Atopic Dermatitis Team Members Tool
Primary Care Provider (MD/DO, NP, PA)
Central Role in Patient Management
Role: Assessment
- Initial diagnosis
- Screening for comorbidities:
- Infections
- Mental health disorders
- Cardiovascular risk factors
- Etc.
Role: Education and Care Plan
- Basic management (skin care, trigger avoidance)
- Acute treatment for mild to moderate AD
- Maintenance treatment
- Consult specialist for severe or nonresponsive AD
Dermatologist / AD Specialist (MD/DO, NP, PA)
Role: Assessment
- Confirmation of AD diagnosis
- Assess severity, response to prior treatment
Role: Education and Care Plan
- Phototherapy
- Dupilumab
- Systemic immunosuppression
- Basic management (skin care, trigger avoidance)
- Acute treatment for mild to moderate AD
- Maintenance treatment
Dermatologist / AD Specialist (MD/DO, NP, PA)
Role: Assessment
- Confirmation of AD diagnosis
- Assess severity, response to prior treatment
Role: Education and Care Plan
- Phototherapy
- Dupilumab
- Systemic immunosuppression
- Basic management (skin care, trigger avoidance)
- Acute treatment for mild to moderate AD
- Maintenance treatment
Dermatologist / AD Specialist (MD/DO, NP, PA)
Role: Assessment
- Confirmation of AD diagnosis
- Assess severity, response to prior treatment
Role: Education and Care Plan
- Phototherapy
- Dupilumab
- Systemic immunosuppression
- Basic management (skin care, trigger avoidance)
- Acute treatment for mild to moderate AD
- Maintenance treatment
Nurse (RN, NP)
Role: Assessment
- Adherence barriers
- Skin care concerns
- Worries about medication side effects
Role: Education and Care Plan
- AD as a chronic condition
- Skin care education
- Environmental controls
Psychologist
Role: Assessment
- Itch-scratch triggers
- Barriers to skin care and treatment adherence
- Sleep/routine disruption
- Social impact
- Impact on education
- Impact on self-esteem
- Bullying/teasing
- Effect on family
- Mental health symptoms/ comorbidities
Role: Education and Care Plan
- Strategies for itch/scratch cycle
- Stress management
- Sleep hygiene
- Behavioral plan for sleep
- Strategies for bullying/teasing
Dietitian/Nutritionist (RD, RDN)
Role: Assessment
- Adequacy of nutrition (including calcium, vitamin D intake)
- Adherence to elimination
diet
- Ability/adherence to read food labels
- Food variety
- Gastrointestinal, chewing, or swallowing problems
- Mealtime dynamics and schedules
- 25-Hydroxy vitamin D level, if available
Role: Education and Care Plan
- Elimination diet
- Avoiding allergens and cross-contact
- Navigating dining out with food allergies
- Substitutions for baking and cooking
- Recipes, ideas for meals and snacks
- Resources for managing food allergies
- Specialty manufacturers for allergy friendly foods
Allergist (MD/DO, NP, PA)
Role: Assessment
- Food and environmental allergy testing
Role: Education and Care Plan
- Allergy treatment as appropriate
Patient/Caregiver
Role: Assessment
- Reports symptoms
- Reports adherence and response to treatment
- Reports quality of life, sleep quality and quantity, ADLs, and social activities
Role: Education and Care Plan
- The patient is the center of the team
- This includes family, friends, advocates
- Active participant in developing plan
- Approves plan and suggests adjustments over time
- Implements plan on a daily basis, titrating treatment according to disease activity
References
- Boguniewicz M et al., J Allergy Clin Immunol Pract. 2017;5:1519-1531.
- Cork MJ et al. Br J Dermatol. 2003;149:582-589.
- Grillo M et al. Pediatr Dermatol. 2006;23:428-436.
- LeBovidge JS, et al. J Allergy Clin Immunol. 2016;138:325-34.
- LeBovidge J, et al. Semin Cutan Med Surg. 2017;36:131-136.
- Moore EJ et al. Australas J Dermatol. 2009;50:100-106.
- Rolinck-Werninghaus C et al. Pediatr Allergy Immunol. 2015;26:805-810.
Atopic Dermatitis Team Members Tool
Primary Care Provider (MD/DO, NP, PA)
Central Role in Patient Management
Dermatologist / AD Specialist (MD/DO, NP, PA)
Nurse (RN, NP)
Psychologist
Dietician/Nutritionist (RD, RDN)
Allergist (MD/DO, NP, PA)
Patient/Caregiver
References
- Boguniewicz M et al., J Allergy Clin Immunol Pract. 2017;5:1519-1531.
- Cork MJ et al. Br J Dermatol. 2003;149:582-589.
- Grillo M et al. Pediatr Dermatol. 2006;23:428-436.
- LeBovidge JS, et al. J Allergy Clin Immunol. 2016;138:325-34.
- LeBovidge J, et al. Semin Cutan Med Surg. 2017;36:131-136.
- Moore EJ et al. Australas J Dermatol. 2009;50:100-106.
- Rolinck-Werninghaus C et al. Pediatr Allergy Immunol. 2015;26:805-810.