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Background: Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence. Objective: Explore our experience with dupilumab for AD in clinical practice at a tertiary care center. Material and method: Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response. Results: Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI

Introducción: el objetivo de esta publicación es mostrar la respuesta clínica, endoscópica e histológica de dos pacientes pediátricos que recibieron dupilumab como estrategia de manejo para esofagitis eosinofílica. El dupilumab es un anticuerpo monoclonal que inhibe la cadena alfa del receptor de las interleucinas 4 y 13, involucradas en la respuesta inflamatoria Th2. El potencial rol terapéutico de este medicamento biológico se ha demostrado en ensayos clínicos en pediatría en otras patologías alérgicas como la dermatitis atópica y el asma, y ha mostrado un adecuado perfil de seguridad y efectividad en pediatría. Casos clínicos: se trata de dos niños con antecedentes personales de atopia, rinitis alérgica, asma, dermatitis atópica y alergia alimentaria, que inician con síntomas gastrointestinales que conducen a confirmar el diagnóstico de esofagitis eosinofílica, en quienes a pesar de las diferentes estrategias de manejo no se logra un adecuado control de la enfermedad, y se considera que se benefician del manejo con dupilumab por la evolución de la enfermedad, así como la coexistencia de dermatitis atópica no controlada. Conclusiones: Nuestros pacientes recibieron la dosis recomendada para su peso y edad aprobada en asma y dermatitis atópica, y se logró la remisión clínica e histológica. La mejoría de los síntomas gastrointestinales se acompañó de un mejor control del asma, la rinitis y la dermatitis. Ninguno de los pacientes tuvo efectos adversos al medicamento.

Introduction: Atopic dermatitis is an inflammatory disease which can significantly affect quality of life of patients. Especially severe forms of this disease are challenging to treat and for a long time forms of treatment have been limited. Because of that- it is crucial to find new ways of treatment which can be registered and impove moderate and severe dermatitis. Aim of study: Fundament purpose of this literature review is focusing on effectiveness, safety, side effects or different potential medical applications of Dupilumab. The main question, which is formulated in the title- is Dupilumab a chance for patients with moderate to severe atopic dermatitis? State of knowledge: Nowadays Dupilumab is well known drug and a lot of trials and analysis focus on efficacy, safety in treatment of moderate and severe dermatitis. The development of Dupilumab and different potential, clinical applications is also a chance for other groups of patients- for example patients with asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis. Conclusion: Dupilumab is definitely a relevant and essential element of treatment therapy for patients with moderate to severe atopic dermatitis. There were many analysis and researches which confirmed effectiveness, safety level and described Dupilumab impact on many different parameteres and scales focused on symptoms and life quality of patients during treatment with Dupilumab.

Resumen: Antecedentes: Dupilumab es una nueva terapia dirigida para la dermatitis atópica (DA) grave con una evidencia en la vida real aún limitada. Objetivo: Explorar nuestra experiencia con dupilumab para la DA en práctica clínica en un centro terciario. Material y método: Estudio observacional retrospectivo y unicéntrico que incluye pacientes adultos y pediátricos con DA grave en tratamiento con dupilumab entre diciembre de 2017 y diciembre de 2021. La gravedad y la respuesta se evaluaron con las escalas Eczema Area and Severity Index (EASI), Pruritus Numerical Rating Scale y Sleep Disturbance Numerical Rating Scale. Resultados: Cincuenta y nueve pacientes recibieron dupilumab: 52, 48, 26 y 13 pacientes alcanzaron los 6, 12, 24 y 36 meses de tratamiento, respectivamente. La tasa de EASI-75 fue del 94,2; 95,8; 92,3 y 100% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI-90 fue del 63,5; 72,9; 84,6 y 92,3% a los 6, 12, 24 y 36 meses, respectivamente. La tasa de EASI

Resumen: La dermatitis atópica (DA) es una enfermedad inflamatoria crónica multifactorial. La dermatitis de contacto alérgica (DCA) y la dermatitis de contacto por proteínas (DCP) son patologías alérgicas que pueden ser comórbidas a la DA y ser causa de algunas de las exacerbaciones. Aunque la DCA tiene una prevalencia similar en pacientes atópicos que en la población general, debemos considerarla una comorbilidad frecuente en la DA por la disrupción de la barrera cutánea. Por ello, se recomienda la realización de pruebas epicutáneas a los pacientes atópicos. Dupilumab podría ser útil para el tratamiento de la DCA mediada por vía Th2 y exacerbar aquellas que ocurren por vía Th1, aunque se precisan más estudios para establecer conclusiones. El mecanismo por el que la exposición a proteínas ambientales produce exacerbaciones en la DA es controvertido, pero es un fenómeno habitual en la práctica clínica diaria. Se recomienda estudio mediante prick test a pacientes con clínica sugestiva y recomendar conductas evitativas ante pacientes sintomáticos y pruebas positivas. Abstract: Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions that may occur in the context of atopic dermatitis and be the cause of exacerbations. Although the prevalence of allergic contact dermatitis is similar in atopic patients and the general population, these 2 conditions are frequently associated because atopic inflammation disrupts the skin barrier. Skin tests are therefore recommended in atopic individuals. Dupilumab could be useful for treating allergic contact dermatitis if it is mediated by type 2 helper T cells but could exacerbate inflammation if mediated by TH1 cells: further study is needed before conclusions can be drawn. Although the mechanism by which exposure to environmental proteins exacerbates atopic dermatitis remains under discussion, such exacerbations are routinely seen in clinical practice. Prick testing is recommended in symptomatic atopic dermatitis. When prick-test findings are positive, patients should be advised to avoid the culprit substances.

A pesar de los avances prometedores en la inmunoterapia oral para alergias alimentarias, su implementación médica enfrenta limitaciones. Se investigan opciones no específicas basadas en la inhibición de la vía inflamatoria tipo 2, incluyendo anticuerpos monoclonales. El TNX-901 y omalizumab han demostrado aumentar los umbrales de reacción, reduciendo eventos adversos en pacientes con alergia al cacahuate. El dupilumab, que bloquea el receptor alfa de IL-4, muestra resultados positivos en alergias alimentarias, así como en la esofagitis eosinofílica. Anticuerpos contra alarminas y anti-IL-5, como etokimab y mepolizumab, han demostrado eficacia en estudios preclínicos y ensayos clínicos. Aunque se necesitan más estudios para establecer su uso clínico práctico y determinar la idoneidad para distintos tipos de alergias alimentarias, estos anticuerpos monoclonales presentan un horizonte prometedor para el tratamiento de dichas condiciones.

Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions that may occur in the context of atopic dermatitis and be the cause of exacerbations. Although the prevalence of allergic contact dermatitis is similar in atopic patients and the general population, these 2 conditions are frequently associated because atopic inflammation disrupts the skin barrier. Skin tests are therefore recommended in atopic individuals. Dupilumab could be useful for treating allergic contact dermatitis if it is mediated by type 2 helper T cells but could exacerbate inflammation if mediated by TH1 cells: further study is needed before conclusions can be drawn. Although the mechanism by which exposure to environmental proteins exacerbates atopic dermatitis remains under discussion, such exacerbations are routinely seen in clinical practice. Prick testing is recommended in symptomatic atopic dermatitis. When prick-test findings are positive, patients should be advised to avoid the culprit substances. Resumen: La dermatitis atópica (DA) es una enfermedad inflamatoria crónica multifactorial. La dermatitis de contacto alérgica (DCA) y la dermatitis de contacto por proteínas (DCP) son patologías alérgicas que pueden ser comórbidas a la DA y ser causa de algunas de las exacerbaciones. Aunque la DCA tiene una prevalencia similar en pacientes atópicos que en la población general, debemos considerarla una comorbilidad frecuente en la DA por la disrupción de la barrera cutánea. Por ello, se recomienda la realización de pruebas epicutáneas a los pacientes atópicos. Dupilumab podría ser útil para el tratamiento de la DCA mediada por vía Th2 y exacerbar aquellas que ocurren por vía Th1, aunque se precisan más estudios para establecer conclusiones. El mecanismo por el que la exposición a proteínas ambientales produce exacerbaciones en la DA es controvertido, pero es un fenómeno habitual en la práctica clínica diaria. Se recomienda estudio mediante prick test a pacientes con clínica sugestiva y recomendar conductas evitativas ante pacientes sintomáticos y pruebas positivas.

Dupilumab is a recombinant human monoclonal antibody of the IgG4 class. Its mechanism of action can most broadly be described as inhibition of interleukin 4 and 13-mediated signal transduction. These cytokines are the main drivers of inflammatory diseases such as atopic dermatitis (AD) and asthma. Currently, dupilumab is the subject of many studies and scientific articles. More and more papers are being written about the efficacy of this drug and the side effects. Based on publications from the PubMed database, we present selected cases of atopic dermatitis patients who experienced uncharacteristic and unclear hair-related changes, such as hair loss, growth and change in hair colour, after dupilumab administration.

The Latin American Society of Allergy, Asthma, and Immunology (SLAAI) conducted a systematic search in the Medline and LILACS’ database in order to get articles linked to 10 current questions about dermatitis. The assessment of the quality of the evidence and the strength of the recommendations was made through the GRADE system. The completeness and transparency of the recommendations for this clinical guide were assessed with the AGREE Reports Verification Checklist. The final document was shared with physicians, allergists, dermatologists, and pediatricians, and with patients and academic institutions such as universities and medical scientific societies for external assessment. According to the review, clinical scales should be used to measure the severity of the dermatitis, and some interventions such as the use of probiotics may benefit the patient; nevertheless, more studies are required before this management option can be used in the everyday practice. Other interventions such as dietary restrictions and the use of antihistamines seem to be well-founded only in particular cases and they should not be a general recommendation for all patients. This practical guide presents recommendations for the treatment of atopic dermatitis; these recommendations can be helpful for medical staff, patients, and health systems.

Dupilumab es un anticuerpo monoclonal humano contra receptores de interleucina (IL)-4 e IL-4/IL-13. Estas son citocinas clave en la génesis de la inflamación tipo 2, predominante en los pacientes con asma. Los ensayos clínicos que evalúan la eficacia de dupilumab incluyen tres ensayos pivotales controlados versus placebo fase 2b o 3 de 24 a 52 semanas en pacientes ≥ 12 años, con asma moderada a grave (no controlada con dosis media a alta de corticosteroides inhalados) o asma grave (dependiente de corticosteroides orales). En estos estudios, la suma de dupilumab al tratamiento se toleró adecuadamente y redujo la tasa de exacerbaciones graves, mejoró la función pulmonar, así como el control del asma y la calidad de vida, de igual forma redujo las dosis de corticosteroides sistémicos orales sin afectar el control. Dupilumab mostró eficacia en varios subgrupos de pacientes, aunque aquellos con inflamación tipo 2 mostraron un beneficio más destacado. Dupilumab está indicado (y es una opción terapéutica valiosa) en pacientes ≥ 12 años de edad que tienen asma de moderada o grave con inflamación tipo 2/fenotipo eosinofílico, descontrolada a pesar de los tratamientos convencionales o en aquellos con dependencia a corticosteroides sistémicos orales para el control.

La fracción exhalada de óxido nítrico (FeNO) se relaciona con el nivel de inflamación eosinofílica en las vías aéreas y los niveles de interleucina-13, por lo que podría ser una herramienta diagnóstica y de seguimiento en el asma. Se convocó un grupo de trabajo integrado por neumólogos, expertos en fisiología de la respiración y alergólogos, con la finalidad de establecer criterios para el uso de la FeNO en asma en México. Mediante un método Delphi simplificado y discusión grupal, se consensaron varios puntos clave en relación con el uso de la FeNO. Sugerimos que la medición de la FeNO sirve para el diagnóstico de asma en clínicas especializadas, tanto en niños como adultos, así como para determinar el nivel de tratamiento con corticosteroides. En asma grave, recomendamos la FeNO para la endotipificación, detectar la mala adherencia terapéutica, el subtratamiento y el riesgo de crisis. Sugerimos su uso para determinar el nivel de tratamiento con corticosteroides e identificar pacientes con riesgo de tener una pérdida de la función pulmonar. También la recomendamos en el adulto para mejorar la elección de medicamentos biológicos y, en este contexto, solo la sugerimos en casos selectos en niños.

Background: Dupilumab is a new targeted therapy for severe atopic dermatitis (AD) with limited real-world evidence., Objective: Explore our experience with dupilumab for AD in clinical practice at a tertiary care center., Material and Method: Unicentric observational retrospective study including adult and pediatric patients with severe AD receiving dupilumab between December 2017 and December 2021. The Eczema Area and Severity Index (EASI) score, Pruritus Numerical Rating Scale (P-NRS) and Sleep disturbance Numerical Rating Scale (S-NRS) were recovered to assess severity and response., Results: Fifty-nine patients received dupilumab: 52, 48, 26 and 13 patients reached 6, 12, 24 and 36 months of treatment, respectively. The EASI-75 response rates were 94.2%, 95.8%, 92.3% and 100% at months 6, 12, 24 and 36. The EASI-90 response rates were 63.5%, 72.9%, 84.6% and 92.3% at months 6, 12, 24 and 36. The EASI <7 response rates were 92.3%, 91.7%, 88.5% and 100% at months 6, 12, 24 and 36. The P-NRS ≥4 reduction rates were 86%, 87.5%, 92.3% and 100% at months 6, 12, 24 and 36. The S-NRS ≥4 reduction rates were 82.7%, 85.4%, 100% and 100% at months 6, 12, 24 and 36. Adverse events were mild and occurred in 20.3% of patients, all of them adults., Conclusion: Our findings support dupilumab's favorable efficacy and tolerability profile in clinical practice. Dupilumab offers a rapid and sustained response, regardless of combined therapy. Longer follow-ups are still required to adequately assess its performance., (Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background Atopic dermatitis (AD) is a chronic, multifactorial, inflammatory skin disease with significant impact on patients’ quality of life. Objective The objective of this analysis was to estimate the incremental cost-effectiveness ratio (ICER) of dupilumab, administered every other week, vs supportive care (SC), in the Italian adult population with severe AD, for whom ciclosporin treatment is contraindicated, ineffective or not tolerated. Methods Simulation of outcomes and costs was undertaken using a 1-year decision tree, followed by a 20-year time horizon Markov model. Clinical data were derived from a pooled analysis of two studies. Given the uncertainty on final National Health Service (NHS) cost of dupilumab in Italy (confidential discount might be applied) multiple cost-utility analyses were conducted using different price hypotheses, starting from dupilumab published ex-manufacturer price, and progressively reducing it up to 50%. Model robustness were tested using sensitivity analyses. Results In the base-case, dupilumab was more effective than SC (+1.92 quality adjusted life years, QALYs). In Analysis A (NHS perspective), -8.0% discount on dupilumab ex-manufacturer price was required to achieve an ICER

Background and research question: Label extension for treatments and the relevant disease cross-coverage may produce an economic benefit. This paper assesses this benefit for dupilumab in the perspective of the Italian National Health Service. Dupilumab was approved for reimbursement for severe atopic dermatitis (AD), severe and refractory asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). The analysis focused on the crowding-out effect of dupilumab on alternative treatments. Methods: The research relied on a simplified budget impact model. The model was populated by data from published evidence and relied on three alternative scenarios for market penetration (15%-30%-100%). Results: Avoidable direct health annual costs due to cross-coverage for (i) asthma in patients treated for AD ranged from 0.46 to 3.43 million euros, (ii) asthma in patients treated for CRSwNP ranged from 0.08 to 0.88 million euros, (iii) CRSwNP in patients treated for asthma ranged from 0.41 to 4.05 million euros respectively. The total economic benefit ranges from 0.95 to 8.36 million euros. Discussion: The research estimated the crowding-out effect of dupilumab on alternative treatments. It did not incorporate avoided/incremental events due to a possible better/worse risk-benefit profile of dupilumab vs alternative treatments and the economic benefit of cross-coverage on lower diseases severity (for example mild asthma). Nonetheless, the analysis relies on the best available evidence for Italy to shed light on a topic which has not been sufficiently investigated, and provides data that will be potentially very important for policy-makers, payers and those who manage new treatments.

Despite promising advancements in oral immunotherapy for food allergies, medical implementation faces limitations. Non-specific treatment options based on inhibiting the type 2 inflammatory pathway, including monoclonal antibodies, are under investigation. TNX-901 and omalizumab have demonstrated increased reaction thresholds, reducing adverse events in peanut-allergic patients. Dupilumab, blocking the IL-4 receptor, shows positive results in both food allergies and eosinophilic esophagitis. Antibodies against alarmins and anti-IL-5, such as etokimab and mepolizumab, have proven efficacy in preclinical studies and clinical trials. While further studies are needed to establish their practical clinical use and determine suitability for different types of food allergies, these monoclonal antibodies present a promising horizon for the treatment of such conditions.

Background: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. Objective: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care. Methods: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from intense electronic communication, several issues of disagreement were discussed in two face-to-face meetings. Results: The clinical experts reached consensus on 46 statements related to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to general care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes —low level evidence—) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimination diet, if there is an IgE-mediated respiratory or food allergy, respectively. Conclusion: The panel of experts reached consensus on relevant aspects of AD with a focus on the transcultural adaptation of recent evidence.

Atopic dermatitis is a chronic inflammatory disease that is multifactorial in nature. Allergic contact dermatitis and protein contact dermatitis are allergic conditions that may occur in the context of atopic dermatitis and be the cause of exacerbations. Although the prevalence of allergic contact dermatitis is similar in atopic patients and the general population, these 2 conditions are frequently associated because atopic inflammation disrupts the skin barrier. Skin tests are therefore recommended in atopic individuals. Dupilumab could be useful for treating allergic contact dermatitis if it is mediated by type 2 helper T cells but could exacerbate inflammation if mediated by T H 1 cells: further study is needed before conclusions can be drawn. Although the mechanism by which exposure to environmental proteins exacerbates atopic dermatitis remains under discussion, such exacerbations are routinely seen in clinical practice. Prick testing is recommended in symptomatic atopic dermatitis. When prick-test findings are positive, patients should be advised to avoid the culprit substances., (Copyright © 2022 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

With the advancement of knowledge in relation to the physiopathogenesis of atopic dermatitis (AD), several new therapeutic forms have been developed. There are also new guidelines for self-care. On the other hand, there is still an underdiagnosis of AD in Mexico. Thus, the need was seen to develop a national guide, with a broad base among the different medical groups that care for patients with AD. The Atopic Dermatitis Guidelines for Mexico (GUIDAMEX) was developed with the ADAPTE methodology, with the endorsement and participation of ten national medical societies, from physicians in Primary Healthcare to allergists and dermatologists. Throughout the manuscript, key clinical questions are answered that lead to recommendations and suggestions for the diagnosis of AD (including differential diagnosis with immunodeficiency syndromes), the recognition of comorbidities and complications, non-pharmacological treatment including therapeutic education, treatment of flares and maintenance therapy. The latter encompasses general measures to avoid triggering factors, first-line treatment focussed on repair of the skin barrier, second-line treatment (topical proactive therapy), and third-line phototherapy or systemic treatment, including dupilumab and JAK inhibitors.

Atopic dermatitis is the most common inflammatory skin disease and up to 20% of cases can be classified as moderate to severe. Our understanding of the pathogenesis of this disease has improved in recent years. The process is primarily driven by the Th2 pathway, but with significant contributions from the Th22 pathway, the Th1 and Th17 axes, epidermal barrier dysfunction, pruritus, and JAK/STAT signaling. Advances in our understanding of the pathogenesis of atopic dermatitis have led to the development of new systemic treatments. Of particular note are biologic agents targeting IL-4 and IL-13 (e. g., dupilumab, tralokinumab, and lebrikizumab) and small molecules, such as JAK inhibitors (e. g., baricitinib, upadacitinib, and abrocitinib). Novel topical treatments include phosphodiesterase 4 and JAK/STAT inhibitors. In this article, we review the main advances in the treatment of atopic dermatitis. Characterization of clinical and molecular phenotypes with a key pathogenic role is essential for driving these advances., (Copyright © 2019 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

The fractional exhaled nitric oxide (FeNO) is related to the level of eosinophilic inflammation in the airways and the levels of interleukin-13, as such it could be a diagnostic and monitoring tool in asthma. A working group was convened between pulmonologists, respiratory physiology experts, and allergists to establish criteria for the use of FeNO in asthma in Mexico. Through a simplified Delphi method and group discussion, seven key points regarding the use of FeNO were agreed upon. We agree that the measurement of FeNO serves for the diagnosis of asthma in specialized clinics, both in children and adults, as well as to determine the level of corticosteroid treatment. In severe asthma, we recommend FeNO for endotyping, for detecting poor therapeutic adherence, undertreatment, and the risk of crisis. We suggest FeNO can be used to determine the level of corticosteroid treatment and to identify patients at risk of loss of lung function. We also recommend it in adults to improve the selection of biological therapy and, in this context, we only suggest it in selected cases for children.

Dupilumab is a drug that has recently been approved by the Food and Drug Administration (FDA) and European Medical Agency (EMA) for the treatment of moderate-to-severe atopic dermatitis in adults. An increase in frequency of conjunctivitis related to dupilumab treatment has been reported in recent publications and clinical trials. We report two steroid-dependent cases satisfactorily treated with cyclosporine 0.1% (Ikervis ® ). To our knowledge there are no reported cases of dupilumab-associated conjunctivitis treated with cyclosporine 0.1% (Ikervis ® )., (Copyright © 2019 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Atopic dermatitis (AD) is a common, chronic, inflammatory skin disorder with high physical and emotional burden. AD usually starts in early childhood and has a heterogeneous course. Emerging evidence suggests that IL-4 and IL-13 are key cytokines in the immunopathogenesis of AD. Dupilumab is a monoclonal antibody directed against IL-4 receptor α subunit, that blocks both IL-4 and IL-13 signaling. Data from Phase I-III studies revealed that dupilumab, administered as monotherapy or with topical corticosteroids, is effective and well tolerated in the treatment of adult patients with moderate-to-severe AD. A large proportion of patients receiving dupilumab had significant improvements in multiple efficacy indexes, including Eczema Area and Severity Index, Investigator's Global Assessment and SCORing Atopic Dermatitis scores. These results introduce a new era of targeted therapies in the management of AD., (Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions., Objective: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care., Methods: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from intense electronic communication, several issues of disagreement were discussed in two face-to-face meetings., Results: The clinical experts reached consensus on 46 statements related to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to general care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes -low level evidence-) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimination diet, if there is an IgE-mediated respiratory or food allergy, respectively., Conclusion: The panel of experts reached consensus on relevant aspects of AD with a focus on the transcultural adaptation of recent evidence.