Review

. 2023 Sep;13(9):e12299.

doi: 10.1002/clt2.12299.

A concept for integrated care pathways for atopic dermatitis-A GA² LEN ADCARE initiative

Torsten Zuberbier^{1

2}, Amir Abdul Latiff³, Xenofon Aggelidis⁴, Matthias Augustin^{5

6}, Radu-Gheorghe Balan⁷, Christine Bangert⁸, Lisa Beck⁹, Thomas Bieber^{10

11}, Jonathan A Bernstein¹², Marta Bertolin Colilla¹³, Alejandro Berardi¹⁴, Anna Bedbrook¹⁵, Carsten Bindslev-Jensen¹⁶, Jean Bousquet¹⁷, Marjolein de Bruin-Weller¹⁸, Dayanne Bruscky¹⁹, Betul Buyuktiryaki²⁰, Giorgio Walter Canonica²¹, Carla Castro²², Natia Chanturidze²³, Herberto Jose Chong-Neto¹⁷, Chia-Yu Chu²⁴, Leena Chularojanamontri²⁵, Michael Cork²⁶, Roberta F J Criado^{27

28}, Laia Curto Barredo²⁹, Adnan Custovic³⁰, Ulf Darsow³¹, Arben Emurlai³², Ana de Pablo³³, Stefano Del Giacco³⁴, Giampiero Girolomoni³⁵, Tanja Deleva Jovanova³⁶, Mette Deleuran³⁷, Nikolaos Douladiris⁴, Bruno Duarte³⁸, Ruta Dubakiene³⁹, Esben Eller¹⁶, Batya Engel-Yeger⁴⁰, Luis Felipe Ensina⁴¹, Nelson Rosario Filho¹⁷, Carsten Flohr⁴², Daria Fomina⁴³, Wojciech Francuzik⁴⁴, Maria Laura Galimberti⁴⁵, Ana M Giménez-Arnau⁴⁶, Kiran Godse⁴⁷, Charlotte Gotthard Mortz¹⁶, Maia Gotua²³, Michihiro Hide⁴⁸, Wolfram Hoetzenecker⁴⁹, Nicolas Hunzelmann⁵⁰, Alan Irvine⁵¹, Carolyn Jack⁵², Ioanna Kanavarou⁴, Norito Katoh⁵³, Tamar Kinaciyan⁸, Emek Kocatürk²⁰, Kanokvalai Kulthanan²⁵, Hilde Lapeere⁵⁴, Susanne Lau⁵⁵, Mariana Machado Forti Nastri⁵⁶, Michael Makris⁴, Eli Mansour⁵⁷, Alexander Marsland⁵⁸, Mara Morelo Rocha Felix⁵⁹, Ana Paula Moschione Castro⁶⁰, Eustachio Nettis⁶¹, J F Nicolas⁶², Audrey Nosbaum^{63

64}, Mikaela Odemyr^{65

66}, Niki Papapostolou⁴, Claudio A S Parisi⁴⁶, Sushil Paudel⁶⁷, Jonny Peter^{68

69}, Prakash Pokharel^{70

71}, Luis Puig⁷², Tamara Quint⁸, German Dario Ramon^{70

71}, Frederico Regateiro⁷³, Giampaolo Ricci⁷⁴, Cristine Rosario⁷⁵, Cansin Sackesen²⁰, Peter Schmid-Grendelmeier^{76

77}, Esther Serra-Baldrich⁶⁴, Kristina Siemens⁷⁸, Cathrine Smith⁷⁹, Petra Staubach⁸⁰, Katarina Stevanovic^{1

2}, Özlem Su-Kücük⁸¹, Gordon Sussman⁸², Simona Tavecchio⁸³, Natasa Teovska Mitrevska⁸⁴, Diamant Thaci⁸⁵, Elias Toubi⁸⁶, Claudia Traidl-Hoffmann⁸⁷, Regina Treudler⁸⁸, Zahava Vadasz⁸⁹, Ingrid van Hofman⁹⁰, Maria Teresa Ventura⁹¹, Zhao Wang⁹², Thomas Werfel⁹³, Andreas Wollenberg^{94

95}, Ariana Yang^{96

97}, Yik Weng Yew⁹⁸, Zuotao Zhao⁹⁹, Ricardo Zwiener¹⁰⁰, Margitta Worm^{5

6}

Affiliations

¹ Institute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
² Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
³ Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
⁴ Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University General Hospital "Attikon", Athens, Greece.
⁵ University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁶ Institute for Health Services Research in Dermatology and Nursing, Hamburg, Germany.
⁷ Institutul Regional de Gastroenterologie si Hepatologie, Cluj-Napoca, Romania.
⁸ Department of Dermatology, Medical University of Vienna, Vienna, Austria.
⁹ University of Rochester Medical Center, Rochester, New York, USA.
¹⁰ University Hospital of Bonn, Bonn, Germany.
¹¹ Christine Kühne-Center of Allergy Research and Education, Davos, Switzerland.
¹² University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
¹³ Hospital del Mar, Barcelona, Spain.
¹⁴ Instituto de Asma, Alergia y Enfermedades Respiratorias, Corrientes, Argentina.
¹⁵ MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France.
¹⁶ Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense C, Denmark.
¹⁷ Division of Allergy and Immunology, Complexo Hospital de Clinicas Federal University of Paraná, Curitiba, Brazil.
¹⁸ Department of Dermatology/Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁹ Federal University of Pernambuco, Recife, Brazil.
²⁰ Division of Pediatric Allergy, Koc University Hospital, Istanbul, Turkey.
²¹ Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
²² Department of Dermatology, Hospital Universitario Austral, Universidad Austral, Buenos Aires, Argentina.
²³ Center of Allergy and Immunology, Tbilisi, Georgia.
²⁴ Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
²⁵ Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
²⁶ Sheffield Dermatology Research, IICD, University of Sheffield, Sheffield, UK.
²⁷ Alergoskin Alergia e Dermatologia, Santo Andre, Brazil.
²⁸ Department of Dermatology, Centro Universitario FMABC, Santo Andre, Brazil.
²⁹ Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
³⁰ National Heart and Lung Institute, Imperial College, London, UK.
³¹ Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
³² Clinical Hospital Tetovo, Tetovo, North Macedonia.
³³ Hospital Universitario Austral, Pilar, Argentina.
³⁴ Allergy and Clinical Immunology, University of Cagliari, Sardinia, Italy.
³⁵ Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy.
³⁶ Health Center Skoplje, Skoplje, North Macedonia.
³⁷ Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
³⁸ Hospital Santo Antonio dos Capuchos, Centro Universitário de Lisboa Central, Lisbon, Portugal.
³⁹ Department of Immunology and Allergology, Medical Faculty, Clinics of Chest Diseases, Vilnius University, Vilnius, Lithuania.
⁴⁰ Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
⁴¹ CPAlpha Clinical Research Center, Barueri - São Paulo, Brazil.
⁴² St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
⁴³ Center of Allergy and Immunology, Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russian Federation.
⁴⁴ Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
⁴⁵ Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
⁴⁶ Dermatology Department, Hospital del Mar, IMIM, Universitat Autonoma y Universitat Pompeu Fabra, Barcelona, Spain.
⁴⁷ D.Y. Patil University, Navi Mumbai, Maharashtra, India.
⁴⁸ Department of Dermatology, Hiroshima University Hospital, Hiroshima, Japan.
⁴⁹ Department of Dermatology, Kepler University Hospital, Linz, Austria.
⁵⁰ Department of Dermatology, University of Cologne, Cologne, Germany.
⁵¹ Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
⁵² Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
⁵³ Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
⁵⁴ Ghent University Hospital, Ghent, Belgium.
⁵⁵ Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁵⁶ Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, Brazil.
⁵⁷ Division of Allergy and Immunology, Department of Clinical Medicine, University of Campinas, Campinas, Brazil.
⁵⁸ Salford Royal Foundation Trust - University of Manchester and Spire Manchester Hospital, Manchester, UK.
⁵⁹ AlergoLife Clinici, Rio de Janeiro, Brazil.
⁶⁰ Instituto da Criança, Rio de Janeiro, Brazil.
⁶¹ Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy.
⁶² Department of Clinical Immunology and Allergy, Lyon-Sud University Hospital, CIRI/INSERM U1111, Lyon, France.
⁶³ Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
⁶⁴ Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, UCBL1, ENS de Lyon, Lyon, France.
⁶⁵ EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
⁶⁶ President of the Swedish Asthma and Allergy Association, Stockholm, Sweden.
⁶⁷ Center Civil Service Hospital, Kathmandu, Nepal.
⁶⁸ Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
⁶⁹ Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
⁷⁰ Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Buenos Aires, Argentina.
⁷¹ Allergia e Inmunologia Section, Hospital Italiano Regional del Sur, Bahia Blanca, Buenos Aires, Argentina.
⁷² Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
⁷³ Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
⁷⁴ Department of Medical and Surgical Sciences DIMEC, University of Bologna, Bologna, Italy.
⁷⁵ Federal University of Parana, Curitiba, Brazil.
⁷⁶ Department of Dermatology Allergy Unit, University Hospital of Zürich, Zürich, Switzerland.
⁷⁷ Chrstine Kèhne Center for Allergy Research and Education CK_CARE, Davos, Switzerland.
⁷⁸ King's College London, London, UK.
⁷⁹ St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK.
⁸⁰ Department of Dermatology and Allergy, Hautklinik und Poliklinik der Universitätsmedizin, University Medical Center, Mainz, Germany.
⁸¹ Department of Dermatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
⁸² Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁸³ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁸⁴ ReMedika General Hospital, Skopje, North Macedonia.
⁸⁵ Center for Comprehensive Inflammation Medicine, University of Lübeck, Lübeck, Germany.
⁸⁶ Allergy and Clinical Immunology, Holy Family Hospital, Nazareth, Israel.
⁸⁷ Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
⁸⁸ Universtiy Leipzig Medical Faculty, Leipziger Interdisziplinäres Centrum für Allergologie, Leipzig, Germany.
⁸⁹ Bnai-Zion Medical Center, Haifa, Israel.
⁹⁰ GA2LEN Network, Berlin, Germany.
⁹¹ University of Bari Aldo Moro, Bari, Italy.
⁹² Department of Dermatology, Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
⁹³ Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
⁹⁴ Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany.
⁹⁵ Department of Dermatology, Free University Brussels, University Hospital Brussels, Brussels, Belgium.
⁹⁶ Division of Allergy and Clinical Immunology of University of Sao Paulo, São Paulo, Brazil.
⁹⁷ Faculty of Medical Sciences of UNICAMP, São Paulo, Brazil.
⁹⁸ National Skin Centre, Singapore, Singapore.
⁹⁹ Department of Dermatology, First Hospital Peking University, Beijing, China.
¹⁰⁰ Medicina Interna y Alergología e Inmunología Clínica, Hospital Universitario Austral, Pilar, Argentina.

PMID: 37746794
PMCID: PMC10500634
DOI: 10.1002/clt2.12299

Review

A concept for integrated care pathways for atopic dermatitis-A GA² LEN ADCARE initiative

Torsten Zuberbier et al. Clin Transl Allergy. 2023 Sep.

. 2023 Sep;13(9):e12299.

doi: 10.1002/clt2.12299.

Authors

Affiliations

¹ Institute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
² Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
³ Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
⁴ Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University General Hospital "Attikon", Athens, Greece.
⁵ University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁶ Institute for Health Services Research in Dermatology and Nursing, Hamburg, Germany.
⁷ Institutul Regional de Gastroenterologie si Hepatologie, Cluj-Napoca, Romania.
⁸ Department of Dermatology, Medical University of Vienna, Vienna, Austria.
⁹ University of Rochester Medical Center, Rochester, New York, USA.
¹⁰ University Hospital of Bonn, Bonn, Germany.
¹¹ Christine Kühne-Center of Allergy Research and Education, Davos, Switzerland.
¹² University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
¹³ Hospital del Mar, Barcelona, Spain.
¹⁴ Instituto de Asma, Alergia y Enfermedades Respiratorias, Corrientes, Argentina.
¹⁵ MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France.
¹⁶ Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense C, Denmark.
¹⁷ Division of Allergy and Immunology, Complexo Hospital de Clinicas Federal University of Paraná, Curitiba, Brazil.
¹⁸ Department of Dermatology/Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, The Netherlands.
¹⁹ Federal University of Pernambuco, Recife, Brazil.
²⁰ Division of Pediatric Allergy, Koc University Hospital, Istanbul, Turkey.
²¹ Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
²² Department of Dermatology, Hospital Universitario Austral, Universidad Austral, Buenos Aires, Argentina.
²³ Center of Allergy and Immunology, Tbilisi, Georgia.
²⁴ Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
²⁵ Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
²⁶ Sheffield Dermatology Research, IICD, University of Sheffield, Sheffield, UK.
²⁷ Alergoskin Alergia e Dermatologia, Santo Andre, Brazil.
²⁸ Department of Dermatology, Centro Universitario FMABC, Santo Andre, Brazil.
²⁹ Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
³⁰ National Heart and Lung Institute, Imperial College, London, UK.
³¹ Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
³² Clinical Hospital Tetovo, Tetovo, North Macedonia.
³³ Hospital Universitario Austral, Pilar, Argentina.
³⁴ Allergy and Clinical Immunology, University of Cagliari, Sardinia, Italy.
³⁵ Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy.
³⁶ Health Center Skoplje, Skoplje, North Macedonia.
³⁷ Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
³⁸ Hospital Santo Antonio dos Capuchos, Centro Universitário de Lisboa Central, Lisbon, Portugal.
³⁹ Department of Immunology and Allergology, Medical Faculty, Clinics of Chest Diseases, Vilnius University, Vilnius, Lithuania.
⁴⁰ Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
⁴¹ CPAlpha Clinical Research Center, Barueri - São Paulo, Brazil.
⁴² St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
⁴³ Center of Allergy and Immunology, Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russian Federation.
⁴⁴ Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
⁴⁵ Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
⁴⁶ Dermatology Department, Hospital del Mar, IMIM, Universitat Autonoma y Universitat Pompeu Fabra, Barcelona, Spain.
⁴⁷ D.Y. Patil University, Navi Mumbai, Maharashtra, India.
⁴⁸ Department of Dermatology, Hiroshima University Hospital, Hiroshima, Japan.
⁴⁹ Department of Dermatology, Kepler University Hospital, Linz, Austria.
⁵⁰ Department of Dermatology, University of Cologne, Cologne, Germany.
⁵¹ Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
⁵² Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
⁵³ Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
⁵⁴ Ghent University Hospital, Ghent, Belgium.
⁵⁵ Charité-Universitätsmedizin Berlin, Berlin, Germany.
⁵⁶ Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, Universidade de São Paulo, São Paulo, Brazil.
⁵⁷ Division of Allergy and Immunology, Department of Clinical Medicine, University of Campinas, Campinas, Brazil.
⁵⁸ Salford Royal Foundation Trust - University of Manchester and Spire Manchester Hospital, Manchester, UK.
⁵⁹ AlergoLife Clinici, Rio de Janeiro, Brazil.
⁶⁰ Instituto da Criança, Rio de Janeiro, Brazil.
⁶¹ Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy.
⁶² Department of Clinical Immunology and Allergy, Lyon-Sud University Hospital, CIRI/INSERM U1111, Lyon, France.
⁶³ Service d'Allergologie et Immunologie Clinique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
⁶⁴ Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, UCBL1, ENS de Lyon, Lyon, France.
⁶⁵ EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
⁶⁶ President of the Swedish Asthma and Allergy Association, Stockholm, Sweden.
⁶⁷ Center Civil Service Hospital, Kathmandu, Nepal.
⁶⁸ Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
⁶⁹ Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
⁷⁰ Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Buenos Aires, Argentina.
⁷¹ Allergia e Inmunologia Section, Hospital Italiano Regional del Sur, Bahia Blanca, Buenos Aires, Argentina.
⁷² Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
⁷³ Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
⁷⁴ Department of Medical and Surgical Sciences DIMEC, University of Bologna, Bologna, Italy.
⁷⁵ Federal University of Parana, Curitiba, Brazil.
⁷⁶ Department of Dermatology Allergy Unit, University Hospital of Zürich, Zürich, Switzerland.
⁷⁷ Chrstine Kèhne Center for Allergy Research and Education CK_CARE, Davos, Switzerland.
⁷⁸ King's College London, London, UK.
⁷⁹ St John's Institute of Dermatology, Guys and St Thomas' NHS Trust, London, UK.
⁸⁰ Department of Dermatology and Allergy, Hautklinik und Poliklinik der Universitätsmedizin, University Medical Center, Mainz, Germany.
⁸¹ Department of Dermatology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
⁸² Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁸³ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁸⁴ ReMedika General Hospital, Skopje, North Macedonia.
⁸⁵ Center for Comprehensive Inflammation Medicine, University of Lübeck, Lübeck, Germany.
⁸⁶ Allergy and Clinical Immunology, Holy Family Hospital, Nazareth, Israel.
⁸⁷ Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
⁸⁸ Universtiy Leipzig Medical Faculty, Leipziger Interdisziplinäres Centrum für Allergologie, Leipzig, Germany.
⁸⁹ Bnai-Zion Medical Center, Haifa, Israel.
⁹⁰ GA2LEN Network, Berlin, Germany.
⁹¹ University of Bari Aldo Moro, Bari, Italy.
⁹² Department of Dermatology, Second Affiliated Hospital, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
⁹³ Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
⁹⁴ Department of Dermatology and Allergy, Ludwig-Maximilian-University, Munich, Germany.
⁹⁵ Department of Dermatology, Free University Brussels, University Hospital Brussels, Brussels, Belgium.
⁹⁶ Division of Allergy and Clinical Immunology of University of Sao Paulo, São Paulo, Brazil.
⁹⁷ Faculty of Medical Sciences of UNICAMP, São Paulo, Brazil.
⁹⁸ National Skin Centre, Singapore, Singapore.
⁹⁹ Department of Dermatology, First Hospital Peking University, Beijing, China.
¹⁰⁰ Medicina Interna y Alergología e Inmunología Clínica, Hospital Universitario Austral, Pilar, Argentina.

PMID: 37746794
PMCID: PMC10500634
DOI: 10.1002/clt2.12299

Abstract

Introduction: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems.

Methods: The GA² LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL² EN ADCARE centres.

Results: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD.

Conclusion: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.

Keywords: ICP; atopic dermatitis; eczema; guidance; integrated care pathways; multidisciplinary; prevention; treatment.

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Conflict of interest statement

T. Zuberbier has received institutional funding for research and/or honoria for lectures and/or consulting from Amgen, AstraZeneca, AbbVie, ALK, Almirall, Astellas, Bayer Health Care, Bencard, Berlin Chemie, FAES, HAL, Henkel, Kryolan, Leti, L'Oreal, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes, Takeda, Teva and UCB, Uriach; in addition, he is a member of ARIA/WHO, DGAKI, ECARF, GA²LEN and WAO. A. A. Latiff declares no COI. X. Aggelidis declares no COI. M. Augustin has received institutional funding for research and/or honoria for lectures and/or consulting and/or was a member of an advisory board from AbbVie, Almirall, Beiersdorf, Eli Lilly, Galderma, LEO, Pfizer and Sanofi‐Genzyme. R.‐G. Balan declares no COI. C. Bangert declares no COI. L. Beck declares no COI. T. Bieber was speaker and/or consultant and/or Investigator for AbbVie, Affibody, Almirall, Amagma, AnaptysBio, AOBiom, Arena, Aristea, Asana Biosciences, ASLAN pharma, Bayer Health, BioVerSys, Böhringer‐Ingelheim, Bristol‐Myers Squibb, Connect Pharma, Daichi‐Sanyko, Dermavant, DIECE Therapeutics, Domain Therapeutics, DS Pharma, EQRx, Galderma, Galapagos, Glenmark, GSK, Incyte, Innovaderm, IQVIA, Janssen, Kirin, Kymab, LEO, LG Chem, Lilly, L'Oréal, MSD, Medac, Nektar, Novartis, Numab, OM‐Pharma, Pfizer, Pierre Fabre, Q32bio, RAPT, Sanofi/Regeneron, UCB, Union Therapeutics. He is the founder and chairman of the board of the non‐profit biotech ‘Davos Biosciences’; in addition is a member of the advisory board for Sanofi and Novartis, president of the Erich‐Hoffmann society in Bonn, member of the scientific board of CK‐CARE, chair of the board of directors of CK‐CARE, chair of the board of directors of Davos Biosciences (non‐profit company), member of the board of directors Medicine Campus Davos. J. A. Bernstein has received institutional funding for research and/or honoria for lectures and/or consulting from Allakos, Sanofi‐Regeneron, AZ, Novartis, Genentech, Celldex, TEVA; in addition is the AAAAI president, is on the board of advisory for WAO, Inerasma, and AFI chairperson. M. B. Collila declares no COI. A. Berardi declares no COI. A. Bedbrook declares no COI. C. Bindslev‐Jensen declares no COI. J. Bousquet reports personal fees from Cipla, Menarini, Mylan, Novartis, Purina, Sanofi‐Aventis, Teva, Uriach, other from KYomed‐Innov, other from Mask‐air‐SAS, outside the submitted work. M. de Bruin‐Weller reports grants and personal fees from Abbvie, personal fees from Almirall, personal fees from Aslan, grants and personal fees from Eli Lilly, personal fees from Galderma, personal fees from Janssen, grants and personal fees from Leo Pharma, grants and personal fees from Pfizer, grants and personal fees from Regeneron/Sanofi, outside the submitted work. D. Bruscky declares no COI. B. Buyuktiryaki declares no COI. G. W. Canonica reports personal fees from Ðanofi, personal fees from Stallergenes, personal fees from Genzyme, personal fees from Menarini, personal fees from GSK, personal fees from Chiesi, outside the submitted work. C. Castro has received institutional funding for research and/or honoria for lectures and/or consulting from Pfizer, Abbvie, Sanofi, Jannsen, L’Oreal, Eucerin, and Galderma and plays a leadership role in Atopic Dermatitis Group SAD. N. Chanturidze declares no COI. H. J. Chong‐Neto declares no COI. C.‐Y. Chu reports personal grants, fees and/or other from AbbVie, Lilly, Novartis, Oneness Biotech, Pfizer, Regeneron, Roche, Sanofi, United BioPharma Viatris, outside the submitted work. L. Chularojanamontri has received grants/research support from Novartis. M. Cork reports grants and personal fees from Hyphens Pharma, grants and personal fees from Johnson & Johnson, grants and personal fees from Pfizer, grants and personal fees from Sanofi, grants and personal fees from L'Oreal, grants and personal fees from Leo Pharma, grants and personal fees from Regeneron, personal fees from Procter & Gamble, personal fees from UCB, outside the submitted work; and is a voluntary medical adviser to the National Eczema Society, UK. R. F. J. Criado has received institutional funding for research and/or honoria for lectures and/or consulting and/or was a member of an advisory board from Takeda, Novartis, Sanofi, Pfizer, Abbvie, and Lilly. L. Curto Barredo reports personal fees and non‐financial support from Sanofi, Leo Pharma, Abbvie, and Lilly, outside the submitted work. A. Custovic reports personal fees from Novartis, Sanofi, Stallergenes Greer, AstraZeneca Worg Pharmaceuticals, and GSK, outside the submitted work. U. Darsow declares no COI. A. Emurlai declares no COI. A. de Pablo declares no COI. S. Del Giacco reports grants and personal fees from Sanofi, outside the submitted work. G. Girolomoni declares no COI. T. Deleva Jovanov declares no COI. M. Deleuran has received institutional funding for research and/or honoria for lectures and/or consulting and/or was a member of an advisory board from Leo Pharma, Abbvie, Eli‐Lilly, Regeneron, Sanofi Genzyme, Pfizer, La Roche Posay, Pierre Farbe, Novartis, Almirall, Arena Pharmaceuticals, ASLAN Pharmaceuticals, Incyte and Kymab. N. Douladiris declares no COI. B. Duarte has received honoraria as a speaker from Sanofi, Abbvie, Leo Pharma, and Lilly. R. Dubakiene declares no COI. E. Eller declares no COI. B. Engel‐Yeger declares no COI. L. F. Ensina reports personal fees from NOVARTIS, non‐financial support from SANOFI, and personal fees from ABBVIE, outside the submitted work. N. Rosario Filho received honoraria as speaker and consultant funded research grant for Sanofi, Abbvie, AstraZeneca, Boehringer, Chiesi, Novartis, Mantecorp, Janssen, Vertex, Abbott. C. Flohr declares no COI. D. Fomina declares no COI. W. Francuzik declares no COI. M. L. Galimberti reports personal fees from Janssen and Novartis. A. Giménez‐Arnau has received institutional funding for research and/or honoria for lectures and/or consulting from Almirall, Amgen, Astra Zeneca, Avene, Celldex, ESXCIENT, Instituto Carlos III‐FEDER, Menarini, Novartis, Sanofi‐Regeneron, Thermo Fisher, and Uriach Pharma/Neucor. K. Godse declares no COI. C. G. Mortz declares no COI. M. Gotua declares no COI. M. Hide reports grants and personal fees from Novartis, grants and personal fees from Sanofi, grants and personal fees from Kyowa‐Hakko‐Kirin, grants and personal fees from Mitsubishi‐Tanabe, and grants and personal fees from Uriach, outside the submitted work. W. Hoetzenecker declares no COI. N. Hunzelmann has received institutional funding for research and/or honoria for lectures and/or consulting from Abbvie, Leo Pharma, and Sanofi. A. Irvine has received institutional funding for research and/or honoria for lectures and/or consulting and/or was a member of an advisory board from Almirall, Abbvie, Eli Lilly, Pfizer, Benevolent AI, Arena, Novartis, Regeneron, Sanofi, Leo Pharma, Janssen, OM Pharma, has a pending patent with J and J, and is the president elect of the International Eczema Council. C. Jack reports grants from Innovaderm Research, McGill University Department of Medicine, MITACS, Canadian Dermatology Foundation, and Eczema Society of Canada, as well as grants, involvement in clinical studies, and/or consultancy work for Sanofi, Eli Lilly, AbbVie, Novartis, Valeant, Bausch, Pfizer, Amgen, Celgene, Janssen, Boehringer Ingelheim, Asana, LEO, Dermavant, AntibioTx, Neokera, Kiniksa, Ralexar, Arcutis, BMS, Boston, Cara, Concert, Incyte, Sienna, Aristea, Target PharmaSolution, and UCB. I. Kanavarou declares no COI. N. Katoh has received honoraria as a speaker/consultant for Sanofi, Maruho, Abbvie, Ely‐Lilly Japan, Mitsubishi Tanabe Pharma, Jansen Pharma, Taiho Pharmaceutical, Torii Pharmaceutical, Kyowa Kirin, Celgene Japan and Leo Pharma and has received grants as an investigator from Maruho, Ely‐Lilly Japan, Sun Pharma, Taiho Pharmaceutical, Torii Pharmaceutical, Boehringer Ingelheim Japan, Kyowa Kirin, Jansen Pharma, Boehringer Ingelheim Japan, A2 Healthcare, Abbvie, and Leo Pharma. T. Kinaciyan reports personal fees and other from BioCryst, grants, personal fees and other from Takeda, other from KalVista, personal fees from Novartis, personal fees from Hal Allergy, outside the submitted work. E. Kocatürk declares no COI. K. Kulthanan has received grants/research support from Novartis, honoraria/consultation fees from Novartis, Sanofi, A. Menarini, and Takeda. H. Lapeere has received institutional funding for research and/or honoria for lectures and/or consulting from Abbvie, Leo Pharma, Sanofi, Pfizer, and Almirall. S. Lau has received institutional funding for research and/or honoria for lectures and/or consulting from Sanofi, GSK, Leo Pharma, DBV, Allergopharma, Bencard, and Leti. M. M. F. Nastri declares no COI. M. Makris declares no COI. E. Mansour declares no COI. A. Marsland reports personal fees or other from Almirall, Galderma, Lilly, La roche Posay, Novartis, outside submitted work. M. Morelo Rocha Felix declares no COI. A. P. Moschione Castro reports being on the ABBVIE advisory board and Sanofi advisory board. E. Nettis reports personal fees from Sanofi, Leo Pharma, Chiesi, and Novartis. J. F. Nicolas declares no COI. A. Nosbaum declares no COI. M. Odemyr declares no COI. N. Papapostolou declares no COI. C. A. S. Parisi declares no COI. S. Paudel declares no COI. J. Peter has received honararia, travel support and/or educational grant funding from Novartis, Sanofi, AstraZeneca and Johnson and Johnson. P. Pokharel declares no COI. L. Puig reports grants and personal fees from AbbVie, grants and personal fees from Almirall, grants and personal fees from Amgen, grants and personal fees from Boehringer Ingelheim, grants and personal fees from Leo‐Pharma, personal fees from Bristol Myers Squibb, grants and personal fees from Lilly, grants and personal fees from Novartis, grants and personal fees from Pfizer, personal fees from Sandoz, grants and personal fees from Sanofi, grants and personal fees from UCB, during the conduct of the study. T. Quint declares no COI. G. D. Ramon declares no COI. F. Regateiro reports personal fees from Sanofi, Abbvie, Lilly and LEO Pharma, outside the submitted work. G. Ricci reports personal fees from Glasosmithkline and Recordiati and is a member of the Scientific Committee of the Italian Pediatric Dermatology Society. C. Rosario declares no COI. C. Sackesen declares no COI. P. Schmid‐Grendelmeier has received research grants from Christine Kühner Center for Allergy Research and Education CK‐CARE, has received personal fees from AbbVIe, Almiral, Galderma, LEO, Lilly, LÒreal, Novartis Pfizer, Pierre Favre, Sanofi‐Regeron, is on the advisory board for AbbVIe, Almiral, Galderma, LEO, Lilly, Pfizer, Sanofi‐Regeron, is a treasurer for the International Society for Atopic Dermatitis ISAC, chair in the Atopic Dermatitis Group in WAO, is a board member of the Swiss Patient Organization at the AHA Swiss Center for Allergy. E. Serra‐Baldrich has received personal fee payments and travel support from Abbvie, Lilly, Sanofi, Novartis, Pfizer, Galderma, and Leo Pharma. K. Siemens has received payment from the GA²LEN ADCARE Network for support of the present manuscript. C. Smith reports receiving a grant from the European Commission‐IMI. P. Staubach declares no COI. K. Stevanovic reports receiving a stipend from GA²LEN. Ö. Su‐Kücük declares no COI. G. Sussman has received research support from Aimmune, Amgen, Astra‐Zeneca, DBV technologies, Genentech, Kedrion S.p.A, Leo Pharma, Novartis, Sanofi, Regeneron, and ALK; and is a medical advisor and/or has received payment for lectures from Novartis, CSL Behring, Pfizer, Abbvie, Astra‐Zeneca, Nuvo Pharmaceuticals, and the Allergy Asthma and Immunology Society of Ontario. S. Tavecchio declares personal fee payments and travel cost payments from Sanofi, Abbvie, and Leo Pharma. N. Teovska Mitrevska declares no COI. D. Thaci reports grants and personal fees from AbbVie, personal fees from Almirall, personal fees from Bristol‐Myers Squibb, personal fees from Amgen, personal fees from Janssen, grants and personal fees from Leo‐Pharma, personal fees from Lilly, grants and personal fees from Novartis, personal fees from Pfizer, personal fees from Regeneron, personal fees from Sanofi, personal fees from Target, personal fees from UCB, during the conduct of the study. E. Toubi declares no COI. C. Traidl‐Hoffmann declares no COI. R. Treudler reports personal fees and grants from Sanofi, AbbVie, Pfizer, Lilly, and Novartis, outside submitted work. Z. Vadasz declares no COI. I. van Hofman declares no COI. M. T. Ventura declares no COI. Z. Wang declares no COI. T. Werfel reports personal fees and grants from Beiersdorf, Novartis, Leo Pharma, Abbvie, Janssen, Celgene, Galderma, Lily, and Sanofi, is on the advisory board for Abbvie, Janssen, Galderma, LEO, Lilly, Pfizer, Sanofi‐Genzyme, and Novartis, and is a board member for ETFAD, EAACI, ESDR, DGAKI, DDG. A. Wollenberg reports personal fees from AbbVie, Chugai, Galderma, LEO Pharma, Lilly, MedImmune, Novartis, Pfizer, Regeneron and Sanofi‐Aventis, and grants from LEO Pharma outside the submitted work. A. Yang declares personal and travel payments from Abbvie and Sanofi, outside submitted work. Y. W. Yew declared no COI. Z. Zhao is a speaker/advisor for and/or has received research funding from Abbvie, Astra Zeneca, Astellas, Novartis, Pfizer, Takeda, Sanofi, Lilly, Galderma, Janssen, GSK, BAYER, LEO, MEDA Pharma and ALK Pharma outside the submitted work. R. Zwiener declares no COI. M. Worm reports grants and personal fees from Stallergens, HAL Allergie, Bencard Allergie, Allergopharma, ALK‐Abello, Mylan Germany, Actelion Pharmaceuticals Deutschland, Biotest, AbbVie Deutschland, Lilly Deutschland Aimmune, DBV Technologies, Regeneron Pharmaceuticals, Sanofi Aventis, Leo Pharma, Novartis and Viatris, outside the submitted work.

Figures

**FIGURE 1**
(A) More than skin diseases—comorbidities in AD., , , , ¹At present, US and Asian data indicate cardiometabolic diseases as a comorbidity of AD, while data from European patients do not support this. Lymphoma is controversially discussed—it is possible that the ‘association’ to AD is based on a misdiagnosis of early stages of CTCL. ²For example, hyper IgE syndromes, WAS and WAS‐like conditions; IPEX and IPEX‐like conditions, CBM‐opathies (CARD11 deficiency, CARD14 deficiency, MALT1 deficiency). ³New data indicate autoimmune comorbidities in adults with AD, for example, rheumatoid arthritis, inflammatory bowel disease, and alopecia areata., ⁴Lymphoma is controversially discussed—it is possible that the ‘association’ to AD is based on a misdiagnosis of early stages of CTCL. (B) The AD multidisciplinary team. Please note the country‐specific differences, for example, in some countries, children are usually not seen by the GP during their first years of life but by primary care pediatricians. Hence, pediatricians as well as AD specialists are included as primary care providers. AD, atopic dermatitis; CTCL, cutaneous T cell lymphoma.

**FIGURE 2**
(A–H) ICPs for the management of atopic dermatitis. (A) ICP—overview. (B) Supported self‐management., (C) Pharmacy., , , (D) Primary care., , , (E) Specialists I., (F) Specialists II., (G) Caregivers and support groups. (H) Work and social life. ICPs, integrated care pathways.

**FIGURE 3**
ICP—additional information. (A) Supported self‐management., , , , (B) Pharmacy. (C) Primary care I., (D) Primary care II., , , (E) Specialist (dermatologist, allergologist, pediatrician). ICPs, integrated care pathways.

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References

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1. Silverberg JI, Barbarot S, Gadkari A, et al. Atopic dermatitis in the pediatric population: a cross‐sectional, international epidemiologic study. Ann Allergy Asthma Immunol. 2021;126(4):417‐428.e2. 10.1016/j.anai.2020.12.020 - DOI - PubMed
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A concept for integrated care pathways for atopic dermatitis-A GA² LEN ADCARE initiative

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A concept for integrated care pathways for atopic dermatitis-A GA² LEN ADCARE initiative

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