing AD in the clinic, this session delivered the tools to address both the inflammation and the frustration.

Reference

Rosmarin D. Atopic dermatitis treatment update. Presented at: Masterclasses in Dermatology APP Institute; October 11–12, 2025; Dallas, TX.