Section : Conference Notes

Early Topical Atopic Dermatitis (AD) Treatment In Children Improves Clinical Outcome (For Professionals)

Early Topical Atopic Dermatitis (AD) Treatment In Children Improves Clinical Outcome (For Professionals)

  • chronic AD which is lichenified is difficult to treat
  • The 3 major problematic factors with AD are:
  1. pruritus
  2. flares
  3. skin infections (bacterial and viral)
  • Etiology of AD
  1. genetic?
  2. environmental ?
  3. atopic march ?
  • In the absence of a definate cause, symptom management is very important as a cure is yet to be found.
  • Steroids and Calcineurin inhibitors* applied at each flare can reduce the severity of the eczema to make the 3 problematic factors of AD disappear. This is effective if preventive and general measures are taken and that emollients (a moisturizer) are applied. *Recommendations then for using tacrolimus on the long term are:
  1. twice weekly prevents flares and prolongs flare free intervals.
  2. Tacrolimus has also been shown to be effective if applied at the very beginnning of flares.
  • The main problem to treat a long term problem is compliance because of:
  1. chronic evolution: flares keep happening
  2. corticophobia: patients, as well as healthcare providers are sometimes scared of using steroids
  3. chronic side effects (SE): skin atrophy among other SE can occur
  • Adaptation for effective long term treatment must therefore be found:

Water stops the fire but when water is too early, fire comes back !

  1. aim of treatment is to have clinically normal skin (not to stop steroids): this will improve chronic evolution (and therefore compliance).
  2. ask weight of steroids: the weight will diminish with the reduction of extent of skin lesions: this will reduce corticophobia.
  3. ask the patient to note date of opening of each tube to use not to much or too little steroids: this will also reduce corticophobia.


Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Cambazzard F. How to cure atopic dermatitis in children with an early and complete topical treatment. 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige). Presentor has a conflict of interest with Stiefel and Astellas

Category : atopic dermatitis - Modifie le 10.12.2010Category : dermatite atopique - Modifie le 10.12.2010Category : importance du traitement precoce - Modifie le 10.12.2010Category : importance of early treatment - Modifie le 10.12.2010