Dr. Ashish Shetty, a consultant dermatologist, in his talk focused on biological therapies for moderate-to-severe atopic dermatitis in adults. He described atopic dermatitis as a prevalent and complex disease affecting roughly 2% to 10% of young adults and 20% of children, noting its significant economic and quality-of-life burdens.
...The condition’s pathophysiology involves epidermal barrier dysfunction, skin microbiome alterations, and immune dysregulation through the TH2 pathway, which releases inflammatory cytokines like IL-4 and IL-13. Dr. Shetty outlined four treatment categories – topicals, oral immunosuppressants, biologics, and oral JAK inhibitors, while emphasizing that newer targeted biologics provide high specificity and a favorable safety profile for long-term management. He detailed specific therapies such as dupilumab, tralokinumab, and lebrikizumab, citing clinical trial data that showed significant improvements in IGA and EASI scores. In his personal clinical practice, Dr. Shetty sees approximately 7 to 10 patients with atopic dermatitis weekly, typically initiating treatment with topical corticosteroids before escalating to oral immunosuppressants like cyclosporine for those who do not respond to standard care.