Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

doi:10.1186/s13052-022-01278-7

Review

. 2022 Jun 14;48(1):95.

doi: 10.1186/s13052-022-01278-7.

Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

Elena Galli¹, Anna Belloni Fortina², Giampaolo Ricci³, Nunzia Maiello⁴, Iria Neri⁵, Ermanno Baldo⁶, Irene Berti⁷, Domenico Bonamonte⁸, Lucetta Capra⁹, Elena Carboni¹⁰, Rossella Carello¹, Francesca Caroppo², Giovanni Cavagni¹¹, Iolanda Chinellato¹², Francesca Cipriani¹³, Pasquale Comberiati¹⁴, Andrea Diociaiuti¹⁵, Vito Di Lernia¹⁶, Marzia Duse¹⁷, Cesare Filippeschi¹⁸, Arianna Giannetti¹⁹, Mattia Giovannini²⁰, Amelia Licari²¹, Gian Luigi Marseglia²², Manuela Pace²³, Annalisa Patrizi^{5

24}, Giovanni Battista Pajno²⁵, Diego Peroni¹⁴, Alberto Villani²⁶, Lawrence Eichenfield²⁷

Affiliations

¹ Pediatric Allergology Unit, Department of Pediatric Medicine, S.Pietro Hospital Fatebenefratelli, Roma, Italy.
² Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padova, Italy.
³ Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
⁴ Department of Woman, Child and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
⁵ Dermatology Unit, IRCCS of Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola Hospital, Bologna, Italy.
⁶ Giovan Battista Mattei" Research Institute, Stenico, Italy.
⁷ Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
⁸ Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy.
⁹ Pediatrician, Ferrara, Italy.
¹⁰ Unit of Paediatrics, Maggiore Hospital, ASST-Cremona, Cremona, Italy.
¹¹ Allergology Service European Diagnostic DRP Centre Parma, Parma, Italy.
¹² Section of Pediatrics, S. Pio Hospital, Castellaneta, Italy.
¹³ Primary Care Pediatrics, AUSL Modena, Nonantola, Italy.
¹⁴ Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
¹⁵ Dermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
¹⁶ Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
¹⁷ Pediatrics, Sapienza University, Rome, Italy.
¹⁸ Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
¹⁹ Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti, 11, 40138, Bologna, Italy. ariannagiannetti25@gmail.com.
²⁰ Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
²¹ Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, University of Pavia, Pavia, Italy.
²² Clinica Pediatrica Università di Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
²³ Department of Pediatrics, S. Maria del Carmine Hospital, Rovereto, Italy.
²⁴ Dermatology, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma MaterStudiorum University of Bologna, Bologna, Italy.
²⁵ Pediatric Unit- Policlinico Hospital, University of Messina, Messina, Italy.
²⁶ Emergency and General Pediatrics Department Bambino Gesù Children Hospital - IRCCS, Rome, Italy.
²⁷ Department of Dermatology, University of California, San Diego and Rady Children's Hospital, San Diego, USA.

PMID: 35701810
PMCID: PMC9195338
DOI: 10.1186/s13052-022-01278-7

Review

Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

Elena Galli et al. Ital J Pediatr. 2022.

. 2022 Jun 14;48(1):95.

doi: 10.1186/s13052-022-01278-7.

Authors

Affiliations

¹ Pediatric Allergology Unit, Department of Pediatric Medicine, S.Pietro Hospital Fatebenefratelli, Roma, Italy.
² Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padova, Italy.
³ Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
⁴ Department of Woman, Child and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
⁵ Dermatology Unit, IRCCS of Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola Hospital, Bologna, Italy.
⁶ Giovan Battista Mattei" Research Institute, Stenico, Italy.
⁷ Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
⁸ Department of Biomedical Science and Human Oncology, Section of Dermatology, University of Bari, Bari, Italy.
⁹ Pediatrician, Ferrara, Italy.
¹⁰ Unit of Paediatrics, Maggiore Hospital, ASST-Cremona, Cremona, Italy.
¹¹ Allergology Service European Diagnostic DRP Centre Parma, Parma, Italy.
¹² Section of Pediatrics, S. Pio Hospital, Castellaneta, Italy.
¹³ Primary Care Pediatrics, AUSL Modena, Nonantola, Italy.
¹⁴ Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
¹⁵ Dermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
¹⁶ Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
¹⁷ Pediatrics, Sapienza University, Rome, Italy.
¹⁸ Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
¹⁹ Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti, 11, 40138, Bologna, Italy. ariannagiannetti25@gmail.com.
²⁰ Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy.
²¹ Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, University of Pavia, Pavia, Italy.
²² Clinica Pediatrica Università di Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
²³ Department of Pediatrics, S. Maria del Carmine Hospital, Rovereto, Italy.
²⁴ Dermatology, Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma MaterStudiorum University of Bologna, Bologna, Italy.
²⁵ Pediatric Unit- Policlinico Hospital, University of Messina, Messina, Italy.
²⁶ Emergency and General Pediatrics Department Bambino Gesù Children Hospital - IRCCS, Rome, Italy.
²⁷ Department of Dermatology, University of California, San Diego and Rady Children's Hospital, San Diego, USA.

PMID: 35701810
PMCID: PMC9195338
DOI: 10.1186/s13052-022-01278-7

Abstract

Currently, there are a few detailed guidelines on the overall management of children and adolescents with moderate-severe atopic dermatitis. AD is a complex disease presenting with different clinical phenotypes, which require an individualized and multidisciplinary approach. Therefore, appropriate interaction between primary care pediatricians, pediatric allergists, and pediatric dermatologists is crucial to finding the best management strategy. In this manuscript, members of the Italian Society of Pediatric Allergology and Immunology (SIAIP), the Italian Society of Pediatric Dermatology (SIDerP), and the Italian Society of Pediatrics (SIP) with expertise in the management of moderate-severe atopic dermatitis have reviewed the latest scientific evidence in the field. This narrative review aims to define a pathway to appropriately managing children and adolescents with moderate-severe atopic dermatitis.

Keywords: Atopic Dermatitis; Childhood; Management; New Drugs; Position Paper; Topical Therapies.

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Conflict of interest statement

The authors declare no conflict of interest.

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References

1. Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, et al. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol. 2020. 10.1111/bjd.19673. Epub ahead of print. - PubMed
1. Severity scoring of atopic dermatitis: the SCORAD index Consensus report of the European task force on atopic dermatitis. Dermatology. 1993;186:23–31. doi: 10.1159/000247298. - DOI - PubMed
1. Hanifin JM, Thurston M, Omoto M, EASI Evaluator Group et al. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. Exp Dermatol. 2001;10:11–8. doi: 10.1034/j.1600-0625.2001.100102.x. - DOI - PubMed
1. Conic RZ, Tamashunas NL, Damiani G, Fabbrocini G, Cantelli M, Young Dermatologists Italian Network, & Bergfeld, W. F. (2020) Comorbidities in pediatric alopecia areata. J Eur Acad Dermatol Venereol. 2020;34(12):2898–2901. doi: 10.1111/jdv.16727. - DOI - PubMed
1. Perugia C, Saraceno R, Ventura A, et al. Atopic dermatitis and dental manifestations. G Ital Dermatol Venereol. 2017;152:122–125. - PubMed

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[1] Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, et al. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol. 2020. 10.1111/bjd.19673. Epub ahead of print. - PubMed

[2] Thomas KS, Apfelbacher CA, Chalmers JR, Simpson E, Spuls PI, Gerbens LAA, et al. Recommended core outcome instruments for health-related quality of life, long-term control and itch intensity in atopic eczema trials: results of the HOME VII consensus meeting. Br J Dermatol. 2020. 10.1111/bjd.19673. Epub ahead of print. - PubMed

[3] Severity scoring of atopic dermatitis: the SCORAD index Consensus report of the European task force on atopic dermatitis. Dermatology. 1993;186:23–31. doi: 10.1159/000247298. - DOI - PubMed

[4] Severity scoring of atopic dermatitis: the SCORAD index Consensus report of the European task force on atopic dermatitis. Dermatology. 1993;186:23–31. doi: 10.1159/000247298. - DOI - PubMed

[5] Hanifin JM, Thurston M, Omoto M, EASI Evaluator Group et al. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. Exp Dermatol. 2001;10:11–8. doi: 10.1034/j.1600-0625.2001.100102.x. - DOI - PubMed

[6] Hanifin JM, Thurston M, Omoto M, EASI Evaluator Group et al. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. Exp Dermatol. 2001;10:11–8. doi: 10.1034/j.1600-0625.2001.100102.x. - DOI - PubMed

[7] Conic RZ, Tamashunas NL, Damiani G, Fabbrocini G, Cantelli M, Young Dermatologists Italian Network, & Bergfeld, W. F. (2020) Comorbidities in pediatric alopecia areata. J Eur Acad Dermatol Venereol. 2020;34(12):2898–2901. doi: 10.1111/jdv.16727. - DOI - PubMed

[8] Conic RZ, Tamashunas NL, Damiani G, Fabbrocini G, Cantelli M, Young Dermatologists Italian Network, & Bergfeld, W. F. (2020) Comorbidities in pediatric alopecia areata. J Eur Acad Dermatol Venereol. 2020;34(12):2898–2901. doi: 10.1111/jdv.16727. - DOI - PubMed

[9] Perugia C, Saraceno R, Ventura A, et al. Atopic dermatitis and dental manifestations. G Ital Dermatol Venereol. 2017;152:122–125. - PubMed

[10] Perugia C, Saraceno R, Ventura A, et al. Atopic dermatitis and dental manifestations. G Ital Dermatol Venereol. 2017;152:122–125. - PubMed

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Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

Affiliations

Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP)

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