Skip to main content

Advertisement

SpringerLink
Log in

Atopic Dermatitis: Early Treatment in Children

  • Pediatric Allergy (F Baroody, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Opinion Statement

Therapeutic regimens for the treatment and long-term management of Atopic Dermatitis (AD) have a twofold objective of decreasing skin inflammation and repairing the defective skin barrier. Essential treatments for AD in children should include topical moisturizers for skin hydration and prevention of flares, topical anti-inflammatory medications (e.g., corticosteroids, calcineurin inhibitors, PDE4 inhibitor), allergen/irritant avoidance, and treatment of skin infections. Treatment regimens should be severity-based and implemented in a stepwise approach tailored to the individual patient. This stepwise approach includes initial use of emollients, gentle skin care, and escalating to more potent anti-inflammatory treatments as the disease severity increases. Currently available systemic medications should be reserved for the presence of recalcitrance to topical therapies due to associated toxicities.

We believe that early treatment of AD is not only essential in treating the skin disease but also in preventing the development of additional atopic diseases, such as food allergy, asthma, and allergic rhinitis. The defective skin barrier of AD permits a route of entry for food and environmental allergens, and upon exposure, keratinocytes secrete thymic stromal lymphopoietin, which activates Type 2 immune responses. This Type 2 immune response initiates the atopic march and the subsequent diseases that are seen. This review highlights treatment options and strategies in pediatric AD therapy with an emphasis on early therapy. Supporting evidence on the efficacy and safety of each intervention will be discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Baron SE, et al. Guidance on the diagnosis and clinical management of atopic eczema. Clin Exp Dermatol. 2012;37(Suppl 1):7–12.

    Article  PubMed  Google Scholar 

  2. Horii KA, et al. Atopic dermatitis in children in the United States, 1997–2004: visit trends, patient and provider characteristics, and prescribing patterns. Pediatrics. 2007;120(3):e527–34.

    Article  PubMed  Google Scholar 

  3. Kay J, et al. The prevalence of childhood atopic eczema in a general population. J Am Acad Dermatol. 1994;30(1):35–9.

    Article  CAS  PubMed  Google Scholar 

  4. Lee SC. Committee of Korean Atopic Dermatitis Association for R. Various diagnostic criteria for atopic dermatitis (AD): a proposal of reliable estimation of atopic dermatitis in childhood (REACH) criteria, a novel questionnaire-based diagnostic tool for AD. J Dermatol. 2016;43(4):376–84.

    Article  PubMed  Google Scholar 

  5. •• Leung DY, Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol. 2014;134(4):769–79. This paper is an educational discussion on the complex pathogenesis of atopic dermatitis, covering the immunological, microbiological, genetic, and environmental etiologies of the disease.

    Article  PubMed  PubMed Central  Google Scholar 

  6. •• Tsakok T, et al. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol. 2016;137(4):1071–8. This systematic review provides evidence of the causal relationship of atopic dermatitis and food allergies/sensitization in the atopic march.

    Article  PubMed  Google Scholar 

  7. Czarnowicki T, et al. Severe atopic dermatitis is characterized by selective expansion of circulating Type 2 immune response/TC2 and TH22/TC22, but not TH17/TC17, cells within the skin-homing T-cell population. J Allergy Clin Immunol. 2015;136(1):104–15.e7. This scientific study demonstrates the immunologic etiology of atopic dermatitis, in relation to aberrant T-cell response.

  8. van Drongelen V, et al. Reduced filaggrin expression is accompanied by increased Staphylococcus aureus colonization of epidermal skin models. Clin Exp Allergy. 2014;44(12):1515–24.

    Article  PubMed  Google Scholar 

  9. Warner JA, et al. Biomarkers of Type 2 immune response polarity are predictive of staphylococcal colonization in subjects with atopic dermatitis. Br J Dermatol. 2009;160(1):183–5.

  10. Saunes M, et al. Early eczema and the risk of childhood asthma: a prospective, population-based study. BMC Pediatr. 2012;12:168.

    Article  PubMed  PubMed Central  Google Scholar 

  11. von Kobyletzki LB, et al. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort. BMC Dermatol. 2012;12:11.

    Article  Google Scholar 

  12. • Bantz SK, et al. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol. 2014;5(2):202. This comprehensive review provides further insight into the pathogenesis of the atopic march.

    PubMed  PubMed Central  Google Scholar 

  13. Akei HS, et al. Epicutaneous aeroallergen exposure induces systemic Type 2 immune response immunity that predisposes to allergic nasal responses. J Allergy Clin Immunol. 2006;118(1):62–9.

  14. Filipiak-Pittroff B, et al. Predictive value of food sensitization and filaggrin mutations in children with eczema. J Allergy Clin Immunol. 2011;128(6):1235–41.e5.

    Article  CAS  PubMed  Google Scholar 

  15. Rhodes HL, et al. Early life risk factors for adult asthma: a birth cohort study of subjects at risk. J Allergy Clin Immunol. 2001;108(5):720–5.

    Article  CAS  PubMed  Google Scholar 

  16. Gustafsson D, et al. Development of allergies and asthma in infants and young children with atopic dermatitis—a prospective follow-up to 7 years of age. Allergy. 2000;55(3):240–5.

    Article  CAS  PubMed  Google Scholar 

  17. Forbes LR, et al. Food allergies and atopic dermatitis: differentiating myth from reality. Pediatr Ann. 2009;38(2):84–90.

    Article  PubMed  Google Scholar 

  18. Kelleher MM, et al. Skin barrier impairment at birth predicts food allergy at 2 years of age. J Allergy Clin Immunol. 2016;137(4):1111-6.e1–8.

    Article  Google Scholar 

  19. Strid J, et al. Epicutaneous exposure to peanut protein prevents oral tolerance and enhances allergic sensitization. Clin Exp Allergy. 2005;35(6):757–66.

    Article  CAS  PubMed  Google Scholar 

  20. Strid J, et al. A novel model of sensitization and oral tolerance to peanut protein. Immunology. 2004;113(3):293–303.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Greer FR, et al. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183–91.

    Article  PubMed  Google Scholar 

  22. Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Evid Based Child Health. 2014;9(2):447–83.

    Article  PubMed  Google Scholar 

  23. Yang YW, et al. Exclusive breastfeeding and incident atopic dermatitis in childhood: a systematic review and meta-analysis of prospective cohort studies. Br J Dermatol. 2009;161(2):373–83.

    Article  CAS  PubMed  Google Scholar 

  24. Osborn DA, Sinn J. Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants. Cochrane Database Syst Rev. 2006;4:CD003664.

    Google Scholar 

  25. Alexander DD, Cabana MD. Partially hydrolyzed 100% whey protein infant formula and reduced risk of atopic dermatitis: a meta-analysis. J Pediatr Gastroenterol Nutr. 2010;50(4):422–30.

    CAS  PubMed  Google Scholar 

  26. Pelucchi C, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology. 2012;23(3):402–14.

    Article  PubMed  Google Scholar 

  27. Kuitunen M, et al. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009;123(2):335–41.

    Article  PubMed  Google Scholar 

  28. Rosenfeldt V, et al. Effect of probiotic lactobacillus strains in children with atopic dermatitis. J Allergy Clin Immunol. 2003;111(2):389–95.

    Article  PubMed  Google Scholar 

  29. •• Du Toit G, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372(9):803–13. The LEAP Study is an important clinical trial that showed that early, regular introduction of peanut in infants may decrease the frequency of peanut allergy in at-risk infants.

    Article  PubMed  PubMed Central  Google Scholar 

  30. •• Eichenfield LF, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116–32. This is a comprehensive set of guidelines from the American Academy of Dermatology on the topical treatments of atopic dermatitis.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Dominguez-Huttinger E, et al. Mathematical modeling of atopic dermatitis reveals “double-switch” mechanisms underlying 4 common disease phenotypes. J Allergy Clin Immunol. 2016.

  32. • Simpson EL, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol. 2014;134(4):818–23. This study showed that early and consistent use of emollients in neonates at increased risk of atopic dermatitis effectively prevents the appearance of atopic dermatitis. Emollient therapy is essential to treating and preventing atopic dermatitis in at-risk children.

    Article  PubMed  PubMed Central  Google Scholar 

  33. • Horimukai K, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol. 2014;134(4):824–30.e6. This is another study demonstrating the efficacy of emollient therapy in preventing atopic dermatitis in children.

    Article  PubMed  Google Scholar 

  34. Grimalt R, et al. The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology. 2007;214(1):61–7.

    Article  CAS  PubMed  Google Scholar 

  35. Korting HC, et al. Efficacy and tolerability of pale sulfonated shale oil cream 4% in the treatment of mild to moderate atopic eczema in children: a multicentre, randomized vehicle-controlled trial. J Eur Acad Dermatol Venereol. 2010;24(10):1176–82.

    Article  CAS  PubMed  Google Scholar 

  36. Czarnowicki T, et al. Petrolatum: barrier repair and antimicrobial responses underlying this “inert” moisturizer. J Allergy Clin Immunol. 2016;137(4):1091-102.e1–7.

    Article  Google Scholar 

  37. Akerstrom U, et al. Comparison of moisturizing creams for the prevention of atopic dermatitis relapse: a randomized double-blind controlled multicentre clinical trial. Acta Derm Venereol. 2015;95(5):587–92.

    Article  PubMed  Google Scholar 

  38. Breternitz M, et al. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol. 2008;21(1):39–45.

    Article  CAS  PubMed  Google Scholar 

  39. Tan WP, et al. A randomized double-blind controlled trial to compare a triclosan-containing emollient with vehicle for the treatment of atopic dermatitis. Clin Exp Dermatol. 2010;35(4):e109–12.

    Article  CAS  PubMed  Google Scholar 

  40. Msika P, et al. New emollient with topical corticosteroid-sparing effect in treatment of childhood atopic dermatitis: SCORAD and quality of life improvement. Pediatr Dermatol. 2008;25(6):606–12.

    Article  PubMed  Google Scholar 

  41. Folster-Holst R. Management of atopic dermatitis: are there differences between children and adults? J Eur Acad Dermatol Venereol. 2014;28(Suppl 3):5–8.

    Article  PubMed  Google Scholar 

  42. Sugarman JL, Parish LC. Efficacy of a lipid-based barrier repair formulation in moderate-to-severe pediatric atopic dermatitis. J Drugs Dermatol. 2009;8(12):1106–11.

    PubMed  Google Scholar 

  43. Chamlin SL, et al. Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity. J Am Acad Dermatol. 2002;47(2):198–208.

    Article  PubMed  Google Scholar 

  44. Kircik LH, Del Rosso JQ. Nonsteroidal treatment of atopic dermatitis in pediatric patients with a ceramide-dominant topical emulsion formulated with an optimized ratio of physiological lipids. J Clin Aesthet Dermatol. 2011;4(12):25–31.

    PubMed  PubMed Central  Google Scholar 

  45. Marseglia A, et al. Local rhamnosoft, ceramides and L-isoleucine in atopic eczema: a randomized, placebo controlled trial. Pediatr Allergy Immunol. 2014;25(3):271–5.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Hon KL, et al. Acceptability and efficacy of an emollient containing ceramide-precursor lipids and moisturizing factors for atopic dermatitis in pediatric patients. Drugs R D. 2013;13(1):37–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Miller DW, et al. An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial. J Drugs Dermatol. 2011;10(5):531–7.

    PubMed  Google Scholar 

  48. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol. 2009;26(3):273–8.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Gutman AB, et al. Soak and smear: a standard technique revisited. Arch Dermatol. 2005;141(12):1556–9.

    Article  PubMed  Google Scholar 

  50. Wong SM, et al. Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia. J Dermatol. 2013;40(11):874–80.

    Article  CAS  PubMed  Google Scholar 

  51. Huang JT, et al. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009;123(5):e808–14.

    Article  PubMed  Google Scholar 

  52. Huang JT, et al. Dilute bleach baths for Staphylococcus aureus colonization in atopic dermatitis to decrease disease severity. Arch Dermatol. 2011;147(2):246–7.

    Article  PubMed  Google Scholar 

  53. Ong PY, Leung DY. The infectious aspects of atopic dermatitis. Immunol Allergy Clin N Am. 2010;30(3):309–21.

    Article  Google Scholar 

  54. Hon KL, et al. Efficacy of sodium hypochlorite (bleach) baths to reduce Staphylococcus aureus colonization in childhood onset moderate-to-severe eczema: a randomized, placebo-controlled cross-over trial. J Dermatolog Treat. 2016;27(2):156–62.

    Article  CAS  PubMed  Google Scholar 

  55. Nicol NH, et al. Wet wrap therapy in children with moderate to severe atopic dermatitis in a multidisciplinary treatment program. J Allergy Clin Immunol Pract. 2014;2(4):400–6.

    Article  PubMed  Google Scholar 

  56. Janmohamed SR, et al. The proactive wet-wrap method with diluted corticosteroids versus emollients in children with atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2014;70(6):1076–82.

    Article  CAS  PubMed  Google Scholar 

  57. Gonzalez-Lopez G, et al. Efficacy and safety of wet wrap therapy for patients with atopic dermatitis: a systematic review and meta-analysis. Br J Dermatol. 2016.

  58. Torrelo A. Methylprednisolone aceponate for atopic dermatitis. Int J Dermatol. 2017.

  59. Eichenfield LF, et al. Translating atopic dermatitis management guidelines into practice for primary care providers. Pediatrics. 2015;136(3):554–65.

    Article  PubMed  Google Scholar 

  60. Siegfried EC, et al. Systematic review of published trials: long-term safety of topical corticosteroids and topical calcineurin inhibitors in pediatric patients with atopic dermatitis. BMC Pediatr. 2016;16:75.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Ellison JA, et al. Hypothalamic-pituitary-adrenal function and glucocorticoid sensitivity in atopic dermatitis. Pediatrics. 2000;105(4 Pt 1):794–9.

    Article  CAS  PubMed  Google Scholar 

  62. McGowan R, et al. Short-term growth and bone turnover in children undergoing occlusive steroid (‘Wet-Wrap’) dressings for treatment of atopic eczema. J Dermatolog Treat. 2003;14(3):149–52.

    Article  CAS  PubMed  Google Scholar 

  63. Kristmundsdottir F, David TJ. Growth impairment in children with atopic eczema. J R Soc Med. 1987;80(1):9–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Aalto-Korte K, Turpeinen M. Bone mineral density in patients with atopic dermatitis. Br J Dermatol. 1997;136(2):172–5.

    Article  CAS  PubMed  Google Scholar 

  65. Schmitt J, et al. Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials. Br J Dermatol. 2011;164(2):415–28.

    Article  CAS  PubMed  Google Scholar 

  66. Callen J, et al. A systematic review of the safety of topical therapies for atopic dermatitis. Br J Dermatol. 2007;156(2):203–21.

    Article  CAS  PubMed  Google Scholar 

  67. Hong E, et al. Evaluation of the atrophogenic potential of topical corticosteroids in pediatric dermatology patients. Pediatr Dermatol. 2011;28(4):393–6.

    Article  CAS  PubMed  Google Scholar 

  68. Charman CR, et al. Topical corticosteroid phobia in patients with atopic eczema. Br J Dermatol. 2000;142(5):931–6.

    Article  CAS  PubMed  Google Scholar 

  69. Cork MJ, et al. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol. 2003;149(3):582–9.

    Article  CAS  PubMed  Google Scholar 

  70. Gutfreund K, et al. Topical calcineurin inhibitors in dermatology. Part I: properties, method and effectiveness of drug use. Postepy Dermatol Alergol. 2013;30(3):165–9.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Papp KA, et al. Long-term control of atopic dermatitis with pimecrolimus cream 1% in infants and young children: a two-year study. J Am Acad Dermatol. 2005;52(2):240–6.

    Article  PubMed  Google Scholar 

  72. Chapman MS, et al. Tacrolimus ointment 0.03% shows efficacy and safety in pediatric and adult patients with mild to moderate atopic dermatitis. J Am Acad Dermatol. 2005;53(2 Suppl 2):S177–85.

    Article  PubMed  Google Scholar 

  73. Siegfried EC, et al. Topical calcineurin inhibitors and lymphoma risk: evidence update with implications for daily practice. Am J Clin Dermatol. 2013;14(3):163–78.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Boguniewicz M, et al. A randomized, vehicle-controlled trial of tacrolimus ointment for treatment of atopic dermatitis in children. Pediatric Tacrolimus Study Group. J Allergy Clin Immunol. 1998;102(4 Pt 1):637–44.

    Article  CAS  PubMed  Google Scholar 

  75. Eichenfield LF, et al. Safety and efficacy of pimecrolimus (ASM 981) cream 1% in the treatment of mild and moderate atopic dermatitis in children and adolescents. J Am Acad Dermatol. 2002;46(4):495–504.

    Article  PubMed  Google Scholar 

  76. Ho VC, et al. Safety and efficacy of nonsteroid pimecrolimus cream 1% in the treatment of atopic dermatitis in infants. J Pediatr. 2003;142(2):155–62.

    Article  CAS  PubMed  Google Scholar 

  77. Kang S, et al. Long-term safety and efficacy of tacrolimus ointment for the treatment of atopic dermatitis in children. J Am Acad Dermatol. 2001;44(1 Suppl):S58–64.

    Article  CAS  PubMed  Google Scholar 

  78. Paller A, et al. A 12-week study of tacrolimus ointment for the treatment of atopic dermatitis in pediatric patients. J Am Acad Dermatol. 2001;44(1 Suppl):S47–57.

    Article  CAS  PubMed  Google Scholar 

  79. Schachner LA, et al. Tacrolimus ointment 0.03% is safe and effective for the treatment of mild to moderate atopic dermatitis in pediatric patients: results from a randomized, double-blind, vehicle-controlled study. Pediatrics. 2005;116(3):e334–42.

    Article  PubMed  Google Scholar 

  80. Ashcroft DM, et al. Efficacy and tolerability of topical pimecrolimus and tacrolimus in the treatment of atopic dermatitis: meta-analysis of randomised controlled trials. BMJ. 2005;330(7490):516.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Broeders JA, et al. Systematic review and meta-analysis of randomized clinical trials (RCTs) comparing topical calcineurin inhibitors with topical corticosteroids for atopic dermatitis: a 15-year experience. J Am Acad Dermatol. 2016;75(2):410–9.e3.

    Article  CAS  PubMed  Google Scholar 

  82. Hebert AA, et al. Desoximetasone 0.25% and tacrolimus 0.1% ointments versus tacrolimus alone in the treatment of atopic dermatitis. Cutis. 2006;78(5):357–63.

    PubMed  Google Scholar 

  83. Paller AS, et al. Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. J Am Acad Dermatol. 2016;75(3):494–503.e4.

    Article  CAS  PubMed  Google Scholar 

  84. Harper JI, et al. Cyclosporin for severe childhood atopic dermatitis: short course versus continuous therapy. Br J Dermatol. 2000;142(1):52–8.

    Article  CAS  PubMed  Google Scholar 

  85. Pedreira CC, et al. Oral cyclosporin plus topical corticosteroid therapy diminishes bone mass in children with eczema. Pediatr Dermatol. 2007;24(6):613–20.

    Article  PubMed  Google Scholar 

  86. •• Sidbury R, et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327–49. This is a comprehensive set of guidelines from the American Academy of Dermatology on the systemic treatments of atopic dermatitis.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Murphy LA, Atherton D. A retrospective evaluation of azathioprine in severe childhood atopic eczema, using thiopurine methyltransferase levels to exclude patients at high risk of myelosuppression. Br J Dermatol. 2002;147(2):308–15.

    Article  CAS  PubMed  Google Scholar 

  88. El-Khalawany MA, et al. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. Eur J Pediatr. 2013;172(3):351–6.

    Article  CAS  PubMed  Google Scholar 

  89. Heller M, et al. Mycophenolate mofetil for severe childhood atopic dermatitis: experience in 14 patients. Br J Dermatol. 2007;157(1):127–32.

    Article  CAS  PubMed  Google Scholar 

  90. Daley-Yates PT, Richards DH. Relationship between systemic corticosteroid exposure and growth velocity: development and validation of a pharmacokinetic/pharmacodynamic model. Clin Ther. 2004;26(11):1905–19.

    Article  CAS  PubMed  Google Scholar 

  91. Schmitt J, et al. Prednisolone vs. ciclosporin for severe adult eczema. An investigator-initiated double-blind placebo-controlled multicentre trial. Br J Dermatol. 2010;162(3):661–8.

    Article  CAS  PubMed  Google Scholar 

  92. Morison WL, et al. Oral psoralen photochemotherapy of atopic eczema. Br J Dermatol. 1978;98(1):25–30.

    Article  CAS  PubMed  Google Scholar 

  93. Tay YK, et al. Experience with UVB phototherapy in children. Pediatr Dermatol. 1996;13(5):406–9.

    Article  CAS  PubMed  Google Scholar 

  94. Clayton TH, et al. The treatment of severe atopic dermatitis in childhood with narrowband ultraviolet B phototherapy. Clin Exp Dermatol. 2007;32(1):28–33.

    CAS  PubMed  Google Scholar 

  95. Jury CS, et al. Narrowband ultraviolet B (UVB) phototherapy in children. Clin Exp Dermatol. 2006;31(2):196–9.

    Article  CAS  PubMed  Google Scholar 

  96. Hearn RM, et al. Incidence of skin cancers in 3867 patients treated with narrow-band ultraviolet B phototherapy. Br J Dermatol. 2008;159(4):931–5.

    Article  CAS  PubMed  Google Scholar 

  97. Levy BD. Lipoxins and lipoxin analogs in asthma. Prostaglandins Leukot Essent Fatty Acids. 2005;73(3–4):231–7.

    Article  CAS  PubMed  Google Scholar 

  98. Wu SH, et al. Efficacy and safety of 15(R/S)-methyl-lipoxin a(4) in topical treatment of infantile eczema. Br J Dermatol. 2013;168(1):172–8.

    Article  CAS  PubMed  Google Scholar 

  99. Lacombe Barrios J, et al. Anti-IgE therapy and severe atopic dermatitis: a pediatric perspective. J Am Acad Dermatol. 2013;69(5):832–4.

    Article  PubMed  Google Scholar 

  100. Wang HH, et al. Efficacy of omalizumab in patients with atopic dermatitis: a systematic review and meta-analysis. J Allergy Clin Immunol. 2016;138(6):1719–22.e1.

    Article  CAS  PubMed  Google Scholar 

  101. Hanifin JM, et al. Recombinant interferon gamma therapy for atopic dermatitis. J Am Acad Dermatol. 1993;28(2 Pt 1):189–97.

    Article  CAS  PubMed  Google Scholar 

  102. • Brar K, Leung DY. Recent considerations in the use of recombinant interferon gamma for biological therapy of atopic dermatitis. Expert Opin Biol Ther. 2016;16(4):507–14. Recombinant interferon gamma is a therapeutic agent that has shown efficacy in treatment of atopic dermatitis patients.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Simpson EL, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335–48.

    Article  CAS  PubMed  Google Scholar 

  104. Brunner PM, et al. The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies. J Allergy Clin Immunol. 2017;139(4S):S65–76.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Amy Huang MD

  2. Department of Pediatrics, National Jewish Health, Denver, CO, USA

    Christine Cho MD, Donald Y. M. Leung MD, PhD & Kanwaljit Brar MD

Authors
  1. Amy Huang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christine Cho MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Donald Y. M. Leung MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kanwaljit Brar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kanwaljit Brar MD.

Ethics declarations

Conflict of interest

A.H., C.C., K.B., and D.Y.M.L. declare that they have no conflict of interest.

D.Y.M.L. is supported by the National Institutes of Health under grant number R01AR41256. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the topical collection on Pediatric Allergy

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, A., Cho, C., Leung, D.Y.M. et al. Atopic Dermatitis: Early Treatment in Children. Curr Treat Options Allergy 4, 355–369 (2017). https://doi.org/10.1007/s40521-017-0140-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40521-017-0140-6

Keywords

Search

Navigation