May 2018 — Bordeaux, FR
Dear Colleagues, Dear Friends,
I have the privilege and the great honor to succeed Johannes Ring as President of our Society. Johannes has been instrumental to launch our Society after international consultations at the Moshi Symposium in Tanzania in 2012. Atopic dermatitis was rightly considered as coming of age as a specific field after a long maturation which started with the first Symposia organized by the late Georg Rajka in Norway, back in the late 1970s.
Atopic dermatitis is easy to recognize as a very prevalent disorder in many countries worldwide, but difficult to situate at the crossroads of allergy, immunology, dermatology, with a very broad clinical scope encompassing pediatric and adult medicine. The disease has also been difficult to name for patients and doctors, and the debate is not completely closed for some.
I started my professional career as a 100% pediatric dermatologist, and AD was one of my areas of dedication with the other pillars of pediatric dermatology, namely genetic diseases and vascular malformations/tumors. By the late 1990s I moved to a mixed practice when I took the head of the department of Dermatology at Bordeaux University Hospitals, and I was naturally drived to offer more appropriate care for adult AD patients, an overall very neglected population in terms of care and research. If I spent more time on vitiligo and pigment cell disorders during this period, I was deeply concerned by the limited options for treatment of adult AD at a time when psoriasis research was booming and benefiting from the advances of targeted biologics.
Times are changing, and now AD is at the center of the stage. Paradoxically, adult AD is currently more in focus now because of the development of systemic targeted therapies. However, we need to remain dedicated to the early stages of the disease, and to work hand to hand with pediatric pulmonologists to design strategies for the prevention of asthma.
The agenda of the new ISAD board must take into account all the recent therapeutic developments, as well as the new research resources allowing the transition towards personalized medicine. To reflect this trend, we need to broaden our membership, which is clearly growing, based on meeting attendance. When I organized the Rajka symposium in 2005 in Arcachon, we were 250. In 2018 in Utrecht, the attendance was over 400. We need to have in addition to dermatologists, pediatricians, allergologists, immunologists, cell biologists, pharmacists, veterinary doctors (who treat routinely canine AD with targeted therapies), nurses, partners from the pharma industry and all specialty care and research specialists who contribute to cutting edge developments of the field.
Our approach needs to be strengthened on a global level. Our meeting has already moved from Europe to Asia, the Americas, Africa, and with return to Asia (Seoul 2020, organizer Kyu-Han Kim), before moving to Canada (2022, organizer Danielle Marcoux). However, subsaharian Africa is not adequately represented when we know that AD is a real burden in this large area. It deserves a special attention. We will take care.
Patient-centered approach has frequently been missed at scientific AD meetings. At the 1900 World Congress of Dermatology, a discussant noted that pruritus was not at all mentioned during the session devoted to the microbial theory of eczema championed by Paul Gerson Unna, and said “itch should be on the agenda at the next congress”. As far as I remember Rajka’s symposia, itch was not on the top of the agenda. Fortunately, neuro-immunogy is now a central area in AD research and patients’ advocacies have their word. Therapeutic patient education (TPE) is a growing field and I am pleased to announce that the international group OPENED DERMATOLOGY created by my long-term friend Jean-Francois Stalder with the support of the “Fondation Dermatite Atopique” has accepted to become the official Task Force of our Society in charge of developing TPE on a global level. In addition, Roberto Takaoka, our vice-President, will organize a meeting on TPE at the next EADV in Paris sponsored by our Society. Patient’s advocacies are closely associated to this initiative and are welcome to exchange freely with our board.
Sabouraud, a famous mycologist and dermatologist (and sculptor) envisioned the eczemas in 1900 “as a huge fortress to take, a fortress still almost intact where there is almost no breach made”. More than 100 years later, large breaches have been opened, we have taken place into the fortress, but there is still a lot of work ahead, and I am counting on you all to make decisive progresses for our patients.
Best wishes to all in your AD research!