Atopic dermatitis
Also known as: eczema
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Atopic dermatitis clinical guideline (AAD guideline series, including the focused update on management in adults)
American Academy of Dermatology (AAD) · 2025 · Focused update (2025) within the 2022-2026 guideline series
The AAD's atopic dermatitis guideline hub, which hosts a multi-part series replacing the 2014 guidelines: separate documents on comorbidities, topical therapy, phototherapy and systemic agents, a focused update covering recently approved therapies in adults, and a first guideline dedicated to paediatric atopic dermatitis.
- The page lists a 2025 focused update addressing newly approved topical and systemic therapies for adults with atopic dermatitis. source
- Separate AAD documents cover comorbidities, topical therapy, and phototherapy plus systemic agents. source
- A dedicated paediatric atopic dermatitis guideline is listed as the AAD's first guidance specific to children and adolescents. source
Living EuroGuiDerm Guideline for the systemic treatment of Atopic Eczema
European Dermatology Forum (EDF) / EuroGuiDerm, with the European Academy of Dermatology and Venereology (EADV) · 2026 · Living guideline, most recent update 2026
The EuroGuiDerm living guideline on atopic eczema, hosted by the European Dermatology Forum. It is maintained as a continuously updated document covering conventional immunosuppressants, biologics and JAK inhibitors, with additional guidance for special situations such as paediatric patients, pregnancy and breastfeeding, and vaccination.
- The guideline is designated a living document and is revised as new evidence and drug approvals appear, most recently in 2026. source
- An earlier consolidated living update was published in the Journal of the European Academy of Dermatology and Venereology in 2025, following the original 2022 guideline. source
- The 2022 guideline was issued in two parts, covering systemic therapy and non-systemic treatments respectively. source
US vs EU key differences
- JAK inhibitor positioning is the biggest divergence: the AAD gives strong recommendations for abrocitinib, baricitinib and upadacitinib alongside biologics, while the European guideline applies the 2022 EMA safety restriction and reserves JAK inhibitors for patients aged 65 or older, smokers, or those with atherosclerotic cardiovascular or malignancy risk only when no suitable alternative exists. source
- The European guideline additionally translates that safety signal into dosing, advising the lower baricitinib dose (2 mg rather than 4 mg) in patients with cardiovascular risk factors, age 65 or above, smoking history or malignancy risk. source
- Update model differs: the European document is a living guideline whose systemic-therapy sections were revised in 2026 to add lebrikizumab and nemolizumab and to delete azathioprine and alitretinoin, whereas the AAD publishes static, periodically replaced guideline papers. source
- Ciclosporin is graded differently: the European guideline keeps it as a first-line option in severe disease where newer agents are unavailable or unsuitable, while the AAD rates cyclosporine only conditionally, alongside methotrexate, azathioprine and mycophenolate. source
What changed recently
- EU2018 EDF atopic eczema guideline → Living guideline, January 2026 update2026-01-01
The January 2026 update to the living EuroGuiDerm atopic eczema guideline re-voted the systemic treatment chapters and redrew the treatment algorithms for adults and for children and adolescents. Azathioprine and alitretinoin recommendations were withdrawn, mycophenolate and omalizumab were moved to past therapies, and new guidance was added on vaccination, switching between drugs, dose interval adjustment, and pregnancy and breastfeeding.
source ↗curation confidence 90% - US2023-2024 AAD atopic dermatitis guidelines → Focused update (2025)2025-01-01
The 2025 focused update adds four new recommendations to the 2023-2024 AAD atopic dermatitis guidelines, covering therapies approved after those documents were written: the topicals tapinarof and roflumilast and the biologics lebrikizumab and nemolizumab. Tapinarof 1% cream received a strong recommendation for adults.
source ↗curation confidence 90%
See the full update feed for changes across every system.