Atopic Dermatitis

A 6-year-old boy presents with intense pruritus, lichenified plaques on flexural surfaces (antecubital and popliteal fossae), and a 3-year history of recurrent skin infections. Serum IgE is markedly elevated. His mother reports that emollients alone provide only temporary relief. What is the most appropriate next step in management?

Which of the following is the primary pathophysiological defect in atopic dermatitis?

Which cytokine profile is most characteristic of the acute phase of atopic dermatitis?

A 4-year-old boy from Delhi presents with intense pruritus and erythematous patches on his face, neck, and flexural surfaces (antecubital and popliteal fossae) for the past 8 months. His mother reports that symptoms worsen in winter and improve during monsoon. On examination, he has lichenification, excoriations, and a positive Dennie–Morgan fold. His serum IgE is elevated at 450 IU/mL. Skin prick testing shows reactivity to dust mites and pollen. What is the most appropriate first-line pharmacological management for acute flare control in this child?

A 28-year-old woman from Mumbai presents with severe pruritus, erythema, and oozing on her hands and forearms for 3 weeks. She works as a healthcare worker and frequently washes her hands. On examination, she has acute vesicles, erosions, and crusting with sharp demarcation at the wrists. Serum IgE is 280 IU/mL (normal <150). Patch testing is negative. She has a personal history of allergic rhinitis and a family history of asthma. What is the most likely diagnosis, and what is the primary pathogenic mechanism underlying her condition?