Ann Dermatol.  2019 Dec;31(6):654-661. 10.5021/ad.2019.31.6.654.

2019 Consensus Korean Diagnostic Guidelines to Define Severity Classification and Treatment Refractoriness for Atopic Dermatitis: Objective and Subjective Assessment of Severity

Affiliations
  • 1Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 2Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea.
  • 3Department of Dermatology, Hallym University College of Medicine, Chuncheon, Korea.
  • 4Department of Dermatology, Inje University Sanggye Paik Hospital, Inje University, Seoul, Korea.
  • 5Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
  • 6Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
  • 7Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.
  • 8Department of Dermatology, College of Medicine, Chosun University, Gwangju, Korea.
  • 9Department of Dermatology, National Medical Center, Seoul, Korea.
  • 10Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
  • 11Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea.
  • 12Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea. 20050078@kuh.ac.kr
  • 13Research Institute of Medical Science, Konkuk University, Seoul, Korea.
  • 14Department of Dermatology, Korea University College of Medicine, Seoul, Korea.
  • 15Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Abstract

BACKGROUND
Systemic immunomodulatory treatment is actively recommended in the treatment for moderate to severe atopic dermatitis (AD) patients. However, consensus criteria for the classification of AD severity or treatment refractoriness have not been established yet.
OBJECTIVE
To establish consensus criteria on the definition of severity classification and treatment refractoriness of AD to provide a basis for proper treatment strategy.
METHODS
The Korean Atopic Dermatitis Association (KADA) comprised a task force team to establish a definition of moderate to severe AD. A draft of definition of moderate to severe AD was made on the basis of evidence. The recommendation was confirmed by KADA members through a web-based survey.
RESULTS
KADA approved that AD with 16≤eczema area and severity index (EASI)<23 should be basically defined as moderate AD whereas AD with EASI score ≥23 should be considered as severe AD. They agreed that it would be reasonable to raise the severity level if patient's daytime or nighttime pruritus numerical rating scale is equal to or higher than 7 (≥7) or dermatology life quality index score exceeds 10. AD patients who do not reach EASI 50 after appropriate treatment for three months should be considered as a non-responder. Patients with recurrence (EASI ≥16) within three months after cessation of treatment should be considered as a recurrent AD.
CONCLUSION
KADA built a consensus of definition of moderate and severe AD and treatment-refractoriness. These guidelines are expected to help physicians determine proper treatment options in need.

Keyword

Consensus; Dermatitis, atopic; Diagnosis; Guideline; Treatment failure
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