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AAD updates guidelines for diagnosing, assessing atopic dermatitis

New evidence-based guidelines have been released by the American Academy of Dermatology for the diagnosis and assessment of atopic dermatitis.

Recommendations on treatment for atopic dermatitis (AD), culled from scientific literature review, were subdivided into four sections to update and expand information and recommendations published in 2004. The first section focuses on disease diagnosis and monitoring, outcome measures for assessment and common clinical associations that affect patients with AD, as well as known risk factors for developing AD.

 

Dirk M. Elston

“This is the first guideline issued by the academy that covers the diagnosis of a condition,” Dirk M. Elston, MD, FAAD, academy president, said in a news release. “Misdiagnosis of atopic dermatitis is a concern, especially for adults, and can contribute to making the disease worse. These guidelines provide criteria for accurately diagnosing atopic dermatitis that differentiate it from other conditions with similar characteristics.”

A group of recognized experts on AD determined essential features that must be present in the diagnosis of patients with AD, namely, pruritus and eczema. A clinical diagnosis should be based on historical features, morphology and distribution of skin lesions. Important features, seen in most cases, include early age of onset, atopy and xerosis.

“For patients with presumed atopic dermatitis, there are no specific biomarkers that can be recommended for diagnosis and/or assessment of disease severity,” the group reported.

The monitoring of immunoglobulin E levels was not recommended for assessing disease severity.

The work group recommended that clinicians ask AD patients general questions about itch, sleep, impact on daily activity and disease persistence.

Conditions associated with AD, including rhinitis/rhinoconjunctivitis, asthma, food allergy, sleep disturbance and depression, should be assessed by physicians, according to the recommendations.

The remaining three sections of the guidelines will be published in 2014 and will focus on management and treatment of AD with topical therapies, systemic agents, adjunctive therapies, and flare prevention, the release said.

Disclosure: See the study for a full list of relevant financial disclosures.