New combination therapy in sever atopic dermatitis in 47 patients in Iran a shift from potent new agents to the baseline treatments

Atopic dermatitis (AD)with occurrence of about 20% in children and 10% in adult is a chronic inflammatory skin disease, with recurrent eczematous lesions and frustrating pruritis, that is originally multifactorial (1). Given the impact of various causes on this disease, combination therapies that can target each of these causes can be an effective solution in cases of severe disease. Immune dysregulation and skin barrier dysfunction prepare microbial invasion that results in dry itchy skin. (2) Due to increased side effects from immunosuppressive drugs, biological agents, and small molecules it is recommended that, considering the factors involved in the development of this disease, treatments with less strength and fewer side effects be used, and in case of lack of response, stronger and newer drugs be used.