Fulltext

A clinician's reference guide for the management of atopic dermatitis in Asians

Chow S 1 , Seow CS 2 , Dizon MV 3 , Godse K 4 , Foong H 5 , Chan V 6 Show all authors , Khang TH 7 , Xiang L 8 , Hidayat S 9 , Listiawan MY 10 , Triwahyudi D 11 , Gondokaryono SP 12 , Sutedja E 12 , Diana IA 12 , Suwarsa O 12 , Dharmadji HP 12 , Siswati AS 13 , Danarti R 13 , Soebaryo R 14 , Budianti WK 15 , Asian Academy of Dermatology & Venereology

Affiliations 

  • 1 Pantai Hospital, Kuala Lumpur, Malaysia
  • 2 National Skin Centre, Singapore, Singapore
  • 3 Makati Medical Center, Manila, the Philippines
  • 4 DY Patil School of Medicine, Nerul, Navi Mumbai, India
  • 5 Foong Skin Specialist Clinic, Ipoh, Malaysia
  • 6 Cadau Skin and Laser Clinic, Pnomh Penh, Cambodia
  • 7 Hanoi Medical University, Hanoi, Vietnam
  • 8 Fudan University, Shanghai, China
  • 9 League of ASEAN Dermatologic Societies, Kuala Lumpur, Malaysia
  • 10 Surabaya Skin Centre, Jawa Timur, Indonesia
  • 11 Rumah Sakit Metropolitan Medical Centre, Jakarta, Indonesia
  • 12 Univerity of Padjadjaran, Bandung, Indonesia
  • 13 Gadjah Mada University, Yogyakarta, Indonesia
  • 14 University of Indonesia, Jakarta, Indonesia
  • 15 Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Asia Pac Allergy, 2018 Oct;8(4):e41.
PMID: 30402408 DOI: 10.5415/apallergy.2018.8.e41

Abstract

Background: Atopic dermatitis (AD) is a common skin condition among Asians. Recent studies have shown that Asian AD has a unique clinical and immunologic phenotype compared with European/American AD.

Objective: The Asian Academy of Dermatology and Venereology Expert Panel on Atopic Dermatitis developed this reference guide to provide a holistic and evidence-based approach in managing AD among Asians.

Methods: Electronic searches were performed to retrieve relevant systematic reviews and guidelines on AD. Recommendations were appraised for level of evidence and strength of recommendation based on the U.K. National Institute for Health and Care Excellence and Scottish Intercollegiate Guidelines Network guidelines. These practice points were based on the consensus recommendations discussed during the Asia Pacific Meeting of Experts in Dermatology held in Bali, Indonesia in October 2016 and April 2017.

Results: The Expert Panel recommends an approach to treatment based on disease severity. The use of moisturizers is recommended across all levels of AD severity, while topical steroids are recommended only for flares not controlled by conventional skin care and moisturizers. Causes of waning efficacy must be explored before using topical corticosteroids of higher potency. Topical calcineurin inhibitors are recommended for patients who have become recalcitrant to steroid, in chronic uninterrupted use, and when there is steroid atrophy, or when there is a need to treat sensitive areas and pediatric patients. Systemic steroids have a limited role in AD treatment and should be avoided if possible. Educational programs that allow a patient-centered approach in AD management are recommended as an adjunct to conventional therapies. Recommendations on the use of phototherapy, systemic drugs, and emerging treatments are also included.

Conclusion: The management of AD among Asians requires a holistic approach, integrating evidence-based treatments while considering accessibility and cultural acceptability.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications