touchDERMATOLOGY coverage from EADV 2025:
Once again, the EADV Congress provided a fantastic platform to share updates on the latest research in dermatology. With so many sessions taking place, it can be difficult to catch everything and take home all the key messages. To help condense the highlights, in both paediatric and adult atopic dermatitis we spoke with leading expert, Prof. Carsten Flohr (London, UK).
Whilst at EADV 2025 in Paris, France, Prof. Flohr presented key updates in paediatric atopic dermatitis during the ‘Updates in Atopic Dermatitis’ session, delivered a presentation on the Global Atopic Dermatitis Atlas, and shared the British Journal of Dermatology “Best Papers of the Year” update.
Q. What were the key highlights from the paediatric atopic dermatitis lecture?
The concept of preclinical atopic dermatitis
The first is the concept of preclinical atopic dermatitis. As I mentioned in my lecture, this is being able to recognise the iceberg beneath the surface before it breaks. This is really important because it opens up the opportunity for disease prevention, and the possibility of recognizing those at risk for atopic dermatitis even before skin inflammation begins.
A useful way to approach this is through biomarkers. For example, one biomarker we have identified is the natural moisturising factor. If you imagine your skin barrier as a wall made of bricks and mortar, people with lower levels of natural moisturising factor have less “mortar” holding the bricks together. This makes one group of babies who are at particularly high risk of developing atopic dermatitis. We can already detect those lower levels from around two weeks of age, which is quite exciting. In addition, differences in microbiome signatures and lipid profiles have also been observed in those who go on to develop atopic dermatitis in the long term.
One area currently being explored is the use of emollients from day one after birth as a way of preventing the condition. It will be interesting to see how these children respond to this intervention and how they fare in terms of biomarkers. I hope this will allow us to stratify risk more effectively and better understand which groups of children we need to focus on.
Preventing food allergies in children
My team is particularly interested in how babies develop food allergies. From our research, and that of others, we now know that this largely happens through the skin barrier. It’s not due to parents avoiding giving certain foods to their children. In fact, whatever foods babies are exposed to orally, they should generally become tolerant to it. Instead, for example, if a baby has not been fed peanuts and a parent eats a peanut butter sandwich and then does not thoroughly wash their hands before touching the baby’s skin—for example, during baby massage—they may end up massaging peanut protein directly into the skin. For a baby with dry skin who has not yet eaten peanuts, this is very likely to lead to the development of a peanut allergy. We have actually had a really interesting paper published recently in Cell that is suggesting that it is the massaging that is the key point, it is this that is kick-starting the engine to the human skin immune system. This means meticulous hand hygiene could be one of the best ways to help prevent food allergy from developing. So the key message for us as dermatologists is to get this information out, not only to other practitioners and those in primary care, but also directly to parents.
Novel therapeutics in paediatric atopic dermatitis
In the session, it was also great to discuss novel therapeutics, not just systemic treatments, but also a new topical medication called tapinarof. It is particularly exciting to see this treatment moving through clinical trials down to age two years, as we haven’t had a truly novel topical therapy in many years.
Q. Outside of your own presentation, what stood out to you as the most important take-home messages from the updates in atopic dermatitis session?
Expanding the Treatment Landscape
In terms of systemic therapies, it was definitely the OX40 ligand inhibitor, which is an exciting new target for us. Previously, we’ve mainly focused on IL-4, IL-13, IL-31, and then the JAK inhibitors, so this represents a new and interesting class of drugs coming through. And when we think about topicals, it’s also exciting to learn how nanotechnology is being used to improve the penetration of these types of therapies.
The skin microbiome and mental health
Another key area was the role of the microbiome, not only through the gut–skin axis but also the skin–brain axis, which is becoming increasingly important in our understanding. A recent publication, in the British Journal of Dermatology investigated the relationship between the human skin microbiome and psychological wellbeing. Interestingly, the study found that certain non-pathogenic bacteria, particularly Cutibacterium from the head and neck area, appeared to be associated with being in a better mood. This suggests that the bacteria that grows on our skin can have an impact on mental health, and perhaps, as dermatologists, we could harness this by purposefully altering the skin microbiome to help people feel better.
Q. Since the launch of the Global Atopic Eczema Atlas, how has it developed, and what were the updates discussed at EADV 2025?
The Global Atopic Eczema Atlas (GADA) began in autumn 2022 with an inaugural report outlining the disease burden, our current understanding of its pathogenesis, the impact on patients, and the gaps that still need to be addressed, particularly in middle- and low-income countries.
Since the launch, we have been busy with what we call a “living” evidence synthesis project, where we regularly incorporate the latest epidemiological data on atopic dermatitis. These updates are freely available on our public website.
The first publication was recently released in the British Journal of Dermatology, bringing this evidence together. We are also running an international consensus exercise called EPISTAR, which aims to standardize research methodology for measuring the burden of atopic dermatitis, particularly prevalence, incidence and disease severity. As you can imagine people conducting studies in different settings, using different questionnaires, physical examinations, diagnostic criteria and sample sizes. Some are hospital based, others are population based, and so on. All of this adds to the challenge as a team to synthesize the data.
In other updates, we are very pleased to announce that the first GADA register was launched in November last year in Lebanon. Credit goes to my colleagues there, who have been working hard to recruit patients. We have also begun conducting qualitative research on atopic dermatitis during pregnancy, and we have plans for a GADA-omics project, deep diving into the skin barrier mechanistically and linking environmental factors such as air pollution with what happens in inflamed skin. So lots to do!
About Prof. Carsten Flohr
Prof. Carsten Flohr is Chair in Dermatology and Population Health Sciences at King’s College London, and Honorary Consultant Dermatologist and Research & Development Lead at St John’s Institute of Dermatology, Guy’s & St Thomas’ NHS Foundation Trust, London. His research focuses on population-based dermatology and clinical trials in atopic dermatitis. He is Chief Investigator of the NIHR-funded TREAT trial, the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR), and several international consortia, including Trans-Foods and Mind & Skin. His group also investigates host-skin and gut microbiome interactions in inflammatory skin disease, and he leads the ILDS Global Atopic Dermatitis Atlas project. Prof. Flohr is a Founding Director of the International Eczema Council and a Past President of the British Society of Paediatric and Adolescent Dermatology.
Disclosures: Prof. Carsten Flohr has served as a consultant for Apogee, Almirall, Incyte, LEO, Pfizer and Sanofi; received grant/research support from Sanofi and Pfizer; participated on advisory boards for Apogee, Almirall, Incyte, LEO, Pfizer and Sanofi; participated in the speaker’s bureau with Almirall, Pfizer and Sanofi, and has received honoraria from these companies.
This content has been developed independently by Touch Medical Media for touchDERMATOLOGY. It is not affiliated with the European Academy of Dermatology and Venereology (EADV). Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Cite: Latest updates in atopic dermatitis treatment and research across all ages. TouchDERMATOLOGY. September 29, 2025
Editors: Gina Furnival & Victoria Jones
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