Abstract:
Atopic dermatitis is a chronic relapsing, inflammatory skin disorder associated with skin
barrier dysfunction, the prevalence of which has increased dramatically in developing
countries. In this article, we propose a treatment algorithm for patients with mild-tomoderate and severe atopic dermatitis flares in daily clinical practice. An international
panel of 15 dermatology and allergy experts from eight countries was formed to develop
a practical algorithm for the treatment of patients with atopic dermatitis, with a particular
focus on topical therapies. In cases of mild-to-moderate atopic dermatitis involving sensitive skin areas, the topical calcineurin inhibitor pimecrolimus should be applied twice
daily at the first signs of atopic dermatitis. For other body locations, patients should apply
a topical calcineurin inhibitor, either pimecrolimus or tacrolimus, twice daily at the first
signs of atopic dermatitis, such as pruritus, or twice weekly in previously affected skin
areas. Emollients should be used regularly. Patients experiencing acute atopic dermatitis flares in sensitive skin areas should apply a topical corticosteroid twice daily or alternate
once-daily topical corticosteroid/topical calcineurin inhibitor until symptoms improve.
Following improvement, topical corticosteroid therapy should be discontinued and patients switched to a topical calcineurin inhibitor. Maintenance therapy should include the
use of pimecrolimus once daily for sensitive areas and tacrolimus for other body locations. This treatment algorithm can help guide clinical decision-making in the treatment
of atopic dermatitis.
