Format

Send to

Choose Destination
J Eur Acad Dermatol Venereol. 2018 May;32(5):657-682. doi: 10.1111/jdv.14891.

Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I.

Author information

1
Department Dermatology and Allergy, Ludwig-Maximilian University, Munich, Germany.
2
Klinik Thalkirchner Straße, Munich, Germany.
3
Department of Dermatology, Centre Hospitalier Universitaire CHU Nantes, Nantes, France.
4
Department of Dermatology and Allergy, Christine Kühne-Center for Allergy Research and Education, University Bonn, Bonn, Germany.
5
Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
6
Department Dermatology, Aarhus University Hospital, Aarhus, Denmark.
7
European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Global Allergy and Asthma Patient Platform (GAAPP), Konstanz, Germany.
8
Department of Dermatology, University of Gießen and Marburg GmbH, Gießen, Germany.
9
Department of Psychosomatics and Psychotherapy, University of Gießen and Marburg GmbH, Gießen, Germany.
10
Department of Medicine, Section of Dermatology, University of Verona, Verona, Italy.
11
Pediatric Pneumology and Immunology, Universitätsmedizin Berlin, Berlin, Germany.
12
Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera, Università di Padova, Padova, Italy.
13
Department of Dermatology, Medical University, Poznan, Poland.
14
Dermatological Practice, Immenstadt, Germany.
15
Allergy Unit, Department of Dermatology, University of Zurich, Zurich, Switzerland.
16
Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland.
17
Department Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
18
Department of Dermatology, Heim Pál Children's Hospital, Budapest, Hungary.
19
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
20
Department of Dermatology and Pediatric Dermatology, Hôpital St André, Bordeaux, France.
21
Department of Dermatology, Hospital Niño Jesus, Madrid, Spain.
22
Department Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
23
Department Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.

Abstract

This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This first part of the guideline covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy, whereas the second part covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions. Management of AE must consider the individual clinical variability of the disease; highly standardized treatment rules are not recommended. Basic therapy is focused on treatment of disturbed barrier function by hydrating and lubricating topical treatment, besides further avoidance of specific and unspecific provocation factors. Topical anti-inflammatory treatment based on glucocorticosteroids and calcineurin inhibitors is used for flare management and for proactive therapy for long-term control. Topical corticosteroids remain the mainstay of therapy, whereas tacrolimus and pimecrolimus are preferred in sensitive skin areas and for long-term use. Topical phosphodiesterase inhibitors may be a treatment alternative when available. Adjuvant therapy includes UV irradiation, preferably with UVB 311 nm or UVA1. Pruritus is targeted with the majority of the recommended therapies, but some patients may need additional antipruritic therapy. Antimicrobial therapy, systemic anti-inflammatory treatment, immunotherapy, complementary medicine and educational intervention will be addressed in part II of the guideline.

PMID:
29676534
DOI:
10.1111/jdv.14891
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center