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

• Kim JE
• Shin MK
• Park GH
• Lee UH
• Lee JH
• Han TY
• Koh HC
• Jang YH
• Kim HO
• Na CH
• Lew BL
• Ahn JY
• Park CO
• Seo YJ
• Lee YW
• Sohn SW
• Park YL

• KMID: 2461988
• DOI: http://doi.org/10.5021/ad.2019.31.6.654

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

MeSH Terms

Advisory Committees
Classification*
Consensus*
Dermatitis, Atopic*
Dermatology
Diagnosis
Humans
Pruritus
Quality of Life
Recurrence
Treatment Failure
Withholding Treatment

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