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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2010 April;145(2):303-8

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Atopic dermatitis in children: what to do when nothing works

Kienast A. K. 1, Hoeger P. H. 2

1 Department of Dermatology, Berufsgenossenschaftliches Unfallkrankenhaus Hamburg Hamburg, Germany; 2 Department of Pediatric Dermatology, Catholic Children’s Hospital Wilhelmstift, Hamburg/Germany


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Atopic eczema in children usually responds to a management programme involving the regular use of emollients and the topical use of anti-inflammatory agents combined with patient education and the avoidance of environmental irritants or allergens (where necessary). If treatment fails, non-compliance should be considered first. Parents need to be reassured; a standardized educational program how to handle the disease with all its implications seems helpful. Persistent allergens or irritative triggers should be identified and eliminated. Systemic immunosuppression with either ciclosporin or azathioprine, mycophenolate mofetil or others should only be considered when parental compliance is warranted and all efforts have been made to eliminate external triggers. This article gives a short review on possible causes of treatment failures and ways to cope with them.

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hoeger@KKH-Wilhelmstift.de