24. Atopic Eczema

  1. Hywel C. Williams DSc, FRCP2,
  2. Michael Bigby MD3,
  3. Andrew Herxheimer MB, FRCP4,
  4. Luigi Naldi MD5,
  5. Berthold Rzany MD, ScM6,
  6. Robert P. Dellavalle MD, PhD, MSPH7,
  7. Yuping Ran8 and
  8. Masutaka Furue9
  1. Kim Thomas,
  2. Carolyn Charman,
  3. Helen Nankervis,
  4. Jane Ravenscroft and
  5. Hywel C. Williams

Published Online: 6 JUN 2014

DOI: 10.1002/9781118357606.ch24

Evidence-Based Dermatology, 3

Evidence-Based Dermatology, 3

How to Cite

Thomas, K., Charman, C., Nankervis, H., Ravenscroft, J. and Williams, H. C. (2014) Atopic Eczema, in Evidence-Based Dermatology, 3 (eds H. C. Williams, M. Bigby, A. Herxheimer, L. Naldi, B. Rzany, R. P. Dellavalle, Y. Ran and M. Furue), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118357606.ch24

Editor Information

  1. 2

    Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK

  2. 3

    Department of Dermatology, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, MA, USA

  3. 4

    UK Cochrane Centre, Oxford, UK

  4. 5

    Centro Studi Gruppo Italiano Studi Epidemiologici in Dermatologia, Department of Dermatology, Ospedali Riuniti, Bergamo, Italy

  5. 6

    RZANY & HUND, Privatpraxis für Dermatologie und Ästhetische Medizin, Berlin, Germany

  6. 7

    Department of Dermatology, University of Colorado Denver, Aurora, USA

  7. 8

    Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu, P. R. China

  8. 9

    Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan

Author Information

  1. Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, UK

Publication History

  1. Published Online: 6 JUN 2014
  2. Published Print: 1 AUG 2014

ISBN Information

Print ISBN: 9781118357675

Online ISBN: 9781118357606



  • atopic eczema;
  • dermatology;
  • house dust mite;
  • placebo;
  • probiotics;
  • topical tacrolimus


This chapter discusses the evidence base for treating atopic eczema (atopic dermatitis) by means of three common clinical scenarios: a child with moderately severe atopic eczema, a person with clinically infected atopic eczema and an adult with severe atopic eczema. Allergic factors such as exposure to house dust mite may be important, but nonallergic factors such as exposure to irritants, bacteria, and hard water may be equally important. Topical tacrolimus has been licensed in the USA and UK for the treatment of people with moderate to severe atopic eczema that is not adequately responsive, or who are intolerant of conventional therapies. The chapter also deals with probiotics used to help reduce symptoms of atopic eczema. The trials of lactobacilli strains of probiotics mostly do not show any significant benefits compared with placebo or in addition to standard treatments.