ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis
Article first published online: 31 AUG 2009
© 2009 The Authors. Journal compilation © 2009 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 24, Issue 3, pages 317–328, March 2010
How to Cite
Darsow, U., Wollenberg, A., Simon, D., Taïeb, A., Werfel, T., Oranje, A., Gelmetti, C., Svensson, A., Deleuran, M., Calza, A.-M., Giusti, F., Lübbe, J., Seidenari, S., Ring, J. and for the European Task Force on Atopic Dermatitis/EADV Eczema Task Force (2010), ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis. Journal of the European Academy of Dermatology and Venereology, 24: 317–328. doi: 10.1111/j.1468-3083.2009.03415.x
Conflicts of interest Authors declare that they have no conflict of interest.
- Issue published online: 8 FEB 2010
- Article first published online: 31 AUG 2009
- Received: 21 July 2009; Accepted: 22 July 2009
- atopic dermatitis;
Background The diagnosis of atopic dermatitis (AD) is made using evaluated clinical criteria. Management of AD must consider the symptomatic variability of the disease.
Methods EADV eczema task force developed its guideline for atopic dermatitis diagnosis and treatment based on literature review and repeated consenting group discussions.
Results and Discussion Basic therapy relies on hydrating topical treatment and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin antagonists is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the topical calcineurin inhibitors, tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial/antiseptic treatment. Systemic antihistamines (H1) can relieve pruritus, but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. ‘Eczema school’ educational programmes have been proven to be helpful.