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Defining "Flares" in Atopic Dermatitis: A Narrative Review
Joseph F Merola1, Stephan Weidinger2, Sally Y Tan3
1Department of Dermatology and Department of Medicine, Division of Rheumatology, O'Donnell School of Public Health, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA. joseph.merola@UTSouthwestern.edu.
American Journal of Clinical Dermatology
|September 1, 2025
Summary
Defining atopic dermatitis (AD) flares is crucial for effective management. Current research lacks consensus, with most definitions relying on clinician reports rather than patient experiences.
Area of Science:
- Dermatology
- Clinical Research
- Patient-Reported Outcomes
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant impact on quality of life.
- Disease flares in AD necessitate treatment adjustments but lack a universally accepted definition.
- This hinders research into flare prevention and management.
Purpose of the Study:
- To review existing frameworks and definitions of atopic dermatitis flares.
- To analyze definitions used in guidelines, clinical trials, and observational studies.
- To highlight the need for patient-centered definitions in AD flare research.
Main Methods:
- Narrative review of systematic literature reviews.
- Examination of American and European guidelines for AD flare definitions.
- Analysis of flare definitions in randomized controlled trials and observational studies (Jan 2014 - Sep 2024).
Main Results:
- A wide range of flare definitions are currently employed in AD research.
- The majority of identified definitions prioritize clinician-reported outcomes.
- Few definitions incorporate the patient's perspective on disease flares.
Conclusions:
- A lack of consensus on a clear, measurable definition of AD flares impedes research.
- Existing definitions predominantly rely on clinician assessments.
- Incorporating patient perspectives is vital for developing clinically relevant and validated AD flare definitions.
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