Atopic Dermatitis Survey

Question Title

* 1. Are you currently in clinical practice?

Yes

Question Title

* 2. How many patients with uncontrolled moderate to severe atopic dermatitis do you see on a weekly basis?

1-5

6-10

11-20

≥21

Question Title

* 3. The remaining questions are regarding your patient case.
Please indicate your patient’s sex:

Male

Female

Question Title

* 4. Please indicate your patient’s age group:

0-1 years

2-11 years

12-17 years

≥18 years

Question Title

* 5. Does the patient have any of the following comorbidities? (Choose all that apply)

Atopic dermatitis

Food allergy

Chronic rhinosinusitis

Nasal Polyps

Anxiety

Depression

Sleep disturbance

Question Title

* 6. Please provide a detailed description of your case, including past and current medication, relevant comorbidities, known laboratory values, and clinical assessment

Question Title

* 7. If my case is selected for discussion, I can be contacted to provide additional HIPAA-compliant details, if necessary, to help elucidate the scenario for resolution by the expert faculty

Yes

Atopic Dermatitis Survey

Question Title

* 1. Are you currently in clinical practice?

Question Title

* 2. How many patients with uncontrolled moderate to severe atopic dermatitis do you see on a weekly basis?

Question Title

* 3. The remaining questions are regarding your patient case. Please indicate your patient’s sex:

Question Title

* 4. Please indicate your patient’s age group:

Question Title

* 5. Does the patient have any of the following comorbidities? (Choose all that apply)

Question Title

* 6. Please provide a detailed description of your case, including past and current medication, relevant comorbidities, known laboratory values, and clinical assessment

Question Title

* 7. If my case is selected for discussion, I can be contacted to provide additional HIPAA-compliant details, if necessary, to help elucidate the scenario for resolution by the expert faculty

Question Title

* 8. If yes, please provide your email address:

* 3. The remaining questions are regarding your patient case.
Please indicate your patient’s sex: