Diagnóstico y tratamiento de la dermatitis atópica en Colombia. Actualización de la guía de práctica clínica
DOI:
https://doi.org/10.29176/2590843X.2040Palabras clave:
Dermatitis atópica, Dermatología, Diagnóstico, Enfoque GRADE, Guías de práctica clínica, TratamientoResumen
Antecedentes: La dermatitis atópica (DA) es una enfermedad inflamatoria crónica de la piel altamente prevalente que afecta de manera negativa la calidad de vida de los pacientes y puede asociarse con comorbilidades sistémicas y afectación psicosocial. Se requiere la actualización de las guías de diagnóstico y tratamiento adecuado de la población y del contexto sanitario local. Objetivo: Esta actualización de la guía de práctica clínica (GPC), de la Asociación Colombiana de Dermatología y Cirugía Dermatológica (AsoColDerma), proporciona recomendaciones basadas en la evidencia para la evaluación y el manejo de la DA en Colombia, con un enfoque específico en tratamientos sistémicos, tópicos y terapias coadyuvantes, así como la gravedad y la gestión del riesgo. Estas recomendaciones están dirigidas a profesionales de la salud, tomadores de decisiones y pacientes. Métodos: Para desarrollar esta guía, se conformó un panel multidisciplinario de expertos y se llevó a cabo un proceso riguroso de revisión sistemática de la literatura para responder preguntas clínicas específicas. La certeza en la evidencia y la fuerza de las recomendaciones se evaluaron utilizando el enfoque GRADE (Grading of Recommendations Assessment, Development and Evaluation, por sus siglas en inglés). Resultados: El panel de expertos alcanzó consenso en once recomendaciones y nueve puntos de buena práctica para la atención de personas con DA. La revisión de la evidencia destaca la eficacia de crisaborol tópico, dupilumab, abrocitinib y upadacitinib en el manejo de la DA, con recomendaciones específicas para su uso en diferentes poblaciones. Se incluyen además recomendaciones para la descolonización de reservorios, la inmunoterapia con alérgenos y la restricción alimentaria, así como para la gestión del riesgo en el uso de terapias biológicas e inhibidores de las janocinasas (JAK, por sus siglas en inglés). Conclusiones: Esta guía proporciona recomendaciones actualizadas y basadas en la evidencia para el manejo integral de la DA en Colombia, considerando las necesidades específicas de adultos y niños. Se alienta a los profesionales de la salud a utilizar estas recomendaciones para optimizar la atención del paciente y mejorar los resultados clínicos.
Biografía del autor/a
Claudia Marcela Arenas-Soto, Universidad Militar Central Nueva Granada, Bogotá D.C., Colombia
Hospital Universitario Centro Dermatológico Federico Lleras Acosta, Bogotá D.C., Colombia. Universidad El Rosario, Bogotá D.C., Colombia. Universidad Militar Central Nueva Granada, Bogotá D.C., Colombia.
Gloria Sanclemente-Mesa, Fundación Centro de Investigación Clínica (CIC)
Grupo de Investigación Dermatológica (GRID), Universidad de Antioquia, Medellín, Colombia. Grupo de Innovación y Desarrollo en Investigación (CIC), Fundación Centro de Investigación Clínica (CIC), Medellín, Colombia.
Juan José Yepes-Nuñez, Fundación Santa Fe de Bogotá Hospital Universitario, Bogotá D.C., Colombia
Facultad de Medicina, Universidad de los Andes, Bogotá D.C., Colombia. Fundación Santa Fe de Bogotá Hospital Universitario, Bogotá D.C., Colombia.
Daniela Chaparro-Reyes, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
Hospital Universitario de la Samaritana, Bogotá D.C., Colombia. Fundación CardioInfantil, Bogotá D.C., Colombia. Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
Jorge Sánchez, Asociación Colombiana de Alergia, Asma e Inmunología, Medellín, Colombia
Grupo de Alergología Clínica y Experimental, Hospital Alma Mater de Antioquia, Universidad de Antioquia, Asociación Colombiana de Alergia, Asma e Inmunología, Medellín, Colombia.
Liliana María Tamayo-Quijano, Universidad Pontificia Bolivariana, Medellín., Colombia
Universidad Pontificia Bolivariana, Medellín., Colombia.
Martha Cecilia Valbuena-Mesa, Hospital Universitario Centro Dermatológico Federico Lleras Acosta, Bogotá D.C., Colombia
Hospital Universitario Centro Dermatológico Federico Lleras Acosta, Bogotá D.C., Colombia.
Mauricio Torres-Pradilla, Fundación Universitaria de Ciencia de la Salud, Bogotá D.C., Colombia
Fundación Universitaria de Ciencia de la Salud, Bogotá D.C., Colombia.
Natalia Velásquez-Gómez, Universidad CES, Medellín, Colombia
Universidad CES, Medellín, Colombia.
Mariela Tavera-Zafra, Hospital Militar Central, Bogotá D.C., Colombia
Hospital Militar Central, Bogotá D.C., Colombia.
Susan Martínez-Rojas, Epithink Health Consulting S.A.S.
Epithink Health Consulting S.A.S.
Linda Ibatá-Bernal, Epithink Health Consulting S.A.S.
Epithink Health Consulting S.A.S.
Juan Raúl Castro-Ayarza, COLPSOR, Bogotá D.C., Colombia.
Universidad Nacional de Colombia, COLPSOR, Bogotá D.C., Colombia.
Angela María Londoño-García, Universidad CES, Medellín, Colombia
Universidad CES, Medellín, Colombia.
Juliana Calle-Isaza, Universidad CES, Medellín, Colombia
Universidad CES, Medellín, Colombia.
Oscar Eduardo Mora-Hernández, Hospital San José, Bogotá D.C., Colombia.
Fundación Universitaria de Ciencias de la Salud (FUCS), Hospital San José, Bogotá D.C., Colombia.
Maribel Trujillo-Hernández, Centro Médico Colmédica, Bogotá D.C., Colombia
Clínica Pediátrica de Colsanitas, Centro Médico Colmédica, Bogotá D.C., Colombia.
Juan David Bedoya-Gutiérrez, Universidad CES, Medellín, Colombia
Universidad CES, Medellín, Colombia.
Edgardo Chapman, Asociación Colombiana de Alergia, Asma e Inmunología, Bogotá D.C., Colombia
Asociación Colombiana de Alergia, Asma e Inmunología, Bogotá D.C., Colombia.
Raniery Acuña-Cordero, Hospital Militar Central
Hospital Militar Central, Bogotá D.C., Colombia.
Javier Quintero, Clínica Somer, Rionegro, Colombia.
Clínica Somer, Rionegro, Colombia.
Francisco Javier Sosa Giraldo, Centro Médico Colmédica, Bogotá D.C., Colombia.
Clínica Pediátrica de Colsanitas, Centro Médico Colmédica, Bogotá D.C., Colombia.
Mauricio Javier Guerrero-Román, Sociedad Colombiana de Pediatría, regional Bolívar, Colombia.
Sociedad Colombiana de Pediatría, regional Bolívar, Colombia.
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Derechos de autor 2020 Claudia Marcela Arenas-Soto, Gloria Sanclemente-Mesa, Juan José Yepes-Nuñez, Daniela Chaparro-Reyes, Jorge Sánchez, Liliana María Tamayo-Quijano, Martha Cecilia Valbuena-Mesa, Mauricio Torres-Pradilla, Natalia Velásquez-Gómez, Mariela Tavera-Zafra, Susan Martínez-Rojas, Linda Ibatá-Bernal, Juan Raúl Castro-Ayarza, Angela María Londoño-García, Juliana Calle-Isaza, Oscar Eduardo Mora-Hernández, Maribel Trujillo-Hernández, Juan David Bedoya-Gutiérrez, Edgardo Chapman, Raniery Acuña-Cordero, Javier Quintero, Francisco Javier Sosa Giraldo, Mauricio Javier Guerrero-Román

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
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