Ann Dermatol.
2021 Dec;33(6):497-514. 10.5021/ad.2021.33.6.497.
Consensus Update for Systemic Treatment of Atopic Dermatitis
- Lee JH
1 - Kim JE2
- Park GH3
- Bae JM4
- Byun JY5
- Shin MK6
- Han TY7
- Hong SP8
- Jang YH9
- Kim HO3
- Na CH10
- Lew BL6
- Ahn J11
- Park CO12
- Seo YJ13
- Lee YW14
- Son SW15
- Choi EH8
- Park YL16
- Roh JY17
- Affiliations
-
- 1Department of Dermatology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Korea
- 2Department of Dermatology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 3Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Choncheon, Korea
- 4Department of Dermatology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Korea
- 5Department of Dermatology, Ewha Womans University College of Medicine, Korea
- 6Department of Dermatology, Kyung Hee University College of Medicine, Korea
- 7Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
- 8Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
- 9Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
- 10Department of Dermatology, College of Medicine, Chosun University, Gwangju, Korea
- 11Department of Dermatology, National Medical Center, Seoul, Korea
- 12Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
- 13Department of Dermatology, Chungnam National University College of Medicine, Daejeon, Korea
- 14Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
- 15Department of Dermatology, Korea University College of Medicine, Seoul, Korea
- 16Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- 17Department of Dermatology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
- KMID: 2522128
- DOI: http://doi.org/10.5021/ad.2021.33.6.497
Abstract
- Background
In 2015, the Korean Atopic Dermatitis Association (KADA) working group published consensus guidelines for treating atopic dermatitis (AD).
Objective
We aimed to provide updated consensus recommendations for systemic treatment of AD in South Korea based on recent evidence and experience.
Methods
We compiled a database of references from relevant systematic reviews and guidelines on the systemic management of AD. Evidence for each statement was graded and classified based on thestrength of the recommendation. Forty-two council members from the KADA participated in three rounds of voting to establish a consensus on expert recommendations.
Results
We do not recommend long-term treatment with systemic steroids forpatients with moderate-to-severe AD due to the risk of adverse effects. We recommend treatment with cyclosporine or dupilumab and selective treatment with methotrexate or azathioprine for patients with moderate-to-severe AD. We suggest treatment with antihistamines as an option for alleviating clinical symptoms of AD. We recommend selective treatment with narrowband ultraviolet B for patients with chronic moderate-to-severe AD. We do not recommend treatment with oral antibiotics for patients with moderate-to-severe AD but who have no signs of infection. We did not reach a consensus on recommendations for treatment with allergen-specific immunotherapy, probiotics, evening primrose oil, orvitamin D for patients with moderate-to-severe AD. We also recommend educational interventions and counselling for patients with AD and caregivers to improve the treatment success rate.
Conclusion
We look forward to implementing a new and updated consensus of systemic therapy in controlling patients with moderate-to-severe AD.
