Kim Jung Eun, Shin Min Kyung, Park Gyeong-Hun, Lee Un Ha, Lee Ji Hyun, Han Tae-Young, Koh Hyun Chang, Jang Yong Hyun, Kim Hye One, Na Chan Ho, Lew Bark-Lynn, Ahn Ji Young, Park Chang Ook, Seo Young Joon, Lee Yang Won, Sohn Sang Wook, Park Young Lip
Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea.
Ann Dermatol. 2019 Dec;31(6):654-661. doi: 10.5021/ad.2019.31.6.654. Epub 2019 Oct 31.
Systemic immunomodulatory treatment is actively recommended in the treatment for moderate to severe atopic dermatitis (AD) patients. However, consensus criteria for the classification of AD severity or treatment refractoriness have not been established yet.
To establish consensus criteria on the definition of severity classification and treatment refractoriness of AD to provide a basis for proper treatment strategy.
The Korean Atopic Dermatitis Association (KADA) comprised a task force team to establish a definition of moderate to severe AD. A draft of definition of moderate to severe AD was made on the basis of evidence. The recommendation was confirmed by KADA members through a web-based survey.
KADA approved that AD with 16≤eczema area and severity index (EASI)<23 should be basically defined as moderate AD whereas AD with EASI score ≥23 should be considered as severe AD. They agreed that it would be reasonable to raise the severity level if patient's daytime or nighttime pruritus numerical rating scale is equal to or higher than 7 (≥7) or dermatology life quality index score exceeds 10. AD patients who do not reach EASI 50 after appropriate treatment for three months should be considered as a non-responder. Patients with recurrence (EASI ≥16) within three months after cessation of treatment should be considered as a recurrent AD.
KADA built a consensus of definition of moderate and severe AD and treatment-refractoriness. These guidelines are expected to help physicians determine proper treatment options in need.
全身免疫调节治疗被积极推荐用于中重度特应性皮炎（AD）患者的治疗。然而，AD严重程度或治疗难治性的分类共识标准尚未确立。
建立AD严重程度分类和治疗难治性定义的共识标准，为恰当的治疗策略提供依据。
韩国特应性皮炎协会（KADA）组建了一个特别工作组来制定中重度AD的定义。基于证据制定了中重度AD的定义草案。该建议经KADA成员通过网络调查得以确认。
KADA批准，湿疹面积和严重程度指数（EASI）为16≤EASI＜23的AD应基本定义为中度AD，而EASI评分≥23的AD应被视为重度AD。他们一致认为，如果患者的日间或夜间瘙痒数字评定量表等于或高于7（≥7）或皮肤病生活质量指数评分超过10，则提高严重程度等级是合理的。经过三个月适当治疗后EASI未达到50的AD患者应被视为无反应者。治疗停止后三个月内复发（EASI≥16）的患者应被视为复发性AD。
KADA建立了中重度AD及治疗难治性定义的共识。这些指南有望帮助医生确定所需的恰当治疗方案。
