{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:41:52Z","timestamp":1780382512139,"version":"3.54.1"},"reference-count":63,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T00:00:00Z","timestamp":1658188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013995","name":"Sanofi Genzyme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013995","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Paediatric atopic dermatitis (AD) can be burdensome, affecting mental health and impairing quality of life for children and caregivers. Comprehensive guidelines exist for managing paediatric AD, but practical guidance on using systemic therapy is limited, particularly for new therapies including biologics and Janus kinase (JAK) inhibitors, recently approved for various ages in this indication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This expert consensus aimed to provide practical recommendations within this advancing field to enhance clinical decision\u2010making on the use of these and other systemics for children and adolescents aged \u22652\u2009years with moderate\u2010to\u2010severe AD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nineteen physicians from Northern Europe were selected for their expertise in managing childhood AD. Using a two\u2010round Delphi process, they reached full or partial consensus on 37 statements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Systemic therapy is recommended for children aged \u22652\u2009years with a clear clinical diagnosis of severe AD and persistent disease uncontrolled after optimizing non\u2010systemic therapy. Systemic therapy should achieve long\u2010term disease control and reduce short\u2010term interventions. Recommended are cyclosporine A for short\u2010term use (all ages) and dupilumab or methotrexate for long\u2010term use (ages \u22656\u2009years). Consensus was not reached on the best long\u2010term systemics for children aged 2\u20136\u2009years, although new systemic therapies will likely become favourable: New biologics and JAK inhibitors will soon be approved for this age group, and more trial and real\u2010world data will become available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This article makes practical recommendations on the use of systemic AD treatments for children and adolescents, to supplement international and regional guidelines. It considers the systemic medication that was available for children and adolescents with moderate\u2010to\u2010severe AD at the time this consensus project was done: azathioprine, cyclosporine A, dupilumab, methotrexate, mycophenolate mofetil and oral glucocorticosteroids. We focus on the geographically similar Northern European countries, whose healthcare systems, local preferences for AD management and reimbursement structures nonetheless differ significantly.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.18410","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T19:09:11Z","timestamp":1657134551000},"page":"2153-2165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Systemic treatment of children and adolescents with atopic dermatitis aged \u22652\u2009years: a Delphi consensus project mapping expert opinion in Northern Europe"],"prefix":"10.1111","volume":"36","author":[{"given":"M.","family":"de Graaf","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, Wilhelmina Children's Hospital University Medical Center Utrecht  Utrecht The 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Pediatrics Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.\u2010D.","family":"Ghislain","sequence":"additional","affiliation":[{"name":"Department of Dermatology, UCL St\u2010Luc Louvain University  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7597-4323","authenticated-orcid":false,"given":"L.","family":"Huilaja","sequence":"additional","affiliation":[{"name":"PEDEGO Research Unit University of Oulu  Oulu Finland"},{"name":"Department of Dermatology and Medical Research Center Oulu Oulu University Hospital  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.K.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology Unit, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Dermatology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.K.","family":"Kvenshagen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics \u00d8stfold Hospital  Gr\u00e5lum Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.M.","family":"Mandelin","sequence":"additional","affiliation":[{"name":"Department of Dermatology Helsinki University Central Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Olset","sequence":"additional","affiliation":[{"name":"Department of Dermatology Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2821-7418","authenticated-orcid":false,"given":"A.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology Malm\u00f6 University Hospital  Malm\u00f6 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