title: Eczema therapeutics in children: what do the clinical trials say?
abstract: Eczema or atopic dermatitis is a common childhood atopic disease associated with chronicity and impaired quality of life. As there is no cure for the disease, treatment relies on topical and systemic anti-allergic or immunomodulating therapies. Topical corticosteroid, macrolide immunosuppressants, and oral immunomodulating drugs for recalcitrant disease have been the mainstay of therapy. Management of atopic dermatitis must consider the individual symptomatic variability of the disease. Basic therapy is focused on patient/family education, hydrating topical treatment, and avoidance of specific and non-specific provocative factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors is used for exacerbation management and more recently in selective cases for proactive therapy. Systemic immunosuppressive treatment is an option for severe refractory cases. Microbial colonisation and superinfection may induce disease exacerbation and justify additional antimicrobial treatment. Adjuvant therapy includes ultraviolet (UV) irradiation preferably with UVA1 or narrowband UVB. Dietary recommendations should be specific and given only when food allergy is confirmed. Allergen-specific immunotherapy against aeroallergens may be useful in selected cases. Parallel use of traditional and proprietary topical and herbal medicine has also been popular in China and many cities in Asia. Complementary and alternative medicine may have a place but evidence-based data are lacking.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, 6/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Theresa N H
authors.initials: TN
authors.lastname: Leung
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, 6/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: K L
authors.initials: KL
authors.lastname: Hon
mesh_terms: D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D003876:Dermatitis, Atopic / Q000628:therapy*; D004032:Diet; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D004485:Eczema / Q000628:therapy; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D063465:Skin Cream / Q000627:therapeutic use; D014467:Ultraviolet Therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D004365:Drugs, Chinese Herbal; D007155:Immunologic Factors
keywords: Child; Eczema