Different Approaches to Atopic Dermatitis by Allergists, Dermatologists, and Pediatricians

Table 2

Questionnaire answers (always and almost always).

Questions	Pediatricians (n = 1.179)	Dermatologists (n = 245)	Allergists (n = 49)	Total (n = 1.473)
1^1	1167 (99.0%)	244 (99.6%)	49 (100.0%)	1460 (99.1%)	0.96
2^2	1083 (91.9%)	239 (97.5%)	49 (100.0%)	1371 (93.1%)	0.07
3^3	672 (57.0%)	186 (75.9%)	35 (71.4%)	893 (60.6%)	<0.001
4^4	319 (27.0%)	40 (16.3%)	25 (51.0%)	384 (26.0%)	<0.001
5^5	511 (43.3%)	100 (40.8%)	32 (65.3%)	643 (43.6%)	<0.001
6^6	268 (22.7%)	128 (52.2%)	29 (59.2%)	425 (28.8%)	<0.001
7^7	848 (71.9%)	209 (85.3%)	47 (95.9%)	1104 (74.9%)	<0.001
8^8	268 (22.7%)	19 (7.8%)	6 (12.2%)	293 (19.9%)	<0.001
9^9	165 (14.0%)	33 (13.5%)	6 (12.2%)	204 (13.8%)	0.84
10^10	427 (36.2%)	92 (37.5%)	20 (40.8%)	539 (36.6%)	0.70
11^11	1121 (95.1%)	240 (98.0%)	49 (100.0%)	1410 (95.7%)	0.19
12^12	67 (5.7%)	10 (4.1%)	3 (6.1%)	80 (5.4%)	0.95
13^13	463 (39.3%)	131 (53.5%)	11 (22.4%)	605 (41.1%)	<0.001
14^14	816 (69.2%)	145 (59.2%)	17 (34.7%)	978 (66.4%)	<0.001
15^15	313 (26.5%)	185 (75.5%)	46 (93.9%)	544 (36.9%)	<0.001
16^16	208 (17.6%)	111 (45.3%)	41 (83.7%)	360 (24.4%)	<0.001
17^17	653 (55.4%)	144 (58.8%)	31 (63.3%)	828 (56.2%)	0.32
18^18	197 (16.7%)	149 (60.8%)	38 (77.5%)	384 (26.1%)	<0.001^a
19^19	318 (27.0%)	114 (46.5%)	32 (65.3%)	464 (31.5%)	<0.001^b
20^20	240 (20.4%)	101 (41.2%)	35 (71.4%)	376 (25.5%)	<0.001
21^21	683 (57.9%)	57 (23.3%)	27 (55.1%)	767 (52.1%)	<0.001
22^22	859 (72.8%)	117 (47.7%)	49 (100.0%)	1025 (69.6%)	<0.001
23^23	560 (47.5%)	84 (34.3%)	19 (38.8%)	663 (45.0%)	<0.001
24^24	939 (79.6%)	148 (60.4%)	44 (89.8%)	1131 (76.8%)	<0.001
25^25	1059 (89.8%)	213 (86.9%)	49 (100.0%)	1321 (89.7%)	0.01
26^26	593 (50.3%)	75 (30.6%)	31 (63.3%)	400 (27.1%)	<0.001
27^27	1092 (92.6%)	192 (78.4%)	49 (100.0%)	1333 (90.5%)	<0.01^c

Pearson’s cui-square test. ^aYes to some immunomodulator, ^bmost frequent answer: cyclosporine, and ^cask for at least one laboratory test. ¹Do you believe that the use of moisturizers can reduce the severity of AD? ²Do you prescribe moisturizer as an integral part of the treatment of atopic dermatitis? ³ Do you prefer the new emollients or “plus” emollients, which influence the cutaneous microbiome? ⁴Do you prescribe the use of “wet-wrap” therapy, wet compresses, with or without a topical corticosteroid, for patients with moderate or severe AD? ⁵For patients with recurrent crises in the same body sites, do you recommend topical corticosteroids for relapse prevention (proactive treatment)? ⁶Do you recommend the proactive use of calcineurin inhibitors as maintenance treatment (2 to 3 times per week)? ⁷Do you believe that calcineurin inhibitors are the second-line treatment, especially indicated for sensitive areas? ⁸Do you prefer calcineurin inhibitors over topical corticosteroids in crisis in inflammatory lesions? ⁹Do you prescribe topical anti-histamines for AD patients? ¹⁰When topical treatment is not sufficient, are oral corticosteroids your first choice for systemic treatment?¹¹Do you agree that systemic corticosteroids are not recommended for children with atopic dermatitis, but only as a short-term transition to other therapies? ¹²Do you maintain long-term treatment with systemic corticosteroids in the absence of phototherapy or other unavailability therapies? ¹³In patients with moderate/severe and/or refractory AD, is phototherapy your next treatment option to basic topical treatment (moisturizers, topical corticosteroids, and/or calcineurin inhibitors)? ¹⁴Do you consider oral anti-histamines effective in controlling pruritus? ¹⁵Do you know the role of superantigens in AD? ¹⁶Do you use therapeutic measures for the control of superantigens? ¹⁷Do you prescribe oral anti-histamines for AD patients? ¹⁸Do you have clinical experience with any of the systemic immunomodulatory agents in atopic dermatitis? ¹⁹Which of these do you consider to be first-line treatment? ²⁰With Dupilumab available in the Brazilian pharmaceutical market, do you have any patient to start this therapy? ²¹Do you usually investigate the association between atopic dermatitis and food allergy? ²²Do you request specific IgE research for the suspected allergen by which method? ²³Do you place dietary restrictions on AD patients? ²⁴Are dietary restrictions based on positive allergy skin tests/specific IgE test and consistent with a clinical history of cause-and-effect relationship? ²⁵Do you recommend environmental control of aeroallergens to AD patients? ²⁶Do you investigate immunodeficiencies in patients with moderate/severe AD? ²⁷What tests would you order to investigate immunodeficiencies in patients with moderate/severe AD?