Ryan Haumschild, PharmD, MS, MBA, CPEL; Andrew Alexis, MD, MPH; April W. Armstrong, MD, MPH; Andrew M. Mastro, MS, PA-C; and Mark Makhinson, PharmD, discuss how atopic dermatitis is an immune-mediated disease with heterogeneous pathways that present differently across skin tones, requiring health care professionals to recognize diverse clinical manifestations, address educational gaps in understanding the complex immunopathogenesis, and ensure equitable access to targeted biologic therapies through improved training, clinical trial representation, and coordinated care teams.
EP. 1: Understanding Atopic Dermatitis as an Immune-Mediated Disease
Panelists discuss how atopic dermatitis involves complex inflammatory and neuronal pathways, with IL-4, IL-13, and IL-31 cytokines driving Th2-mediated inflammation that varies across different racial populations.
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EP. 2: Bridging the Gaps: Health Care Professional Knowledge Gaps in AD Pathophysiology
Panelists discuss how health care professionals face educational gaps in understanding atopic dermatitis (AD) immunopathogenesis, with advanced practice providers (APPS) particularly needing additional training outside standard curricula to master biologic therapy selection.
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EP. 3: Beyond the Itch: The Full Spectrum of AD Symptoms and Their Impact on Patients
Panelists discuss how atopic dermatitis (AD) extends far beyond pruritus to include pain, sleep disturbances, psychosocial stigma, and quality-of-life impacts that affect patients’ work, school, and daily functioning regardless of disease severity.
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EP. 4: Recognizing AD Across All Skin Tones
Panelists discuss how atopic dermatitis (AD) presents differently across skin tones, appearing as purple, gray, or barely visible inflammation rather than classic redness, with perifollicular prominence and postinflammatory pigmentation changes being more prominent in patients with darker skin.
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EP. 5: Diagnostic Challenges and Patient Education Across Skin Tones
Panelists discuss how patients with darker skin tones often experience delayed diagnosis due to misidentification as fungal infections or other conditions, emphasizing the importance of shared decision-making and patient education about the immune-mediated nature of the disease.
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EP. 6: Biologic Therapy Decision-Making and Monitoring in AD
Panelists discuss how biologic therapy selection depends on disease burden rather than just body surface area (BSA), with monitoring requiring objective measures, patient-reported outcomes, and specialized photography documentation for patients with darker skin tones.
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EP. 7: Access, Adaptation, and Cost-Effectiveness in AD Treatment
Panelists discuss how treatment access challenges require provider advocacy through peer-to-peer reviews and patient assistance programs, whereas cost-effectiveness evaluation focuses on time to specialist care, therapy duration, and quality-of-life outcomes.
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EP. 8: Empowering Health Care Professionals: Training and Resources for Diverse AD Care
Panelists discuss how health care providers need coordinated multidisciplinary care teams, visual resources like databases for eczema in skin of color, peer-to-peer educational sessions, and case-based learning to better recognize and manage atopic dermatitis (AD) across diverse skin tones.
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EP. 9: Atopic Dermatitis Clinical Trial Representation: Addressing Historical Gaps
Panelists discuss how historical underrepresentation of patients with darker skin tones in clinical trials has limited understanding of treatment efficacy and safety across diverse populations, hampering real-world clinical decision-making.
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Panelists discuss how recent clinical trials like ADmirable and DISCOVER intentionally enrolled patients with skin of color (Fitzpatrick types IV-VI), demonstrating similar efficacy and safety profiles for biologics across diverse racial populations, with more than 70% achieving a 75% or greater improvement in the Eczema Area and Severity Index (EASI-75).
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EP. 11: From Research to Practice: Translating AD Clinical Trial Results and Overcoming Barriers
Panelists discuss how diverse clinical trial data help build patient trust by demonstrating therapy effectiveness in similar populations and address barriers like health care mistrust and representation in treatment development.
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EP. 12: Improving Access and Care for All Patients With Atopic Dermatitis
Panelists discuss how successful access initiatives include integrated specialty pharmacies, community-based clinics, clinical trial opportunities, telehealth services, and financial assistance programs like 340B to serve underserved populations with atopic dermatitis.
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