A Treatment Algorithm for Moderate to Severe Atopic Dermatitis in Adults. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: Lynde, Charles W.; Bourcier, Marc; Gooderham, Melinda; Guenther, Lyn; Hong, Chih-ho; Papp, Kim A.; Poulin, Yves; Sussman, Gordon; Vender, Ronald
• Is Part Of: Journal of cutaneous medicine and surgery. Volume 22:Issue 1(2018)
• Page Start: 78
• Page End: 83
• Publication Date: 2018-01
• Subjects: atopic dermatitis -- adults -- systemic therapy -- patient criteria -- algorithm; Dermatology -- Periodicals; Skin -- Diseases -- Treatment -- Periodicals; Skin -- Surgery -- Periodicals; Dermatology -- Canada -- Periodicals; Skin -- Diseases -- Treatment -- Canada -- Periodicals; Skin -- Surgery -- Canada -- Periodicals; 616.5005
• DOI: 10.1177/1203475417733460
• Languages: English
• ISSNs: 1203-4754

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.