Epidemiological and Therapeutic Profile in Atopic Dermatitis According to the Involvement on Special Locations. Spanish Atopic Dermatitis Registry (BIOBADATOP)

BACKGROUND: The development of new therapies for atopic dermatitis (AD) has represented a qualitative leap in disease control. However, involvement of special locations (SL) may pose a challenge, given its association with a high impact on quality of life that is not always related to objective extension. MATERIAL AND METHODS: We used the BIOBADATOP registry (Spanish AD Registry). We conducted a descriptive analysis of the epidemiology of SL involvement, as well as its therapeutic and prognostic implications. Three areas were defined as SL: the face, genitals, and hands. Patients were grouped according to the absence of involvement, involvement of one SL, or involvement of > 2 SLs. RESULTS: Of the 616 patients included, 70% presented facial involvement, 46.6% hand involvement, and 28.2% genital involvement. Among adults (82.1%; N = 506), 23.7% presented involvement of 1 SL and 52.8% involvement of > 2SLs. Greater SL involvement was associated with a higher number of previous systemic treatments and higher baseline EASI and POEM scores, among other findings. In the pediatric group (17.9%; N = 110), 30% presented involvement of 1 SL and 45.5% involvement of > 2 SLs. A greater number of previous treatments was also recorded compared with patients without SL involvement. CONCLUSIONS: Involvement of SLs tends to be associated with greater baseline severity and a higher number of previous systemic treatments, a circumstance that should be taken into consideration in the management of these patients.