Atopic dermatitis (AD) is a disease that significantly impacts the quality of life of patients. Although there are multiple evidence-based guidelines, they are usually aimed at providing recommendations to AD specialists rather than primary care physicians (PCPs). The aim of this study was to construct a consensus document for PCPs, with the aim of presenting evidence-based recommendations that allow general practitioners, family physicians, pediatricians, internists and emergency physicians to provide appropriate care to AD patients, facilitating their diagnosis, management, and avoiding delays that can deteriorate patients' f quality of life. As a central source of information, we used the recommendations of different international AD guidelines. Delegates from distinct medical societies identify barriers to care and possible solutions for the application of recommendations in primary care. Subsequently, a second evaluation for physicians from different Latin American countries was carried out. The main doubts and barriers that PCPs face in applying the recommendations proposed by the guidelines were identified across different areas, diagnostic criteria, non-pharmacological therapies, pharmacological therapies, management in special conditions and guidelines for referral to a specialist. Consensus solutions were proposed for each identified issue. In conclusion, this consensus contains recommendations regarding the management and treatment of AD in children and adults, which clarify doubts and provide tools to primary care physicians to offer effective treatment for patients and their families.
Para la dermatitis atópica existen múltiples pautas de tratamiento basadas en evidencia científica, pero generalmente están dirigidas a brindar recomendaciones a los especialistas en el área. El objetivo de este estudio fue: elaborar un consenso para los médicos de atención primaria, con la finalidad de ofrecer recomendaciones prácticas basadas en la evidencia y brindar atención oportuna a los pacientes con dermatitis atópica. Como fuente central de información se utilizaron las recomendaciones de múltiples guías para el tratamiento de la dermatitis atópica. Se convocó a delegados de diferentes sociedades médicas para identificar las barreras en la atención y posibles soluciones para la correcta aplicación de las recomendaciones en atención primaria. Posteriormente se realizó una segunda evaluación de su aplicabilidad, invitando a una revisión externa por médicos de diferentes países de Latinoamérica. Se identificaron las principales dudas y barreras de los médicos de atención primaria para la aplicación de las recomendaciones propuestas por las guías, de acuerdo con los criterios diagnósticos, tratamientos no farmacológicos y farmacológicos, tratamiento en condiciones especiales y pautas para envío de pacientes al especialista. Se propusieron soluciones de consenso para cada interrogante identificada.
Keywords: Allergy; Atopic dermatitis; Atopy; Consensus; Evidence-based guidelines; Latin America; Primary care physicians; Treatment.