Guidelines for treatment of atopic eczema (atopic dermatitis) Part II

Ring, J; Alomar, A; Bieber, T; Deleuran, M; Fink-Wagner, A; Gelmetti, C; Gieler, U; Lipozencic, J; Luger, T; Oranje, A P; Schäfer, T; Schwennesen, T; Seidenari, S; Simon, D; Ständer, S; Stingl, G; Szalai, S; Szepietowski, J C; Taïeb, A; Werfel, T; ... (2012). Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. Journal of the European Academy of Dermatology and Venereology, 26(9), pp. 1176-93. Oxford: Blackwell 10.1111/j.1468-3083.2012.04636.x

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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.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Simon, Dagmar

ISSN:

0926-9959

Publisher:

Blackwell

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:38

Last Modified:

17 Mar 2015 21:31

Publisher DOI:

10.1111/j.1468-3083.2012.04636.x

PubMed ID:

22813359

Web of Science ID:

000307555400024

URI:

https://boris.unibe.ch/id/eprint/15499 (FactScience: 222854)

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