A Treatment Algorithm for Moderate to Severe Atopic Dermatitis in Adults

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Abstract

Background:

Atopic dermatitis (AD) is a common and chronic inflammatory skin disease. Approximately 10% of adults with AD do not respond adequately to topical therapies and require phototherapy and/or systemic therapy.

Objective:

To provide a patient-focused approach to the identification and management of adults with AD who require systemic treatment.

Methods:

A working group of clinicians experienced in managing AD was convened to review and discuss current evidence on the identification and clinical management of adults with moderate to severe AD.

Results:

We propose a set of simple and practical clinical criteria for selecting candidates for systemic treatment of AD based on their response to first-line topical therapy and 4 clinical measures that are easily incorporated into routine practice. We also suggest a framework for evaluating systemic treatments according to attributes that are important from both a clinician’s and a patient’s perspective. An algorithm was developed proposing a pathway for treatment of moderate to severe AD in adults.

Conclusion:

Adults with moderate to severe AD that does not respond adequately to topical therapies currently have few safe and effective treatment options. A clinical algorithm could help guide treatment decisions.

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