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Background: Phototherapy is used to treat atopic dermatitis (AD). Evidence for its efficacy, impact on quality of life, cost‐effectiveness and short‐ and long‐term safety with real‐life usage is weak. Objectives: We established a taskforce to examine how phototherapy is currently being used as a treatment for AD across the United Kingdom and Europe to inform our understanding and guide future research into management of patients with AD using UV‐based phototherapies. Methods: An anonymous electronic multiple‐response survey exploring phototherapy prescribing practices and experience of phototherapy modalities was developed by the study authors and sent to members of phototherapy networks from the United Kingdom and Europe. Responses were received between February and July 2021. Results: About 144 respondents from 27 European countries completed the survey. NBUVB was the most widely used [n = 138 (96%)]. Home‐based NBUVB was available in 8/27 countries (25/144 respondents, 17%). Oral psoralen‐UVA (PUVA) was more widely available than bath PUVA (n = 106, 74% vs. n = 60, 42%) and used mainly in adult patients. 49/144 (34%) of respondents had access to UVA1. Phototherapy would be considered instead of systemic treatment in 96% of adults and 82% of children for NBUVB, versus 40% of adults and 3% of children for PUVA. Starting doses, standard dosing increments, length of treatment courses, lifetime limits for treatments and thresholds for performing annual skin assessments varied between responders. Conclusions: NBUVB was the most widely used phototherapy for AD in adult and paediatric patients, while PUVA and UVA1 were less used. Prescribing practices varied considerably, highlighting the lack of consensus practice in many different aspects of phototherapy for the treatment of AD in children and adults. This indicates that further studies are required to determine optimal phototherapeutic regimens for AD and informs our understanding of parameters that should be included in future high‐quality randomized controlled trials (RCT) of phototherapy. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) and food allergy (FA) share similar type 2 inflammation and commonly co‐occur, but the precise proportion of AD patients with FA and vice versa, as well as the effect of AD disease severity on the strength of this association remains uncertain. The aim of this comprehensive systematic review and meta‐analysis was to determine the prevalence and bidirectional associations of AD with food sensitivity (FS), FA and challenge‐proven food allergy (CPFA). We searched PubMed and EMBASE and three independent reviewers performed title/abstract and full‐text review and data extraction. Overall, 557 articles (n = 225,568 individuals with AD, n = 1,128,322 reference individuals; n = 1,357,793 individuals with FS, FA or CPFA, n = 1,244,596 reference individuals) were included in quantitative analyses. The overall pooled prevalence of FS, FA and CPFA in individuals with AD were 48.4% (95% confidence interval: 43.7–53.2), 32.7% (28.8–36.6) and 40.7% (34.1–47.5) respectively. AD prevalence among individuals with FS, FA and CPFA were 51.2% (46.3–56.2), 45.3% (41.4–49.3) and 54.9% (47.0–62.8) respectively. Children with AD had higher pooled FS (49.8% (44.4–55.1)) and FA (31.4% (26.9–36.1)) prevalences than adults with AD (28.6% (13.4–46.8) and 24.1% (12.1–38.7) respectively). Prevalences of FS and FA numerically increased with AD severity. FS, FA and CPFA are common comorbidities of AD and are closely related. Physicians should be attentive to this relationship to optimize management and treatment strategies in patients. [ABSTRACT FROM AUTHOR]

How to integrate atopic dermatitis in the management of skin neglected tropical diseases in Sub-Saharan Africa? However, NTDs represent only 2%-4% of all skin diseases in SSA.[1] Geographical and financial hurdles make skin NTDs in SSA diseases of poverty affecting underserved people. Itch is a common denominator between skin NTDs, such as scabies and skin non NTDs such as AD. [Extracted from the article]

Background: Chronic inflammatory skin diseases such as atopic dermatitis (AD) and psoriasis (PSO) present major challenges in health care. Thus, biomarkers to identify disease trajectories and response to treatments to improve the lives of affected individuals warrant great research consideration. The requirements that these biomarkers must fulfil for use as practical clinical tools have not yet been adequately investigated. Aim: To identify the core elements of high‐quality AD and PSO biomarkers to prepare recommendations for current biomarker research. Method: A cross‐sectional two‐round Delphi survey was conducted from August to October 2019 and October to November 2020. All participants were members of the BIOMAP project, an EU‐funded consortium of clinicians, researchers, patient organizations and pharmaceutical industry partners. The first round consisted of three open‐ended questions. Responses were qualitatively analysed, and 26 closed statements were developed. For the second round, 'agreement' was assumed when the responses of ≥70% of the participants were ≥5 points on a 7‐point Likert scale for each statement. Priority classification was based on mean scores (<20th percentile = low, 20th to 60th percentile = medium, >60th percentile = high). Results: Twenty‐one and twenty‐six individuals participated in rounds one and two, respectively. From 26 statements that were included in round 2, 18 achieved agreement (8 concerning the performance, 8 for the purpose and 2 on current obstacles). Seven statements were classified as high priority, e.g. those concerning reliability, clinical validity, a high positive predictive value, prediction of the therapeutic response and disease progression. Another seven statements were assigned medium priority, e.g. those about analytical validity, prediction of comorbidities and therapeutic algorithm. Low priority included four statements, like those concerning cost effectiveness and prediction of disease flares. Conclusion: The core requirements that experts agreed on being essential for high‐quality AD and PSO biomarkers require rapid validation. Biomarkers can therefore be assessed based on these prioritized requirements. [ABSTRACT FROM AUTHOR]

The addition of montelukast to a second-generation H SB 1 sb -antihistamine, in people with CSU whose symptoms are not adequately responsive to H SB 1 sb -antihistamines alone. Prognosis Approximately 45% of people with CSU respond to H SB 1 sb -antihistamines at licensed doses,65 and reports estimate that up to two-thirds of the residual may respond to updosing.50 About two-thirds of those unresponsive to H SB 1 sb -antihistamines respond to omalizumab,66 and a similar, probably different but overlapping, proportion to ciclosporin, although there is less evidence for the latter.67 Of note, the response rates given include partial and complete responses, so full disease suppression may not be achieved in many people with CSU with these treatments alone. The GDG does not recommend routinely offering combinations of two different second-generation H SB 1 sb -antihistamines at the same time to people with CSU, although it was noted that some people may benefit.51 The safety of giving two H SB 1 sb -antihistamines at lower dosages has not been investigated and there is no published evidence on using such combination treatment. B R18 (^) b Consider montelukast, in addition to a second-generation H SB 1 sb -antihistamine, in people whose symptoms are inadequately controlled by standard and increased doses of second-generation H SB 1 sb -antihistamines. B FRR5 b Randomized controlled trials (RCTs) evaluating the safety and efficacy of updosing one second-generation H SB 1 sb -antihistamine compared with using two different second-generation H SB 1 sb -antihistamines at the same time in people with CSU. [Extracted from the article]

Background: Observational studies suggest an increased risk of eczema in children living in hard versus soft water areas, and there is, therefore, an interest in knowing whether softening water may prevent eczema. We evaluated the feasibility of a parallel‐group assessor‐blinded pilot randomized controlled trial to test whether installing a domestic ion‐exchange water softener before birth in hard water areas reduces the risk of eczema in infants with a family history of atopy. Methods: Pregnant women living in hard water areas (>250 mg/L calcium carbonate) in and around London UK, were randomized 1:1 antenatally to either have an ion‐exchange water softener installed in their home or not (ie to continue to receive usual domestic hard water). Infants were assessed at birth and followed up for 6 months. The main end‐points were around feasibility, the primary end‐point being the proportion of eligible families screened who were willing and able to be randomized. Clinical end‐points were evaluated including frequency of parent‐reported doctor‐diagnosed eczema and visible eczema on skin examination. Descriptive analyses were conducted, and no statistical testing was performed as this was a pilot study. Results: One hundred and forty‐nine families screened were eligible antenatally and 28% (41/149) could not have a water softener installed due to technical reasons or lack of landlord approval. Eighty of 149 (54%) were randomized, the primary end‐point. Two participants withdrew immediately after randomization, leaving 39 participants in each arm (78 total). Attrition was 15% (12/78) by 6 months postpartum. All respondents (n = 69) to the study acceptability questionnaire reported that the study was acceptable. Fifty‐six of 708 (7.9%) water samples in the water softener arm were above the hard water threshold of 20 mg/L CaCO3. At 6 months of age 27/67 infants (40%) developed visible eczema, 12/36 (33%) vs. 15/31 (48%) in the water softener and control groups, respectively, difference −15% (95% CI −38, 8.3%), with most assessments (≥96%) remaining blinded. Similarly, a lower proportion of infants in the water softener arm had parent‐reported, doctor‐diagnosed eczema by 6 months compared to the control arm, 6/17 (35%) versus 9/19 (47%), difference −12% (95% CI −44, 20%). Conclusion: A randomized controlled trial of water softeners for the prevention of atopic eczema in high‐risk infants is feasible and acceptable. Trial registration: NCT03270566 (clinicaltrials.gov) [ABSTRACT FROM AUTHOR]

Iterative discussions between each dataset custodian and the harmonization bioinformaticians culminate with a dataset-specific mapping document specifying how individual variables will be transformed to the glossary-defined dataset, thus ensuring accurately harmonized data (step 4). Dear Editor, The BIOMarkers in Atopic dermatitis and Psoriasis (BIOMAP) is a large European consortium aiming to advance personalized medicine for atopic dermatitis and psoriasis by identifying biomarkers that predict therapeutic response and disease progression. The BIOMarkers in Atopic Dermatitis and Psoriasis (BIOMAP) glossary: developing a lingua franca to facilitate data harmonization and cross-cohort analyses. [Extracted from the article]

Summary: Background: Clinical practice guidelines (CPGs) play a critical role in standardizing and improving treatment outcomes based on the available evidence. It is unclear how many CPGs are available globally to assist clinicians in the management of patients with skin disease. Objectives: To search for and identify CPGs for dermatological conditions with the highest burden globally. Methods: We adapted a list of 12 dermatological conditions with the highest burden from the Global Burden of Disease (GBD) study 2019. A systematic literature search was done to identify CPGs published between October 2014 to October 2019. The scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) framework. Results: A total of 226 CPGs were included. Melanoma had the greatest representation in the CPGs, followed by dermatitis and psoriasis. Skin cancers had a relatively high CPG representation but with lower GBD disease burden ranking. There was an uneven distribution by geographical region, with resource‐poor settings being under‐represented. The skin disease categories of the CPGs correlated weakly with the GBD disability‐adjusted life‐years metrics. Eighty‐nine CPGs did not have funding disclosures and 34 CPGs were behind a paywall. Conclusions: The global production of dermatology CPGs showed wide variation in geographical representation, article accessibility and reporting of funding. The number of skin disease CPGs were not commensurate with its disease burden. Future work will critically appraise the methodology and quality of dermatology CPGs and lead to the production of an accessible online resource summarizing these findings. What is already known about this topic? Skin‐related diseases are leading causes of disability and disease burden globally.Clinical practice guidelines (CPGs) are important to ensure appropriate standards of care for skin conditions.The number, distribution, accessibility and quality of dermatological CPGs available globally is unknown. What does this study add? This is the first scoping review to describe the distribution of CPGs for common dermatological conditions of highest burden available internationally.Inflammatory skin conditions and skin cancers represent a higher proportion of the number of CPGs produced, largely driven by high‐income countries.Further studies to evaluate the quality of CPGs in dermatology, and the development of CPGs in skin diseases predominantly affecting resource‐poor countries, are needed. Linked Comment: T.E. Sivesind and R.P. Dellavalle. Br J Dermatol 2021; 185:690–691. Plain language summary available online [ABSTRACT FROM AUTHOR]

Dr. Seneschal has been an investigator, speaker, or consultant for Novartis, Abbvie, Sanofi, LeoPharma and Eli Lilly. Dr. De Raeve is a consultant, member of scientific advisory boards and/ or received personal fees and non-financial support from LEO Pharma, Pierre Fabre, Sanofi-Genzyme and Bioderma. Dr. Vestergaard has been investigator, speaker, or consultant for Novartis, Abbvie, Sanofi, LeoPharma and Eli Lilly. [Extracted from the article]

Dr. Chernyshov, Dr. Stalder, Dr. Svensson, Dr. Kunz reports no conflict of interest. At least 3 weeks are recommended between the two COVID-19 vaccine doses, which increases the risk of AD flares and loss of AD control if the systemic AD medication is paused or reduced in dose for longer periods. European Task Force on Atopic Dermatitis: position on vaccination of adult patients with atopic dermatitis against COVID-19 (SARS-CoV-2) being treated with systemic medication and biologics. [Extracted from the article]

Summary: Background: The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease‐related morbidity and mortality worldwide. Objectives: Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. Methods: Data on the burden of AD were obtained from the GBD Study. Results: Atopic dermatitis (AD) ranks 15th among all nonfatal diseases and has the highest disease burden among skin diseases as measured by disability‐adjusted life‐years (DALYs). Overall, the global DALY rate for AD in 1990 was 121 [95% uncertainty interval (UI) 65·4–201] and remained similar in 2017 at 123 (95% UI 66·8–205). The three countries with the highest DALY rates of AD were Sweden (327, 95% UI 178–547), the UK (284, 95% UI 155–478) and Iceland (277, 95% UI 149–465), whereas Uzbekistan (85·1, 95% UI 45·2–144), Armenia (85·1, 95% UI 45·8–143) and Tajikistan (85·1, 95% UI 46·1–143) ranked lowest. Conclusions: The global prevalence rate of AD has remained stable from 1990 to 2017. However, the distribution of AD by age groups shows a bimodal curve with the highest peak in early childhood, decreasing in prevalence among young adults, and a second peak in middle‐aged and older populations. We also found a moderate positive correlation between a country's gross domestic product and disease burden. GBD data confirm the substantial worldwide burden of AD, which has remained stable since 1990 but shows significant geographical variation. Lifestyle factors, partially linked to affluence, are likely important disease drivers. However, the GBD methodology needs to be developed further to incorporate environmental risk factors, such as ultraviolet exposure, to understand better the geographical and age‐related variations in disease burden. What is already known about this topic?Atopic dermatitis (AD) is a common skin condition affecting around 20% of children and up to 10% of adults in high‐income countries.There is a sparsity of studies that have taken a truly global approach, in particular among adult populations. What does this study add?We provide the first global map of the burden of AD across age groups, including disability‐adjusted life‐years.This ranks AD 15th among nonfatal diseases overall and top among skin diseases.The burden of AD has remained stable between 1990 and 2017, with the highest prevalence rate seen during early childhood and a second rise from middle age. Plain language summary available online [ABSTRACT FROM AUTHOR]

Accordingly, in 2018 the British Society of Paediatric Dermatology (BSPD) issued unified consensus guidelines for prescribing propranolol for the treatment of IH.4 We undertook a national audit to determine current prescribing patterns 2 years after the publication of this guidance. Ninety-five per cent of respondents agreed that oral propranolol was indicated; 3% considered topical timolol to be the first-line therapy. The aims of the audit were to ascertain indications for the initiation, baseline investigations, dosing and daycare admission rates for the induction of oral propranolol. [Extracted from the article]

Summary: Background: For many years dermatologists have had access to few therapies for patients with moderate‐to‐severe atopic eczema (AE). New promising therapies are entering the market but conventional phototherapies and systemic therapies have more well‐known safety profiles, lower costs and wider availability. Objectives: To provide insight into current prescribing practices of conventional phototherapy and systemic immunomodulatory therapies for adults with chronic AE, and the factors influencing these prescribing practices, before biologics and other novel therapeutics become routine clinical practice. Methods: In this exploratory study dermatologists were invited to participate in an online survey via a mailing list of the European Academy of Dermatology and Venereology and national societies. Data were collected on participant characteristics (including clinical practice data), the use of phototherapies and systemic therapies, and factors influencing their use. Results: From 30 European countries, 238 out of 361 dermatologists willing to participate (65·9%) completed the survey, with 229 meeting the inclusion criteria. For phototherapy (prescribed by 84·7%), most preferred narrowband ultraviolet B as first line (80·9%) and psoralen plus ultraviolet A as second (21·6%). For systemic therapy (prescribed by 95·2%) ciclosporin (54·1%), oral corticosteroids (32·6%) and methotrexate (30·7%) were used first line. Dermatologists relied mostly on personal experience for prescribing phototherapy and systemic therapy. Azathioprine and mycophenolic acid were prescribed by only 135 (59·0%) and 85 (37·1%) participants in total, mostly due to a lack of personal experience. Conclusions: This study provides insight into prescribing practices for conventional phototherapy and systemic therapy in Europe and shows that off‐label therapies are also preferred as first‐line choice of systemic therapy. What is already known about this topic? Varying prescribing practices were found for adult (in the UK) and paediatric (in Northern America and Europe) patients with moderate‐to-severe atopic eczema (AE).Not much is known about the prescription of phototherapy and (off‐label) systemic therapy for adult patients in Europe.Although therapies like dupilumab are promising new treatment modalities, better‐known safety profiles, lower costs and better availability are reasons to improve the evidence profile of conventional systemic therapies like ciclosporin. What does this study add? Prescribing practices of European dermatologists treating adult patients with moderate‐to-severe AE show diversity.Most dermatologists prefer narrowband ultraviolet B as first‐line phototherapy, followed by psoralen plus ultraviolet A as second line.Next to ciclosporin, which is most commonly prescribed, (off‐label) methotrexate and oral corticosteroids are also frequently used as first‐line systemic agents in chronic AE.Lack of personal experience with azathioprine and mycophenolic acid was the most important reason against their prescription. What are the clinical implications of the work? The results from this study might help to improve the experience with, and prescribing of, all available conventional phototherapies and (off‐label) systemic therapies.Guidelines developers might use these results to develop and implement treatment algorithms. Linked Comment:Bruin‐Weller. Br J Dermatol 2020; 183:987–988. Plain language summary available online [ABSTRACT FROM AUTHOR]

Editor Atopic dermatitis (AD), a common inflammatory skin condition characterized by chronic or relapsing episodes of eczema, itch and sleep disturbance,1 is associated with psychiatric, infectious and allergic comorbidities. Dr. Hijnen has been investigator, speaker or consultant for Abbvie, Eli Lilly, Incyte, LeoPharma, MedImmune/Astrazeneca, Pfizer, Sanofi and ThermoFisher. Dr. Ring has been an advisor or speaker for AbbVie, Allergika, Sanofi-Genzyme, Pfizer, Bencard, LEO Pharma and Mylan. [Extracted from the article]

Summary: Background: Epidemiological studies indicate that gene–environment interactions play a role in atopic dermatitis (AD). Objectives: To review the evidence for gene–environment interactions in AD aetiology, focusing on filaggrin (FLG) loss‐of‐function mutations. Methods: A systematic search from inception to September 2018 in Embase, MEDLINE and BIOSIS was performed. Search terms included all synonyms for AD and filaggrin/FLG; any genetic or epidemiological study design using any statistical methods were included. Quality assessment using criteria modified from guidance (ROBINS‐I and Human Genome Epidemiology Network) for nonrandomized and genetic studies was completed, including consideration of power. Heterogeneity of study design and analyses precluded the use of meta‐analysis. Results: Of 1817 papers identified, 12 studies fulfilled the inclusion criteria required and performed formal interaction testing. There was some evidence for FLG–environment interactions in six of the studies (P‐value for interaction ≤ 0·05), including early‐life cat ownership, older siblings, water hardness, phthalate exposure, higher urinary phthalate metabolite levels (which all increased AD risk additional to FLG null genotype) and prolonged breastfeeding (which decreased AD risk in the context of FLG null genotype). Major limitations of published studies were the low numbers of individuals (ranging from five to 94) with AD and FLG loss‐of‐function mutations and exposure to specific environmental factors, and variation in exposure definitions. Conclusions: Evidence on FLG–environment interactions in AD aetiology is limited. However, many of the studies lacked large enough sample sizes to assess these interactions fully. Further research is needed with larger sample sizes and clearly defined exposure assessment. Linked Comment: Park and Seo. Br J Dermatol 2020; 183:411. What's already known about this topic? Gene–environment interactions are considered important in the aetiology of atopic dermatitis.Loss‐of-function mutations in the gene coding filaggrin (FLG) are the most consistently reported genetic variants for atopic dermatitis.Studies have reported evidence for gene–environment interaction involving FLG and a range of different environmental exposures. What does this study add? There is some evidence for FLG–environment interactions in the aetiology of atopic dermatitis; however, the evidence is limited.Studies lack large enough sample sizes to achieve adequate power in order to assess these interactions fully. Linked Comment: Park and Seo. Br J Dermatol 2020; 183:411. Plain language summary available online [ABSTRACT FROM AUTHOR]

Summary: Background: Several studies have identified an association between water hardness and atopic eczema (AE); however, there is a paucity of longitudinal data in early life. Objectives: To examine whether water hardness is associated with an increased risk of AE and skin barrier dysfunction in infants and to assess effect modification by filaggrin (FLG) loss‐of‐function variants. Methods: We performed a longitudinal analysis of data from infants in the Enquiring About Tolerance (EAT) study, who were enrolled at 3 months and followed up until 36 months of age. Results: Of 1303 infants enrolled in the EAT study, 91·3% (n = 1189) attended the final clinic visit and 94·0% (n = 1225) of participants' families completed the 36‐month questionnaire. In total, 761 (58·4%) developed AE by 36 months. There was no overall association between exposure to harder (> 257 mg L−1 CaCO3) vs. softer (≤ 257 mg L−1 CaCO3) water: adjusted hazard ratio (HR) 1·07, 95% confidence interval (CI) 0·92–1·24. However, there was an increased incidence of AE in infants with FLG mutations exposed to hard water (adjusted HR 2·72, 95% CI 2·03–3·66), and statistically significant interactions between hard water plus FLG and both risk of AE (HR 1·80, 95% CI 1·17–2·78) and transepidermal water loss (0·0081 g m−2 h−1 per mg L−1 CaCO3, 95% CI 0·00028–0·016). Conclusions: There is evidence of an interaction between water hardness and FLG mutations in the development of infantile AE. What's already known about this topic? Several cross‐sectional studies have found an association between domestic water hardness exposure and atopic eczema (AE) risk.Loss‐of‐function mutations in the skin barrier gene filaggrin (FLG) are the strongest genetic risk factor for AE. What does this study add? There was no overall association between AE risk and exposure to harder vs. softer domestic water in a large, well‐phenotyped cohort of infants living in England and Wales followed up at 3–36 months of age.However, infants with at least one FLG loss‐of‐function mutation exposed to harder water have a threefold increased risk of developing AE up to age 36 months compared with infants with wild‐type FLG exposed to softer water. Linked Comment: Arents and Leonardi-Bee. Br J Dermatol 2020; 183:203–204. Plain language summary available online [ABSTRACT FROM AUTHOR]

Summary: Patients with atopic dermatitis (AD) have an increased risk of bacterial skin infections, which cause significant morbidity and, if untreated, may become systemic. Staphylococcus aureus colonizes the skin of most patients with AD and is the most common organism to cause infections. Overt bacterial infection is easily recognized by the appearance of weeping lesions, honey‐coloured crusts and pustules. However, the wide variability in clinical presentation of bacterial infection in AD and the inherent features of AD – cutaneous erythema and warmth, oozing associated with oedema, and regional lymphadenopathy – overlap with those of infection, making clinical diagnosis challenging. Furthermore, some features may be masked because of anatomical site‐ and skin‐type‐specific features, and the high frequency of S. aureus colonization in AD makes positive skin swab culture of suspected infection unreliable as a diagnostic tool. The host mechanisms and microbial virulence factors that underlie S. aureus colonization and infection in AD are incompletely understood. The aim of this article is to present the latest evidence from animal and human studies, including recent microbiome research, to define the clinical features of bacterial infections in AD, and to summarize our current understanding of the host and bacterial factors that influence microbial colonization and virulence. [ABSTRACT FROM AUTHOR]

Summary: Background: Comparative, real‐life and long‐term evidence on the effectiveness and safety of phototherapy and systemic therapy in moderate‐to‐severe atopic eczema (AE) is limited. Such data must come from well‐designed prospective patient registries. Standardization of data collection is needed for direct comparisons and data pooling. Objectives: To reach a consensus on how and when to measure the previously defined domain items of the TREatment of ATopic eczema (TREAT) Registry Taskforce core dataset for research registries for paediatric and adult patients with AE. Methods: Proposals for the measurement instruments were based on recommendations of the Harmonising Outcome Measures for Eczema (HOME) initiative, the existing AE database of TREATgermany, systematic reviews of the literature and expert opinions. The proposals were discussed at three face‐to‐face consensus meetings, one teleconference and via e‐mail. The frequency of follow‐up visits was determined by an expert survey. Results: A total of 16 experts from seven countries participated in the 'how to measure' consensus process and 12 external experts were consulted. A consensus was reached for all domain items on how they should be measured by assigning measurement instruments. A minimum follow‐up frequency of initially 4 weeks after commencing treatment, then every 3 months while on treatment and every 6 months while off treatment was defined. Conclusions: This core dataset for national AE research registries will aid in the comparability and pooling of data across centres and country borders, and enables international collaboration to assess the long‐term effectiveness and safety of phototherapy and systemic therapy used in patients with AE. What's already known about this topic? Comparable, real‐life and long‐term data on the effectiveness and safety of phototherapy and systemic therapy in patients with atopic eczema (AE) are needed.There is a high diversity of outcomes and instruments used in AE research, which require harmonization to enhance comparability and allow data pooling. What does this study add? Our taskforce has reached international consensus on how and when to measure core domain items for national AE research registries.This core dataset is now available for use by researchers worldwide and will aid in the collection of unified data. What are the clinical implications of this work? The data collected through this core dataset will help to gain better insights into the long‐term effectiveness and safety of phototherapy and systemic therapy in AE and will provide important information for clinical practice.Standardization of such data collection at the national level will also allow direct data comparisons and pooling across country borders (e.g. in the analysis of treatment‐related adverse events that require large patient numbers). Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]