Overcoming challenges in management of atopic dermatitis: Role of oxidative stress in the pathogenesis and treatment target of atopic dermatitis (ROAD)

Abstract

The Dermatology Advisory Board on Atopic Dermatitis from Asian Medical Expert Academy compiles current evidence-based approach review in managing atopic dermatitis (AD) among Asians. Electronic searches were performed to retrieve relevant published paper, systematic reviews, and guidelines on AD in the period of 2010-2020. A premeeting survey was performed prior to the meeting to gather opinions from experts to identify the individual unmet demands in the current management, and the possible strategies to overcome these issues. Collective opinions are scrutinized during the next step in a meeting, with the establishment of the opinions into an updated consensus in current AD management. Meeting of all committees through webinar platform in 2020 is called in making the current position in the AD management. Current challenges in AD management include steroid phobia, compliance, myths among the community, frequent flares leading to loss of patience, and good rapport. The Expert Panel recommends a stepwise approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity. Oxidative stress is recognized as an important contributor to AD that can directly damage skin cells and induce an immune response that leads to AD. Prescribed Emollient Device (PED) with antioxidants can help mitigate the effects of oxidative stress in causing AD. Furfuryl palmitate is an antioxidant that has demonstrated efficacy in managing symptoms of AD in adults and children, as well as other inflammatory dermatoses. PEDs can potentially play an important role in the treatment of AD by augmenting "upstream" treatment. This could potentially help reduce the risk of side effects and adverse events in patients undergoing treatment for AD. Furfuryl palmitate is an antioxidant that has demonstrated efficacy in managing symptoms of AD in adults and children.