Journal of the European Academy of Dermatology and Venereology· 2018Q1· Guideline
Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II
- 688citations
- Q1SCImago
- 2018year
Short summary
European guidelines recommend established systemic immunosuppressants (cyclosporine, methotrexate, azathioprine, mycophenolic acid) for severe refractory atopic eczema, with biologics like dupilumab as a safe and effective alternative. Antimicrobial therapy is advised for superinfections, and allergen-specific immunotherapy may be considered for selected cases. Psychosomatic counselling and patient education ('Eczema school') are also recommended.
AI-generated from the title and abstract; the full text is not read.
Key points
- Established systemic immunosuppressants (cyclosporine, methotrexate, azathioprine, mycophenolic acid) are recommended for severe refractory atopic eczema.
- Biologics targeting the T helper 2 pathway, such as dupilumab, are presented as a safe and effective disease-modifying alternative.
- Antimicrobial treatment is indicated for microbial colonization and superinfection, which can exacerbate the disease.
- Allergen-specific immunotherapy with aeroallergens may be considered in selected patients.
- Psychosomatic counselling and therapeutic patient education ('Eczema school') are recommended, particularly for stress-induced exacerbations and overall management.
AI-generated from the title and abstract; the full text is not read.
Abstract
This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease-modifying alternative when available. Oral drugs such as JAK inhibitors and histamine 4 receptor antagonists are in development. Microbial colonization and superinfection may cause disease exacerbation and can require additional antimicrobial treatment. Allergen-specific immunotherapy with aeroallergens may be considered in selected cases. Psychosomatic counselling is recommended especially in stress-induced exacerbations. Therapeutic patient education ('Eczema school') is recommended for children and adult patients. General measures, basic emollient treatment, bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy have been addressed in the first part of the guideline.
The authors' abstract, as published at the source. Journal of the European Academy of Dermatology and Venereology, 2018 · DOI ↗
Continue with a free account
Ask the paper: 3 free questions a day about this paper; save it, get its citation, new summaries every day for your field. Takeaways are Premium.
Continue free on the webSign in with Google or Apple; no card needed. You come back to this paper.
On your phone:
Field: Dermatology
DermatologyMedicine