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. 2011 Jul;1(2):53-63.
doi: 10.5415/apallergy.2011.1.2.53. Epub 2011 Jul 28.

A proposal: Atopic Dermatitis Organizer (ADO) guideline for children

Sang-Il Lee  1 , Jihyun Kim, Youngshin Han, Kangmo Ahn
Affiliations

A proposal: Atopic Dermatitis Organizer (ADO) guideline for children

Sang-Il Lee et al. Asia Pac Allergy. 2011 Jul.

Abstract

Atopic dermatitis (AD) is the most common chronic inflammatory skin disorder in children, with a worldwide cumulative prevalence in children of 8-20%. The number of AD patients is beyond the level that can be dealt with at clinics and it is time to make an effort to reduce the number of AD patients in the community. Thus, caregivers and all persons involved with AD management, including health care providers, educators, technologists and medical policy makers, should understand the development and the management of AD. Although a number of guidelines such as Practical Allergy (PRACTALL) report have been developed and used, community understanding of these is low. This is probably because there are still remarkable differences in management practices between specialists and between countries and most of the reported guidelines have been prepared for physicians. From the viewpoint of providing a basis for a multidisciplinary team approach, easily comprehensible guidelines for organizing treatment of AD, i.e. an Atopic Dermatitis Organizer (ADO), are required. guidelines should be simple and well organized. We suggest an easy approach with a new classification of AD symptoms into early and/or progressive lesions in acute and/or chronic symptoms. The contents of this ADO guideline basically consist of 3 steps approaches: conservative management, topical anti-inflammatory therapy, and systemic anti-inflammatory therapy.

Keywords: Atopic dermatitis; Guideline; classification, Management.

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Figures

Fig. 1
Fig. 1
Korean data on prevalence of atopic dermatitis by age in 2008. These data were provided by the Korean National Health Insurance Corporation. The patients were diagnosed by clinicians, including pediatricians, dermatologists, internists, family physicians and traditional medicine practitioners.
Fig. 2
Fig. 2
Prevalence of atopic dermatitis (AD) in children aged 6-11 years in Seoul between 1995 and 2005. The one-year point prevalence (treatment of AD, last 12 months) was about 50% of the cumulative prevalence (diagnosis of AD, ever).
Fig. 3
Fig. 3
The multifactorial pathogenesis of atopic dermatitis (AD). The mechanisms for the development of AD involve complex interactions between susceptibility genes, immaturity and/or abnormality in barrier function and environmental factors.
Fig. 4
Fig. 4
Food sensitization rates in patients with atopic dermatitis (AD). Egg-white-specific IgE was detected in 24.3% of patients with AD followed by wheat-, milk-, peanut- and soy-specific IgE in order of decreasing frequency.
Fig. 5
Fig. 5
Basic framework of the stepwise management in the atopic dermatitis organizer (ADO) guideline. The contents of this ADO guideline basically consist of 3 steps approaches: conservative management, topical anti-inflammatory therapy, and systemic anti-inflammatory therapy. IVIG: intravenous immunoglobulin.
Fig. 6
Fig. 6
The management target curve. The treatment goals are to decrease the incidence of atopic dermatitis (AD), to decrease the suffering of patients and their guardians and to induce a natural outgrow of AD. Black line indicates the incidence of AD by age, and green line indicates the natural clinical course of AD.
See this image and copyright information in PMC

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