Atopic dermatitis (AD) has a prevalence of 20% in children and 10% in adults. Hand eczema (HE) is common among AD patients. Since AD and HE share overlapping symptoms and pathogenesis, treatments developed for AD may also be effective for HE.
In chapter 2, of the thesis of Esmé Kamphuis, we examined the effectiveness of dupilumab in AD patients of all ages in daily practice. The results showed that dupilumab remained effective for up to 5 years of treatment, with conjunctivitis as the most common side effect. In children, dupilumab had higher drug survival rates after 1, 2, and 3 years of treatment compared to methotrexate and cyclosporine A.
Additionally, chapter 3 demonstrated that Janus kinase (JAK)-inhibitors baricitinib, upadacitinib, and abrocitinib were effective for treating AD in daily practice. These JAK-inhibitors were effective early. During treatment patients experienced side effects such as nausea, acne, and infections.
In chapter 4, we compared alitretinoin and azathioprine for the treatment of severe HE. Both treatments improved HE, but alitretinoin appeared more effective. Due to the small sample size and high dropout rates, no definitive conclusions could be drawn. Dupilumab and JAK-inhibitors also showed potential for treating HE in chapters 2 and 3, but further research is needed.
Chapter 5 investigated the social health of AD patients. Patients with severe AD had a lower ability to participate in social roles and activities compared to those with mild or moderate AD. Further research is needed to assess the impact on overall health and the need for additional support.
