Pediatric dermatologist Dr Daisy Blanco warned at a medical conference in Santo Domingo that atopic dermatitis affects up to one in five children worldwide. She urged doctors to overhaul how they treat the chronic skin condition.
Speaking at a medical update breakfast hosted by the Dominican Society of Pediatrics, Blanco explained that nearly 60 percent of cases begin during a child's first year of life. More than 85 percent of patients develop symptoms before reaching five years of age.
The Dominican Republic is a sovereign Caribbean nation sharing the island of Hispaniola with Haiti. Health authorities in the country currently lack precise national data on local prevalence, but medical specialists handle a heavy volume of pediatric dermatology consultations for the condition in early childhood.
Blanco stated that the disease must be recognized as a systemically relevant inflammatory condition rather than a simple cosmetic or surface skin issue. She noted that effective management requires looking beyond cutaneous lesions to assess broader impacts on sleep, neurodevelopment, mental health, and overall family quality of life.
Advanced Medical Treatments and Clinical Approach
Scientific understanding of the condition has expanded significantly in recent years. Researchers have identified key mechanisms driving the disease, including skin barrier dysfunction, type 2 inflammation, alterations in the microbiome, and associated comorbidities.
Atopic dermatitis, commonly known as eczema, causes severe itching, redness, and inflammation when the outer protective barrier of the skin breaks down. Type 2 inflammation involves specific immune system pathways that trigger allergic responses throughout the body.
Blanco detailed modern treatment options available to physicians, ranging from monoclonal antibody biological pills and subcutaneous biological therapies such as Dupixent to novel Janus kinase inhibitors, known as JAK inhibitors. These targeted treatments work by blocking specific proteins and signals involved in the inflammatory response.
She emphasized that medical treatment must be individualized for each child. Doctors must evaluate the patient's age, disease severity, skin phototype, quality of life, access to specific therapies, and local environmental conditions when prescribing care.
Screening for Mental Health and Allergic Comorbidities
Routine pediatric care must adapt to address the wider health consequences of the illness. Blanco advised pediatricians to actively screen young patients for emotional and developmental complications during regular clinical consultations.
She cautioned that uncontrolled inflammation and chronic itching frequently lead to sleep disruption, anxiety, depression, poor school performance, and attention deficit hyperactivity disorder. She added that unmanaged cases severely disrupt daily family dynamics and emotional well-being.
Pediatricians were also advised to monitor children for related allergic conditions that frequently accompany the skin disease. These include asthma, allergic rhinitis, and food allergies, which together form what medical professionals refer to as the atopic march.
Environmental Risk Factors in the Caribbean
In an interview following her presentation, Blanco outlined environmental factors specific to the Caribbean region that frequently trigger or aggravate flare-ups. The Caribbean climate presents distinct challenges for sensitive skin owing to constant warmth and moisture.
Blanco identified tropical climate conditions, high humidity, continuous sweating, dust mite exposure, urban pollution, and the frequent application of perfumes and body oils as key environmental triggers in the region. She added that predominant skin phototypes in the local population must also be factored into treatment plans.
Despite the availability of advanced targeted therapies, Blanco stressed that successful outcomes still rely on fundamental clinical steps. Early diagnosis, restoring the skin barrier with appropriate emollients, strict adherence to prescribed treatments, and regular follow-up with pediatricians and dermatologists remain essential.
The Dominican Society of Pediatrics reaffirmed its ongoing commitment to continuous medical education, aiming to integrate the latest scientific evidence into daily clinical practice to improve health outcomes for children across the country.
