Recommended strategies for atopic dermatitis management in Romania

Abstract

Recommended stRategies foR atopic deRmatitis management in Romaniaprof. george-sorin tiplica 1 , md, phd, prof. carmen maria salavastru 2 , md, phd, prof. Jacek c. szepietowski 3 , md, phd, prof. magdalena czarnecka-operacz 4 , md, phd, assist. prof. alina suru 2 , md, phd, assist. prof. ionela manole 1 , md, phd student ABSTRACT Atopic dermatitis (AD) is a chronic inflammatory skin disease with a relapsing course that has a significant impact on the quality of life of both patients and their families. The pathogenesis of AD is due to a multitude of factors and can be associated with other allergy-related diseases, including asthma, food allergies or rhinitis. Treatment of AD aims to reduce duration, severity, and frequency of disease exacerbations. Understanding the maintenance of skin barrier integrity by continuing the use of basic therapy can prevent breaks. Patient and family education is important.

Global Guidelines in Dermatology Mapping Project (GUIDEMAP), a systematic review of atopic dermatitis clinical practice guidelines: are they clear, unbiased, trustworthy and evidence based (CUTE)?*

“…We included 40 CPGs, 12–67 of which the majority (27) were from countries with a high sociodemographic index (SDI), 14,16–27,29–36,41–48,51–55,59–61,64–67 with only two 37–40 from a country with a middle‐low SDI (both from India) and none from countries with a low SDI. Nine CPGs came from Asia 13,36–40,46–49,59–61 ; one from Australia 14 ; 22 from Europe 29–35,41–45,51–58,62–66 ; four from North America 16–27,67 and four from South America 12,15,28,50 . Funding was not disclosed in seven CPGs 44,45,56,57,59,62,63 ; eight were funded and/or facilitated by pharmaceutical companies…”

“…The CPGs from Columbia, 28 the Netherlands 51 and the UK (antimicrobials) 66 scored ‘excellent’ for all six AGREE II domains, whereas CPGs from Poland (phototherapy), 55 Romania 56 and Serbia 58 scored ‘poor’ on all domains. The remainder showed a large variety in scoring and grading per domain (Table 3).…”

“…The hand search yielded 14 additional full‐text reports. Thorough examination of eligibility resulted in 40 included CPGs on AD, published in 56 reports 12–67 . The reason for the latter is that some CPGs were published in parts as journal articles (Figure 1).…”

“…Nine CPGs came from Asia 13,36–40,46–49,59–61 ; one from Australia 14 ; 22 from Europe 29–35,41–45,51–58,62–66 ; four from North America 16–27,67 and four from South America 12,15,28,50 . Funding was not disclosed in seven CPGs 44,45,56,57,59,62,63 ; eight were funded and/or facilitated by pharmaceutical companies 12–14,17–27,40,50,67 ; 10 were not funded 15,16,30,31,33,36–39,43,64,65,66 and the remaining 15 were funded by the government, through a research grant or by the medical societies involved 28,29,32,34,35,41,42,46–49,51–55,58,60,61 . Dissemination was mostly done through medical journals (30) and 10 reports 12,28–31,34,49,51,57,63,66 were only available on the website of either a medical society or a governmental agency.…”

“…Nine CPGs came from Asia 13,[36][37][38][39][40][46][47][48][49][59][60][61] ; one from Australia 14 ; 22 from Europe [29][30][31][32][33][34][35][41][42][43][44][45][51][52][53][54][55][56][57][58][62][63][64][65][66] ; four from North America [16][17][18][19][20][21][22][23][24][25][26][27]67 and four from South America. 12,…”