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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.* ; Wollenberg, A.* ; Darsow, U. ; European Dermatology Forum (EDF) (*) ; European Academy of Dermatology and Venereology (EADV) (*) ; European Federation of Allergy (EFA) (*) ; European Task Force on Atopic Dermatitis (ETFAD) (*) ; European Society of Pediatric Dermatology (ESPD) (*) ; GA²LEN Study Group (*)

Guidelines for treatment of atopic eczema (atopic dermatitis) Part I.

J. Eur. Acad. Dermatol. Venereol. 26, 1045-1060 (2012)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
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.
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Publication type Article: Journal article
Document type Review
Keywords Topical Calcineurin Inhibitors; 0.1-Percent Tacrolimus Ointment; Pimecrolimus Cream 1-Percent; Testing Enhances Identification; Vehicle-Controlled Trial; Placebo-Controlled Trial; Silver-Coated Textiles; Skin Barrier Function; Long-Term Treatment; Wet-Wrap Dressings
ISSN (print) / ISBN 0926-9959
e-ISSN 1468-3083
Journal Journal of the European Academy of Dermatology and Venereology
Quellenangaben Volume: 26, Issue: 8, Pages: 1045-1060 Article Number: , Supplement: ,
Publisher Wiley
Reviewing status Peer reviewed
Institute(s) Institute for Allergy Research (IAF)