BackgroundAtopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD.ObjectiveThe Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians.MethodsElectronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017.ResultsThe Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included.ConclusionThe management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.

Psoriasis merupakan peradangan kulit kronik dengan dasar genetik. Untuk mencapai remisi dan kualitas hidup yang baik, pilihan terapi disesuaikan dengan kebutuhan perorangan pasien. Tipe dan derajat keparahan psoriasis perlu ditentukan guna memilih tata laksana yang sesuai karena memengaruhi keberhasilan terapi, masa remisi, serta tingkat morbiditas. Penelitian ini bertujuan menilai kesesuaian tata laksana psoriasis berdasarkan derajat keparahan dengan menggunakan Panduan Praktik Klinis (PPK) RSUPN dr. Cipto Mangunkusumo (RSCM) dan Persatuan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI). Studi retrospektif ini mengambil subjek seluruh pasien baru psoriasis di Divisi Alergi Imunologi, Departemen Ilmu Kesehatan Kulit dan Kelamin RSCM periode Oktober 2017 – Oktober 2018. Keparahan psoriasis dinilai dengan skor body surface area (BSA) dan psoriasis area severity index (PASI). Sebanyak 32 di antara 35 pasien (91,4%), skor BSA dan/atau PASI terdokumentasi pada rekam medis, dan 30 di antara 32 pasien (93,8%), mendapatkan pilihan terapi sesuai dengan tipe psoriasis atau skor BSA dan/atau PASI. Kepatuhan pasien sangat penting sehingga pemilihan tata laksana psoriasis perlu mempertimbangkan kenyamanan pasien terkait efek samping pengobatan, kemudahan pasien untuk mengakses fasilitas, dan aspek ekonomi. Kesesuaian terapi tidak mencapai 100% karena kontraindikasi pemberian terapi standar, penolakan pasien, dan ketidaktersediaan obat misalnya metotreksat. Sebanyak 93,8% pasien psoriasis di RSCM telah ditata laksana sesuai dengan PPK RSCM dan PERDOSKI.Kata Kunci: BSA, PASI, psoriasis, tata laksana

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