Pediatric Allergic Diseases: Clinical Course and Management Strategies of Atopic Dermatitis

Abstract

Atopic dermatitis is one of the most common chronic allergic disorders in children
and represents a key component of the atopic march. Its clinical course is shaped by early-onset inflammation, skin-barrier dysfunction, immune dysregulation, and
environmental triggers that collectively contribute to recurrent flare-ups and long-term morbidity. This review synthesizes contemporary evidence on the age-dependent clinical presentation of pediatric atopic dermatitis, emphasizing the distinct features observed in infancy, childhood, and adolescence. Pathophysiological mechanisms involving filaggrin deficiency, Type-2 immune activation, microbiome imbalance, and increased transepidermal water loss are explored to provide a comprehensive understanding of disease progression. Management strategies are presented through an integrated approach that includes skin-barrier restoration, anti-inflammatory therapy, biologic agents, infection control, and patient-centered education. Despite notable therapeutic advances, challenges remain in optimizing long-term disease control and improving psychosocial outcomes for affected children. The findings highlight the need for individualized, evidence-based interventions and continued research to refine management strategies for pediatric atopic dermatitis.