4項目のうち1項目を先行発表、診断に初めて言及
米国皮膚科学会（AAD）は12月2日、アトピー性皮膚炎に対する新たな治療ガイドラインを発表した。Journal of the American Academy of dermatology誌オンライン版に掲載。
今回発表されたのは、ガイドライン全4項中の第1項。アトピー性皮膚炎の診断法とモニタリング法、重症度やQOLの評価、患者に影響を与えることが多い関連疾患などについて扱っている。
AADによると、同学会ガイドラインが診断について言及したのは今回が初めて。アトピー性皮膚炎の誤診は病状の悪化を来し、その懸念は特に成人で大きい。今回のガイドラインは、他の類似疾患からアトピー性皮膚炎を鑑別し、正確な診断を下すための基準を盛り込んでいる。
今回発表の第1項に含まれる主要勧告は、
患者のIgEをモニターしないこと、
患者に対し痒みや睡眠状況、症状の持続性について質問すること、
関連疾患（睡眠障害、喘息、食物アレルギー、ADHD、精神疾患など）を持つ患者の治療は他科の専門医と協調して行う
ことの3点。
ガイドラインを作成したのは、アトピー性皮膚炎治療の実績を持つ皮膚科医による作業部会。残り3項では、アトピー性皮膚炎の管理、局所性および全身性薬剤や補助療法を用いた治療、再燃防止などを取り上げ、2014年中に発表する予定。
American Academy of Dermatology issues new guidelines of care for the diagnosis of atopic dermatitis
SCHAUMBURG, Ill. (Dec. 2, 2013) —
The American Academy of Dermatology (Academy) has released new evidence-based guidelines for the diagnosis and assessment of atopic dermatitis based on an extensive review of the scientific literature on this chronic skin condition characterized by itchy, red patches of skin.
Published online in the Journal of the American Academy of Dermatology, the Academy’s first of four sections in the guidelines of care for atopic dermatitis focuses on methods for diagnosing and monitoring the disease. The guidelines also discuss measurements for disease severity and quality of life, as well as associated conditions that commonly affect patients with atopic dermatitis.
According to current estimates, up to 25 percent of children and 2 to 3 percent of adults have atopic dermatitis. Studies show that the onset of atopic dermatitis is most common between three and six months of age.
“This is the first guideline issued by the Academy that covers the diagnosis of a condition,” said dermatologist Dirk M. Elston, MD, FAAD, president of the Academy. “Misdiagnosis of atopic dermatitis is a concern, especially for adults, and can contribute to making the disease worse. These guidelines provide criteria for accurately diagnosing atopic dermatitis that differentiate it from other conditions with similar characteristics.”
Key recommendations
Based on a comprehensive review of available data for diagnosing and managing atopic dermatitis, the first section of the Academy’s guidelines include three key recommendations:
•Monitoring of patients’ immunoglobulin E levels is not recommended because they do not correlate with disease severity.
•Physicians should ask their patients general questions about itch, sleep, impact on daily activity, and persistence of the disease.
•Dermatologists should coordinate with other specialties when providing care for atopic dermatitis patients who have associated conditions that affect more than the skin, such as sleep issues, asthma, food allergies, ADHD, and other psychological conditions.
“The itch associated with atopic dermatitis is one of the most problematic symptoms of this skin condition and can significantly impact a patient’s quality of life,” said Dr. Elston. “Children with persistent itching may experience sleep disruptions and problems focusing in school, which is why proper diagnosis and treatment is so important.”
These guidelines were developed by a work group of recognized atopic dermatitis experts. The remaining three sections, which will be published in 2014, will focus on the management and treatment of atopic dermatitis with topical therapies, systemic agents, adjunctive therapies, and the prevention of flares.
To learn more about atopic dermatitis, visit the atopic dermatitis section of Dermatology A to Z on the Academy’s website.
The Academy’s guidelines of care for the management of atopic dermatitis can be accessed here.
Celebrating 75 years of promoting skin, hair and nail health
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 17,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org. Follow the Academy on Facebook (American Academy of Dermatology) or Twitter (@AADskin).
