What is the mainstay of treatment in pediatric atopic dermatitis (AD)?

Updated: Jun 03, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Topical corticosteroids are the mainstay of treatment of atopic dermatitis (AD). [49] These medications reduce inflammation and pruritus primarily by inhibiting the transcriptional activity of various proinflammatory genes. Topical steroids should be applied only to areas of acute exacerbations, whereas emollients should be used over the remainder of the skin. The regular use of emollients in children with mild-to-moderate atopic dermatitis reduces the symptom severity; they should be considered first-line treatment. [50] The absorption of topical steroids is much better through hydrated skin; thus, the ideal time for application is in the first 3 minutes after a bath or shower. The various topical steroid formulations, in ascending order of occlusiveness, include lotions, creams, gels, and ointments. The proactive wet-wrap method with diluted corticosteroids has been advocated. [51]


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