The Top 5 Atopic Dermatitis Studies in the Past 2 Years, with Matthew Zirwas, MD

Thousands of dermatology studies have been published in the past 2 years, but which ones are the most useful to dermatologists?

At the 2025 New Wave Dermatology meeting in Aventura, Florida, Matthew Zirwas, a dermatologist at Bexley Dermatology, presented the most useful dermatology journal entries in the past year.¹ He reviewed dermatologic uses for metformin, potential mechanisms of pimozide in delusions of parasitosis, ways to boost JAK inhibitor response in alopecia totalis, and treatments for burning mouth syndrome.

HCPLive sat down with Zirwas at the meeting to discuss these highlights and his other talk on how to streamline the first 4 visits when diagnosing spongiotic dermatitis. He also shared his picks for the top 5 atopic dermatitis studies published in the past 2 years. ^2,3,4,5,6

“There have been some incredibly interesting new things, especially around atopic dermatitis,” Zirwas said. “[The most important finding is] that we are terrible at diagnosing it. As dermatology providers, we misdiagnose 2 out of 3 people who have atopic dermatitis. Instead of calling it atopic dermatitis, we're diagnosing it as dermatitis, unspecified. That needs to stop.”

Zirwas explained that adult atopic dermatitis is often misdiagnosed because the wrong criteria are used. While the Hanafin and Rajka criteria from the 1980s work well for children, they fall short in adults. Instead, he said dermatologists should follow the American Academy of Dermatology guidelines.

The difference lies in pathogenesis: genetics drive pediatric atopic dermatitis, but skin damage underlies adult cases. Zirwas pointed to toluene diisocyanate (TDI), a chemical in car exhaust and nylon and polyester clothing, as a major factor for skin damage.

“That explains why atopic dermatitis has been becoming more common, particularly since the 1970s, because the 1970s car exhaust changed to start to have this TDI in it, and that was because they put catalytic converters on cars,” Zirwas said. “Second, nylon and polyester became much more common in clothing, and residual TDI in nylon and polyester clothing is the other big driving factor for this acquired atopic dermatitis.”

The Top 5 Studies on Atopic Dermatitis:

Variation in clinical presentation of pediatric-onset and adult-onset atopic dermatitis: a retrospective, single-center, chart review of adults with atopic dermatitis from the United States

This retrospective review compared clinical features of adult- vs pediatric-onset AD. Adults had less flexural involvement and more nummular eczema and extensor surface involvement, with fewer personal or family histories of atopic disease.

Exposure to isocyanates predicts atopic dermatitis prevalence and disrupts therapeutic pathways in commensal bacteria

This study identified diisocyanates as strong predictors of atopic dermatitis. These chemicals disrupt beneficial lipid production and therapeutic modeling of R. mucosa and commensal Staphylococcus. Diisocyanates demonstrated a temporospatial and epidemiological association with atopic dermatitis.

The 2023 Annual Report of DataDerm: The database of the American Academy of Dermatology

DataDerm, the American Academy of Dermatology’s massive dermatology database, included data from 14.2 million unique patients and 53.5 million visits in 2022. This report analyzed longitudinal care patterns for common dermatologic conditions, with emphasis on skin cancer.

Cohort studies on 71 outcomes among people with atopic eczema in UK primary care data

Using UK primary care data, investigators compared 3.6 million people with eczema to 16.8 million controls. They found eczema was strongly associated with hodgkin's lymphoma, alopecia areata, Crohn Disease, urticaria, coeliac disease, ulcerative colitis, autoimmune liver disease, and irritable bowel syndrome.

Association of air pollution and genetic risks with incidence of elderly-onset atopic dermatitis: A prospective cohort study

A UK Biobank study found both air pollution and genetics independently increased the risk of elderly-onset AD, but pollutants had a stronger effect than genetic predisposition.

Other useful dermatology journal entries published in the past 2 years that Zirwas presented are reported here.

Relevant disclosures for Zirwas include Galderma Laboratories, L.P, Regeneron Healthcare Solutions, GENZYME CORPORATION, Arcutis Biotherapeutics, Lilly USA, Novartis Pharmaceuticals Corporation, Dermavant Sciences, LEO Pharma, Verrica Pharmaceuticals, Incyte Corporation, AbbVie, and PFIZER.

References

1. Zirwas M. The Most Useful Journal Articles of the Last 2 Years. Presented at the 2025 New Wave Dermatology at Aventura, Florida.

2. Munayco Maldonado G, Foy V, Tai H, Chiesa Fuxench ZC. Variation in clinical presentation of pediatric-onset and adult-onset atopic dermatitis: a retrospective, single-center, chart review of adults with atopic dermatitis from the United States. Arch Dermatol Res. 2024;316(7):409. Published 2024 Jun 15. doi:10.1007/s00403-024-03008-x

3. Zeldin J, Chaudhary PP, Spathies J, et al. Exposure to isocyanates predicts atopic dermatitis prevalence and disrupts therapeutic pathways in commensal bacteria. Sci Adv. 2023;9(1):eade8898. doi:10.1126/sciadv.ade8898

4. Van Beek MJ, Swerlick RA, Daveluy S, et al. The 2023 Annual Report of DataDerm: The database of the American Academy of Dermatology. J Am Acad Dermatol. 2024;91(5):904-909. doi:10.1016/j.jaad.2024.05.096

5. Matthewman J, Schultze A, Strongman H, et al. Cohort studies on 71 outcomes among people with atopic eczema in UK primary care data. Nat Commun. 2024;15(1):9573. Published 2024 Nov 6. doi:10.1038/s41467-024-54035-1

6. Gu X, Jing D, Xiao Y, et al. Association of air pollution and genetic risks with incidence of elderly-onset atopic dermatitis: A prospective cohort study. Ecotoxicol Environ Saf. 2023;253:114683. doi:10.1016/j.ecoenv.2023.114683