A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative

INTRODUCTION

The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems.

METHODS

The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres.

RESULTS

The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD.

CONCLUSION

The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.

ASSOCIATION BETWEEN URTICARIA AND INFECTIONS (REVIEW)

Urticaria is a common disease with 20% of prevalence and marked effects on quality of life. The burden of chronic urticaria for patients, their family and friends, the healthcare system and society is substantial. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. The remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Chronic viral infections including hepatitis B and C have been reported to be associated with CSU. More research is needed to make definitive recommendations regarding the role of infections and their management in case of urticaria and urticarial vasculitis. The routine screening of parasitic, bacterial or viral infections in CU is not recommended, however, testing a patient with urticaria for certain infections is a physician's choice based on the specific characteristics of the patient, such are clinical symptoms and laboratory results, dietary and cultural habits, country of origin and residency, traveling history.