Published online October 1, 2008
PEDIATRICS Vol. 122 No. 4 October 2008, pp. 812-824 (doi:10.1542/peds.2007-2232)
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STATE-OF-THE-ART REVIEW ARTICLE

Management of Atopic Dermatitis in the Pediatric Population

Andrew C. Krakowski, MDa,b, Lawrence F. Eichenfield, MDb,c,d and Magdalene A. Dohil, MDc,d,e

a Divison of Pediatric Dermatology
c Departments of Pediatrics
d Medicine, University of California, San Diego, California
e Eczema Center
b Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California

ABSTRACT

Atopic dermatitis, one of the most common skin disorders in young children, has a prevalence of 10% to 20% in the first decade of life. It is a chronic illness that requires a multifaceted treatment strategy in the setting of limited therapeutic options. Balancing safety concerns with efficacious treatment is of particular importance in the pediatric population. Parents of patients with atopic dermatitis turn to their primary caregivers for guidance regarding this physically demanding and psychologically stressful condition. In addition to serving as a review of atopic dermatitis, this article delves into the state-of-the-art therapeutic options and includes a detailed review of the differences between topical corticosteroids and topical calcineurin inhibitors. We also discuss 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.

Key Words: topical calcineurin inhibitors • atopic dermatitis • atopy • management strategies • topical steroids

Abbreviations: AD—atopic dermatitis • IL—interleukin • TNF-{alpha}—tumor necrosis factor {alpha} • Th—T helper • IgE—immunoglobulin E • FDA—Food and Drug Administration • TCI—topical calcineurin inhibitor • FTU—fingertip unit

Accepted Jan 23, 2008.


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