Ann Dermatol.  2015 Oct;27(5):578-592. 10.5021/ad.2015.27.5.578.

Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Systemic Treatment

• Kim JE
• Kim HJ
• Lew BL
• Lee KH
• Hong SP
• Jang YH
• Park KY
• Seo SJ
• Bae JM
• Choi EH
• Suhr KB
• Lee SC
• Ko HC
• Park YL
• Son SW
• Seo YJ
• Lee YW
• Cho SH
• Park CW
• Roh JY

• KMID: 2171458
• DOI: http://doi.org/10.5021/ad.2015.27.5.578

Abstract

BACKGROUND
Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD.
OBJECTIVE
We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD.
METHODS
We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established.
RESULTS
The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD.
CONCLUSION
We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.

Keyword

Administration; oral; Dermatitis; Guideline; Korea; Therapeutics

MeSH Terms

Consensus*
Cyclosporine
Dermatitis
Dermatitis, Atopic*
Histamine Antagonists
Humans
Hypersensitivity
Immunologic Factors
Immunotherapy
Korea*
Phototherapy
Pruritus
Quality of Life
Cyclosporine
Histamine Antagonists
Immunologic Factors

Figure

• 

  Fig. 1 Treatment algorithm for atopic dermatitis (AD). SCORAD: SCORing atopic dermatitis, EASI: eczema area and severity index, AZA: azathioprine, MMF: mycophenolate mofetil, MTX: methotrexate, IFN-γ: interferon-γ.

• 

  Fig. 2 Strategy for tailored treatment of atopic dermatitis (AD).

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