Atopic dermatitis in children: An update for pediatricians

Abstract

Atopic dermatitis (AD), also known as atopic eczema, is a chronic, relapsing, inflammatory skin disorder commonly affecting children, and its hallmark is constant pruritus. The etiopathogenesis is complex, involving genetics and environmental triggers. There is skin barrier dysfunction along with an aberrant helper T-cell type 2 immune response. Diagnosis is primarily clinical, and a simplified version of the United Kingdom Working Party's diagnostic criteria can be helpful. The disease can be debilitating and significantly impairs the quality of life of the patients and family. The treatment has to be tailored to an individual patient, and the various components include education, identification and avoidance of triggers, skin barrier repair and maintenance, control of inflammation, management of secondary infection, and prevention of flares. The mainstay of treatment includes emollients to maintain the skin barrier, as well as topical anti-inflamamtory agents to control inflammation. However, in moderate-to-severe disease, systemic agents might be required. We hope to provide an overview of the pathogenesis, clinical features, and pharmacological and nonpharmacological treatment of AD, which will help a family physician or a pediatrician to manage children with AD preting to them.