New Review Reveals Gaps in Atopic Dermatitis Guidelines for Children, Especially Those with Skin of Colour
Published On: 09 Jul, 2025 12:31 PM | Updated On: 09 Jul, 2025 8:19 PM

New Review Reveals Gaps in Atopic Dermatitis Guidelines for Children, Especially Those with Skin of Colour

A new systematic review has highlighted significant disparities and quality concerns in global clinical guidelines for managing atopic dermatitis (AD) in children, particularly for those with skin of colour. The chronic inflammatory skin condition, which is rising in prevalence—especially among children and individuals with pigmented skin—requires nuanced and inclusive management strategies.

Researchers examined 28 international guidelines published between 1990 and 2023, selected from over 1,600 articles across major databases and grey literature. Using the AGREE II appraisal tool, they assessed guideline quality and compared recommendations, with a focus on treatment differences and inclusivity.

The review found notable variation in treatment recommendations, particularly regarding the use of emollients, bleach baths, bath additives, oral antihistamines, and age cut-offs for topical calcineurin inhibitors. Importantly, many guidelines failed to incorporate recent advances such as dupilumab and PDE4 inhibitors, reflecting a lag in updating treatment protocols.

Worryingly, only 12 of the 28 guidelines met the satisfactory quality threshold based on the AGREE II tool, with many lacking methodological rigor. Even more concerning, most guidelines offered little to no specific recommendations for managing AD in children with skin of colour—despite this group being disproportionately affected.

The findings underscore the urgent need for updated, high-quality, and inclusive guidelines that reflect the diverse population of patients with AD. Experts call for future guidelines to adopt robust development tools like AGREE II and prioritize evidence-based strategies tailored to skin of colour to improve health outcomes in pediatric dermatology.

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