ATOPIC DERMATITIS

Definition: Characterized by intense pruritus accompanied by excoriations, erythematous papules, lichenified skin, plaques, serous exudates.

Treatment:

Class

Drug

Indication

When to give

Topical corticosteroids

Diprolene AF or Temovate 0.05% cream/ointment

Then Synalar 0.025% cream or Kenalog 0.1% lotion

HC 1-2.5% cream/ointment

Acute phase

 

maintenance

 

 

Acute & maintenance

Trunk and extremities ONLY, short course

 

 

 

Face and neck

Topical calcineurin inhibitors

Elidel or Protopic cream

Itching and inflammation

Sever cases relieves quickly- VERY costly

Systemic drugs

Prednisone boost and taper- start topical steroids as oral dose is being tapered

Antihistamines

Itching and inflammation

 

Need to be in higher dose than for allergic rhinitis

 

Short course only

 

 

Short course only

 

Non-pharmacologic treatment

Emollients, moisturizers, eliminating harsh soap or offending foods, humidify air

Maintenance

Ongoing

References: Geriatrics At Your Fingertips, 2004 Edition, p. 50-51.

The Medical Letter Treatment Guidelines: Drugs for Allergic Disorders, Vol. 1, #15, November 2003.

5/04

 

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