S2k guideline on diagnosis and treatment of atopic dermatitis - short version (original) (raw)

S2k guideline on diagnosis and treatment of atopic dermatitis – short version Date of production

Atopic dermatitis (AD) represents a pruritic, non-contagious, chronic or chronically relapsing, inammatory skin disease. e course of the disease may be complicated by bacterial or viral super-infections. e rst manifestation of the disease and further are-ups are due to genetic predisposition and also to a variety of further trigger factors. e therapy regimen should be adapted to disease symptoms that are actually present and consider individual features of the disease as reported by the patients or their parents. is short version of the German guideline on AD provides an overview of evidence-based diagnostic and treatment options. All recommendations made here are the result of a consensus of the scientic medical societies, working groups and support groups based on scientic data published to date. Abstracts and details of the studies cited are provided in the long version of this guideline (see: www. awmf.org).

Clinical practice guidelines for the diagnosis and management of atopic dermatitis

2021

Atopic dermatitis (AD), a chronic, relapsing dermatitis, is characterized by dry and pruritus skin in patients with a personal or family history of atopy. It affects up to 20% of children and 1-3% of adults in most countries worldwide, and leads to significant treatment costs and morbidity. These guidelines are developed in accordance with evidence-based publications and expert opinions. Following simple algorithms, the guidelines aim to assist adult and pediatric physicians in the better care of patients with AD. As with other diseases, there have been several diagnosis criteria proposed over time. Nonetheless, the classical Hanifin and Rajka criterion with no pathognomonic laboratory biomarkers is still the most widely used worldwide for the diagnosis of AD. The management of AD must be considered case by case to provide suitable care for each patient. Basic therapy is focused on avoiding specific/unspecific provoking factors and hydrating skin. Topical anti-inflammatory treatment...

Guidelines for management of atopic dermatitis

The Journal of dermatology, 2009

Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease characterized by pruritus and inflammation and accompanied by cutaneous physiological dysfunction (dry and barrier-disrupted skin). Most of the patients have atopic diathesis. A standard guideline for the management (diagnosis, severity classification and therapy) of AD has been established. In our guideline, the necessity of dermatological training is emphasized in order to assure diagnostic skill and to enable evaluation of the severity of AD. The definitive diagnosis of AD requires the presence of all three features: (i) pruritus; (ii) typical morphology and distribution; and (iii) chronic and chronically relapsing course. For the severity classification of AD, three elements of eruption (erythema/acute papules, exudation/crusts and chronic papules/nodules/lichenification) are evaluated in the most severely affected part of each of the five body regions (head/neck, anterior trunk, posterior trunk, upper limbs a...

Atopic Dermatitis: A Review on Diagnosis and Management

https://www.ijrrjournal.com/IJRR\_Vol.7\_Issue.6\_June2020/Abstract\_IJRR0015.html, 2020

Atopic Dermatitis (AD), also known as eczema, is a chronic, relapsing, and itchy inflammatory skin condition. The pathogenesis of AD including genetic, environmental, and immunologic factors. The primary biologic changes in AD are decreased skin barrier function, Filaggrin gene impairment, and Calcineurin-mediated Th2 cell activation. History taking and clinical manifestations play an essential role in ruling out common differential diagnoses because there is no specific diagnostic tool for AD. The management of AD varies in children and adults depend on the severity of cases. Successful treatment of AD requires multifocal modalities from non-pharmacologic and pharmacologic therapy as well as identification and elimination of flare factors. Managementfor AD including moisturizer, topical corticosteroid, non-steroidal immunomodulators (topical Calcineurin Inhibitors), antibiotics to treat secondary infection, systemic immunosuppressive agents (Cyclosporine, Azathioprine, Methotrexate) and targeted biologic therapeutic agent (Dupilumab). Treatment outcome also affected by the severity of the disease and concomitant atopic conditions. A physician needs to inform the patient that the treatment does not produce a cure to the disease, but it can be controlled.

Position paper on diagnosis and treatment of atopic dermatitis

Journal of the European Academy of Dermatology and Venereology, 2005

The diagnosis of atopic dermatitis (AD) is made using evaluated clinical criteria. Management of AD must consider the symptomatic variability of the disease. It is based on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment is used for exacerbation management. Topical corticosteroids remain the first choice. Systemic anti-inflammatory treatment should be kept to a minimum, but may be necessary in rare refractory cases. The new topical calcineurin inhibitors (tacrolimus and pimecrolimus) expand the available choices of topical antiinflammatory treatment. Microbial colonization and superinfection (e.g. with Staphylococcus aureus , Malassezia furfur) can have a role in disease exacerbation and can justify the use of antimicrobials in addition to the anti-inflammatory treatment. Evidence for the efficacy of systemic antihistamines in relieving pruritus is still insufficient, but some patients seem to benefit. Adjuvant therapy includes ultraviolet (UV) irradiation preferably of UVA wavelength; UVB 311 nm has also been used successfully. Dietary recommendations should be specific and only given in diagnosed individual food allergy. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programmes have proved to be helpful.

The Turkish guideline for the diagnosis and management of atopic dermatitis-2018

TURKDERM, 2018

Amaç: Atopik dermatit (AD), tanı ve tedavisinde zaman zaman zorluklar yaşanan bir hastalıktır. Farklı yaklaşımların görülebildiği bir hastalık olması, hastalığın tanı, sınıflama, etiyopatogenez, tanısal testler ve tedavi yaklaşımları açısından bir algoritma içerisinde değerlendirilmesi Background and Design: Atopic dermatitis (AD) has a complicated etiopathogenesis and difficulties in diagnosis and treatment from time to time. Because of the disease which different approaches can be seen rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology aimed to create an AD guideline for the diagnosis, treatment and followup. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach of AD. Lesions show age-related morphology and distribution. There are no in vivo/in vitro tests that have high sensitivity and specificity that can be used to identify AD and trigger factors. The first step of treatment consists of moisturizers, topical corticosteroids and calcineurin inhibitors, respectively. Moisturizers are used therapeutically in all forms of AD. Topical corticosteroids are the first agents to be used when moisturizers are inadequate. Topical calcineurin inhibitors should be used in lesions resistant to corticosteroids, for proactive treatment, special areas. Antimicrobial agents and antiseptics should only be added to treatment when clinical signs of infection are present. And in topical treatment-resistant cases, secondline treatment is phototherapy or oral cyclosporine. The biologic agent, dupilumab, is promising in the treatment of severe AD. Conclusion: AD is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of AD and help the physician to overcome the challenges in the management.