Consensus on the Clinical Approach to Moderate-to-Severe Atopic Dermatitis in Spain: A Delphi Survey
Table 3
Results regarding differential diagnosis, severity of AD, etiology and physiopathology, comorbidities, and health-related quality of life.
Item
Consensus (%)
Majority (%)
Discrepancy (%)
Differential diagnosis
(i) In certain situations, skin biopsy should be considered to exclude other conditions, such as early stage T-cell cutaneous lymphoma, psoriasis, or dermatitis herpetiformis
99.1
Severity of AD
(i) The SCORAD index is used to quantify the severity of the disease in order to assess the comparative efficacy of treatments and progression of the disease in routine clinical practice
86.7
(ii) The EASI score is a validated scale that is not used in routine clinical practice
58.1
Etiology and physiopathology
(i) A high percentage of patients with AD also present food allergy, allergic rhinitis, or asthma
94.4
(ii) Treatments oriented to increase filaggrin expression can be useful in the management of AD in a particular group of patients
93.3
(iii)Currently there is an unmet need in the treatment of moderate-severe AD
98.4
(iv) Biologic drugs are especially promising for adult patients with moderate or severe forms of the disease
89.6
Comorbidities of AD
(i) AD in adults is frequently associated with allergic comorbidities
78.1
(ii) AD in children is frequently associated with allergic comorbidities
91.4
(iii) The relative risk of suffering from immune-mediated inflammatory diseases such as rheumatoid arthritis and chronic inflammatory bowel disease is higher in patients with AD than in the general population
(iv) Children with AD are more prone to suffer from mental disorders such as depression, anxiety, and behavior disorders
84.8
Health-related quality of life
(i) AD causes considerable psychological anxiety and results in a dramatic impact on the quality of life for both patients and their families
91.2
(ii) The usefulness of PO-SCORAD for the self-assessment of AD in children suggests the importance of integrating the perspectives of the physician and the patient in the management of AD
91.2
AD: atopic dermatitis; SCORAD: scoring atopic dermatitis; EASI: eczema area and severity index; PO-SCORAD: patient-oriented SCORAD. 43.8% neither agree nor disagree.
