Guidelines for treatment of atopic eczema (atopic dermatitis) Part II
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Open Access
- 19 July 2012
- journal article
- review article
- Published by Wiley in Journal of the European Academy of Dermatology and Venereology
- Vol. 26 (9), 1176-1193
- https://doi.org/10.1111/j.1468-3083.2012.04636.x
Abstract
The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti‐inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune‐suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen‐specific immunotherapy to aeroallergens may be useful in selected cases. Stress‐induced exacerbations may make psychosomatic counselling recommendable. ‘Eczema school’ educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies.Keywords
This publication has 102 references indexed in Scilit:
- Enteric-coated mycophenolate sodium versus cyclosporin A as long-term treatment in adult patients with severe atopic dermatitis: A randomized controlled trialJournal of the American Academy of Dermatology, 2011
- Efficacy of anti-IgE therapy in patients with atopic dermatitisJournal of the American Academy of Dermatology, 2006
- Treatment of recalcitrant atopic dermatitis with omalizumabJournal of the American Academy of Dermatology, 2006
- Failure of omalizumab for treatment of severe adult atopic dermatitisJournal of the American Academy of Dermatology, 2005
- Treatment of atopic dermatitis with herbal combination of Eleutherococcus, Achillea millefolium, and Lamium album has no advantage over placebo: A double blind, placebo-controlled, randomized trialJournal of the American Academy of Dermatology, 2005
- Infliximab in the treatment of moderate to severe atopic dermatitisJournal of the American Academy of Dermatology, 2005
- Evaluating the relevance of aeroallergen sensitization in atopic eczema with the atopy patch test: A randomized, double-blind multicenter studyJournal of the American Academy of Dermatology, 1999
- Recombinant interferon gamma therapy for atopic dermatitisJournal of the American Academy of Dermatology, 1993
- PUVA and skin cancer: A historical cohort study on 492 patientsJournal of the American Academy of Dermatology, 1992
- Atopic eczema unresponsive to evening primrose oil (linoleic and γ-linolenic acids)Journal of the American Academy of Dermatology, 1985