Updated AAD Management Guidelines for Moderate-Severe Atopic Dermatitis

Essential features for atopic dermatitis diagnosis include pruritis, eczema/spongiotic skin disease, and chronic/relapsing history. The atopic dermatitis diagnosis can be made without early age of onset or personal/family history of atopy.

Consider the long term implications of uncontrolled systemic inflammation in management of AD patients. Comorbidities associated with AD in adults include alopecia areata, urticaria, asthma, food allergy, rhinitis, depression, anxiety, hypertension, coronary artery disease, peripheral artery disease, obesity, osteoporosis, bone fractures, and skin infection.

Definition of moderate to severe AD may be considered with 10% or more BSA involvement, individual lesions with moderate to severe features, involvement of highly visible areas or those important for function (neck, face, genitals, palms, soles), or significant impact on quality of life. Severity rating can be expressed with both BSA and IGA to help justify treatment choices.