Guidelines of care for the primary prevention of atopic dermatitis and awareness of comorbid conditions in pediatric atopic dermatitis.

Abstract

Pediatric atopic dermatitis (AD) is a common, chronic inflammatory skin disorder that significantly impacts the quality of life of affected children and their families. In addition to skin-related symptoms, AD in pediatric patients may be associated with a range of comorbid conditions. To provide evidence-based recommendations on primary prevention of AD and to appraise evidence of the association between AD and comorbidities among pediatric patients. A multidisciplinary workgroup conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. The workgroup developed 14 evidence-based recommendations on primary prevention of AD and 29 statements on the association between pediatric AD and comorbid conditions. This analysis is based on the best available evidence at the time it was conducted. This guideline does not make recommendations for screening or management of comorbidities in children with AD. We make a conditional recommendation for moisturizing skin care to reduce the occurrence of AD and conditional recommendations against early food introduction, human milk consumption, and probiotic or vitamin D supplementation for the primary prevention of AD. Clinicians should be aware of comorbidities associated with pediatric AD, but further research is needed to optimize screening and/or management of comorbidities.