Video

Practical Updates in Primary Care Recap—Atopic Dermatitis in Practice: Assessing Severity, Addressing Skin of Color, and Navigating New Treatments

Annie Truss, MD


 

Key Highlights

  • Atopic dermatitis should be managed as a systemic disease, with clinicians assessing not only skin findings but also sleep disruption, mental health, and the broader impact on patients and their families.
  • Disease severity extends beyond body surface area, as involvement of high-impact sites such as the eyelids, hands, and groin can warrant more aggressive management even when overall skin involvement is limited.
  • The treatment landscape for atopic dermatitis has expanded significantly, requiring primary care clinicians to incorporate newer options—including topical calcineurin inhibitors, JAK inhibitors, and biologics—alongside foundational therapies such as moisturizers and topical corticosteroids.

With more than 90% of atopic dermatitis visits occurring in primary care, clinicians must move beyond rash-based assessment. In this video recap, Annie Truss, MD, outlines practical strategies to evaluate high-impact disease, identify underrecognized presentations in skin of color, and incorporate newer therapies into routine care. The session was co-presented with Cynthia Trickett, MPAS, PA-C.

Additional Resource: https://www.hmpglobalevents.com/pupc 

Transcript

Annie Truss, MD: Hi. I am Annie Truss. I am one of the associate professors at Rutgers Robert Wood Johnson in New Brunswick in the Department of Family Medicine.

Consultant360: What are some of the key themes of your presentation?

Dr. Truss: Yeah, so our presentation today is on atopic dermatitis, and it's built really around three connected ideas.

First is that atopic dermatitis is more than just a skin condition. It has real systemic symptoms, and the burden on patients goes well beyond the rash itself. We need to think about sleep disruption, anxiety, school and work performance, and really the toll that it takes on patients and their families.

Second, we know that atopic dermatitis has been historically underdiagnosed in patients with skin of color, where the erythema might look a little more violaceous, brown, or gray, and lichenification and post-inflammatory pigment changes really dominate the picture.

And third, severity assessment in primary care needs to go beyond just the body surface area affected by atopic dermatitis. We really need to think about how small areas can have big impacts, such as the eyelids, the hands, and the groin, and when to escalate care more quickly.

So, pretty much wrapped around all of that is a practical treatment component—how to use moisturizers and topical treatments such as steroids to help our patients.

Consultant360: Why is this topic particularly relevant right now?

Dr. Truss: Atopic dermatitis is always relevant, but especially now because more than 90% of atopic dermatitis visits happen in the primary care office. So PCPs really need to be well-equipped to treat these patients.

A few things have changed in the past years that make this an important moment. While we've used topical steroids for a long time—and they are still often first-line for treating atopic dermatitis—the treatment landscape has expanded. Now we're thinking about using topical calcineurin inhibitors, JAK inhibitors, as well as many biologics.

So essentially, we can offer a lot more in the primary care office than ever before.

Consultant360: What are the most important takeaways from your session?

Dr. Truss: I really want clinicians to walk out with a couple of things.

Number one: treat atopic dermatitis like the systemic disease that it is. Ask about mood, sleep, family impact—not just the rash.

Number two: patient counseling on the skin barrier is really key to long-term success and control. I like to use what we call the “brick and cement” model, and that's something that can be easily translated into any primary care office.

And again, severity is more than just body surface area. It's thinking about eyelid or hand disease and other high-impact areas, even if they represent a small percentage of body surface area.

Consultant360: Is there else you would like to add about your presentation?

Dr. Truss: One piece I'd like to highlight is that this is a co-presentation between myself, a primary care doctor, and dermatology—and that's really intentional.

I think the most useful conversations about skin disease happen when we collaborate. I hope that after this, primary care doctors feel more empowered and confident in treating patients themselves, but also know when to collaborate and what our local dermatologists can offer.

©2026 HMP Global. All Rights Reserved. Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Consultant360 or HMP Global, their employees, and affiliates.