Consensus on the therapeutic management of atopic dermatitis ‒ Brazilian Society of Dermatology: an update on phototherapy and systemic therapy using e-Delphi technique

Raquel Leao Orfali¹, Daniel Lorenzini², Aline Bressan³, Anber Ancel Tanaka⁴, Ana Maria Mósca de Cerqueira⁵, André da Silva Hirayama⁶, Andréa Machado Coelho Ramos⁷, Carolina Contin Proença⁸, Claudia Marcia de Resende Silva⁷, Cristina Marta Maria Laczynski⁹, Francisca Regina Carneiro¹⁰, Gleison Duarte¹¹, Gunter Hans Filho¹², Heitor de Sá Gonçalves¹³, Ligia Pessoa de Melo¹⁴, Luna Azulay-Abulafia¹⁵, Magda Blessmann Weber¹⁶, Maria Cecília Rivitti-Machado¹⁷, Mariana Colombini Zaniboni⁶, Marília Ogawa¹⁸, Mario Cezar Pires¹⁹, Mayra Ianhez²⁰, Paulo Antonio Oldani Felix²¹, Renan Bonamigo²², Roberto Takaoka⁶, Rosana Lazzarini⁸, Silmara Cestari²³, Silvia Assumpção Soutto Mayor⁸, Tania Cestari²², Zilda Najjar Prado de Oliveira²⁴, Phyllis I Spuls²⁵, Louise A A Gerbens²⁵, Valeria Aoki²⁴

Affiliations

¹ Department of Dermatology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: raquel.orfali@fm.usp.br.
² Department of Dermatology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
³ Department of Dermatology, Hospital Universitário Pedro Ernesto, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
⁴ Department of Dermatology, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil.
⁵ Department of Dermatology, Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil.
⁶ Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
⁷ Department of Dermatology, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
⁸ Dermatology Clinic, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
⁹ Department of Dermatology, Centro Universitário Faculdade de Medicina do ABC, Santo André, SP, Brazil.
¹⁰ Department of Dermatology, Universidade do Estado Pará, Belém, PA, Brazil.
¹¹ Department of Dermatology, Instituto Bahiano de Imunoterapia, Salvador, BH, Brazil.
¹² Department of Dermatology, Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
¹³ Department of Health, National Reference Center in Sanitary Dermatology Dona Libânia, Fortaleza, CE, Brazil.
¹⁴ Department of Dermatology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil; Health Department, Hospital Otávio de Freitas, Recife, PE, Brazil.
¹⁵ Department of Dermatology, Hospital Universitário Pedro Ernesto, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Professor Rubem David Azulay Institute of Dermatology, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
¹⁶ Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
¹⁷ Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Department of Dermatology, Universidade Metropolitana de Santos, Santos, SP, Brazil.
¹⁸ Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
¹⁹ Department of Dermatology, Complexo Hospitalar Padre Bento, Guarulhos, SP, Brazil; Department of Dermatology, State Public Servant Hospital, São Paulo, SP, Brazil.
²⁰ Department of Dermatology, Hospital for Tropical Diseases, Goiânia, GO, Brazil; Department of Dermatology, Universidade Federal de Goiás, Goiânia, GO, Brazil.
²¹ Department of Dermatology, Federal Hospital of State Servers, Rio de Janeiro, RJ, Brazil.
²² Department of Dermatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
²³ Department of Dermatology, Teaching and Research Institute of Hospital Sírio-Libanês, São Paulo, SP, Brazil.
²⁴ Department of Dermatology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
²⁵ Department of Dermatology, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, The Netherlands.

PMID: 37302894
PMCID: PMC10589461
DOI: 10.1016/j.abd.2023.04.003

Practice Guideline

Consensus on the therapeutic management of atopic dermatitis ‒ Brazilian Society of Dermatology: an update on phototherapy and systemic therapy using e-Delphi technique

Raquel Leao Orfali et al. An Bras Dermatol. 2023 Nov-Dec.

. 2023 Nov-Dec;98(6):814-836.

doi: 10.1016/j.abd.2023.04.003. Epub 2023 Jun 9.

Authors

Affiliations

¹ Department of Dermatology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: raquel.orfali@fm.usp.br.
² Department of Dermatology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil.
³ Department of Dermatology, Hospital Universitário Pedro Ernesto, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
⁴ Department of Dermatology, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil.
⁵ Department of Dermatology, Hospital Municipal Jesus, Rio de Janeiro, RJ, Brazil.
⁶ Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
⁷ Department of Dermatology, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
⁸ Dermatology Clinic, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
⁹ Department of Dermatology, Centro Universitário Faculdade de Medicina do ABC, Santo André, SP, Brazil.
¹⁰ Department of Dermatology, Universidade do Estado Pará, Belém, PA, Brazil.
¹¹ Department of Dermatology, Instituto Bahiano de Imunoterapia, Salvador, BH, Brazil.
¹² Department of Dermatology, Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil.
¹³ Department of Health, National Reference Center in Sanitary Dermatology Dona Libânia, Fortaleza, CE, Brazil.
¹⁴ Department of Dermatology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil; Health Department, Hospital Otávio de Freitas, Recife, PE, Brazil.
¹⁵ Department of Dermatology, Hospital Universitário Pedro Ernesto, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Professor Rubem David Azulay Institute of Dermatology, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
¹⁶ Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
¹⁷ Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Department of Dermatology, Universidade Metropolitana de Santos, Santos, SP, Brazil.
¹⁸ Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
¹⁹ Department of Dermatology, Complexo Hospitalar Padre Bento, Guarulhos, SP, Brazil; Department of Dermatology, State Public Servant Hospital, São Paulo, SP, Brazil.
²⁰ Department of Dermatology, Hospital for Tropical Diseases, Goiânia, GO, Brazil; Department of Dermatology, Universidade Federal de Goiás, Goiânia, GO, Brazil.
²¹ Department of Dermatology, Federal Hospital of State Servers, Rio de Janeiro, RJ, Brazil.
²² Department of Dermatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
²³ Department of Dermatology, Teaching and Research Institute of Hospital Sírio-Libanês, São Paulo, SP, Brazil.
²⁴ Department of Dermatology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
²⁵ Department of Dermatology, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, The Netherlands.

PMID: 37302894
PMCID: PMC10589461
DOI: 10.1016/j.abd.2023.04.003

Abstract

This publication is an update of the "Consensus on the therapeutic management of atopic dermatitis - Brazilian Society of Dermatology" published in 2019, considering the novel, targeted-oriented systemic therapies for atopic dermatitis. The initial recommendations of the current consensus for systemic treatment of patients with atopic dermatitis were based on a recent review of scientific published data and a consensus was reached after voting. The Brazilian Society of Dermatology invited 31 experts from all regions of Brazil and 2 international experts on atopic dermatitis who fully contributed to the process. The methods included an e-Delphi study to avoid bias, a literature search and a final consensus meeting. The authors added novel approved drugs in Brazil and the indication for phototherapy and systemic therapy for AD. The therapeutical response to systemic treatment is hereby reported in a suitable form for clinical practice and is also part of this updated manuscript.

Keywords: Atopic dermatitis; Delphi technique; Medication therapy management; Phototherapy.

PubMed Disclaimer

Figures

**Figure 1**
Basic and systemic AD therapy: overview of SBD expert consensus-based recommendations for adults and children. *Other immunosuppressants: azathioprine and mycophenolate mofetil. ** Awaiting approval in Brazil

See this image and copyright information in PMC

References

1. Vermeulen F.M., Gerbens L.A.A., Schmitt J., Deleuran M., Irvine A.D., Logan K., et al. The European TREatment of ATopic eczema (TREAT) Registry Taskforce survey: prescribing practices in Europe for phototherapy and systemic therapy in adult patients with moderate-to-severe atopic eczema. Br J Dermatol. 2020;183:1073–1082. - PMC - PubMed
1. Werfel T., Heratizadeh A., Aberer W., Ahrens F., Augustin M., Biedermann T., et al. Update “Systemic treatment of atopic dermatitis” of the S2k-guideline on atopic dermatitis. J Dtsch Dermatol Ges. 2021;19:151–168. - PubMed
1. Drucker A.M., Lam M., Flohr C., Thyssen J.P., Kabashima K., Bissonnette R., et al. Systemic therapy for atopic dermatitis in older adults and adults with comorbidities: a scoping review and International Eczema Council Survey. Dermatitis. 2022;33:200–206. - PMC - PubMed
1. Drucker A.M., Morra D.E., Prieto-Merino D., Ellis A.G., Yiu Z.Z.N., Rochwerg B., et al. Systemic immunomodulatory treatments for atopic dermatitis: update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022;158:523–532. - PMC - PubMed
1. homeforeczema.org [Internet]. UK: Harmonizing Outcome Measures for Eczema (HOME). [cited 2023 Apr 4]. Available from: http://www.homeforeczema.org/.

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Consensus on the therapeutic management of atopic dermatitis ‒ Brazilian Society of Dermatology: an update on phototherapy and systemic therapy using e-Delphi technique

Affiliations

Consensus on the therapeutic management of atopic dermatitis ‒ Brazilian Society of Dermatology: an update on phototherapy and systemic therapy using e-Delphi technique

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources