Clinical practice guidelines for the diagnosis and management of atopic dermatitis

Overview

Atopic dermatitis is a chronic, relapsing inflammatory skin disease. It affects both children and adults and is characterised by intense itch, dry skin and eczematous lesions. It significantly affects sleep, quality of life and mental wellbeing. These clinical practice guidelines provide evidence-based recommendations on diagnosing and managing the disease across its full range of severity.

Diagnosis and assessment

Diagnosis is clinical and relies on established criteria: itch, typical morphology and distribution of lesions, a chronic relapsing course and a personal or family history of atopy. The guidelines stress the importance of assessing disease severity and its impact on the patient with validated tools. They also stress identifying aggravating factors, such as irritants, infections and, in selected cases, relevant allergens.

Treatment

Management follows a stepwise approach matched to severity. Basic skin care, including regular emollients and gentle cleansing, underpins treatment at every stage. Topical anti-inflammatory therapy is the mainstay for flares. The guidelines also describe proactive maintenance treatment of commonly affected areas to prevent relapses. For moderate to severe disease that does not respond to topical treatment, phototherapy and systemic therapies, including newer targeted agents, are discussed in terms of efficacy, safety and monitoring. Managing skin infections and addressing itch are included as part of comprehensive care.

Clinical implications

The guidelines emphasise patient and caregiver education, adherence and shared decision-making, including addressing fears about topical treatments. Comorbidities such as other atopic conditions and psychological burden should be recognised. The document supports consistent care between primary care and dermatology and clarifies when referral for advanced therapy is appropriate.