Atopic dermatitis (AD) is a common and chronic, pruritic inflammatory skin
condition that can affect all age groups. This evidence-based guideline addresses
important clinical questions that arise in its management. In this second of four
sections, treatment of AD with non-pharmacological interventions and pharmacological
topical therapies are reviewed. Where possible, suggestions on dosing and monitoring are
given based on available evidence.
To assess the patient-level and societal burden of atopic dermatitis, we comprehensively reviewed the literature related to quality of life, social, economic, academic, and occupational impacts. Atopic dermatitis has profound impacts on patient and family quality of life. A conservative estimate of the annual costs of atopic dermatitis in the United States is $5.297 billion (in 2015 USD). People with atopic dermatitis may change their occupation because of their skin disease. Research gaps include quality of life assessments outside of tertiary care centers, impacts on partners and families of adult patients, and updated comprehensive cost estimates.
Atopic dermatitis (AD) is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2–3% of adults. This guideline addresses important clinical questions that arise in AD management and care, providing updated and expanded recommendations based on the available evidence. In this first of four sections, methods for diagnosis and monitoring of disease, outcomes measures for assessment and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed.
Atopic dermatitis (AD) is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2-3% of adults. This guideline addresses important clinical questions that arise in AD management and care, providing recommendations based on the available evidence. In this third of four sections, treatment of AD with phototherapy and systemic immunomodulators, antimicrobials, and antihistamines is reviewed, including indications for use and the risk-benefit profile of each treatment option.
The consequences of atopic dermatitis reach beyond the skin and past childhood. Patients with atopic dermatitis are at risk of developing allergic comorbidities, but less is known about the associations between atopic dermatitis and non-allergic conditions. Understanding these non-allergic comorbidities has the potential to improve patient outcomes and to help mitigate the cost and burdens associated with these conditions. Atopic dermatitis is associated with cutaneous bacterial infections, more severe forms/courses of cutaneous viral infections, and extra-cutaneous infections. Atopic dermatitis is also associated with several mental health comorbidities particularly attention-deficit hyperactivity disorder, anxiety, and depression. Data are largely inconsistent for specific cancers, but atopic dermatitis appears to protect against malignancy overall; severe long-term atopic dermatitis is associated with adult lymphomas. Atopic dermatitis may also be associated with obesity, cardiovascular disease, and autoimmune disease, particularly alopecia areata and gastrointestinal immune-mediated disorders. Although the causative mechanisms underlying these associations are poorly understood, treating physicians should be aware of associations in seeking to alleviate the burden for patients with atopic dermatitis.
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