When Is Systemic Treatment Appropriate for Atopic Dermatitis?

Recommendations made as part of consensus statement by International Eczema Council
Recommendations made as part of consensus statement by International Eczema Council

HealthDay News — A new framework is available to help clinicians determine when systemic therapy is appropriate for treatment of atopic dermatitis (AD), according to a consensus statement published in the October issue of the Journal of the American Academy of Dermatology.

As a subgroup of the International Eczema Council, Eric L. Simpson, MD, from Oregon Health and Science University in Portland, and colleagues developed a framework for evaluation of therapeutic decisions regarding the use of systemic therapy in AD. They performed a topic-specific literature review, referred to guidelines when available, and provided interpretation and expert opinion. 

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The authors recommend a systematic and holistic approach to assess patients with severe signs and symptoms of AD and impact on quality of life before systemic therapy. Before commencing systemic therapy, steps to be taken include considering alternate or concomitant diagnoses, avoiding trigger factors, optimizing topical therapy, ensuring adequate patient/caregiver education, treating coexistent infection, assessing the impact on quality of life, and considering phototherapy.

"The decision to start systemic medication should include assessment of severity and quality of life while considering the individual's general health status, psychologic needs, and personal attitudes toward systemic therapies," conclude the authors.

Several authors disclosed financial ties to pharmaceutical companies, which sponsor the International Eczema Council.

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