Management of Pediatric Atopic Dermatitis in Contemporary Settings, With Vivian Hernandez-Trujillo, MD

Management of chronic inflammatory diseases like atopic dermatitis can involve a variety of approaches to treatment, with non-steroidal agents often being considered by caregivers who are wary of steroidal drugs.1

In a new interview with HCPLive following a clinical forum, Vivian Hernandez-Trujillo, MD, the medical director for the Division of Allergy and Immunology at Nicklaus Children's Hospital, touched on atopic dermatitis management approaches. Hernandez-Trujillo was first asked how the shift from steroid-dominant to targeted and nonsteroidal therapies changed her approach to managing atopic dermatitis in pediatric and adult patients.

“I think that now we have so many treatment options that are safer, and I think that's really the key is having options that are safe and that work well,” Hernandez-Trujillo said. “I think that's really the greatest shift that's happened, that we don't have to necessarily just use topical steroids on everybody.”

Hernandez-Trujillo was also asked what she believes effective comanagement looks like in her practice, and how it influences diagnostic accuracy and atopic dermatitis treatment success.

“It really enhances the success, and it's the best for the patients,” she explained. “I think that when specialists work together, and it was definitely discussed during the forum…It's having a mutual respect and understanding. One person may be the primary treatment physician, but then bringing in the rest of the team who have a lot of insights [is helpful]. We're all coming at it from different angles, and I think that's only to the benefit of the patients.”

The conversation highlighted the evolution of atopic dermatitis treatment, emphasizing safer options beyond topical steroids. Hernandez-Trujillo expressed her belief in persistent advocacy in prior authorizations and acknowledged access issues, such as those in urban areas.

“The reality is, we can do that, but number one, we're limited as specialists,” she explained. “And number two, there's only so much that we can do. That can't take up the majority of our day. I think the advocating piece is very important. So really, using the information that we have, and having the families work with us on that, [is key]. If I've really fought for the family, and I've had, let's say, a peer-to-peer, and it's still not going through, I tell the families, ‘I need you to call it. This is partly your responsibility, too. I'm trying to do what's best for you, but I'm reaching a roadblock.’”

Chronic disease management involves consistent routines, such as moisturizing after showers and keeping medications accessible. The importance of proactive care over reactive measures was underscored by Hernandez-Trujillo, especially for pediatric patients, to prevent long-term effects and flare-ups.

In this summary, the quotes used were edited for the purposes of clarity.

Hernandez-Trujillo has reported serving as an advisor for CSL, Takeda, Kaleo, Genentech, Sanofi/Regeneron, Pfizer, Bayer, ARS, Bryn, Stallergens/Greer, and SMPA/Enzyvant; as a speaker for CSL, Takeda, Kaleo, and Genentech; and as a consultant for Pharming.

References

1. Gallagher K, Halperin-Goldstein S, Paller AS. New treatments in atopic dermatitis update. Ann Allergy Asthma Immunol. 2025 Jun 23:S1081-1206(25)00312-6. doi: 10.1016/j.anai.2025.06.020. Epub ahead of print. PMID: 40562170.