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Topical Therapy of AD: How to Reach Better Results

  • Atopic Dermatitis (T Bieber, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review summarizes the current state-of-the-art in topical therapy of atopic dermatitis (atopic eczema), a clinically defined, highly variable, pruritic chronic skin disease characterized by age-dependent distribution patterns and lesion morphology.

Recent Findings

Current emollient treatment should be performed at least once daily, using about 250 g of emollient per week. Commonly used topical anti-inflammatory treatment is based on topical corticosteroids and the topical calcineurin inhibitors tacrolimus and pimecrolimus. Acute intervention for flares works best with topical corticosteroid creams, which may be applied in a wet-wrap technique. Proactive therapy is defined as long-term intermittent, anti-inflammatory therapy of the frequently relapsing problem zones. This new regimen works with mid-potent topical corticosteroid (TCS) and tacrolimus ointment, may prevent flares, improves the quality of life significantly, and is cost-effective. Topical phosphodiesterase 4 inhibitors may become a treatment alternative for mild to moderate forms.

Summary

All management should consider the above findings and individual course of disease, with special aim of flare prevention.

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Authors and Affiliations

  1. Department of Dermatology and Allergology, Ludwig Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany

    Alexandra Walter, Marlene Seegräber, Christoph Rothenberger, Jerome Srour & Andreas Wollenberg

  2. Städt. Klinikum Thalkirchner Strasse, Munich, Germany

    Christoph Rothenberger & Andreas Wollenberg

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  1. Alexandra Walter
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  2. Marlene Seegräber
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  3. Christoph Rothenberger
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  4. Jerome Srour
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  5. Andreas Wollenberg
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Corresponding author

Correspondence to Andreas Wollenberg.

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Conflict of Interest

A. Walter has received travel support from Novartis; M. Seegräber and C. Rothenberger have received travel support from L’Oreal; and J. Srour declares that he has no conflict of interest with relevance to this work. A. Wollenberg been an advisor for or received honoraria for lectures from Bioderma, Celgene, Galderma, Glaxo Smith Kline, Hans Karrer, LEO, MedImmune, Novartis, Pierre Fabre, Pfizer, Regeneron, and Sanofi.

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This article is part of the Topical Collection on Atopic Dermatitis

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Walter, A., Seegräber, M., Rothenberger, C. et al. Topical Therapy of AD: How to Reach Better Results. Curr Derm Rep 6, 137–143 (2017). https://doi.org/10.1007/s13671-017-0183-8

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  • DOI: https://doi.org/10.1007/s13671-017-0183-8

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