title: Treatment strategies for atopic dermatitis: optimizing the available therapeutic options.
abstract: Bathing and moisturization to control dryness, applications of topical anti-inflammatory agents (including corticosteroids and calcineurin inhibitors [TCIs]) to control flares, minimization of the risk for infection, and relief of pruritus are the cornerstones of effective therapy for atopic dermatitis. Education of parents and patients is crucial to enhance adherence. Strategies for reduced Staphylococcus aureus colonization may help control re-emergence of flares following cessation of antimicrobial treatment for infection; these include dilute bleach baths and minimizing the risk for contamination of topical agents. In severe, refractory cases, more aggressive therapy with systemic immunosuppressants may be considered, but appropriate laboratory testing must be included as part of patient monitoring during treatment. The value of adjuvant therapy with wet wraps to "cool down" particularly erythematous and pruritic flares is becoming increasingly recognized.
authors.affiliation: Department of Dermatology, Northwestern University Feinberg School of Medicine, Attending Physician, Ann & Robert Lurie Children's Hospital of Chicago, Chicago, IL, USA. APaller@nmff.org
authors.forename: Amy S
authors.initials: AS
authors.lastname: Paller
authors.forename: Eric L
authors.initials: EL
authors.lastname: Simpson
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
authors.forename: Charles N
authors.initials: CN
authors.lastname: Ellis
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Mancini
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001494:Baths / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D003879:Dermatologic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018450:Disease Progression; D004643:Emollients / Q000008:administration & dosage; D006801:Humans; D011537:Pruritus / Q000188:drug therapy; D012874:Skin Diseases, Infectious / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000517:prevention & control; D013211:Staphylococcus aureus
chemical_list: D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D004643:Emollients