The Unmet Needs in Atopic Dermatitis Control in Latin America: A Multidisciplinary Expert Perspective

Sánchez, Jorge; Chérrez-Ojeda, Iván; Galván, César; García, Elizabeth; Hernández-Mantilla, Natalia; García, Á. Londoño; McElwee, Elizabeth; Restrepo, Mariana Rico; Rivas, Enrique; Hidalgo, Benjamin

doi:10.1007/s13555-021-00595-9

Cited by 11 publications

(26 citation statements)

References 92 publications

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“…8,46 A careful differential diagnosis must be made to rule out other common causes of pruritus, especially in specific LA communities where scabies, papular urticaria, and helminth infections (which can induce rashes) are frequent. 8,49 There are several regional and country-specific clinical practice guidelines (CPGs) for AD management like those for Colombia, 48 Argentina, 50 Brazil, 51 Mexico, 2 and LA 47 that contain indications representative of the region's different characteristics; however, the level of adoption is not ideal, and international guidelines continue to be used throughout the region.…”

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

“…Because of the absence of pathognomonic biomarkers or diagnostic tests, AD diagnosis is primarily based on the clinical history and physical examination. The use of diagnostic criteria is vital to improving accuracy 47,48 . The critical clinical AD characteristics are pruritus, the presence of eczematous lesions, dry skin, and the typical morphology and distribution of lesions according to age 8,46 .…”

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

“…In addition, once an AD diagnosis is established, disease severity must be determined through available scores. Both diagnostic criteria and clinimetric tools would benefit from studies to validate them in LA 47 …”

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

“…In LA, the patient journey usually begins with a PCP or pediatrician. Well-trained PCPs on clinical diagnostic criteria, testing, and treatment can improve patients' chances of receiving earlier and more accurate care 2,47,58 . Most mild cases are well diagnosed and well controlled, whereas moderate-to-severe disease usually requires care from an AD specialist and multidisciplinary team.…”

Section: Unmet Needs Of Ad In Lamentioning

confidence: 99%

“…The use of diagnostic criteria is vital to improving accuracy. 47 , 48 The critical clinical AD characteristics are pruritus, the presence of eczematous lesions, dry skin, and the typical morphology and distribution of lesions according to age. 8 , 46 A careful differential diagnosis must be made to rule out other common causes of pruritus, especially in specific LA communities where scabies, papular urticaria, and helminth infections (which can induce rashes) are frequent.…”

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

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Atopic Dermatitis in Latin America: A Roadmap to Address Data Collection, Knowledge Gaps, and Challenges

et al. 2022

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BackgroundAtopic dermatitis (AD) is a systemic, multifactorial disease that causes significant morbidity and health care burden in Latin America (LA). Data on AD are scarce in LA. Lack of disease registries and non-standardized study methodologies, coupled with region-specific genetic, immunological, and environmental factors, hamper data collection. A panel of LA experts in AD was given a series of relevant questions to address before a conference. Each narrative was discussed and edited through numerous rounds of deliberation until achieving consensus. Identified knowledge gaps in AD research were updated prevalence, adult-disease epidemiology, local phenotypes and endotypes, severe-disease prevalence, specialist distribution, and AD public health policy. Underlying reasons for these gaps include limited funding for AD research, from epidemiology and public policy to clinical and translational studies. Regional heterogeneity requires that complex interactions between race, ethnicity, and environmental factors be further studied. Informed awareness, education, and decision making should be encouraged.

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Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

Section: Unmet Needs Of Ad In Lamentioning

confidence: 99%

Section: Ad Diagnostic Landscape In Lamentioning

confidence: 99%

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Atopic Dermatitis in Latin America: A Roadmap to Address Data Collection, Knowledge Gaps, and Challenges

et al. 2022

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Healthcare Disparities in Atopic Dermatitis in Latin America: A Narrative Review

Sánchez

Ale

Angles

et al. 2022

Dermatol Ther (Heidelb)

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Introduction Atopic dermatitis (AD) is a chronic, pruritic skin disease caused by a mixture of genetic, immunological, and environmental factors, characterized by periods of inflammation and remission. In Latin America (LA), the prevalence of AD ranges up to 25% in children and 1–3% in adults. The natural history of the disease for most patients is that AD goes into remission in adolescence and adult life. Only 10–30% of patients continue to have symptoms of the disease in adulthood. There are patients (3–4%) who have the onset of AD during adolescence or after adulthood. Those with limited access to healthcare services, such as diagnosis and treatment, have increased difficulties coping with AD. Healthcare disparities are a complex topic that include social, political, racial/ethnic, and geographical factors. Publications about healthcare disparities in AD in LA are scarce. As a result, recognizing and resolving healthcare inequalities is critical to improving the treatment and quality of life (QoL) of individuals with AD. Methods A panel of Latin American experts in dermatology and allergies was provided with a series of relevant questions to address before a multiday conference. During this conference, the entire group discussed and edited each narrative through numerous drafts and rounds of discussion until they reached a consensus. Results This paper examines the barriers to equal access to care and recommends realistic actions to overcome them. Inadequate disease knowledge, cultural and linguistic barriers, stigmatization, maldistribution of resources, absence of local clinical practice guidelines, arduous patient journey, and limited consultation time were identified as causes of health inequality. Conclusions Among the suggested solutions are enhanced education for healthcare professionals, patients, and the general public, a focus on underprivileged communities, telemedicine and telementoring, translators, multidisciplinary teams, and local living clinical practice guidelines.

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Challenges in the Use of the Treat-to-Target Strategy in Atopic Dermatitis in Latin America: A Case Series Review

Chérrez-Ojeda

Robles‐Velasco

Thomsen

et al. 2023

Dermatol Ther (Heidelb)

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Introduction Atopic dermatitis (AD) is a chronic, relapsing–remitting illness. In moderate-to-severe instances, recommendations urge patient-centered systemic therapy. Existing standards lack long-term treatment success requirements. A treat-to-target methodology was proposed for systemic therapy patients that requires global improvements to prompt decisions about treatment. Methods We conducted an observational study between May 2021 and June 2022 in three Ecuadorian patients with severe AD who were treated with dupilumab to assess the clinical evolution and behavior of the subdomains evaluated by clinimetric tools. Results Patients A and C satisfied disease-domain response criteria to dupilumab at 12 and 24 weeks, but B did not complete the algorithm objectives. Nonetheless, patient A improved AD severity, itching, bleeding, desquamation, sleep, daily activities, mood, emotions, sexual troubles, clothing, and sports subdomains. Patient B experienced reduced symptomatology, AD aggravation, daily activities impact, and work/study impairment. Patient C improved from severe to mild desquamation, itching, exudate, lichenification, and rough/dry skin. Sleep, shame, and study subdomains improved the most. Conclusion We provide a new operational construct for analyzing current patient-reported outcome measures (PROMs) and clinician-reported outcome measures (CROMs) based on subdomains to widen our understanding of the state of disease activity and make clinical decisions when the treat-to-target strategy is not attained.

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The Unmet Needs in Atopic Dermatitis Control in Latin America: A Multidisciplinary Expert Perspective

Cited by 11 publications

References 92 publications

Atopic Dermatitis in Latin America: A Roadmap to Address Data Collection, Knowledge Gaps, and Challenges

Atopic Dermatitis in Latin America: A Roadmap to Address Data Collection, Knowledge Gaps, and Challenges

Healthcare Disparities in Atopic Dermatitis in Latin America: A Narrative Review

Challenges in the Use of the Treat-to-Target Strategy in Atopic Dermatitis in Latin America: A Case Series Review

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