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Content Update

January 10, 2023

Tralokinumab for the Management of Moderate-to-Severe Atopic Dermatitis Tralokinumab (Adbry™), a novel interluekin-13 antagonist, was recently approved by the U.S. Food and Drug Administration for the treatment of moderate-to-severe atopic dermatitis (AD) in adult patients whose disease is not adequately controlled using prescription topical corticosteroids (TCS). Tralokinumab may be used as monotherapy or in combination with TCS. It is anticipated that tralokinumab will be incorporated into future guidelines for the management of moderate-to-severe AD as an alternative therapy option for adult patients amenable to injectable therapy, whose eczema is not adequately controlled or who cannot tolerate first-line therapies.



Upon completion of the chapter, the reader will be able to:

  1. Describe the pathophysiology of dermatitis.

  2. Assess the signs and symptoms of dermatitis in a presenting patient.

  3. List the goals of treatment for patients with dermatitis.

  4. Select appropriate nonpharmacologic and pharmacologic treatment regimens for patients presenting with dermatitis.

  5. Identify adverse effects that may result from pharmacologic agents used in the treatment of dermatitis.

  6. Develop a monitoring plan that will assess the safety and efficacy of the overall disease state management of dermatitis.

  7. Create educational information for patients about dermatitis, including appropriate self-management, available drug treatment options, and anticipated therapeutic responses.


Several thousand skin disorders are currently documented, and many patients seek the assistance of a health care provider when a complication with their skin develops. Others will utilize self-care to effectively treat their symptoms.

This chapter discusses contact dermatitis (irritant and allergic), atopic dermatitis, and diaper dermatitis; other common skin and soft tissue infections, and superficial fungal infections are discussed in Chapters 76 and 85, respectively. Providing patients with appropriate therapy options, as well as patient education on treatment and prevention, will assist the successful management of many common skin disorders.


Contact dermatitis is a condition in which exposure to an offending substance produces inflammation, erythema, and pruritus of the skin.1,2 More specifically, contact dermatitis can be divided into either irritant or allergic forms.3 image Irritant contact dermatitis (ICD) results from first-time exposure to irritating substances, such as soaps, plants, cleaning solutions, or solvents. Allergic contact dermatitis (ACD) is a delayed hypersensitivity reaction that occurs after an initial exposure to an allergen results in sensitization. With additional exposure, activation of the immune system results in dermatitis. Allergens that commonly cause ACD include poison ivy, latex, and certain types of metal (Figures 67–1 and 67–2). Table 67–1 lists agents commonly responsible for irritant and ACD. Although generally occurring on the exposed skin, such as the hands and face, contact dermatitis can appear anywhere on the body.4,5

FIGURE 67–1.

Acute irritant contact dermatitis on ...

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