Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

doi:10.1016/j.jaad.2014.03.023

. 2014 Jul;71(1):116-32.

doi: 10.1016/j.jaad.2014.03.023. Epub 2014 May 9.

Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

Lawrence F Eichenfield¹, Wynnis L Tom¹, Timothy G Berger², Alfons Krol³, Amy S Paller⁴, Kathryn Schwarzenberger⁵, James N Bergman⁶, Sarah L Chamlin⁷, David E Cohen⁸, Kevin D Cooper⁹, Kelly M Cordoro², Dawn M Davis¹⁰, Steven R Feldman¹¹, Jon M Hanifin³, David J Margolis¹², Robert A Silverman¹³, Eric L Simpson³, Hywel C Williams¹⁴, Craig A Elmets¹⁵, Julie Block¹⁶, Christopher G Harrod¹⁷, Wendy Smith Begolka¹⁸, Robert Sidbury¹⁹

Affiliations

¹ Division of Pediatric and Adolescent Dermatology, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
² Department of Dermatology, University of California, San Francisco, California.
³ Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
⁴ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
⁵ Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee.
⁶ Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Department of Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
⁸ Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
⁹ Department of Dermatology, Case Western University, Cleveland, Ohio.
¹⁰ Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
¹¹ Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
¹² Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
¹³ private practice, Fairfax, Virginia.
¹⁴ Center of Evidence-based Dermatology, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom.
¹⁵ Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama.
¹⁶ National Eczema Association, San Rafael, California.
¹⁷ American Academy of Dermatology, Schaumburg, Illinois.
¹⁸ American Academy of Dermatology, Schaumburg, Illinois. Electronic address: wsmithbegolka@aad.org.
¹⁹ Department of Dermatology, Seattle Children's Hospital, Seattle, Washington.

PMID: 24813302
PMCID: PMC4326095
DOI: 10.1016/j.jaad.2014.03.023

Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

Lawrence F Eichenfield et al. J Am Acad Dermatol. 2014 Jul.

. 2014 Jul;71(1):116-32.

doi: 10.1016/j.jaad.2014.03.023. Epub 2014 May 9.

Authors

Affiliations

¹ Division of Pediatric and Adolescent Dermatology, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
² Department of Dermatology, University of California, San Francisco, California.
³ Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
⁴ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
⁵ Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee.
⁶ Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Department of Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
⁸ Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
⁹ Department of Dermatology, Case Western University, Cleveland, Ohio.
¹⁰ Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
¹¹ Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
¹² Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
¹³ private practice, Fairfax, Virginia.
¹⁴ Center of Evidence-based Dermatology, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom.
¹⁵ Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama.
¹⁶ National Eczema Association, San Rafael, California.
¹⁷ American Academy of Dermatology, Schaumburg, Illinois.
¹⁸ American Academy of Dermatology, Schaumburg, Illinois. Electronic address: wsmithbegolka@aad.org.
¹⁹ Department of Dermatology, Seattle Children's Hospital, Seattle, Washington.

PMID: 24813302
PMCID: PMC4326095
DOI: 10.1016/j.jaad.2014.03.023

Abstract

Atopic dermatitis is a common and chronic, pruritic inflammatory skin condition that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this second of 4 sections, treatment of atopic dermatitis with nonpharmacologic interventions and pharmacologic topical therapies are reviewed. Where possible, suggestions on dosing and monitoring are given based on available evidence.

Keywords: antihistamines; antimicrobials; atopic dermatitis; bathing; calcineurin inhibitors; corticosteroids; emollients; topicals; wet wraps.

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Comment in

Management of Atopic Dermatitis.
Stein SL, Cifu AS. Stein SL, et al. JAMA. 2016 Apr 12;315(14):1510-1. doi: 10.1001/jama.2016.1459. JAMA. 2016. PMID: 27115267 No abstract available.

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References

1. Nankervis H, Maplethorpe A, Williams HC. Mapping randomized controlled trials of treatments for eczema--the GREAT database (the Global Resource of EczemA Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010) BMC dermatology. 2011;11:10. - PMC - PubMed
1. Hanifin JM, Cooper KD, Ho VC, Kang S, Krafchik BR, Margolis DJ, et al. Guidelines of care for atopic dermatitis, developed in accordance with the American Academy of Dermatology (AAD)/American Academy of Dermatology Association "Administrative Regulations for Evidence-Based Clinical Practice Guidelines". Journal of the American Academy of Dermatology. 2004;50:391–404. - PubMed
1. Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. Journal of the European Academy of Dermatology and Venereology : JEADV. 2012;26:1176–1193. - PubMed
1. Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) part I. Journal of the European Academy of Dermatology and Venereology : JEADV. 2012;26:1045–1060. - PubMed
1. Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. The Journal of allergy and clinical immunology. 2013;131:295–299. e1–e27. - PubMed

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[1] Nankervis H, Maplethorpe A, Williams HC. Mapping randomized controlled trials of treatments for eczema--the GREAT database (the Global Resource of EczemA Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010) BMC dermatology. 2011;11:10. - PMC - PubMed

[2] Nankervis H, Maplethorpe A, Williams HC. Mapping randomized controlled trials of treatments for eczema--the GREAT database (the Global Resource of EczemA Trials: a collection of key data on randomized controlled trials of treatments for eczema from 2000 to 2010) BMC dermatology. 2011;11:10. - PMC - PubMed

[3] Hanifin JM, Cooper KD, Ho VC, Kang S, Krafchik BR, Margolis DJ, et al. Guidelines of care for atopic dermatitis, developed in accordance with the American Academy of Dermatology (AAD)/American Academy of Dermatology Association "Administrative Regulations for Evidence-Based Clinical Practice Guidelines". Journal of the American Academy of Dermatology. 2004;50:391–404. - PubMed

[4] Hanifin JM, Cooper KD, Ho VC, Kang S, Krafchik BR, Margolis DJ, et al. Guidelines of care for atopic dermatitis, developed in accordance with the American Academy of Dermatology (AAD)/American Academy of Dermatology Association "Administrative Regulations for Evidence-Based Clinical Practice Guidelines". Journal of the American Academy of Dermatology. 2004;50:391–404. - PubMed

[5] Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. Journal of the European Academy of Dermatology and Venereology : JEADV. 2012;26:1176–1193. - PubMed

[6] Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. Journal of the European Academy of Dermatology and Venereology : JEADV. 2012;26:1176–1193. - PubMed

[7] Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) part I. Journal of the European Academy of Dermatology and Venereology : JEADV. 2012;26:1045–1060. - PubMed

[8] Ring J, Alomar A, Bieber T, Deleuran M, Fink-Wagner A, Gelmetti C, et al. Guidelines for treatment of atopic eczema (atopic dermatitis) part I. Journal of the European Academy of Dermatology and Venereology : JEADV. 2012;26:1045–1060. - PubMed

[9] Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. The Journal of allergy and clinical immunology. 2013;131:295–299. e1–e27. - PubMed

[10] Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. The Journal of allergy and clinical immunology. 2013;131:295–299. e1–e27. - PubMed

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Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

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Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

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