ORIGINAL ARTICLE Therapeutic management of adults with atopic dermatitis: comparison with psoriasis and chronic urticaria C. Pascal, 1, * D. Maucort-Boulch, 1,2 S. Gilibert, 3 D. Bottigioli, 3 V. Verdu, 3 C. Jaulent, 3 F. Hacard, 3,4 F. B erard, 3,4 J.-F. Nicolas, 1,3,4 A. Nosbaum 1,3,4, * 1 Universit e Claude Bernard Lyon 1, Lyon Cedex 03, France 2 Department of Biostatics and Bioinformatic, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-B enite, France 3 Allergology and Clinical Immunology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-B enite, France 4 CIRI (International Center for Infectiology Research), INSERM U1111, Ecole Normale Sup erieure de Lyon, CNRS UMR 5308, Universit e Claude Bernard Lyon 1, Lyon, France *Correspondence: A. Nosbaum and C. Pascal. E-mails: audrey.nosbaum@chu-lyon.fr and clapascal@hotmail.fr Abstract Background The therapeutic options in atopic dermatitis rely on consensus-based guidelines, also established for psoriasis and chronic urticaria. However, the therapeutic approach in atopic dermatitis, especially in the moderate- to-severe forms of the disease, seems less aggressive than in psoriasis and in chronic urticaria with a less frequent use of systemic agents. Objectives To compare in real-life conditions the therapeutic management of adults with atopic dermatitis with those with psoriasis and chronic urticaria. Methods A transversal analysis was performed in May 2017, using retrospective data from a monocentric database. Data on epidemiology, severity, therapeutic educational intervention and systemic treatments were analysed from 401 patients with atopic dermatitis, compared with data from 230 patients with chronic urticaria and 535 patients with psoriasis. Results A high proportion (73%) of atopic dermatitis patients presented with a moderate-to-severe form of the disease compared to only 39% of chronic urticaria and 17% of psoriasis patients. Most of atopic dermatitis patients (78%) had completed a therapeutic educational programme, while the adherence was lower in chronic urticaria (35%) and in psoria- sis (3%) patients. A systemic treatment, including biologicals, was recorded in 8% of atopic dermatitis patients, while it concerned 26% and 47% of chronic urticaria and psoriasis patients, respectively. Conclusions We confirmed that atopic dermatitis treatment mostly relies on topical treatments. Only a minority of moderate-to-severe atopic dermatitis patients who are eligible for a systemic treatment receive such therapy. This may suggest promoting a more frequent use of systemic agents in moderate-to-severe atopic dermatitis. Received: 16 January 2020; Accepted: 18 February 2020 Conflicts of interest Dr. Pascal, Dr. Jaulent reports grants from Novartis Pharma S.A.S, during the conduct of the study. Dr. Maucort-Boulch, Dr. Gilibert, Bottigioli, Verdu, Pr. B erard, Pr. Nicolas have nothing to disclose. Dr. Hacard reports grants from Novartis Pharma SAS, during the conduct of the study. Dr. Nosbaum reports grants from Novartis Pharma S.A.S, during the conduct of the study, other from Novartis Pharma S.A.S, other from Pierre Fabre, personal fees and other from Medac, personal fees and other from AbbVie, personal fees and other from Leo Pharma, personal fees and other from Lilly, grants, personal fees and other from Sanofi-Regeneron, and other from Janssen Cilag, outside the submitted work. Funding source The database was partly funded by Novartis Pharma S.A.S. Introduction Atopic dermatitis (AD) is a chronic inflammatory skin disease, constantly affecting the quality of life, due to itching, time con- sumption and sleep disturbance. 1,2 Moderate-to-severe forms of AD affect nearly 50% of patients and are associated with other atopic diseases, like allergic asthma and food allergy. 3 In these cases, the morbidity is important, leading to a considerable eco- nomic burden. 4 The first-line treatments of AD are essentially © 2020 European Academy of Dermatology and Venereology JEADV 2020 DOI: 10.1111/jdv.16329 JEADV