Managing pediatric atopic dermatitis

Although atopic dermatitis is a very common inflammatory skin condition in children and results in many pediatric healthcare visits, its exact cause i s unknown. No single laboratory test can reliably diagnose atopic dermatiti s, but a relatively simple set of diagnostic criteria was recently validate d for use by practicing physicians. Because existing remedies for atopic de rmatitis do not cure the disorder, a program of disease control and managem ent should be pursued. Patients and their caregivers should be advised that current therapies are primarily preventive and palliative. However, a comp rehensive plan that includes routine general skin care, medical management of symptoms, identification and avoidance of aggravating factors (including psychological factors), and attention to quality-of-life issues can reduce the occurrence of skin flares. Successful treatment of acute flare-ups can be achieved with appropriate use of topical corticosteroids, but occasiona lly children afflicted with severe atopic dermatitis require more intensive therapies (e.g., ultraviolet light exposure, systemic corticosteroids, and cyclosporine) that need close physician monitoring. Physicians must remain mindful of the psychological and quality-of-life burdens imposed on childr en with atopic dermatitis and their families and tailor treatments to the n eeds of each individual patient.