ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children - PubMed
A Wollenberg 1 ,
Article Images. 2020 Dec;34(12):2717-2744.
doi: 10.1111/jdv.16892. Epub 2020 Nov 17.
S Christen-Zäch 2 , A Taieb 3 , C Paul 4 , J P Thyssen 5 , M de Bruin-Weller 6 , C Vestergaard 7 , J Seneschal 8 , T Werfel 9 , M J Cork 10 , B Kunz 11 , R Fölster-Holst 12 , M Trzeciak 13 , U Darsow 14 15 , Z Szalai 16 , M Deleuran 7 , L von Kobyletzki 17 18 , S Barbarot 19 , A Heratizadeh 9 , U Gieler 20 , D J Hijnen 21 , S Weidinger 12 , L De Raeve 22 , Å Svensson 23 , D Simon 24 , J F Stalder 25 , J Ring 14 26 ; European Task Force on Atopic Dermatitis/EADV Eczema Task Force
Affiliations
- PMID: 33205485
- DOI: 10.1111/jdv.16892
Free article
ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children
A Wollenberg et al. J Eur Acad Dermatol Venereol. 2020 Dec.
Free article
Abstract
Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and pathogenic variabilities, the patient's age and also target flare prevention. Basic therapy includes hydrating and barrier-stabilizing topical treatment universally applied, as well as avoiding specific and unspecific provocation factors. Visible skin lesions are treated with anti-inflammatory topical agents such as corticosteroids and calcineurin inhibitors (tacrolimus and pimecrolimus), which are preferred in sensitive locations. Topical tacrolimus and some mid-potency corticosteroids are proven agents for proactive therapy, which is defined as the long-term intermittent anti-inflammatory therapy of frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is a rapidly changing field requiring monitoring. Oral corticosteroids have a largely unfavourable benefit-risk ratio. The IL-4R-blocker dupilumab is a safe, effective and licensed, but expensive, treatment option with potential ocular side-effects. Other biologicals targeting key pathways in the atopic immune response, as well as different Janus kinase inhibitors, are among emerging treatment options. Dysbalanced microbial colonization and infection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) only have limited effects on AD-related itch and eczema lesions. Adjuvant therapy includes UV irradiation, preferably narrowband UVB or UVA1. Coal tar may be useful for atopic hand and foot eczema. Dietary recommendations should be patient-specific, and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. Efficacy-proven 'Eczema school' educational programmes and therapeutic patient education are recommended for both children and adults.
© 2020 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
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References
-
- Darsow U, Lubbe J, Taieb A et al. Position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 2005; 19: 286-295.
-
- Darsow U, Wollenberg A, Simon D et al. ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 2010; 24: 317-328.
-
- Wollenberg A, Oranje A, Deleuran M et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. J Eur Acad Dermatol Venereol 2016; 30: 729-747.
-
- Wollenberg A, Barbarot S, Bieber T et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol 2018; 32: 657-682.
-
- Wollenberg A, Barbarot S, Bieber T et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol 2018; 32: 850-878.
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