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. 2013 Mar 14;6(1):6.
doi: 10.1186/1939-4551-6-6.

Difficult to control atopic dermatitis

Ulf Darsow  1 , Andreas Wollenberg, Dagmar Simon, Alain Taïeb, Thomas Werfel, Arnold Oranje, Carlo Gelmetti, Ake Svensson, Mette Deleuran, Anne-Marie Calza, Francesca Giusti, Jann Lübbe, Stefania Seidenari, Johannes Ring; European Task Force on Atopic Dermatitis / EADV Eczema Task Force
Affiliations

Difficult to control atopic dermatitis

Ulf Darsow et al. World Allergy Organ J. .

Abstract

Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial / antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. "Eczema school" educational programs have been proven to be helpful.

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Figures

Figure 1
Figure 1
Recommendation for treatment of adult eczema / atopic dermatitis according to graded severity (modified from 44).
See this image and copyright information in PMC

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