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Treatment of atopic dermatitis (eczema)

Authors
William L Weston, MD
William Howe, MD
Section Editors
Robert P Dellavalle, MD, PhD, MSPH
Moise L Levy, MD
Joseph Fowler, MD
Deputy Editor
Rosamaria Corona, MD, DSc

INTRODUCTION

Atopic dermatitis is a chronic, pruritic, inflammatory skin disease that occurs most frequently in children, but also affects many adults [1]. Clinical features of atopic dermatitis include skin dryness, erythema, oozing and crusting, and lichenification. Pruritus is a hallmark of the condition and is responsible for much of the disease burden for patients and their families.

The goals of treatment are to reduce symptoms (pruritus and dermatitis), prevent exacerbations, and minimize therapeutic risks. Standard treatment modalities for the management of these patients are centered around the use of topical antiinflammatory preparations and moisturization of the skin, but patients with severe disease may require phototherapy or systemic treatment [2,3].

Conventional therapy for atopic dermatitis is reviewed here. The management of severe, refractory atopic dermatitis and the epidemiology, pathogenesis, clinical manifestations, and diagnosis of atopic dermatitis are discussed separately. (See "Management of severe refractory atopic dermatitis (eczema)" and "Pathogenesis, clinical manifestations, and diagnosis of atopic dermatitis (eczema)".)

GENERAL APPROACH

The optimal management of atopic dermatitis requires a multipronged approach that involves the elimination of exacerbating factors, restoration of the skin barrier function and hydration of the skin, patient education, and pharmacologic treatment of skin inflammation [4].

Elimination of exacerbating factors — Exacerbating factors in atopic dermatitis that disrupt an already abnormal epidermal barrier include excessive bathing without subsequent moisturization, low humidity environments, emotional stress, xerosis (dry skin), overheating of skin, and exposure to solvents and detergents [5,6]. Avoiding these situations is helpful for acute flares as well as for long-term management. Since atopic individuals tend to respond more readily to pruritic stimuli, anything that tends to induce itch in an individual should be avoided.

                                              

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 21 00:00:00 GMT+00:00 2016.
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