Atopic dermatitis (AD) represents the most common inflammatory skin disease with a highly intricated immune fingerprint. Until recently, AD management mostly relied on topical corticosteroids, calcineurin inhibitors, and systemic immunosuppressants, with a range of safety and tolerability concerns including toxicity, drug interactions, and contraindications. With the onset of biologics, safer and more targeted therapeutics have become available, displaying various degrees of success in treating AD, but not yet able to meet all the needs of AD patients. Some of the challenges encountered included variability of responses among patients, long-term safety, and limited access due to prohibitive costs. As the pathophysiology of AD has been increasingly understood within the last years, new approaches are explored, leading to an unprecedented diversification of therapeutic options to address these hurdles. This review highlights current immunotherapeutic strategies developed towards AD, whether already in the clinical pipeline or still in preclinical exploration.

Asthma is a common chronic inflammatory disease of the airways that affects more than 330 million people globally. Severe asthma, despite being 5–10% of the total asthmatic population presents significant morbidity and high cost due to health care utilization. The management of severe asthma has dramatically changed with the use of biologics. However, biologics have been approved only for patients with severe asthma with type-2 mediated inflammation. Eosinophils are central in the T2 inflammatory process in asthma and this stands true for the severe form of the disease as well. In this review, we discuss basic insights into the pathogenesis of severe asthma related to eosinophilic inflammation and the pivotal role of T2 cytokines which have also become along with eosinophils the target of biologics. Novel biologics such as tezepelumab have demonstrated efficacy regardless of the blood eosinophil count and have shown promise for T2 low asthma, although to a lesser degree.

A granulomatous vasculitis of the medium and large vessels, giant cell arteritis (GCA) is a persistent, idiopathic condition. The overlapping phenotypes of this condition include conventional cranial arteritis and extra-cranial GCA, also known as large-vessel GCA. Vascular problems linked with considerable vessel involvement may partly be caused by delayed diagnosis, emphasizing the necessity of early detection and the fast beginning of appropriate therapy. The cornerstone of treatment for GCA is glucocorticoids, but using them for an extended period has numerous, often severe, side effects. We aim to explore the most recent literature on GCA therapies to investigate the current and potential therapeutic options for induction and maintaining treatment in GCA. By now, only tocilizumab is approved for GCA treatment, but several other biological drugs may be efficient and safe for GCA patients, like abatacept, baricitinib and upadacitinib, mavrilimumab, secukinumab, ustekinumab, and anakinra.

Allergic and immunologic skin diseases are becoming increasingly common and this requires clinicians to be able to recognize and diagnose them. A joint meeting (GET TOGETHER 2022) of the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) aimed to review the current knowledge on the differential diagnosis of contact dermatitis, atopic dermatitis, hereditary angioedema, urticaria, and cutaneous mastocytosis. The most important aspects to take into consideration when faced with a new cutaneous manifestation are the clinical features of the lesions, their distribution, age of onset, and comorbidities/aggravating factors. The document does not aim to provide an exhaustive and comprehensive description of all allergic and immunologic skin diseases. Instead, it should be a reference tool for the clinician who is faced with the onset of a new skin manifestation and its differential diagnosis.

Atopic dermatitis (AD) is a chronic inflammatory skin disease that primarily affects the barrier function of the skin in patients. The condition has been documented to cause xerosis in patients from birth onwards. In order to protect the skin barrier in AD, it is of the utmost importance to moisturize the skin. Moisturizers and emollients play a pivotal role in the prevention and treatment of AD. Concordantly, the use of moisturizers and emollients can facilitate the reduction in the necessity for the application of topical treatments such as corticosteroids. An understanding of the use of moisturizers and emollients, in conjunction with an appreciation of the pathophysiology of the skin barrier, will prove invaluable in the treatment of AD.

Aim: Few reports on atopic dermatitis (AD) in adults from Africa exist in the literature. AD in adults can occur as childhood-onset, in which AD begins in childhood and continues till adulthood, or adult-onset, in which AD develops in adulthood. Typical appearance of AD includes acute or chronic eczematous lesions recurring or chronic in nature that is symmetrically distributed on flexural body surfaces. Atypical clinical patterns and morphology are commonly described among the adult population. The purpose of this study is to describe the frequency, clinical pattern, and contact sensitization of adults with AD. Methods: A prospective study of patients seen at the dermatology clinic of a tertiary referral center in Abuja, Nigeria, between September 2020 and September 2022. Adult patients who fulfilled at least three major and three minor criteria of the Hanifin and Rajka guidelines were recruited. The Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index for black skin was used to determine AD severity. Contact sensitivity was assessed using a modified European baseline series and skin prick testing of common aeroallergens was also done. Results: Out of a total of 2,177 patients, only 38 adults were diagnosed with AD. Two-thirds of them had adult-onset AD. The majority (63.2%) had chronic eczema at presentation, 23.7% had perifollicular accentuations, and 13.2% had acute eczema. The mean SCORAD index was 20.5 (16.4 to 24.6). The mean eosinophil count was 5.9 ± 3.4 cells/dL. The skin prick test revealed sensitization to at least one allergen in 68.8% of the patients. Contact sensitivity to methyldibromoglutaronitrile, lanolin, and paraben was highly observed. Conclusions: Adult-onset AD is more common than childhood-onset AD in adults. The morphology and distribution of eczema did not differ from other studies. Adult AD individuals tend to develop contact sensitivity to preservatives.