Part 1—A Dermatologist’s Perspective: Updated Atopic Dermatitis Guidelines from the AAAAI/ACAAI Joint Task Force
Featuring Peter Lio, MD |

Clinical Assistant Professor of Dermatology Pediatrics 
Northwestern University Feinberg School of Medicine
Chicago, IL

| Published February 05, 2024
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Joint Task Force 

In Part 1 of this Topical Conversations feature with Peter Lio, MD, FAAD, he introduces the latest updates to the atopic dermatitis management guidelines from the American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force (AAAAI/ACAAI JTF). Guidance addressing atopic dermatitis management was last issued by the AAAAI/ACAAI JTF in 2012. 

As part of the multidisciplinary guideline panel, Dr Peter Lio offers a dermatologist’s overview of the updated guidelines. 

Guideline design 

The guidelines employed systematic reviews of evidence, ensuring a robust foundation for recommendations. They reflect adherence to rigorous guideline development processes and prominent utilization of the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) framework. 

A key strength is the engagement of a multidisciplinary panel, which incorporated the expertise of dermatologists, allergists, primary care practitioners, and allied health professionals. 

Crucially, the guidelines also prioritized the voices of patients and caregivers throughout the entire development process. 

Inclusiveness is highlighted throughout, with a focus on addressing atopic dermatitis in patients with skin of color and health disparities. There is also an emphasis on clear translation, underscoring the commitment to providing clinically actionable and contextually relevant recommendations and steering away from impractical or theoretical advice. The guidelines are designed with practicality in mind, framed in the form of questions to facilitate easy implementation in real-world practice. 

Moisturizers 

A key point the guidelines address is the significance of moisturizers in atopic dermatitis care, highlighting that the best moisturizer is one that patients will consistently use. Shared decision-making is crucial in discussing the risks, benefits, and tradeoffs of different types of treatments, including moisturizers, and with moisturizer recognized as a centerpiece of atopic dermatitis care, the emphasis is on patients finding one they like and will use regularly. 

Topical therapies 

A second key point underscores the importance of topical corticosteroids as a mainstay of therapy. Topical corticosteroids are recommended as a first-line treatment in patients for whom moisturization and avoidance of irritants are not sufficient. 

Topical corticosteroids have been shown to be very effective, easily accessible, and generally safe when used correctly. They’re also strongly recommended for continued intermittent therapy to prevent future flare-ups. 

Topical nonsteroidal options and elimination diets 

Watch Part 2 to hear Dr Peter Lio discuss the updated guidelines for elimination diets and nonsteroidal agents, including topical calcineurin inhibitors and PDE-4 inhibitors, and the noteworthy guidance on the use of topical JAK inhibitors. 

Key points 

  • The AAAAI/ACAAI Joint Task Force updates to the clinical guidelines for atopic dermatitis were developed by a multidisciplinary panel and incorporated the expertise of dermatologists 
  • Updates were designed to be clinically actionable for implementation in real-world practice 
  • The guidelines conclude that the best moisturizer for atopic dermatitis is one patients will use consistently 
  • Topical corticosteroids remain a mainstay of atopic dermatitis therapy due to their effectiveness, accessibility, and safety
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