Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin condition with a complex pathogenesis and variable clinical presentation, often overlapping with other dermatologic diseases. This article considers the differential diagnoses for AD, emphasizing the importance of accurately distinguishing it from both common and rare conditions. Among inflammatory dermatoses, seborrheic dermatitis, psoriasis, allergic and irritant contact dermatitis, lichen simplex chronicus, and pityriasis rosea share overlapping features but can be differentiated based on history, distribution, and morphology. Infectious mimickers include scabies, tinea corporis, impetigo, and secondary syphilis, each with unique clinical or diagnostic markers. High priority diagnoses such as neoplastic diseases (mycosis fungoides), autoimmune conditions (dermatomyositis), nutritional deficiencies (zinc, niacin), genetic syndromes (Netherton, severe dermatitis-allergies-metabolic wasting), primary immunodeficiencies (hyper-IgE, DiGeorge, Wiskott-Aldrich syndrome), and drug eruptions require special consideration. Despite growing interest in immunologic and molecular biomarkers for AD, no single biomarker offers diagnostic certainty. Advances in diagnostic tools such as epidermal profiling and RNA sequencing may pave the way for more personalized approaches to dermatologic care. Currently, accurate diagnosis of AD remains clinical and requires vigilance, especially when disease course and response to therapy deviate from expected patterns.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 8 fatty ethers as used in cosmetic formulations. These ingredients are reported to function in cosmetics as skin conditioning agents. The Panel reviewed the available data to determine the safety of these ingredients, and concluded that these ingredients are safe in cosmetics in the present practices of use and concentrations described in this safety assessment.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 12 Salvia officinalis (Sage)-derived ingredients as used in cosmetic formulations. These ingredients are most commonly reported to function as skin conditioning agents and fragrance ingredients. Because final product formulations may contain multiple botanicals, each containing the same constituents of concern, formulators are advised to be aware of these constituents and to avoid reaching levels that may be hazardous to consumers. With Salvia officinalis (Sage)-derived ingredients, the Panel was concerned about certain terpenes as potential sensitizers. Industry should use current good manufacturing practices to minimize impurities. The Panel reviewed data relevant to the safety of these ingredients in cosmetic formulations, and concluded that 6 of the ingredients (those derived from the leaves and the oil) are safe in cosmetics in the present practices of use and concentrations described in this safety assessment when formulated to be non-sensitizing, and that the data are insufficient to make a determination of safety for the remaining 6 ingredients under the intended conditions of use in cosmetic formulations.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of Diatomaceous Earth as used in cosmetic formulations. It is reported to function as an abrasive, absorbent, anticaking agent, bulking agent, and opacifying agent in cosmetic products. The Panel reviewed all relevant data, and concluded that Diatomaceous Earth is safe in cosmetics in the present practices of use and concentration described in this safety assessment.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 4 starch phosphates as used in cosmetic formulations. Distarch Phosphate is reported to function in cosmetics as an anticaking agent and binder. Distarch Phosphate Acetate, Hydroxypropyl Starch Phosphate, and Sodium Hydroxypropyl Starch Phosphate are all reported to function as viscosity increasing agents. The Panel considered the available data and concluded that these ingredients are safe in cosmetics in the present practices of use and concentrations described in this safety assessment.

Allergic contact dermatitis (ACD) to personal care products (PCPs) represents a significant and growing clinical challenge, with increasing use of diverse PCPs and their expanding range of ingredients. Common allergenic components include fragrances, botanicals, preservatives, surfactants, emollients, emulsifiers, vitamins, and ultraviolet filters. Patch testing remains the gold standard for diagnosing ACD and identifying causative allergens, but traditional panels often fail to capture emerging PCP-related allergens. This review highlights key established and emerging PCP allergens, such as limonene and linalool hydroperoxides, sodium benzoate, octocrylene, and benzophenone-4. Strategies are discussed to optimize diagnostic accuracy through targeted series and repeated open application tests. Patient education about PCP labeling is paramount when assisting patients with allergen avoidance. Clinicians must balance precise allergen identification with practical management knowledge to improve outcomes in PCP-related ACD.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 9 Zingiber officinale (ginger)-derived ingredients. The majority of these ingredients are reported to function in cosmetics as skin-conditioning agents. The Panel reviewed the available data to determine the safety of these ingredients. Because final product formulations may contain multiple botanicals, each containing similar constituents of concern, formulators are advised to be aware of these constituents and to avoid reaching levels that may be hazardous to consumers. With Zingiber officinale (ginger)-derived ingredients, the Panel was concerned about the presence of potential sensitizers (e.g., citronellol) in cosmetics. Industry should continue to use good manufacturing practices to minimize impurities that could be present in botanical ingredients. The Panel concluded that 8 Zingiber officinale (ginger)-derived ingredients are safe in cosmetics in the present practices of use and concentration described in this safety assessment when formulated to be non-sensitizing. In addition, the Panel concluded that the available data are insufficient to make a determination that Zingiber Officinale (Ginger) Leaf Cell Extract is safe under the intended conditions of use in cosmetic formulations.

BACKGROUND:While many adults diagnosed with atopic dermatitis (AD) achieve disease control with standard treatments, a subset of patients remains refractory to optimal management. In these cases, misdiagnosis or the presence of concomitant conditions may be contributing to treatment failure. OBJECTIVE:To provide evidence-informed guidance for the diagnostic workup of presumed adult AD unresponsive to optimized treatment. METHODS:An expert multidisciplinary workgroup applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for issuing guidance on approaching suspected AD refractory to treatment by reviewing the indirect evidence, assessing the balance of benefits and harms, and reaching consensus. RESULTS:The workgroup developed a Good Practice Statement on the diagnostic workup of adults with presumed AD unresponsive to therapy. LIMITATIONS:This guidance is based on indirect evidence and expert consensus, as direct empirical data on diagnostic workup strategies for treatment-resistant AD are lacking. Applicability may vary depending on access to dermatologic and allergy specialist care. CONCLUSION:The Good Practice Statement supports consideration of diagnostic reassessment in cases of presumed AD in adults not responding to optimized treatment.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of Acetyl Glucosamine, Glucosamine, Glucosamine HCl, and Glucosamine Sulfate. Two of the ingredients, Acetyl Glucosamine and Glucosamine Sulfate, are reported to function in cosmetics as skin-conditioning agents, Glucosamine HCl is reported to function as a pH adjustor, and the function of Glucosamine in cosmetics is not reported. The Panel reviewed the available data and concluded that these glucosamine ingredients are safe in cosmetics in the present practices of use and concentration described in this safety assessment when formulated to be non-irritating.

Background Pediatric atopic dermatitis (AD) is a common, chronic inflammatory skin disorder that significantly impacts the quality of life of affected children and their families. In addition to skin-related symptoms, AD in pediatric patients may be associated with a range of comorbid conditions. Objective To provide evidence-based recommendations on primary prevention of AD and to appraise evidence of the association between AD and comorbidities among pediatric patients. Methods A multidisciplinary workgroup conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. Results The workgroup developed 14 evidence-based recommendations on primary prevention of AD and 29 statements on the association between pediatric AD and comorbid conditions. Limitations This analysis is based on the best available evidence at the time it was conducted. This guideline does not make recommendations for screening or management of comorbidities in children with AD. Conclusions We make a conditional recommendation for moisturizing skin care to reduce the occurrence of AD and conditional recommendations against early food introduction, human milk consumption, and probiotic or vitamin D supplementation for the primary prevention of AD. Clinicians should be aware of comorbidities associated with pediatric AD, but further research is needed to optimize screening and/or management of comorbidities.

The Expert Panel for Cosmetic Safety (Panel) assessed the safety of 8 naturally-sourced clay ingredients, of which 6 were previously reviewed, as used in cosmetic formulations. All of these ingredients are reported to function in cosmetics as absorbents and bulking agents; other cosmetic functions are also reported. The Panel reviewed all relevant data and concluded that Kaolin is safe in cosmetics in the present practices of use and concentration described in this safety assessment. The remaining 7 naturally-sourced clay ingredients are safe in cosmetics in the present practices of use and concentration, with the exception that the available data are insufficient to make a determination that these ingredients are safe in products that may be incidentally inhaled.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of Basic Yellow 87, which is reported to function as a hair dye in cosmetic products. The Panel reviewed the available data to determine the safety of this ingredient. The Panel concluded that Basic Yellow 87 is safe for use as a hair dye ingredient in the present practices of use and concentration described in this safety assessment.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 7 radish root-derived ingredients, most of which are reported to function as hair and skin conditioning agents in cosmetic products. Because final product formulations may contain multiple botanicals, each containing similar constituents of concern, formulators are advised to be aware of these constituents and to avoid reaching levels that may be hazardous to consumers. With radish root-derived ingredients, the Panel was concerned about the presence of anthocyanins and isothiocyanates in cosmetics. Industry should use current good manufacturing practices to minimize impurities that could be present in botanical ingredients. The Panel reviewed the available data and concluded that these ingredients are safe in cosmetics in the present practices of use and concentration described in this safety assessment when formulated to be non-sensitizing.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 5 glycolactone ingredients. Glucoheptonolactone and Gluconolactone are reported to function in cosmetics as skin-conditioning agents-miscellaneous, and Gluconolactone is also reported to function as a chelating agent. No functions are reported for the other 3 ingredients. The Panel considered the available data and concluded that Gluconolactone is safe in cosmetics in the present practices of use and concentration described in this safety assessment; however, the Panel concluded the available data are insufficient to make a determination that Galactonolactone, Glucarolactone, Glucoheptonolactone, and Ribonolactone are safe under the intended conditions of use in cosmetic formulations.

Background Pediatric atopic dermatitis (AD) is a common, chronic inflammatory skin disorder that significantly impacts the quality of life of affected children and their families. Multiple therapies were approved to treat AD in children and adolescents since publication of the AAD's 2014 AD guidelines. Objective To provide evidence-based recommendations on the use of topical therapies, phototherapy, and systemic therapies for AD in children and adolescents. Methods A multidisciplinary workgroup conducted a systematic review and applied the GRADE approach for assessing the certainty of evidence and formulating and grading recommendations. Results The workgroup developed 27 evidence-based recommendations on the medical management of pediatric AD. Limitations This analysis is based on the best available evidence at the time it was conducted. Most randomized controlled trials of therapies for AD are of short duration limiting long-term efficacy and safety conclusions. Conclusions We make strong recommendations for the use of moisturizers, topical calcineurin inhibitors, topical corticosteroids, crisaborole ointment, roflumilast cream, ruxolitinib cream, tapinarof cream, dupilumab, tralokinumab, lebrikizumab, nemolizumab with concomitant topical therapy, upadacitinib, abrocitinib, and baricitinib in the treatment of pediatric AD. We make conditional recommendations in favor of bathing, bleach baths, wet dressings, phototherapy, methotrexate, mycophenolate mofetil, azathioprine, and cyclosporine. We conditionally recommend against the use of topical antimicrobials, PUVA phototherapy, and strongly recommend against systemic corticosteroids.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of Polyhydroxystearic Acid, Poly(3-Hydroxyoctanoic Acid), and Polylactic Acid as used in cosmetic formulations. These ingredients are reported to function in cosmetics as a non-surfactant dispersing agent, a skin-conditioning agent, and an abrasive agent, respectively. The Panel reviewed the available data to determine the safety of these ingredients and concluded that these ingredients are safe in cosmetics in the present practices of use and concentrations described in this safety assessment.

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 8 Melaleuca alternifolia (tea tree)-derived ingredients as used in cosmetic formulations; 5 of these ingredients are reported to function in cosmetics as skin-conditioning agents. Because final product formulations may contain multiple botanicals, each containing the same constituents of concern, formulators are advised to be aware of these constituents and to avoid reaching levels that may be hazardous to consumers. Industry should use good manufacturing practices to minimize impurities that could be present in botanical ingredients. The Panel noted that oxidized tea tree oil could be a sensitizer, and stated that industry should employ methods to minimize oxidation of the oil in the final cosmetic product. The Panel considered all the data and concluded that these ingredients are safe in cosmetics in the present practices of use and concentration described in this safety assessment when formulated to be non-sensitizing.

The Expert Panel for Cosmetic Ingredient Safety (Panel) considered whether the safety of Glyceryl Isostearates and Glyceryl Stearate/Acetate as used in cosmetics should be reassessed. The Panel reviewed newly available safety data related to these ingredients. The Panel concluded, based on the available data contained in the report, that these two ingredients are safe as cosmetic ingredients in the present practices of use and concentration as described in the report.

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of 7 saccharides/saccharide derivatives as used in cosmetic products; all of these ingredients are reported to function as skin-conditioning agents-humectant in cosmetics. The Panel reviewed data relevant to the safety of these ingredients in cosmetic formulations and concluded that Anhydrogalactose, Anhydroglucitol, Anhydroxylitol, Arabinose, Psicose, Saccharide Hydrolysate, and Saccharide Isomerate are safe in cosmetics in the present practices of use and concentration described in this safety assessment.