Supporting evidence and recommendations for the management of patients with systemic-eligible atopic dermatitis: A Canadian consensus document

Kerri Purdy; Melinda Gooderham; Mohannad Abu-Hilal; April Armstrong; Rachel Asiniwasis; Gurbir Dhadwal; Carolyn Jack; Perla Lansang; Fiona Lovegrove; Julien Ringuet; Shanna Spring

doi:10.1016/j.jdin.2025.06.009

Supporting evidence and recommendations for the management of patients with systemic-eligible atopic dermatitis: A Canadian consensus document

JAAD Int. 2025 Sep 26:24:31-49. doi: 10.1016/j.jdin.2025.06.009. eCollection 2026 Feb.

Authors

Kerri Purdy¹, Melinda Gooderham^{2

3}, Mohannad Abu-Hilal⁴, April Armstrong⁵, Rachel Asiniwasis⁶, Gurbir Dhadwal⁷, Carolyn Jack⁸, Perla Lansang⁹, Fiona Lovegrove¹⁰, Julien Ringuet¹¹, Shanna Spring¹²

Affiliations

¹ Division of Dermatology, Dalhousie University, Halifax, Nova Scotia, Canada.
² Department of Dermatology, Queen's University, Kingston, Ontario, Canada.
³ SKiN Centre for Dermatology and Probity Medical Research, Toronto, Ontario, Canada.
⁴ Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁵ Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
⁶ Department of Dermatology, University of Saskatchewan, Regina, Saskatchewan, Canada.
⁷ Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Division of Dermatology, McGill University, Montreal, Québec, Canada.
⁹ Division of Dermatology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Lovegrove Dermatology, London, Ontario, Canada.
¹¹ Centre de Recherche Dermatologique du Québec Métropolitain (CRDQ), Québec City, Québec, Canada.
¹² Department of Pediatrics, Division of Dermatology and Rheumatology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.

Abstract

Background: Atopic dermatitis is a chronic, relapsing, and remitting inflammatory skin disease. Multiple systemic therapeutic options are available to treat atopic dermatitis.

Objective: To provide evidence-based recommendations on the use of systemic therapies for atopic dermatitis in Canada that consider the nuances of the Canadian healthcare system and provide guidance for populations of clinical interest.

Methods: A panel of 14 experts, including 11 dermatologists from Canada and 3 from the United States, reviewed available literature on systemic therapies for atopic dermatitis. The published evidence, along with clinical expertise and opinion, was used to draft a concise set of statements to guide healthcare providers in Canada on systemic treatment of atopic dermatitis.

Results: During 3 rounds of virtual meetings with all 14 experts voting in all meetings, a total of 29 statements reached the 75% agreement required for consensus.

Limitations: The consensus statements are based on expert opinions and consensus in the absence of evidence-based clinical research for patient outcomes. The statements represent considerations for patient management and not specific guidelines for patient treatment.

Conclusion: The recommendations and statements provided serve to guide Canadian healthcare providers on the practical aspects of managing systemic-eligible patients with atopic dermatitis.

Keywords: atopic dermatitis; consensus; pathophysiology; practical management; special populations; systemic therapy; systemic-eligible.