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Management of atopic dermatitis in the inpatient setting

Abstract

Purpose of Review

Despite the significant burden of inpatient hospitalization for AD, there are few reviews of inpatient management of AD. In this review, we address common indications for hospitalization in AD patients, the role of dermatology consultation, treatment considerations, and discharge planning.

Recent Findings

There are significant socioeconomic and racial/ethnic disparities that lead to increased risk of hospitalization and readmission for AD. A significant burden of mental health disorders in patients with AD can result in psychiatric emergencies and hospitalization in AD patients.

Summary

The mainstay of hospital treatment for severe or refractory AD remains topical corticosteroid wet wraps. Dermatology should be consulted early in the hospital course. In order to prevent readmission, patients with AD need to be discharged with timely outpatient follow-up to ensure both short-term and long-term disease control. Finally, patients hospitalized for AD may benefit from a multidisciplinary team that can also address their other health conditions and barriers to care.

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Fig. 1
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Abbreviations

AD:

Atopic dermatitis

NIS:

National inpatient

TCS:

Topical corticosteroids

TCI:

Topical calcineurin inhibitors

US:

United States

RCT:

Randomized controlled trial

SCORAD:

Scoring atopic dermatitis

JTF:

Joint Task Force Practice Parameter

SCID :

Severe combined immunodeficiency

EH:

Eczema herpeticum

CCB:

Calcium channel blocker

AA:

African America

EAP:

Eczema action plan

CsA:

Cyclosporine A

UVB:

Ultraviolet B

PHQ:

Patient Health Questionnaire

qSOFA:

Quick Sequential [Sepsis-related] Organ Failure Assessment

CRP:

c-reactive protein; ESR = Erythrocyte sedimentation rate

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Correspondence to Jonathan I. Silverberg.

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Narla, S., Silverberg, J.I. Management of atopic dermatitis in the inpatient setting. Curr Derm Rep (2021). https://doi.org/10.1007/s13671-021-00332-7

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Keywords

  • Atopic dermatitis
  • Inpatient
  • Management
  • Adults
  • Pediatrics
  • Infection
  • Comorbid
  • Hospital
  • Emergency
  • Admission
  • Psychiatric
  • Mental health
  • Sleep