Year: 2012
Type: review
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.
Institutions: Helmholtz Munich, CK-CARE, Technical University of Munich, Universitat Autònoma de Barcelona, Hospital de Sant Pau, University of Bonn, Aarhus University Hospital, University of Milan, Justus-Liebig-Universität Gießen, University Hospital Centre Zagreb, University Hospital Münster, Erasmus MC, Erasmus MC - Sophia Children’s Hospital, University of Lübeck, University of Modena and Reggio Emilia, University of Vienna, Heim Pál Országos Gyermekgyógyászati Intézet, University of Wrocław, Wroclaw Medical University, Hôpital Saint-André, Medizinische Hochschule Hannover, Ludwig-Maximilians-Universität München
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4211044813