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Sunderland Repository records the research produced by the University of Sunderland including practice-based research and theses.

Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists.

Taylor, K, Swan, David, Affleck, A, Flohr, C and Reynolds, N J (2017) Treatment of moderate-to-severe atopic eczema in adults within the U.K.: results of a national survey of dermatologists. The British journal of dermatology, 176 (6). pp. 1617-1623. ISSN 0007-0963

Item Type: Article



Little is known about U.K. dermatologists' treatment approaches towards adult patients with recalcitrant moderate-to-severe atopic eczema.


We wanted to learn about (i) treatment approaches used for this disease in the U.K.; (ii) factors that influence treatment decisions and (iii) perceived gaps in evidence on treatment safety and efficacy, and priorities for future trials.


We conducted an online survey of consultant-level dermatologists in the U.K.


Sixty-one respondents from over 30 centres reported on management of moderate-to-severe atopic eczema in adults, outwith the context of an acute flare. Phototherapy or psoralen-ultraviolet A was the most common therapeutic modality chosen first line (46%), and this was usually narrowband ultraviolet B. Systemic therapy was chosen as a first-line approach by 36% of dermatologists. Azathioprine was the commonest drug reported being used as first line followed by oral corticosteroids, ciclosporin and methotrexate. Methotrexate was the most common second-line treatment of respondents. The key factors that influenced decision making on the use of phototherapy and systemic agents were the respondent's clinical experience, results of baseline tests (systemic agents) and knowledge of both efficacy and acute and chronic side-effect profiles. The most important evidence gaps identified were the relative effectiveness of treatments, the alternatives to current approaches and the safety of long-term maintenance treatment. With regard to future trials, respondents suggested that priority should be given to studies involving methotrexate.


While survey study designs have limitations, we found that phototherapy, in particular narrowband ultraviolet B, was respondents' preferred first-line treatment for adults with recalcitrant moderate-to-severe atopic eczema, perhaps reflecting access to, and clinical experience of, this approach. Azathioprine is widely used as a longer-term maintenance treatment.

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Depositing User: David Swan


Item ID: 16672
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ISSN: 0007-0963
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ORCID for David Swan: ORCID iD

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Date Deposited: 10 Oct 2023 11:02
Last Modified: 10 Oct 2023 11:02


Author: David Swan ORCID iD
Author: K Taylor
Author: A Affleck
Author: C Flohr
Author: N J Reynolds


Sciences > Biomedical Sciences

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