Comparison of Dermatology and Allergy Guidelines for Atopic Dermatitis Management

A topic dermatitis (AD) is a chronic, inflammatory skin con-ditioncommonly treatedbydermatologists, allergists, pe-diatricians, and family practitioners. As the pathogenesis ofAD is complex andmultifactorial, there aremanydifferent thera-pies. In addition, there is evidence that subtypes of AD exist with distinct pathogeneses, consequently requiring different ap-proaches to management. Management of AD addresses awide variety of issues, ranging fromhandling acute exacerbations tomodifyingenvironmental ex-posures. Different groups of physicians treating AD may have dif-ferent strategies and outcomes. Saavedra et al1 reported that aller-gistsweremore likely than dermatologists to prescribe elimination diets and use dietary change alone as therapy. Henderson et al2 showed that dermatologists were more likely than other physi-cians to use topical corticosteroids (TCS), especially high-potency agents. Even within dermatology there is some discrepancy: Japa-nese dermatologists were less likely to use TCS and more likely to use alternative treatments thanwere their colleagues in theUnited States or United Kingdom.3 Updated treatment guidelines to help direct physicians in the managementof thismultifacetedconditionallowcomparisonofap-proaches to disease management. We review these guidelines to highlight potentially important differences among the guidelines, which could suggest variations in conceptualizationof thedisorder between allergists and dermatologists, and/or highlight biases re-garding the subtypes of patients with AD. Methods Published guidelines from the following organizations were re-viewed