Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

  • A. Wollenberg
    Department Dermatology and Allergy Ludwig‐Maximilian University Munich Germany
  • S. Barbarot
    Department of Dermatology Centre Hospitalier Universitaire CHU Nantes Nantes France
  • T. Bieber
    Department of Dermatology and Allergy Christine Kühne‐Center for Allergy Research and Education University Bonn Bonn Germany
  • S. Christen‐Zaech
    Pediatric Dermatology Unit Departments of Dermatology and Pediatrics Centre Hospitalier Universitaire Vaudois Lausanne Switzerland
  • M. Deleuran
    Department Dermatology Aarhus University Hospital Aarhus Denmark
  • A. Fink‐Wagner
    European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) Global Allergy and Asthma Patient Platform (GAAPP) Konstanz Germany
  • U. Gieler
    Department of Dermatology University of Gießen and Marburg GmbH Gießen Germany
  • G. Girolomoni
    Department of Medicine Section of Dermatology University of Verona Verona Italy
  • S. Lau
    Pediatric Pneumology and Immunology Universitätsmedizin Berlin Berlin Germany
  • A. Muraro
    Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera Università di Padova Padova Italy
  • M. Czarnecka‐Operacz
    Department of Dermatology Medical University Poznan Poland
  • T. Schäfer
    Dermatological Practice Immenstadt Germany
  • P. Schmid‐Grendelmeier
    Allergy Unit Department of Dermatology University of Zurich Zurich Switzerland
  • D. Simon
    Department Dermatology, Inselspital Bern University Hospital University of Bern Bern Switzerland
  • Z. Szalai
    Department of Dermatology Heim Pál Children's Hospital Budapest Hungary
  • J.C. Szepietowski
    Department of Dermatology, Venereology and Allergology Wroclaw Medical University Wroclaw Poland
  • A. Taïeb
    Department of Dermatology and Pediatric Dermatology Hôpital St André Bordeaux France
  • A. Torrelo
    Department of Dermatology Hospital Niño Jesus Madrid Spain
  • T. Werfel
    Department Dermatology and Allergy Hannover Medical School Hannover Germany
  • J. Ring
    Christine Kühne Center for Allergy Research and Education CK‐CARE Davos Switzerland

説明

<jats:title>Abstract</jats:title><jats:p>This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus‐based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This first part of the guideline covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti‐inflammatory therapy, phototherapy and antipruritic therapy, whereas the second part covers antimicrobial therapy, systemic treatment, allergen‐specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions. Management of <jats:styled-content style="fixed-case">AE</jats:styled-content> must consider the individual clinical variability of the disease; highly standardized treatment rules are not recommended. Basic therapy is focused on treatment of disturbed barrier function by hydrating and lubricating topical treatment, besides further avoidance of specific and unspecific provocation factors. Topical anti‐inflammatory treatment based on glucocorticosteroids and calcineurin inhibitors is used for flare management and for proactive therapy for long‐term control. Topical corticosteroids remain the mainstay of therapy, whereas tacrolimus and pimecrolimus are preferred in sensitive skin areas and for long‐term use. Topical phosphodiesterase inhibitors may be a treatment alternative when available. Adjuvant therapy includes <jats:styled-content style="fixed-case">UV</jats:styled-content> irradiation, preferably with <jats:styled-content style="fixed-case">UVB</jats:styled-content> 311 nm or <jats:styled-content style="fixed-case">UVA</jats:styled-content>1. Pruritus is targeted with the majority of the recommended therapies, but some patients may need additional antipruritic therapy. Antimicrobial therapy, systemic anti‐inflammatory treatment, immunotherapy, complementary medicine and educational intervention will be addressed in part <jats:styled-content style="fixed-case">II</jats:styled-content> of the guideline.</jats:p>

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