Pediatric Atopic Dermatitis: Prevalence and Symptomology

Melodie Young, NP: Hello, and welcome to this HCPLive® Peer Exchange titled “An Expert Nurse Practitioner & Physician Assistant Exchange on the Management of Pediatric Atopic Dermatitis.” I’m Melodie Young, a nurse practitioner [NP] at Mindful Dermatology and Modern Research Associates in Dallas, Texas. Joining me in this discussion are my colleagues Lakshi Aldridge, the director for the primary care NP residency program and an adult nurse practitioner at the VA [Veterans Affairs Medical Center] in Portland, Oregon; Alexa Hetzel, a physician assistant at the Psoriasis Treatment Center of Central New Jersey in East Windsor, New Jersey; and Matthew Brunner, a physician assistant at the Dermatology & Skin Surgery Center in Stockbridge, Georgia. Welcome, I’m glad to have you here.

Our discussion will focus on providing an overview of pediatric atopic dermatitis and take a deep dive into the management of this condition, highlighting recent treatment advances. The first segment that we’re going to address is the pathogenesis, the prevalence, and the severity of atopic dermatitis in the pediatric population. Alexa, start by teaching us the rates of recurrence and spontaneous resolution that you’ve heard about in pediatric atopic dermatitis and how often this disease can persist.

Alexa Hetzel, MA, PA-C: What’s frustrating as a provider treating atopic dermatitis is that it’s almost as if you’re stuck on a roller coaster. You’re constantly stuck: up and down, up and down. The recurrence is just like that. You can come and be really good or you can go down and up and be really bad. Our patients come in, and they’re scratching like crazy. They look exhausted, or they’re impetiginized or infected. This happens often, and you feel for them because there’s nothing worse than being exhausted. The itch is the biggest complaint that people can experience, and you wouldn’t wish it on your worst enemy because it’s something you don’t want to deal with. Our patients experience this constant ebb and flow, and they never know when it’s coming.

Melodie Young, NP: That’s the thing: the recurrence of what we see clinically is it seems as though you’re always seeing these folks. Matthew, can you give us some information about the prevalence of atopic dermatitis worldwide in the pediatric population?

Matthew Brunner, PA: It’s fairly common. About 20% of patients have atopic dermatitis. For the most severe patients, it’s around 15%. It can be a persistent disease, and for patients and caregivers alike, it can be a very trying and frustrating time for the development, as Alexa indicated.

Transcript edited for clarity