• Yik Weng Yew, Uma Alagappan, Derrick Aw, Nisha Suyien Chandran, Karen Jl Choo, Roland Chu, Hong Yi Koh, KohMark Jean AanMJADepartment of Dermatology, KK Women's and Children's Hospital, Singapore., Shan Xian Lee, Ching Yin Neoh, Siyun Lucinda Tan, Mark Tang, Yong-Kwang Tay, Seth Francis-Graham, Andrew Lim, and Haur Yueh Lee.
• National Skin Centre, Singapore.
• Ann Acad Med Singap. 2024 Nov 29; 53 (11): 670682670-682.

IntroductionSince 2016, several therapies have been approved for treating atopic dermatitis (AD) in Singapore, including biologics, oral Janus kinase (JAK) inhibitors and topical crisaborole. This study supplements the 2016 Singapore treatment guidelines for AD, focusing on newer therapies for moderate-to-severe disease, while revisiting older treatment regimens to accommodate changes in knowledge and practice.MethodA modified Delphi panel was held, led by 2 co-chairs. The voting expert panel consisted of 12 dermatologists experienced in managing AD in Singapore. Delphi survey rounds were conducted between 24 July and 27 October 2023. Panellists indicated their agreement with drafted statements using a 5-point Likert scale. Consensus was defined as ≥80% agreement. An expert meeting was held to facilitate the consensus process between rounds 1 and 2 of voting.ResultsAll expert panellists participated in both survey rounds, with a 100% response rate. Thirty-nine statements, classified into general principles, conventional treatments, biologics and JAK inhibitors, were proposed. Of these, 27 statements reached consensus at the end of round 1. After the expert meeting, 17 statements were included in round 2, of which 16 statements reached consensus. One statement did not reach consensus. Key updates are the inclusion of dupilumab and JAK inhibitors as potential first-line treatments for moderate-to-severe AD, in certain populations.ConclusionThis modified Delphi study generated consensus among Singapore dermatology experts, to update treatment guidelines in moderate-to-severe atopic dermatitis. The consensus statements developed are intended to supplement the 2016 Singapore treatment guidelines for AD. Further revisions may be required when new evidence and/or treatments become available.

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