Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape

Abstract

The implementation of treatment guidelines for atopic dermatitis is challenging, in part because of different guidance documents being used by different groups of specialists and in part because the language of guidelines often reflects the evidence base rather than the practical "how to." The Atopic Dermatitis Yardstick is part of a series developed in response to the need to proactively address the loss of disease control for atopic illnesses at all levels of severity. It presents a comprehensive update on how to conduct a sustained step-up in therapy for the patient with inadequately controlled or poorly controlled atopic dermatitis. Patient profiles, based on current guidelines and the authors' combined clinical experience, provide a practical and clinically meaningful guide to aid physicians in helping their patients achieve the goal of clear to almost clear. The intent is not to replace guidelines but to complement their recommendations incorporating the latest research and therapies.

Moisturizers versus Current and Next-Generation Barrier Repair Therapy for the Management of Atopic Dermatitis

“…Current guidelines for the management of AD typically recommend the use of moisturizers along with anti-inflammatory agents [26]. This approach seems prudent, since coapplication of moisturizers under nursing supervision have been shown to reduce reliance on topical steroids in AD management [27, 28].…”

Systemic Tofacitinib Concentrations in Adult Patients With Atopic Dermatitis Treated With 2% Tofacitinib Ointment and Application to Pediatric Study Planning

“…Treatment usually involves the use of topical creams or ointments including emollients, corticosteroids, calcineurin inhibitors, and phosphodiesterase 4 inhibitors . Additional treatments for atopic dermatitis include refined coal tar, topical and oral antibiotics, phototherapy, and systemic immunosuppressants …”

Atopic dermatitis made easy: The Schachner Ladder

“…Individualized care based on severity is essential for atopic dermatitis as physicians must find a balance between providing enough therapy that targets the inflammation while also balancing the side effects of the potential medications. Several action plans for atopic dermatitis have been published; Boguniewicz et al recently published a comprehensive update on step‐up therapy, also known as their “Atopic Dermatitis Yardstick,” which describes methods to tailor therapy as needed based on patient severity …”