Treatment of childhood eczema.
Eczema in childhood is almost always atopic eczema, a common disease with huge impact on the quality of life of the child and family. Although atopic eczema constitutes part of the atopic syndrome, avoidance of allergens is never enough for disease control. Treatment of eczema in childhood has the same components as in adults. Emollients constitute the preventive background therapy in all stages of eczema, and topical corticosteroids are still the mainstay of treatment. Infectious exacerbation may require the use of a short course of topical or systemic antimicrobials. UV phototherapy should be considered as an adjunctive treatment to assist topical corticosteroids after an acute exacerbation of the disease. Cyclosporine can also be used in the treatment of childhood eczema in severe cases. Maternal allergen avoidance for disease prevention, oral antihistamines, Chinese herbs, dietary restriction in established atopic eczema, homeopathy, house-dust mite reduction, massage therapy, hypnotherapy, evening primrose oil, emollients, and topical coal tar are other temporarily used treatment modalities, without, however, firm evidence of efficacy from proper controlled trials. Calcineurin inhibitors constitute a new generation of drugs for both adult and childhood eczema already marketed in some countries. It is postulated that they will replace topical corticosteroids as first-line treatment of eczema.
Granlund
Håkan
H
Department of Dermatology, Helsinki University Central Hospital, Helsinki, Finland. hakan.granlund@pp.fimnet.fi
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D002648:Child; D003876:Dermatitis, Atopic / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy; D004643:Emollients / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology; D012874:Skin Diseases, Infectious / Q000209:etiology / Q000517:prevention & control; D014467:Ultraviolet Therapy
D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D065095:Calcineurin Inhibitors; D004643:Emollients; D006634:Histamine H1 Antagonists; D010726:Phosphodiesterase Inhibitors