Allergy and dermatology US treatment guidelines review for adults with atopic dermatitis

Atopic dermatitis (AD) is a chronic, inflammatory condition that affects patients of all ages. Dermatologists and allergists often treat these patients, with each group of specialists following distinct sets of guidelines. Therefore, patients may receive different management depending on the specialist whom they consult.

The goal of this article is to identify similarities and differences in the treatment of adults with AD using the most recent management guidelines in the United States put forth by the American Academy of Dermatology (AAD) and the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters.

The management guidelines for adults with AD from the American Academy of Dermatology and the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters were reviewed to highlight similarities and differences.

We identified key similarities in the use of newer biologic agents, including dupilumab and tralokinumab. There are differences between the recommendations for topical phosphodiesterase-4 inhibitors, including crisaborole, and both topical and systemic Janus kinase inhibitors, including ruxolitinib, upadacitinib, abrocitinib, and baricitinib.

This article highlights the fact that although the updated management guidelines for adults with AD in dermatology and allergy align on certain recommendations, notable differences that could influence clinical decision making remain. Despite both sets of guidelines being evidence-based, variations in recommendations arise when factoring in patient preferences, perspectives, and risk aversion. As newer treatments become available for patients with AD, it will be important to monitor the evolving concordance or discordance of these guidelines given their direct impact on patient care.