Atopic dermatitis and alternative management strategies.
OBJECTIVE
To discuss the significance of studies published over the previous year regarding the pathogenesis and treatment of atopic dermatitis, including prevention, skin care, environmental modifications, nutrition, education, and anti-inflammatory medications.


RESULTS
Recent evidence shows that 42.5% of the caregivers of children with atopic dermatitis had used alternative therapies, most commonly due to fears of topical steroid side-effects and dissatisfaction with conventional treatment. Common questions, such as the potential utility of prenatal probiotics for prevention of atopic dermatitis, as well as the interplay of food allergies and eczema will be discussed in detail. New research continues to show the efficacy and safety of topical calcineurin inhibitors and atopiclair. We will review advances in the understanding of the pathogenesis of atopic dermatitis, and the latest research on therapies available to clinicians to aid them in discussions with their patients.


CONCLUSIONS
Atopic dermatitis impacts negatively the quality of life of both patients and their families. General pediatricians play a pivotal role in the management of this chronic condition. Management should focus on providing sound advice and easing fears regarding topical steroids, as well as pursuing conservative treatments that have the potential to prevent flares.
Anderson
P Chris
PC
Section of Dermatology, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire 03756, USA. pchris@hitchcock.org
Dinulos
James G
JG
D000279:Administration, Cutaneous; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019703:Calcineurin / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D017281:Cost of Illness; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000178:diet therapy* / Q000188:drug therapy* / Q000453:epidemiology; D004643:Emollients / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D010353:Patient Education as Topic; D019936:Probiotics / Q000627:therapeutic use; D012720:Severity of Illness Index; D017592:Skin Care / Q000379:methods; D016896:Treatment Outcome; D016312:Treatment Refusal; D014807:Vitamin D / Q000627:therapeutic use; D014886:Weaning; D015032:Zinc / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D065095:Calcineurin Inhibitors; D004643:Emollients; D005938:Glucocorticoids; D014807:Vitamin D; D019703:Calcineurin; D015032:Zinc