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Italian Journal of Dermatology and Venereology 2021 April;156(2):184-97

DOI: 10.23736/S2784-8671.20.06654-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Diagnosis and management of moderate to severe atopic dermatitis in adolescents. A Consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Italian Association of Hospital Dermatologists and Public Health (ADOI), the Italian Association of Hospital and Territorial Allergists and Immunologists (AAIITO), the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC), the Italian Society of Pediatric Allergy and Immunology (SIAIP), the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA), and the Italian Society of Pediatric Dermatology (SIDerP)

Piergiacomo CALZAVARA-PINTON ¹ ✉, Anna BELLONI FORTINA ², Domenico BONAMONTE ³, Gian L. MARSEGLIA ⁴, Michele MIRAGLIA DEL GIUDICE ⁵, Antonino MUSARRA ⁶, Eustachio NETTIS ⁷, Iria NERI ⁸, Cataldo PATRUNO ⁹, Luca STINGENI ¹⁰, Ketty PERIS ¹¹ on behalf of RADAR Group 

¹ Clinic of Dermatology, University of Brescia, Brescia, Italy; ² Pediatric Dermatology (DIMED), University of Padua, Padua, Italy; ³ Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy; ⁴ Department of Pediatrics, IRCCS San Matteo Polyclinic Foundation, University of Pavia, Pavia, Italy; ⁵ Department of Woman and Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy; ⁶ Unit of Allergy, National Healthcare System, Reggio Calabria, Italy; ⁷ Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, Aldo Moro University, Bari, Italy; ⁸ Unit of Dermatology, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy; ⁹ Unit of Dermatology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; ¹⁰ Section of Clinical Allergological Venereological Dermatology, Department of Medicine, University of Perugia, Perugia, Italy; ¹¹ Unit of Dermatology, Sacred Heart Catholic University, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy

Atopic dermatitis (AD) is a chronic inflammatory disease with increasing global incidence, which has a multifactorial pathogenesis and a variable expressivity. Clinical features of AD are different in adults compared to children, but it is well recognized the substantial impact of the disease on patients’ quality of life at any age. Indeed, little is known about AD in adolescence, a period of life generally associated with high psychological burden and vulnerability to depression. Guidelines for the management of AD are available for both children and adults but specific guidelines for the diagnosis and treatment of AD in adolescents are lacking. Seven Italian scientific societies of dermatologists, allergists, and pediatric allergists joined in a specific meeting to provide practical guidance for the diagnosis and management of moderate-to-severe adolescent AD suitable for the Italian clinical practice. Through a modified Delphi procedure, consensus was reached by 59 Italian experts in the management of AD on 20 statements covering five areas of interest about adolescent AD, including disease complexity, burden and social impact, diagnosis and definition of severity, current treatments, and new biologic therapies. This paper reports recommendations for the diagnosis and management of AD specifically in adolescents, pointing out some peculiar clinical features and focusing on the choice of medications. Dupilumab, the first biologic approved for the treatment of adolescents with AD, represents a useful treatment option due to its efficacy and reassuring safety profile.

KEY WORDS: Dermatitis, atopic; Adolescent; Diagnosis; Therapy; Dupilumab