Abordaje de la dermatitis atópica en cinco escenarios clínicos: recomendaciones de un grupo de expertos.

BACKGROUND: Atopic dermatitis is the most common chronic inflammatory disease of the skin. This study presents the recommendations of a group of Colombian experts on the management of atopic dermatitis in adults in five frequent clinical scenarios, according to the available treatments, the socioeconomic situation and the coverage of treatments in the health system. METHODS: We carried out a consensus of 12 Colombian dermatologists divided into two groups to analyze five clinical scenarios: Moderate atopic dermatitis without control with topical therapy, severe atopic dermatitis without response to phototherapy, moderate/severe atopic dermatitis without control with topical therapy in pandemic times, facial atopic dermatitis, and atopic dermatitis and asthma. In each of the groups of experts a plenary discussion was held. Consensus was considered when at least 5 of the 6 participants of each session coincided in the analyzed treatment option. RESULTS: For patients with moderate/severe atopic dermatitis who have failed topical treatment, phototherapy would be the first choice, as long as it is available, and the patient has easy access. Systemic immunosuppressants are important options in all the clinical scenarios analyzed. In pandemic, dupilumab is considered the first choice, the same as for patients with severe uncontrolled asthma. DISCUSSION: Due to the need to optimize the resources of the health system, it is rational to consider evaluating the response and tolerance to systemic immunosuppressants before escalating to biological therapy. [ABSTRACT FROM AUTHOR]