Dermatológia pre prax 1/2015

Atopic dermatitis – what´s new?

Atopic dermatitis (AD) is a common chronic, itchy, inflammatory multifactorial disease that can occur at any age. The clinical manifestations of AD vary considerably and change with the age of the patient (atopic march). Infant, child, adolescent, and adult phases are distinguished. In the infant phase, AD affects the scalp, face, and extensor surface of the limbs. If it presents with erythroderma, differential diagnosis must be performed in order to rule out metabolic disorders and immunodeficiency. Early occurrence of AD predisposes to the development of extrinsic AD. Current research into the genetic, immunological, and epidemiological properties of AD is a source of new knowledge that will gradually be applied in treating and preventing the disease. Psychosomatic approach to the patient and education of parents are part of the treatment that should result in managing AD and improving the quality of life of the patient as well as that of the family. The treatment algorithm for mild and moderate AD recommends topical corticosteroids in the short term followed by a switch to treatment with topical calcineurin inhibitors. Tacrolimus and pimecrolimus do not cause skin atrophy and are recommended for treating the manifestations of atopic dermatitis in areas with sensitive skin. Controlled studies in adults and children confirm that early treatment with topical calcineurin inhibitors can slow down the progression of the disease, prolong the interval between exacerbations of atopic dermatitis, suppress pruritus rapidly, and markedly improve the quality of life in both patients with active disease and those on maintenance therapy.

Keywords: atopic dermatitis, difference in children and adults, atopic march, topical calcineurin inhibitors in treatment algorithm for mild and moderate AD.