Available online 23 September 2022

The last decade has seen an unprecedented pace of change, particularly of clinical research in atopic dermatitis (AD). This review summarizes some key discoveries. Over the last 10 years, nearly half of all studies investigated the efficacy and safety of novel therapeutic agents, particularly biologics and small molecules. Clear demonstration of benefit in clinical trials with no significant safety concerns provided strong evidence leading to subsequent Food and Drug Administration (FDA) approval and routine use of the anti-IL-4Rα antagonist dupilumab in patients 6 months and older; the selective JAK1 inhibitors upadacitinib for patients 12 years and older; abrocitinib, the IL-13 antagonist tralokinumab, and the JAK1/2 inhibitor baricitinib for adults 18 years and older. Several other drugs are in the pipeline. Other areas under the spotlight have been trials of skin moisturizers and probiotics in prevention of AD, investigating the role of filaggrin and skin barrier function, and the role of skin and gut microbiome, with Staphylococcus aureus Sbi having been found to uniquely trigger allergic skin responses in AD. Skin microbiome, epidermal metabolites/structural components, and local inflammatory biomarkers are now commonly assessed using genomic and proteomic analysis of tape strips rather than more invasive biopsy to identify factors such as CCL17 which correlate with disease severity and response to therapy. Overall, the last decade has ushered in a new and exciting era in our understanding, diagnosis and treatment of this common allergic skin disease.

© 2022 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology