Therapy of atopic dermatitis

Abstract

Background: Appropriate management of patients with atopic dermatitis must depend primarily on early, accurate diagnosis and allergen avoidance in infants. Patients with less typical lesions, such as extensor involvement, may be misdiagnosed. Aim: Dermatologists should try to ensure that correct management is initiated in the primary care setting and maintained by patients and parents. Guidelines for the management of both paediatric and adult patients with atopic dermatitis have been drawn up by an international panel of dermatologists. For patients with mild disease, elaborate investigations to identify the trigger factors are unnecessary. Management should include general measures (skin hydration, irritant and allergen avoidance), provision of information to parents and intermittent use of low potency topical corticosteroids when necessary. For patients with mild to moderate disease, investigations may require assessment of food allergies in paediatric cases and of contact allergens and irritants in adult cases. Identification of Staphylococcus aureus and herpes simplex virus secondary infection is also important. Conclusions: General measures remain important in mild to moderate atopic dermatitis, with appropriate education and support for parents. Topical corticosteroids play an important role, possibly with antihistamines to help alleviate the pruritus. In certain situations, systemic treatment with antibiotics, corticosteroids and other agents may be indicated.