A systematic review of guidelines for the management of atopic dermatitis in children
Atopic dermatitis (AD) is a chronic disease that is increasing in prevalence, particularly in children and people with skin of colour. Current management involves topical treatments, phototherapy and immunosuppressants, as well as newer therapies like dupilumab. Health professionals should also be a...
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Elsevier
2024-12-01
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| Series: | World Allergy Organization Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455124001212 |
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| author | Maya Deva, MBBS Merryn J. Netting, PhD Jemma Weidinger, MN, NP Roland Brand, FACD Richard KS. Loh, FRACP Sandra L. Vale, PhD |
| author_facet | Maya Deva, MBBS Merryn J. Netting, PhD Jemma Weidinger, MN, NP Roland Brand, FACD Richard KS. Loh, FRACP Sandra L. Vale, PhD |
| author_sort | Maya Deva, MBBS |
| collection | DOAJ |
| description | Atopic dermatitis (AD) is a chronic disease that is increasing in prevalence, particularly in children and people with skin of colour. Current management involves topical treatments, phototherapy and immunosuppressants, as well as newer therapies like dupilumab. Health professionals should also be aware of the specific management considerations for AD in people with skin of colour. This systematic review was conducted to examine global guidelines for the management of AD in children, compare management recommendations, examine specific recommendations for children with skin of colour, and assess the quality of the guidelines.The databases Medline, Embase, CINAHL, Scopus, Guidelines International Network, and Emcare Nursing and Allied Health were searched to identify guidelines or articles relating to the management of AD in children from 1990 to 2023. A grey literature search was also undertaken. The recommendations from the guidelines were extracted and compared, and the quality of the guidelines was assessed using the Appraisal Guidelines for Research and Evaluation (AGREE) II tool.A total of 1644 articles were identified from the initial search. Title and abstract screening, full text screening, and reference checking yielded 28 guidelines for the final appraisal and data extraction. The main variations in management recommendations were the timing of emollients, bleach baths, bath additives, oral antihistamines, and the age cut-offs for topical calcineurin inhibitors. Many guidelines were not updated to reflect newer therapies like dupilumab and topical phosphodiesterase-4 (PDE4) inhibitors. There were minimal recommendations regarding management of skin of colour. Only 12/28 guidelines met the satisfactory cut-off score for the AGREE II appraisal, largely due to a lack of well-documented methodology.This review showed that the recommendations for AD management in skin of colour were consistently lacking. Despite generally consistent management strategies over the last 5 years, less than half of the guidelines met high-quality criteria, emphasising the importance of using tools like AGREE II in future guideline development. |
| format | Article |
| id | doaj-art-9458c553ccd5478b9572c53c2d25a114 |
| institution | OA Journals |
| issn | 1939-4551 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj-art-9458c553ccd5478b9572c53c2d25a1142025-08-20T02:38:14ZengElsevierWorld Allergy Organization Journal1939-45512024-12-01171210098910.1016/j.waojou.2024.100989A systematic review of guidelines for the management of atopic dermatitis in childrenMaya Deva, MBBS0Merryn J. Netting, PhD1Jemma Weidinger, MN, NP2Roland Brand, FACD3Richard KS. Loh, FRACP4Sandra L. Vale, PhD5James Cook University, 1 James Cook Drive, Douglas, QLD, 4814, AustraliaNational Allergy Council, Sydney NSW, 2000, AustraliaPerth Children's Hospital, Hospital Avenue, Nedlands, WA 6009, AustraliaPerth Children's Hospital, Hospital Avenue, Nedlands, WA 6009, AustraliaPerth Children's Hospital, Perth WA, 6000, AustraliaNational Allergy Council, Sydney NSW, 2000, Australia; Corresponding author. National Allergy Council, PO Box 367, Guildford, WA 6055, Australia.Atopic dermatitis (AD) is a chronic disease that is increasing in prevalence, particularly in children and people with skin of colour. Current management involves topical treatments, phototherapy and immunosuppressants, as well as newer therapies like dupilumab. Health professionals should also be aware of the specific management considerations for AD in people with skin of colour. This systematic review was conducted to examine global guidelines for the management of AD in children, compare management recommendations, examine specific recommendations for children with skin of colour, and assess the quality of the guidelines.The databases Medline, Embase, CINAHL, Scopus, Guidelines International Network, and Emcare Nursing and Allied Health were searched to identify guidelines or articles relating to the management of AD in children from 1990 to 2023. A grey literature search was also undertaken. The recommendations from the guidelines were extracted and compared, and the quality of the guidelines was assessed using the Appraisal Guidelines for Research and Evaluation (AGREE) II tool.A total of 1644 articles were identified from the initial search. Title and abstract screening, full text screening, and reference checking yielded 28 guidelines for the final appraisal and data extraction. The main variations in management recommendations were the timing of emollients, bleach baths, bath additives, oral antihistamines, and the age cut-offs for topical calcineurin inhibitors. Many guidelines were not updated to reflect newer therapies like dupilumab and topical phosphodiesterase-4 (PDE4) inhibitors. There were minimal recommendations regarding management of skin of colour. Only 12/28 guidelines met the satisfactory cut-off score for the AGREE II appraisal, largely due to a lack of well-documented methodology.This review showed that the recommendations for AD management in skin of colour were consistently lacking. Despite generally consistent management strategies over the last 5 years, less than half of the guidelines met high-quality criteria, emphasising the importance of using tools like AGREE II in future guideline development.http://www.sciencedirect.com/science/article/pii/S1939455124001212Atopic dermatitisEczemaGuidelines |
| spellingShingle | Maya Deva, MBBS Merryn J. Netting, PhD Jemma Weidinger, MN, NP Roland Brand, FACD Richard KS. Loh, FRACP Sandra L. Vale, PhD A systematic review of guidelines for the management of atopic dermatitis in children World Allergy Organization Journal Atopic dermatitis Eczema Guidelines |
| title | A systematic review of guidelines for the management of atopic dermatitis in children |
| title_full | A systematic review of guidelines for the management of atopic dermatitis in children |
| title_fullStr | A systematic review of guidelines for the management of atopic dermatitis in children |
| title_full_unstemmed | A systematic review of guidelines for the management of atopic dermatitis in children |
| title_short | A systematic review of guidelines for the management of atopic dermatitis in children |
| title_sort | systematic review of guidelines for the management of atopic dermatitis in children |
| topic | Atopic dermatitis Eczema Guidelines |
| url | http://www.sciencedirect.com/science/article/pii/S1939455124001212 |
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