title: Management of severe atopic dermatitis in children.
abstract: Severe childhood atopic dermatitis refers to the presence of recurrent, widespread, eczematous dermatitis that significantly interferes with the daily activities and/or the quality of life of the affected child and family. The vast majority of children with severe, long-standing atopic dermatitis can be managed with the appropriate use of topical treatments, including long-term maintenance therapy and adjunctive treatments. In the recalcitrant patient, second line therapies such as narrowband ultraviolet light therapy and systemic immunosuppressants such as cyclosporine, azathioprine, mycophenolate moefetil, and methotrexate have been shown to be safe and effective in children with severe atopic dermatitis and can lead to sustained clinical improvement. To date, biologic therapy has not been uniformly effective in childhood atopic dermatitis. Management of severe childhood atopic dermatitis, including topical and adjunctive treatments and second-line therapies including systemic immunosuppressants will be reviewed here.
authors.affiliation: New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Ainah U
authors.initials: AU
authors.lastname: Tan
authors.forename: Mercedes E
authors.initials: ME
authors.lastname: Gonzalez
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001494:Baths; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000628:therapy*; D004202:Disinfectants / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008727:Methotrexate / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D014467:Ultraviolet Therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D004202:Disinfectants; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D012973:Sodium Hypochlorite; D009173:Mycophenolic Acid; D001379:Azathioprine; D008727:Methotrexate