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Giornale Italiano di Dermatologia e Venereologia 2018 April;153(2):133-45

DOI: 10.23736/S0392-0488.17.05892-8


language: English

Diagnosis and management of moderate to severe adult atopic dermatitis: a Consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Italian Association of Hospital Dermatologists (ADOI), the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC), and the Italian Society of Allergological, Environmental and Occupational Dermatology (SIDAPA)

Piergiacomo CALZAVARA PINTON 1 , Antonio CRISTAUDO 2, Caterina FOTI 3, Giorgio W. CANONICA 4, Nicola BALATO 5, Antonio COSTANZO 6, 7, Ornella DE PITÀ 8, Clara DE SIMONE 9, Cataldo PATRUNO 5, Giovanni PELLACANI 10, Ketty PERIS 9, Giampiero GIROLOMONI 11

1 Department of Dermatology, Spedali Civili of Brescia, University of Brescia, Brescia, Italy; 2 San Gallicano Dermatological Institute, IRCCS, Rome, Italy; 3 Unit of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy; 4 Personalized Medicine Asthma & Allergy Clinic, Humanitas University, Clinical and Research Hospital, Rozzano, Milan, Italy; 5 Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy: 6 Unit of Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; 7 Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; 8 Clinical Pathology, Cristo Re Hospital, Rome, Italy; 9 Department of Dermatology, Sacro Cuore Catholic University, Rome, Italy; 10 Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy; 11 Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy


Atopic dermatitis (AD) is a chronic immune-mediated inflammatory skin disease, currently recognized as a systemic disease possibly burdened by various comorbidities, including, but not limited to, other allergic conditions. Management guidelines issued by American and European dermatology and allergy scientific societies are available. However, some discrepancies exist in these guidelines, and some aspects of the management process, including diagnosis and severity assessment, as well as therapy duration and switch criteria, are not fully clarified by existing guidelines. Moreover, biologics such as dupilumab have now entered the therapeutic scenario of moderate-to-severe AD, offering a great opportunity to treat effectively and safely in need AD patients. For all these reasons, four Italian dermatology and allergy scientific societies joined to provide practical guidance for the management of moderate-to-severe adult AD suitable for the Italian clinical practice. Through a modified Delphi procedure, consensus was reached by 63 Italian dermatologists and allergists experienced in the management of adult AD on 14 statements covering five AD areas of interest, i.e. diagnosis, severity definition, current systemic therapies, eligibility criteria to biologic treatments, and comorbidities, with the aim to define treatment goals and improve adult AD management. The potential usefulness of a multidisciplinary approach is also underlined, given the complexity of AD and its comorbidities.

KEY WORDS: Dermatitis, atopic - Diagnosis - Disease management - Therapeutics

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