A team of investigators from the University of Colorado College of Nursing at CU Anschutz Medical Campus and National Jewish Health has identified comprehensive guidelines for managing severe atopic dermatitis (AD).

The clinical management review was recently published in The Journal of Allergy and Clinical Immunology: In Practice.

"The FDA approval of biologic medication for treating moderate-to-severe AD has transformed the therapeutic landscape highlighting the need for comprehensive and clear guidelines," says Noreen Nicol, PhD, RN, Associate Professor in the College of Nursing at CU Anschutz Medical Campus, in a news release. "Without comprehensive guidelines that analyze national and international findings, we risk clinicians skipping crucial conventional steps, such as wet-wrap therapy, that need to be utilized prior to initiating biologics."

In their clinical review, the researchers incorporate national and international guidelines to deliver a comprehensive algorithm to guide clinicians in treating AD patients, as seen in the chart.

The steps include:

Making a proper diagnosis and defining severity of AD

Addressing the basics of AD care:

Appropriate skin hydration and use of moisturizers and topical medications

Identifying irritants and allergens

Treating bacterial, viral or fungal infections

Treating psychosocial aspects

Developing an action plan

Consultations with an AD specialist

Considering acute management with wet-wrap therapy

Considering hospitalization, treatment with the systemic biologic dupilumab and phototherapy

"Life with severe atopic dermatitis can be incredibly difficult for our patients and their families, and it can be quite challenging to care for. It's important to let our patients, caregivers, and healthcare providers know that we have entered a new and exciting era in the treatment of AD with a number of targeted therapies approved or being studied which are referenced in this clinical review," says Mark Boguniewicz, MD, Professor, Division of Allergy-Immunology and Department of Pediatrics at National Jewish Health and University of Colorado School of Medicine.

PHOTO CAPTION: Annotated algorithm for the patient with severe AD.

PHOTO CREDIT: CU Anschutz Medical Campus