SignalTrace

MOC-evidence-base-and-guidance

John Montgomery4 min read

Evidence Base & Guidance

Map of Content — topic group mapped by judgment from infranodus community detection

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Members

  • Cochrane — Systematic-review network; its Skin group’s eczema reviews (emollients, TCS, supplements, probiotics) anchor most Track A vs B verdicts.
  • NICE — England’s health guidance body; publishes CG57 (eczema under 12s), QS44, NG190 and the CKS eczema summary.
  • NICE CG57 — NICE guideline ‘Atopic eczema in under 12s’ (2007, updated 2025): stepped care, emollients always, TCS potency by severity, referral rules.
  • NICE NG153 — NICE 2020 impetigo guideline: hydrogen peroxide 1% first if localised; then fusidic acid, oral flucloxacillin/clarithromycin; 5 days.
  • NICE NG190 — NICE 2021: no routine antibiotics for infected eczema in a well child; fusidic acid or flucloxacillin 5–7 days if needed; check herpeticum.
  • AAD Pediatric Guideline 2026 — AAD’s first child-specific AD guideline (JAAD 2026): 27 GRADE recs; strong for emollients, TCS, TCIs, new non-steroids, dupilumab ≥6 mo.
  • American Academy of Dermatology — US dermatology body; first child-specific AD guidelines published April 2026 replace its 2014 guidance for under-18s.
  • British Association of Dermatologists — UK dermatologists’ professional body and charity; publishes the atopic eczema patient leaflet and the 2024 joint TSW statement.
  • National Eczema Society — UK eczema charity (1975); nurse-supported helpline, factsheets used across this vault, co-author of the 2024 UK joint statement on TSW.
  • National Eczema Association — US eczema patient charity; runs the Seal of Acceptance, backs bleach baths, flags TSW as under-recognised, open to complementary care.
  • South African Eczema Guidance — SA atopic dermatitis guidance (Sinclair et al SAMJ 2014/15; Kannenberg 2020 algorithm): cheap emollients, TCS/TCI, limited public access.
  • HOME Initiative — International group setting the core outcome set for eczema trials: EASI (signs), POEM (symptoms), IDQoL/CDLQI (QoL), RECAP/ADCT (control).
  • MHRA — UK regulator of medicines and devices; warned on aqueous cream, emollient fire risk and steroid-spiked ‘herbal’ eczema creams.
  • FDA — US regulator: OTC monographs (hydrocortisone, oatmeal), 2006 TCI boxed warning; licensed dupilumab, crisaborole, ruxolitinib for young kids.
  • European Medicines Agency — EU medicines regulator; via CHMP/PDCO sets EU paediatric eczema licences, often narrower than FDA’s (dupilumab, ruxolitinib, crisaborole).
  • SAHPRA — South Africa’s health-products regulator (ex-MCC): registers TCIs and dupilumab (AD from 6 y); phasing in complementary-medicine control.
  • Traditional Herbal Registration — UK MHRA herbal licence based on 30+ years’ traditional use: checks quality and safety, but needs no proof the product works.
  • Stepped Care Approach — NICE CG57 model: emollients always, add treatments by severity (mild/moderate/potent TCS, TCIs, bandages, phototherapy, systemics).
  • When to Refer — When toddler eczema needs referral: same-day (herpeticum), urgent (2 weeks), routine dermatology, allergy, growth and psychology criteria.

Key Relations

Cochrane [relates] NICE NICE CG57 [part-of] NICE NICE [relates] American Academy of Dermatology NICE NG153 [relates] NICE NG190 NICE NG190 [part-of] NICE CG57 American Academy of Dermatology [part-of] AAD Pediatric Guideline 2026 AAD Pediatric Guideline 2026 [relates] NICE CG57 British Association of Dermatologists [relates] NICE CG57 National Eczema Society [relates] National Eczema Association MHRA [supports] National Eczema Society National Eczema Association [relates] National Eczema Society South African Eczema Guidance [relates] NICE CG57 FDA [contradicts] European Medicines Agency European Medicines Agency [relates] MHRA SAHPRA [regulates] South African Eczema Guidance When to Refer [part-of] Stepped Care Approach NICE CG57 [defines] Stepped Care Approach NICE [part-of] NICE CG57 NICE NG153 [precedes] When to Refer NICE NG190 [precedes] When to Refer American Academy of Dermatology [relates] NICE CG57 British Association of Dermatologists [relates] National Eczema Society National Eczema Society [relates] British Association of Dermatologists MHRA [regulates] Traditional Herbal Registration South African Eczema Guidance [relates] Stepped Care Approach European Medicines Agency [contradicts] FDA SAHPRA [relates] MHRA NICE CG57 [relates] American Academy of Dermatology NICE [defines] NICE NG153 NICE NG190 [relates] NICE NG153

Open Questions

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