Optimizing a clinical guidance for diagnosis of atopic dermatitis in adults: joint recommendations of the Italian Society of Dermatology and Venereology (SIDeMaST), Italian Association of Hospital Dermatologists (ADOI), and Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA)

Abstract

Atopic dermatitis (AD) places significant burden not only on quality of life, but is also associated with considerable costs to healthcare systems. Diagnosis of AD may be challenging when it starts in adolescence or adulthood, and is further complicated as its manifestations are different from those generally seen in children. Accordingly, better definition of diagnostic criteria for adult onset AD is needed to avoid misdiagnosis and undertreatment in adult patients. to provide practical guidance for clinicians to reliably diagnose ad in adult patients, representatives from three Italian dermatology scientific societies (Italian Society of Dermatology and Venereology [SIDeMaST], Italian Association of Hospital Dermatologists [ADOI], Italian Society of Allergological, Occupational and Environmental Dermatology [SIDAPA]) carried out a joint consensus meeting to develop useful indications for improving diagnosis of moderate to severe ad in adult patients in routine clinical practice. the most representative criteria for morphological criteria, localization, clinical history, and differential diagnosis were identified by the experts. The most frequent clinical presentations are those on the flexural areas, hands, face/neck, and trunk, with itch and eczema as key manifestations. The diagnostic path defined herein can form a sort of "check list" for physicians to adopt when evaluating patients with suspected AD, which can help in refining a diagnosis and refer the patient for specialist dermatological care. It is hoped that the practical guidance developed by the consensus group will help to improve outcomes, lower overall costs of care, and ameliorate the patient's quality of life, even though validation in a large cohort of patients is still needed.

The less‐known face of dupilumab: its role in mesenchymal stem cells by interleukin‐13 modulation

“…The efficacy and tolerability of this combination treatment in HS-AI has previously been assessed in three retrospective studies and one prospective study. [4][5][6][7] To the best of our knowledge, the present study is the first to examine a cohort of paediatric patients, and the results are in agreement with those previously reported in the literature. This study demonstrates that rifampicin in association with clindamycin is a good option for the treatment of active inflammatory HS-AI in paediatric patients in terms of efficacy, tolerability, quick onset of action and limited cost of therapy.…”

Oxidative Stress and Atopic Dermatitis

“…Moreover, the amount of papers published is sometimes not proportional to the geographical extension, number of inhabitants, or number of ethnicities of nations: as an example, the sum of AD patients from the United States of America [49] and India [26] ever studied concerning the association between oxidative stress and atopic dermatitis is 34, which is equal to the number of patients analyzed in a single Finnish paper [39] and only slightly superior to that (n = 33) of a single-center study performed in Italy [28]. Adequate representation of all ethnicities and areas is important in studies on the role of oxidative stress in diseases, because the oxidoreductive balance results from the complex interplay of three variables that may significantly change even within a small geographical area: genetics (with reference to the entire genetic structure of individuals, not only antioxidant enzymes), environment, and individual habits [50][51][52][53][54].…”

Atopic Dermatitis and Patient Perspectives: Insights of Bullying at School and Career Discrimination at Work

“…23 Finally, AD also compromises the ability to undertake some specific jobs, such as front office positions, or tasks, such as using irritating chemicals. 24 Recently, Italian dermatologists have worked intensively on the harmonization of AD diagnosis and management in adults 25 and in adolescents 26 with great emphasis on social isolation, bullying and reduced level of attention at school. Since no recent data were available, to better explore these aspects, in this study we aimed to investigate AD QoL, feelings and interpersonal relationships across adolescence and adulthood both at school and at the workplace, inquiring about the frequency of bullying and self-isolation episodes among students and professional discrimination among workers.…”