Management of difficult and severe eczema in childhood

  title={Management of difficult and severe eczema in childhood},
  author={Maeve A. McAleer and Carsten Flohr and Alan D. Irvine},
  journal={BMJ : British Medical Journal},
Summary points Childhood eczema is the most common inflammatory skin disease and affects around 20% of children in the United Kingdom.w1 The condition is also referred to as atopic dermatitis and atopic eczema. The correct nomenclature is debated by experts. The World Allergy Organisation recommends the term eczema, and this is widely used in the UK literature. Atopic dermatitis is perhaps the more accepted term historically and internationally. In this review we will use the term eczema… 

Aspects of eczema in childhood

It is shown that allergy - related diseases affect a majority of children during the first 12 years of life and that eczema, asthma and rhinitis develop dynamic ally throughout childhood and that comorbidity between allergy- related diseases increase with increasing age.

The management of eczema in children

Treatments for Atopic Dermatitis

Although there is no cure for atopic dermatitis, several drugs are used to manage the disease and patients also have to learn how to change their lifestyles in order to avoid triggers for the disease.

Paediatric Dermatology Column: Review Article The use of systemic therapy in childhood eczema: a review and our Australian experience

This review will focus mainly on the more commonly used systemic therapies in paediatric dermatology and also give advice based on the experience.

Methotrexate vs. ciclosporin in the treatment of severe atopic dermatitis in children: author response

Methotrexate may offer an appealing alternative to ciclosporin and also to azathioprine, which has been associated with safety concerns of its own, including increased risk of lymphoma, while methotrexate has a good safety profile based on long-term follow-up of paediatric rheumatology cohorts.

Commentary: Methotrexate and ciclosporin in the treatment of severe eczema in children

  • A. Irvine
  • Medicine
    The British journal of dermatology
  • 2014
Methotrexate vs. ciclosporin in the treatment of severe atopic dermatitis in children: a critical appraisal.

Novel topical and systemic therapies in atopic dermatitis

It is revealed that topical phosphodiesterase 4 inhibitors and Janus kinase (JAK) inhibitors are promising treatments for AD and systemic therapies such as biologics targeting IL-13 and oral JAK inhibitors show strong efficacy in AD.

Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol

A series of retrospective studies using a large population-based cohort derived from the Royal College of General Practitioners Research and Surveillance Centre (RSC) network database to explore two key research themes: AD epidemiology and AD management.

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Community nurses can provide patients with information about their condition, how to apply their topical treatment effectively and how to manage flares and maintain a routine that will improve the eczema and the patient's quality of life.

Consensus Conference on Clinical Management of pediatric Atopic Dermatitis

Levels and models of intervention are enriched by the Italian experience to facilitate a practical approach to the disease and the therapeutical approach should be adapted to the clinical severity.



Systematic review of treatments for atopic eczema.

An up-to-date coverage 'map' of randomised controlled trials (RCTs) of treatments of atopic eczema is produced to assist in making treatment recommendations by summarising the available RCT evidence using qualitative and quantitative methods.

Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema

  • S. Lewis-jones
  • Medicine, Psychology
    International journal of clinical practice
  • 2006
HRQoL measures are proving to be valuable tools for use in the clinical setting, as outcome measures for pharmaceutical studies, for health economics and audit purposes and it is recommended that in future, they should be used in conjunction with objective measures of severity, as part of the assessment process of a child with atopic eczema.

Management of Atopic Dermatitis in the Pediatric Population

New treatment strategies that are being used by atopic dermatitis specialists, such as comprehensive “education-as-intervention” models, wet wraps, bleach baths, and systemic immunomodulatory therapies are discussed.

Systemic Treatment of Pediatric Atopic Dermatitis with Azathioprine and Mycophenolate Mofetil

AZ dosing was correlated to TPMT levels successfully, with comparable levels of improvement in the heterozygous and homozygous wild‐type groups, and success with AZ and MM in the treatment of severe pediatric AD was experienced.

Systemic treatment of severe atopic eczema: a systematic review.

Cyclosporine is recommended as first option for patients with atopic eczema refractory to conventional treatment and intravenous immunoglobulins and infliximab are not recommended based on published data.

What’s new in atopic eczema? An analysis of the clinical significance of systematic reviews on atopic eczema published in 2006 and 2007

The evidence suggests that avoidance of allergenic foods during pregnancy or the use of hydrolyzed or soy formula milks does not prevent Eczema, and delayed introduction of solids may decrease eczema risk.

The Burden of Atopic Dermatitis: Impact on the Patient, Family, and Society

Targeting parents and caregivers with education and psychosocial support can decrease family and personal burden, which in turn may decrease the cost of treating the condition because of better medical, psychossocial, and family outcomes.

What’s new in atopic eczema? An analysis of systematic reviews published in 2009–2010

This review provides a summary of key findings from 18 systematic reviews on atopic eczema, published or indexed between January 2009 and 24 August 2010, which found no evidence of a benefit from any form of antistaphylococcal treatment in managing clinically infected or uninfected Eczema.

Established corticosteroid creams should be applied only once daily in patients with atopic eczema

It is proposed that established preparations need be applied only once daily for atopic eczema, and three newer preparations have been developed for once daily application.