Page 47 - LECTURE NOTES

9 In severe cases, hospitalization for a short period may promote rapid reduction of

symptoms mainly by providing a changed environment

Specific

Specific measures are aimed at modifying the following pathogenetic factors: dryness,

inflammation, infection, and itching.

Topical Steroids

High potency steroids are used for a short period to rapidly reduce inflammation.

Hove ever they should not be used on the face.

Maintenance therapy, if needed is best done with mild steroids like hydrocortisone.

On face and intertriginous areas, mild steroids should be used; mid-potency
formulations are used for trunk and limbs.

Topical steroids are applied initially twice or thrice a day after the symptoms are
lessened, frequency of application should be reduced. Intermittent use if topical steroid

may be alternated with application of emollients. Ointments are superior to creams or
lotions.

Systemic steroids: a short course of systemic steroids (prednisolone, triamcinolone)
may occasionally be needed to suppress acute flare-ups

Emmolients – liquid paraffin, Vaseline, olive oil used after bath

Antihistamines - Non-sedating antihistamines like cetirizine, loratadine or fexofenadine
may be used to alleviate pruritus .

Infections and colonization with Staphylococcus aureus may aggravate or complicate
Atopic dermatitis Erythromycin, or cloxacillin is usually prescribed

Course and prognosis

Most infantile and childhood cases improve over time and the prevalence of atopic

dermatitis diminishes significantly in older ages. Children tend to outgrow the condition.

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