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Italian Journal of Dermatology and Venereology 2021 Dec 21

DOI: 10.23736/S2784-8671.21.07129-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Long-term management of moderate-to-severe adult atopic dermatitis: a consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Association of Italian Territorial and Hospital Allergists and Immunologists (AAIITO ), the Italian Association of Hospital Dermatologists (ADOI), the Italian Society of Allergological, Environmental and Occupational Dermatology (SIDAPA), and the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC)

Antonio COSTANZO 1, 2, Paolo AMERIO 3, Riccardo ASERO 4, Andrea CHIRICOZZI 5, 6, Monica CORAZZA 7, Antonio CRISTAUDO 8, Francesco CUSANO 9, Silvia M. FERRUCCI 10, Eustachio NETTIS 11, Annalisa PATRIZI 12, 13 , Cataldo PATRUNO 14, Ketty PERIS 5, 6, Mario PICOZZA 15, Luca STINGENI 16, Giampiero GIROLOMONI 17, on behalf of Italian AD Study Group 

1 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; 2 Unit of Dermatology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy; 3 Unit of Dermatology, Department of Medicine and Aging Science, G. D’Annunzio University, Chieti, Chieti-Pescara, Italy; 4 Department of Allergology, San Carlo Clinic, Paderno Dugnano, Milan, Italy; 5 Unit of Dermatology, Department of Surgical and Medical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 6 Unit of Dermatology, Department of Medicine and Translational Surgery, Sacred Heart Catholic University, Rome, Italy; 7 Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; 8 Department of Dermatology, IRCCS San Gallicano Dermatological Institute, Rome, Italy; 9 Unit of Dermatology, San Pio Hospital - G. Rummo Hospital, Benevento, Italy; 10 Section of Dermatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; 11 Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, Aldo Moro University, Bari, Italy; 12 Dermatology of Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy; 13 Unit of Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy; 14 Department of Health Sciences, Magna Grecia University, Catanzaro, Italy; 15 National Association of Atopic Dermatitis (ANDeA), Prato, Italy; 16 Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 17 Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy


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Atopic dermatitis (AD) is a common chronic-relapsing inflammatory skin disease, burdened by various comorbidities. AD most commonly occurs in children but may persist or present in adulthood becoming a lifelong condition. Therefore, AD requires an effective long-term treatment improving disease signs and symptoms but also of patients’ quality of life (QoL). However continuous long-term use of most traditional AD immunosuppressive treatments is not recommended for safety reasons or insufficient efficacy data. Despite the available guidelines, there is still need for knowledge of AD long-term treatment, taking into account new disease measures and recent treatment options. Five Italian scientific societies implemented a joint consensus procedure to define the most appropriate clinical practice for the long-term management of adult moderate-severe AD. Through a modified Delphi procedure, consensus was reached by overall 51 Italian dermatologists and allergists (The Italian AD Study Group) experienced in the management of adult AD on 14 statements covering three AD areas of interest, namely diagnosis, definition of disease severity and clinimetrics, and a treat-to-target approach. This paper reports and discusses the agreed statements, which define disease and patient impact measures, therapeutic approach, and a treatment decision algorithm to support clinicians in the long-term management of adult patients with moderate-to-severe AD in their daily clinical practice.


KEY WORDS: Dermatitis, atopic; Adult; Diagnosis; Biological products; Dupilumab

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