Abstract
A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.
Highlights
Is methotrexate more effective in rapidly controlling severity of symptoms of atopic dermatitis in children 8 years old compared to other non-steroid systemic therapies after failure of topical steroids and oral antihistamines?
Cyclosporine shows benefit as compared to methotrexate for treatment of pediatric atopic dermatitis refractory to topical medications when rapidity of clinical response is of key importance to the patient
By adding the additional term “systemic,” as our patient had failed the first-line treatment of topical corticosteroids, narrowband UV-B, and antihistamines, we reduced the number of applicable results to 56
Summary
Jacob Williams [pseudonym], an 8-year-old Caucasian male, presented with a chief complaint of atopic dermatitis refractory to several months of high-potency topical corticosteroids, narrowband UV-B light, and oral antihistamines. The patient’s father stated that the patient had been home-taught in the past calendar year due to his symptoms, but was very interested in returning to public school and his friends in the month. There were no significant socioeconomic factors preventing the pursual of additional treatment The father anticipated his son being prescribed low-dose methotrexate, due to prior conversations with healthcare professionals. He was against the use of systemic corticosteroids due to the potential for hypothalamic-pituitary axis suppression. He was wondering whether methotrexate would be better than a different systemic therapy to control his son’s symptoms and allow school attendance
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