Guidelines for diagnostic testing in adults with presumed atopic dermatitis refractory to treatment
In brief
Experts urge diagnostic reassessment for adults with treatment-resistant atopic dermatitis
A multidisciplinary panel issued a Good Practice Statement recommending that clinicians re-evaluate the diagnosis in adults whose presumed atopic dermatitis does not improve with optimized therapy, to rule out misdiagnosis or co-existing conditions. The guidance is based on indirect evidence and expert consensus, and its applicability may depend on specialist access.
- Journal
- Journal of the American Academy of Dermatology (Q1)
- Published
- 31 August 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Robert Sidbury, Peggy A Wu, Ali Alikhan, Lionel Bercovitch, David E Cohen, Jennifer M Darr, et al.
- PMID
- 42678322
- DOI
- 10.1016/j.jaad.2026.07.039
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 6 September 2026): Guidelines for diagnostic testing in refractory adult atopic dermatitis
Abstract
BACKGROUND: While many adults diagnosed with atopic dermatitis (AD) achieve disease control with standard treatments, a subset of patients remains refractory to optimal management. In these cases, misdiagnosis or the presence of concomitant conditions may be contributing to treatment failure. OBJECTIVE: To provide evidence-informed guidance for the diagnostic workup of presumed adult AD unresponsive to optimized treatment. METHODS: An expert multidisciplinary workgroup applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for issuing guidance on approaching suspected AD refractory to treatment by reviewing the indirect evidence, assessing the balance of benefits and harms, and reaching consensus. RESULTS: The workgroup developed a Good Practice Statement on the diagnostic workup of adults with presumed AD unresponsive to therapy. LIMITATIONS: This guidance is based on indirect evidence and expert consensus, as direct empirical data on diagnostic workup strategies for treatment-resistant AD are lacking. Applicability may vary depending on access to dermatologic and allergy specialist care. CONCLUSION: The Good Practice Statement supports consideration of diagnostic reassessment in cases of presumed AD in adults not responding to optimized treatment.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.