Therapeutic management of adults with atopic dermatitis: comparison with psoriasis and chronic urticaria

• Published in: Journal of the European Academy of Dermatology and Venereology 2020-10, Vol.34 (10), p.2339-2345
• Main Authors: Pascal, C., Maucort‐Boulch, D., Gilibert, S., Bottigioli, D., Verdu, V., Jaulent, C., Hacard, F., Bérard, F., Nicolas, J.‐F., Nosbaum, A.
• Format: Article
• Language: English
• Subjects: Adult; Chronic Urticaria; Dermatitis, Atopic - complications; Dermatitis, Atopic - drug therapy; Dermatitis, Atopic - epidemiology; Eczema; Humans; Life Sciences; Psoriasis - complications; Psoriasis - drug therapy; Psoriasis - epidemiology; Retrospective Studies; Urticaria - drug therapy; Urticaria - epidemiology
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/jdv.16329

Background The therapeutic options in atopic dermatitis rely on consensus‐based guidelines, also established for psoriasis and chronic urticaria. However, the therapeutic approach in atopic dermatitis, especially in the moderate‐to‐severe forms of the disease, seems less aggressive than in psoriasis and in chronic urticaria with a less frequent use of systemic agents. Objectives To compare in real‐life conditions the therapeutic management of adults with atopic dermatitis with those with psoriasis and chronic urticaria. Methods A transversal analysis was performed in May 2017, using retrospective data from a monocentric database. Data on epidemiology, severity, therapeutic educational intervention and systemic treatments were analysed from 401 patients with atopic dermatitis, compared with data from 230 patients with chronic urticaria and 535 patients with psoriasis. Results A high proportion (73%) of atopic dermatitis patients presented with a moderate‐to‐severe form of the disease compared to only 39% of chronic urticaria and 17% of psoriasis patients. Most of atopic dermatitis patients (78%) had completed a therapeutic educational programme, while the adherence was lower in chronic urticaria (35%) and in psoriasis (3%) patients. A systemic treatment, including biologicals, was recorded in 8% of atopic dermatitis patients, while it concerned 26% and 47% of chronic urticaria and psoriasis patients, respectively. Conclusions We confirmed that atopic dermatitis treatment mostly relies on topical treatments. Only a minority of moderate‐to‐severe atopic dermatitis patients who are eligible for a systemic treatment receive such therapy. This may suggest promoting a more frequent use of systemic agents in moderate‐to‐severe atopic dermatitis. Linked Commentary: P. Gisondi et al. J Eur Acad Dermatol Venereol 2020; 34: 2168–2169. https://doi.org/10.1111/jdv.16876