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Atopic Dermatitis


Treatment is mainly supportive to relieve itch, improve skin dryness, reduce inflammation and treat infection. It is also important to avoid identifiable allergens and harsh environmental conditions, such as excessive exposure to irritants or sharp changes in temperature. Many children improve naturally with time so any risk from treatments that might cause long term damage should be minimized. The main pharmacological approaches are to improve barrier function of skin with regular applications of emollients, reduce inflammation with topical steroids or calcineurin inhibitors and treat infection with systemic or topical antimicrobials. More severe atopic eczema might require ultraviolet phototherapy or short term systemic immunosuppressants. Education of patients and their carers is a very important part of management. Nurse-led clinics that offer practical demonstrations of topical therapies and provide a forum for discussion are usually very popular. Short admissions to hospital for concentrated skin care such as wet dressings can be very effective and may give the carers a much needed break from their responsibilities.