Atopic dermatitis (AD) is a chronic, auto‐immune condition that imposes a high burden on individuals, society, and the healthcare system. Approximately 4.4% of adults and up to 18.6% of children/adolescents have AD in Europe, with 20% of all cases accounting for moderate‐to‐severe forms. This form of the condition in adults results in annual societal costs across Europe of an estimated €30 billion; €15.2 billion related to missed workdays or reduced work productivity, €10.1 billion related to direct medical costs and €4.7 billion related to personal expenditure of patients/families. AD can also substantially impact physical, emotional, and social quality‐of‐life. Several studies have shown the debilitating itch‐scratch cycle is the main cause of the multifaceted burden, as it causes substantial sleep deprivation and stigmatisation due to the physical appearance of the skin, and confidence issues. These factors lead to psychosocial issues and can cumulate over time and prohibit patients reaching their ‘full life potential’. Despite this, many patients with the condition are undertreated, resulting in uncontrolled symptoms and a further strain placed on patients, society, and the economy. The authors of this White Paper comprise the European Atopic Dermatitis Working Group, which is a network of international specialists with expertise in dermatology and healthcare policy decisions. Their programme of action is focused on harnessing their expertise to build consensus, advance research, share knowledge, and ultimately seek to improve AD care outcomes through achieving long‐term symptom control. This White Paper presents a systematic evaluation of the overall financial and humanistic burden of moderate‐to‐severe AD and the current challenges that exist with AD care. It introduces recommendations for how, collaboratively, key stakeholders and policy makers can support improvements in AD management to achieve better disease control, thus reducing the costs and associated burden placed on individuals, society, and the economy.

Background Analyses of the European Surveillance System on Contact Allergies (ESSCA) database have focused primarily on prevalence of contact allergies to the European baseline series; overall and in subgroups of patients. However, affected body sites have hitherto not been addressed. Objective To determine prevalence of contact allergies for distinct body sites in patients with allergic contact dermatitis (ACD). Methods Analysis of data collected by ESSCA (www.essca‐dc.org) in consecutively patch tested patients, 2009‐2014, in 8 European countries. Cases were selected based on the presence of minimally one positive patch test to the baseline series, and a final diagnosis of ACD attributed to only one single body site. Results N=6,255 cases were analyzed. The head and hand were the most common single sites ACD was attributed to. Differences between countries were seen for several body sites. Nickel, fragrance mix I, cobalt and methylchloroisothiazolinone/methylisothiazolinone were the most frequent allergens reported for various body sites. Conclusion Distinct allergen patterns per body site were observed. However, contact allergies were probably not always relevant for the dermatitis that patients presented themselves with. Adding possibility to link positive patch test reactions to relevance, along with affected body sites should be a useful addition to data capturing systems.

Introduction: Hidradenitis suppurativa is a chronic inflammatory disease characterized by significant morbidity. Current medical therapies are usually only minimally effective. Objective: To assess the efficacy and safety of infliximab monotherapy for the treatment of severe extensive refractory forms of hidradenitis suppurativa. Design: A retrospective study in a group of 6 patients who received treatment with infliximab for hidradenitis suppurativa, in the Dermatology Department of the University Hospital of Puerto Real in the last year. The dose was 5–10 mg/kg at weeks 0, 2 and 6, followed by a maintenance dose every 4 weeks. Subjective and objective efficacy was assessed before and after each treatment session. Results: All patients experienced improvement in subjective symptoms after the initial dose. A decrease in exudation, the size and number of lesions and less development of fistulous tracts were observed. The patients were followed up during 6 months. Treatment was generally well tolerated and there was only one mild reaction to the infusion in the form of headache. No patient required treatment discontinuation due to adverse effects. Conclusions: Infliximab was shown to be an effective therapeutic alternative for severe extensive forms of hidradenitis suppurativa when it is used as monotherapy.