Strategies for Successful Management of Severe Atopic Dermatitis.

Patients with severe atopic dermatitis (AD) are reported to represent between 10% and 18% of all patients with AD. However, in this subgroup of patients, quality of life is significantly affected and patients may have a number of atopic and nonatopic comorbidities. Treatment of this severe population has often been reactive with inappropriate use of systemic corticosteroids and unapproved immunosuppressants. Recent insights point to the systemic nature of AD, which has important therapeutic implications. Management of severe AD requires a comprehensive approach that incorporates proper diagnosis, assessment of disease severity, and impact on patient's and caregiver's quality of life, along with education regarding the chronic relapsing nature of the disease as well as treatment options. Biologics such as dupilumab offer a novel, targeted therapeutic approach for this systemic disease.

The contribution of the nursing service worldwide and its capacity to benefit within the dermatology field.

The nursing service is a significant element in the dermatological capacity to respond to skin care and dermatological needs worldwide. Although it is an area of development often neglected by dermatologists, it is one that is undergoing rapid and substantial evolution. This paper outlines the initiatives undertaken by nurses to enhance their contribution, and examines the development of nursing within the dermatology field. It argues for the need to develop a service delivery model in dermatology care that utilizes specialist-nursing expertise to cascade dermatological knowledge and skill through primary care. The paper summarizes the strategic importance of nursing in dermatology care delivery, whether in resource-rich or -poor countries, and its unmet potential in the capacity to benefit and meet skin care and dermatological care needs. The paper specifically focuses on the development work led by the International Skin Care Nursing Group (ISNG) to stimulate and develop the capacity of nursing to respond to these widespread needs through promoting service delivery models that operate interdependently with dermatologist-led care.