title: Management of itch in atopic dermatitis.
abstract: Atopic dermatitis is a common, pruritic, inflammatory skin disorder. Chronic, localized, or even generalized pruritus is the diagnostic hallmark of atopic dermatitis, and its management remains a challenge for physicians. The threshold for itch and alloknesis is markedly reduced in these patients, and infections can promote exacerbation and thereby increase the itch. Modern management consists of anti-inflammatory, occasionally antiseptic, as well as antipruritic therapies to address the epidermal barrier as well as immunomodulation or infection. Mild forms of atopic dermatitis may be controlled with topical therapies, but moderate-to-severe forms often require a combination of systemic treatments consisting of antipruritic and immunosuppressive drugs, phototherapy, and topical compounds. In addition, patient education and a therapeutic regimen to help the patient cope with the itch and eczema are important adjuvant strategies for optimized long-term management. This review highlights various topical, systemic, and complementary and alternative therapies, as well as provide a therapeutic ladder for optimized long-term control of itch in atopic dermatitis.
authors.affiliation: Department of Dermatology, University of California San Francisco, San Francisco, CA 94143, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Hong
authors.forename: Joerg
authors.initials: J
authors.lastname: Buddenkotte
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Berger
authors.forename: Martin
authors.initials: M
authors.lastname: Steinhoff
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000628:therapy; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D018377:Neurotransmitter Agents / Q000627:therapeutic use; D010353:Patient Education as Topic; D010789:Phototherapy; D028321:Plant Preparations / Q000627:therapeutic use; D011537:Pruritus / Q000188:drug therapy* / Q000503:physiopathology* / Q000517:prevention & control / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D007155:Immunologic Factors; D018377:Neurotransmitter Agents; D028321:Plant Preparations