Clinical Management of Atopic Dermatitis in Adults: Mapping of Expert Opinion in 4 Nordic Countries using a Modified Delphi Process
Jacob P. Thyssen, Teresa Berents, Maria Bradley, Mette Deleuran, Øystein Grimstad, Laura Korhonen, Tor Langeland, Tore Särnhult, Simon Francis Thomsen, Turid Thune, Carl-Fredrik Wahlgren, Christian Vestergaard, Laura B. von Kobyletzki, Anita Remitz
Similarities and differences in the everyday clinical management of moderate-to-severe atopic dermatitis in Nordic countries are unknown. Using a modified Delphi approach, 15 dermatologists from Denmark, Finland, Norway and Sweden completed face-to-face and online questionnaires and participated in summary discussions to map expert opinion on the clinical management of moderate-to-severe atopic dermatitis in these Nordic countries. Through discussions, 6 adult patient profiles, reflecting common disease presentations of atopic dermatitis, were identified. Using these case profiles, diagnostic work-up, treatment goals, patient education and treatment approaches were discussed. Patient education was identified as essential for effective management. A treatment sequence of moderate-to-potent topical glucocorticosteroids and emollients, followed by systemic treatment, was recommended, allowing 3 months to ascertain systemic treatment response before switching, if necessary. Consensus was not reached on systemic treatment choice, reflecting differences in clinical practice and reimbursement between countries. Practical, case-based clinical recommendations were developed for optimal patient care.
Atopic dermatitis is a disease associated with various skin complaints. There is currently no consensus on the diagnosis and treatment of atopic dermatitis in the Nordic region. We therefore gathered 15 Nordic dermatologists to discuss patient education, diagnosis and treatment of atopic dermatitis. Patient education was identified as essential for effective management of atopic dermatitis, and treatment with moderate-to-potent topical glucocorticosteroids and emollients, followed by systemic treatment, was recommended. This article provides insights into the challenges associated with effective management of atopic dermatitis across the Nordic region and provides recommendations for optimal patient care.