Healthcare facility | Actor | Action | |
---|---|---|---|
Phase 1 | General Practice | Primary Care Pediatrician and General Practitioner | • Management of mild AD, • Promotion of basic management strategies of AD (i.e. moisturizing, mild-moderate potency topical steroids, antibiotics) • Refer moderate-severe AD patients to specialists |
Phase 2 | Community or 1-2nd levels Hospitals | Pediatric Allergist and/or Dermatologist | • Management of mild to moderate AD (SCORAD <50) using I-II line therapy (eg. Wet-wrap therapy; phototherapy) • Specific testing, if needed (eg. skin prick test and/or serum specific IgE testing, patch test, biopsy) • Educational therapy • To refer the patient to a University or 3rd level Hospital if severe AD (SCORAD >50) or difficult to treat AD patient |
Phase 3 | University or 3rd level Hospitals | Pediatric allergist AND dermatologist | • Re-evaluation of differential diagnosis and comorbidities • Definition of the baseline severity (SCORAD and EASI) and further specific testing, if needed • To start III line therapies for severe AD (eg. add on immunosuppressants, biologics) and management of eventual comorbidities • Involvement of other specialist health care professionals (eg. immunologist, psychologist, dietician) |