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

Details

Serval ID
serval:BIB_0B5A7203D2BE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I.
Journal
Journal of the European Academy of Dermatology and Venereology
Author(s)
Wollenberg A., Barbarot S., Bieber T., Christen-Zaech S., Deleuran M., Fink-Wagner A., Gieler U., Girolomoni G., Lau S., Muraro A., Czarnecka-Operacz M., Schäfer T., Schmid-Grendelmeier P., Simon D., Szalai Z., Szepietowski J.C., Taïeb A., Torrelo A., Werfel T., Ring J.
Working group(s)
European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS)
ISSN
1468-3083 (Electronic)
ISSN-L
0926-9959
Publication state
Published
Issued date
05/2018
Peer-reviewed
Oui
Volume
32
Number
5
Pages
657-682
Language
english
Notes
Publication types: Journal Article ; Practice Guideline
Publication Status: ppublish
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.
Keywords
Administration, Cutaneous, Adolescent, Adult, Allergens/adverse effects, Calcineurin Inhibitors/therapeutic use, Child, Child, Preschool, Consensus, Dermatitis, Atopic/etiology, Dermatitis, Atopic/therapy, Diet, Emollients/therapeutic use, Environmental Exposure/prevention & control, Environmental Pollutants/adverse effects, Europe, Food Hypersensitivity/complications, Food Hypersensitivity/diagnosis, Glucocorticoids/administration & dosage, Glucocorticoids/therapeutic use, Humans, Infant, Infant, Newborn, Phototherapy, Pruritus/etiology, Pruritus/therapy, Severity of Illness Index, Skin Care
Pubmed
Web of science
Open Access
Yes
Create date
26/04/2018 18:54
Last modification date
13/04/2021 6:36
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