atopic eczema

Introduction

a chronic inflammatory dermatitis that affects 30% of children, often starting under the age of 12 months, and some may continue to have it lifelong
it appears that a key enzyme, Granzyme B, is secreted by cells and weakens the skin barrier by cleaving through the proteins holding cells together making it easier for allergens to penetrate across, and that by knocking out Granzyme B with genetic modification, or inhibiting it with a topical gel, results in significantly reduced severity ¹⁾
there is a new very effective Rx option for those over 12yrs age with mod-severe disease:
- dupilumab (Dupixent)
  - inhibits IL-4 and IL-13 proteins by blocking a shared receptor
  - s/c dose once every 2 weeks
  - C/I include:
    - helminth infections
    - pregnancy, lactation
    - due to receive a vaccine
a new IL-22 blocker seems to also improve inflammation in early trials in 2025

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