GUIDELINES   Open access

Italian Journal of Dermatology and Venereology 2024 May 10

DOI: 10.23736/S2784-8671.24.07664-3

Copyright © 2024 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.

language: English

Italian S3-Guideline on the treatment of Atopic Eczema - Part 1: Systemic therapy, adapted from EuroGuiDerm by the Italian Society of Dermatology and STD (SIDEMAST), the Italian Association of Hospital Dermatologists (ADOI) and the Italian Society of Allergological and Environmental Dermatology (SIDAPA)

Authors of the Italian Adaption of the EuroGuiDerm Guidelines: Giuseppe ARGENZIANO ¹, Francesco CUSANO ², Monica CORAZZA ³, Salvatore AMATO ⁴, Paolo AMERIO ⁵, Luigi NALDI ⁶, Cataldo PATRUNO ⁷, Paolo D. PIGATTO ⁸, Pietro QUAGLINO ⁹, Paolo GISONDI ¹⁰, Andrea CHIRICOZZI ^{11, 12}, Francesco TONON ¹³, Luca STINGENI ¹⁴, Piergiacomo CALZAVARA-PINTON ¹³ ✉
Original Authors: Andreas WOLLENBERG ^{15, 16}, Maria KINBERGER ¹⁷, Bernd W. ARENTS ¹⁸, Nora ASZODI ¹⁵, Gabriela L. AVILA VALLE ¹⁷, Sebastien BARBAROT ¹⁹, Thomas BIEBER ²⁰, Helen A. BROUGH ^{21, 22}, Piergiacomo CALZAVARA-PINTON ¹³, Stéphanie CHRISTEN-ZÄCH ²³, Mette DELEURAN ²⁴, Martin DITTMANN ¹⁷, Corinna DRESSLER ¹⁷, Antjie H. FINK-WAGNER ²⁵, Nicole FOSSE ²⁶, Krisztián GÁSPÁR ²⁷, Louise A. GERBENS ²⁸, Uwe GIELER ²⁹, Giampiero GIROLOMONI ³⁰, Stamatios GREGORIOU ³¹, Charlotte G. MORTZ ³², Alexander NAST ¹⁷, Uffe NYGAARD ³³, Magali REDDING ³⁴, Eva M. REHBINDER ³⁵, Johannes RING ³⁶, Mariateresa ROSSI ³⁷, Esther SERRA-BALDRICH ³⁸, Dagmar SIMON ³⁹, Zsuzsanna Z. SZALAI ⁴⁰, Jacek C. SZEPIETOWSKI ⁴¹, Antonio TORRELO ⁴², Thomas WERFEL ⁴³, Carsten FLOHR ^{44, 45}

¹ Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy; ² Dermatology Unit, G. Rummo Hospital, Benevento, Italy; ³ Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; ⁴ Department of Dermatology and Sexually Transmitted Diseases, ARNAS-Palermo, Palermo, Italy; ⁵ Section of Dermatology, Department of Medicine and Aging Science, G. D’Annunzio University, Chieti, Italy; ⁶ Dermatology Unit, San Bortolo Hospital, Vicenza, Italy; ⁷ Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy; ⁸ Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; ⁹ University of Turin Medical School, Department of Medical Sciences, Dermatologic Clinic, Turin, Italy; ¹⁰ Dermatology and Venereology Section, Department of Medicine, University of Verona, Verona, Italy; ¹¹ Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; ¹² Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy; ¹³ Department of Dermatology, University of Brescia, Brescia, Italy; ¹⁴ Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy; ¹⁵ Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany; ¹⁶ Department of Dermatology, Free University of Brussel (VuB), Brussels University Hospital (UZ Brussel), Brussels, Belgium; ¹⁷ Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany; ¹⁸ European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), Brussels, Belgium; ¹⁹ Department of Dermatology, CHU Nantes, UMR1280 PhAN, INRAE, Nantes University, Nantes, France; ²⁰ Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany; ²¹ Children’s Allergy Service, Evelina London Children’s Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK; ²² Paediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London, UK; ²³ University Hospital Lausanne, Lausanne, Switzerland; ²⁴ Aarhus University Hospital, Aarhus, Denmark; ²⁵ Global Allergy and Airways Diseases Patient Platform (GAAPP), Vienna, Austria; ²⁶ Department of Dermatology, University Hospital Basel, Basel, Switzerland; ²⁷ Department of Dermatology of the University of Debrecen, Debrecen, Hungary; ²⁸ Department of Dermatology, Amsterdam UMC (University Medical Centers), Amsterdam, the Netherlands; ²⁹ Department of Dermatology, University of Giessen, Giessen, Germany; ³⁰ Dermatology and Venereology Section, Department of Medicine, University of Verona, Verona, Italy; ³¹ Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece; ³² Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark; ³³ Department of Dermato-Venerology, Aarhus University Hospital, Aarhus, Denmark; ³⁴ Eczema Outreach Support, Linlithgow, UK; ³⁵ Dermatology Department, Oslo University Hospital, Oslo, Norway; ³⁶ Department of Dermatology Allergology Biederstein, Technical University Munich, Munich, Germany; ³⁷ Dermatology Unit, Spedali Civili Hospital Brescia, Brescia, Italy; ³⁸ Dermatology, Hospital of Sant Pau, Barcelona, Spain; ³⁹ Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; ⁴⁰ Pediatric Dermatology Unit, Heim Pa’l National Children’s Institute Budapest, Budapest, Hungary; ⁴¹ Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland; ⁴² Hospital Infantil Niño Jesús, Madrid, Spain; ⁴³ Hannover Medical School, Hannover, Germany; ⁴⁴ St John’s Institute of Dermatology, King’s College London, London, UK; ⁴⁵ Guy’s and St Thomas’ NHS Foundation Trust, London, UK

SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by atopic dermatitis. The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This first part of the guideline includes general information on its scope and purpose, the health questions covered, target users and a methods section. It also 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, omalizumab and tralokinumab) and janus kinase inhibitors (abrocitinib, baricitinib and upadacitinib). Part two of the guideline will address avoidance of provocation factors, dietary interventions, immunotherapy, complementary medicine, educational interventions, occupational and psychodermatological aspects, patient perspective and considerations for pediatric, adolescent, pregnant and breastfeeding patients.

KEY WORDS: Atopic dermatitis; Eczema; Guidelines