Guidelines for the Management of Atopic Dermatitis in Singapore

Ann Acad Med Singap. 2016 Oct;45(10):439-450.

Abstract

Introduction: Atopic dermatitis is a common, chronic pruritic condition affecting both children and adults, which has a negative impact on the quality of life. These guidelines were developed by an expert workgroup appointed by the Dermatological Society of Singapore, to provide doctors with information to assist in the management of their patients with atopic dermatitis. The workgroup members are experienced dermatologists with interest and expertise in eczemas.

Materials and methods: Workgroup members arrived at a consensus on the topics to be included. Relevant studies from the literature were assessed for best evidence, supplemented by the collective experience of the workgroup.

Results: For mild atopic dermatitis, emollients, mild potency topical steroids and topical calcineurin inhibitors are recommended. For moderate-to-severe atopic dermatitis, the use of emollients, moderate-to-potent topical steroids, topical calcineurin inhibitors, wet dressings, antimicrobials for secondary skin infection, phototherapy, and systemic therapy (e.g. prednisolone, cyclosporine, azathioprine or methotrexate) may be warranted. Patients with moderate-to-severe atopic dermatitis should be managed in conjunction with a dermatologist.

Conclusion: Good outcomes can be achieved with an individualised therapeutic approach combined with adequate patient and parental education.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use
  • Azathioprine / therapeutic use
  • Calcineurin Inhibitors / therapeutic use*
  • Coinfection / complications
  • Coinfection / drug therapy
  • Cyclosporine / therapeutic use
  • Dermatitis, Atopic / complications
  • Dermatitis, Atopic / immunology
  • Dermatitis, Atopic / therapy*
  • Dermatology
  • Disease Management
  • Emollients / therapeutic use*
  • Food Hypersensitivity / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Methotrexate / therapeutic use
  • Patient Education as Topic
  • Phototherapy*
  • Practice Guidelines as Topic
  • Referral and Consultation
  • Severity of Illness Index
  • Singapore

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Calcineurin Inhibitors
  • Emollients
  • Immunosuppressive Agents
  • Cyclosporine
  • Azathioprine
  • Methotrexate