Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches

doi:10.1016/j.jaad.2014.08.038

. 2014 Dec;71(6):1218-33.

doi: 10.1016/j.jaad.2014.08.038. Epub 2014 Sep 26.

Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches

Robert Sidbury¹, Wynnis L Tom², James N Bergman³, Kevin D Cooper⁴, Robert A Silverman⁵, Timothy G Berger⁶, Sarah L Chamlin⁷, David E Cohen⁸, Kelly M Cordoro⁶, Dawn M Davis⁹, Steven R Feldman¹⁰, Jon M Hanifin¹¹, Alfons Krol¹¹, David J Margolis¹², Amy S Paller⁷, Kathryn Schwarzenberger¹³, Eric L Simpson¹¹, Hywel C Williams¹⁴, Craig A Elmets¹⁵, Julie Block¹⁶, Christopher G Harrod¹⁷, Wendy Smith Begolka¹⁸, Lawrence F Eichenfield²

Affiliations

¹ Department of Dermatology, Seattle Children's Hospital, Seattle, Washington.
² University of California, San Diego and Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California.
³ Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Department of Dermatology, Case Western University, Cleveland, Ohio.
⁵ private practice, Fairfax, Virginia.
⁶ Department of Dermatology, University of California San Francisco, San Francisco, California.
⁷ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
⁸ Department of Dermatology, New York University School of Medicine, New York, New York.
⁹ Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
¹⁰ Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
¹¹ Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
¹² Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
¹³ Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee.
¹⁴ Centre 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.

PMID: 25264237
PMCID: PMC4430554
DOI: 10.1016/j.jaad.2014.08.038

Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches

Robert Sidbury et al. J Am Acad Dermatol. 2014 Dec.

. 2014 Dec;71(6):1218-33.

doi: 10.1016/j.jaad.2014.08.038. Epub 2014 Sep 26.

Authors

Affiliations

¹ Department of Dermatology, Seattle Children's Hospital, Seattle, Washington.
² University of California, San Diego and Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California.
³ Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Department of Dermatology, Case Western University, Cleveland, Ohio.
⁵ private practice, Fairfax, Virginia.
⁶ Department of Dermatology, University of California San Francisco, San Francisco, California.
⁷ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
⁸ Department of Dermatology, New York University School of Medicine, New York, New York.
⁹ Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
¹⁰ Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
¹¹ Department of Dermatology, Oregon Health & Science University, Portland, Oregon.
¹² Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
¹³ Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee.
¹⁴ Centre 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.

PMID: 25264237
PMCID: PMC4430554
DOI: 10.1016/j.jaad.2014.08.038

Abstract

Atopic dermatitis is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on use are given based on available evidence.

Keywords: aeroallergens; allergy testing; atopic dermatitis; calcineurin inhibitors; complementary therapy; corticosteroids; diet; education; flare; food allergy; topicals.

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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”. J Am Acad Dermatol. 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 I. J Eur Acad Dermatol Venereol. 2012;26:1045–60. - 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. J Eur Acad Dermatol Venereol. 2012;26:1176–93. - PubMed
1. Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol. 2013;131:295–9 e1-27. - 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”. J Am Acad Dermatol. 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”. J Am Acad Dermatol. 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 I. J Eur Acad Dermatol Venereol. 2012;26:1045–60. - 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 I. J Eur Acad Dermatol Venereol. 2012;26:1045–60. - 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 II. J Eur Acad Dermatol Venereol. 2012;26:1176–93. - 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 II. J Eur Acad Dermatol Venereol. 2012;26:1176–93. - PubMed

[9] Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol. 2013;131:295–9 e1-27. - PubMed

[10] Schneider L, Tilles S, Lio P, Boguniewicz M, Beck L, LeBovidge J, et al. Atopic dermatitis: a practice parameter update 2012. J Allergy Clin Immunol. 2013;131:295–9 e1-27. - PubMed

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Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches

Affiliations

Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches

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