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Guidelines for atopic dermatitis management differ regarding therapies
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Although the basic principles of atopic dermatitis management were similar in various guidelines, recommendations regarding adjunctive therapies differed, according to a recently published review.
Researchers compared atopic dermatitis (AD) management guidelines from the American Academy of Dermatology (AAD) and the Joint Task Force on Practices Parameters (JTF), representing the American Academy of Allergy, Asthma and Immunology, the American College of Allergy Asthma and Immunology, the Joint Council of Allergy, Asthma & Immunology, and international guidelines from the 2012 European Task Force on Atopic Dermatitis and the 2013 Asia-Pacific Consensus Group for Atopic Dermatitis.
The reviewers looked at guidelines for specific therapies, including:
- topical emollients and anti-inflammatory therapy;
- topical antimicrobial therapy;
- other topical therapies;
- oral and systemic therapy, including systemic antimicrobial therapy;
- environmental modifications;
- aeroallergens;
- food allergens; and
- vitamin D.
According to the researchers, all of the guidelines seemed to recognize the relatively large gaps that exist in high-quality evidence, as well as the need to use lower-quality studies and clinical experience in order to develop a more comprehensive guideline.
Guidelines regarding recommendations of the use of diluted bleach baths, vitamin D and environmental modifications had noteworthy differences between the organizations. Low-risk adjunctive strategies, including vitamin D; minimizing aeroallergen exposure; and implementing environmental strategies, including clothing modifications, were stressed more in the JTF and European guidelines. The AAD guidelines often did not recommend such strategies if there was little or low-quality evidence that supported such strategies.
“Comparison of different guidelines may ultimately augment knowledge of different strategies and enhance realization of biases in the understanding and the management of AD,” the researchers concluded. – by Bruce Thiel
Disclosure: Mohan reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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