European Guideline (EuroGuiDerm) on atopic eczema: Living update

A Wollenberg^{1

2

3}, M Kinberger⁴, B Arents⁵, N Aszodi², S Barbarot⁶, T Bieber⁷, H A Brough^{8

9}, P Calzavara-Pinton¹⁰, S Christen-Zaech¹¹, M Deleuran¹², M Dittmann⁴, N Fosse¹³, K Gáspár¹⁴, L A A Gerbens¹⁵, U Gieler¹⁶, G Girolomoni¹⁷, S Gregoriou¹⁸, S Holland¹⁹, C G Mortz²⁰, A Nast⁴, U Nygaard²¹, E M Rehbinder^{22

23}, J Ring²⁴, M Rossi¹⁰, E Serra-Baldrich²⁵, D Simon²⁶, Z Z Szalai²⁷, J C Szepietowski^{28

29}, A Torrelo³⁰, T Werfel³¹, R N Werner⁴, C Flohr^{32

33}

Affiliations

¹ Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany.
² Department of Dermatology and Allergy, Ludwig Maximilian University Munich, Munich, Germany.
³ Comprehensive Center for Inflammatory Medicine, University of Luebeck, Luebeck, Germany.
⁴ Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
⁵ European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium.
⁶ Department of Dermatology, Nantes Université, CHU Nantes, UMR 1280 PhAN, INRAE, Nantes, France.
⁷ Christine Kühne-Center for Allergy Research and Education, Medicine Campus, Davos, Switzerland.
⁸ Children's Allergy Service, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
⁹ Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.
¹⁰ Dermatology Department, University of Brescia, Brescia, Italy.
¹¹ University Hospital Lausanne, Lausanne, Switzerland.
¹² Department of Dermatology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
¹³ Department of Dermatology, University Hospital Basel, Basel, Switzerland.
¹⁴ Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
¹⁵ Department of Dermatology, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health & Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands.
¹⁶ Department of Dermatology, University of Giessen, Giessen, Germany.
¹⁷ Dermatology and Venereology Section, Department of Medicine, University of Verona, Verona, Italy.
¹⁸ Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹⁹ Eczema Outreach Support (UK), Linlithgow, UK.
²⁰ Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
²¹ Department of Dermato-Venerology, Aarhus University Hospital, Aarhus, Denmark.
²² Dermatology Department, Oslo University Hospital, Oslo, Norway.
²³ Clinical Medicine, University of Oslo, Oslo, Norway.
²⁴ Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany.
²⁵ Dermatology, Hospital of Sant Pau, Barcelona, Spain.
²⁶ Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁷ Pediatric Dermatology Unit, Heim Pál National Children's Institute Budapest, Budapest, Hungary.
²⁸ Department of Dermato-Venereology, 4th Military Hospital, Wroclaw, Poland.
²⁹ Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland.
³⁰ Hospital Infantil Niño Jesús, Madrid, Spain.
³¹ Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
³² St John's Institute of Dermatology, King's College London, London, UK.
³³ Guy's & St Thomas' NHS Foundation Trust, London, UK.

PMID: 40317496
PMCID: PMC12376260
DOI: 10.1111/jdv.20639

Practice Guideline

European Guideline (EuroGuiDerm) on atopic eczema: Living update

A Wollenberg et al. J Eur Acad Dermatol Venereol. 2025 Sep.

. 2025 Sep;39(9):1537-1566.

doi: 10.1111/jdv.20639. Epub 2025 May 2.

Authors

Affiliations

¹ Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany.
² Department of Dermatology and Allergy, Ludwig Maximilian University Munich, Munich, Germany.
³ Comprehensive Center for Inflammatory Medicine, University of Luebeck, Luebeck, Germany.
⁴ Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
⁵ European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium.
⁶ Department of Dermatology, Nantes Université, CHU Nantes, UMR 1280 PhAN, INRAE, Nantes, France.
⁷ Christine Kühne-Center for Allergy Research and Education, Medicine Campus, Davos, Switzerland.
⁸ Children's Allergy Service, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
⁹ Paediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.
¹⁰ Dermatology Department, University of Brescia, Brescia, Italy.
¹¹ University Hospital Lausanne, Lausanne, Switzerland.
¹² Department of Dermatology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
¹³ Department of Dermatology, University Hospital Basel, Basel, Switzerland.
¹⁴ Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
¹⁵ Department of Dermatology, Amsterdam UMC, Academic Medical Center, Amsterdam Public Health & Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands.
¹⁶ Department of Dermatology, University of Giessen, Giessen, Germany.
¹⁷ Dermatology and Venereology Section, Department of Medicine, University of Verona, Verona, Italy.
¹⁸ Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹⁹ Eczema Outreach Support (UK), Linlithgow, UK.
²⁰ Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
²¹ Department of Dermato-Venerology, Aarhus University Hospital, Aarhus, Denmark.
²² Dermatology Department, Oslo University Hospital, Oslo, Norway.
²³ Clinical Medicine, University of Oslo, Oslo, Norway.
²⁴ Department of Dermatology and Allergology Biederstein, Technical University Munich, Munich, Germany.
²⁵ Dermatology, Hospital of Sant Pau, Barcelona, Spain.
²⁶ Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
²⁷ Pediatric Dermatology Unit, Heim Pál National Children's Institute Budapest, Budapest, Hungary.
²⁸ Department of Dermato-Venereology, 4th Military Hospital, Wroclaw, Poland.
²⁹ Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland.
³⁰ Hospital Infantil Niño Jesús, Madrid, Spain.
³¹ Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
³² St John's Institute of Dermatology, King's College London, London, UK.
³³ Guy's & St Thomas' NHS Foundation Trust, London, UK.

PMID: 40317496
PMCID: PMC12376260
DOI: 10.1111/jdv.20639

Abstract

The evidence- and consensus-based living guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. The original EuroGuiDerm Guideline on atopic eczema was published in June 2022. Since then, the part of the guideline dealing with systemic therapy has been updated twice. This paper summarizes the results of the second update. Twenty-eight experts (including clinicians and patient representatives) from 12 European countries participated. The updated guideline provides guidance on which patients should be treated with systemic therapies, as well as recommendations and detailed information on each systemic drug. The systemic treatment options discussed in the guideline comprise conventional immunosuppressive drugs (azathioprine, ciclosporin, glucocorticosteroids, methotrexate and mycophenolate mofetil), biologics (dupilumab, lebrikizumab, nemolizumab and tralokinumab) and Janus kinase (JAK) inhibitors (abrocitinib, baricitinib and upadacitinib). Additionally, the updated guidelines address considerations for paediatric, adolescent, pregnant and breastfeeding patients. For all other aspects, please refer to the 2022 version.

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Conflict of interest statement

This is a summary of the second update of the EuroGuiDerm Guideline on atopic eczema. For the complete guideline, methods report (including COI disclosures) and evidence report, see https://www.guidelines.edf.one/.

Figures

**FIGURE 1**
Stepped‐care plan for adults with atopic eczema.

**FIGURE 2**
Stepped‐care plan for children and adolescents with atopic eczema.

See this image and copyright information in PMC

References

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1. Wollenberg A, Christen‐Zäch S, Taieb A, Paul C, Thyssen JP, de Bruin‐Weller M, et al. ETFAD/EADV eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020;34(12):2717–2744. - PubMed

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European Guideline (EuroGuiDerm) on atopic eczema: Living update

Affiliations

European Guideline (EuroGuiDerm) on atopic eczema: Living update

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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MeSH terms

Substances

LinkOut - more resources

Full Text Sources