Atopic Dermatitis Knowledge Centre
Treatment
Treatment Adjuncts
In addition to treating the primary symptoms of atopic dermatitis, treatment strategies for patients can also include adjuncts, such as antihistamines. The efficacy of histamine in reducing pruritis in atopic dermatitis is thought to be minimal and it is generally accepted that antihistamine drugs provide benefit due to sedative, and not anti-pruritic, effects. As atopic dermatitis is also frequently associated with skin infections; successful treatment regimens also include antibiotics, either oral or topical, to help reduce the additional burden caused by excessive bacterial colonisation of the skin (usually Staphylococcus). These treatment adjuncts can help provide symptomatic relief for atopic dermatitis patients, but do not treat the condition per se.3,8
For the most severe cases of atopic dermatitis that are recalcitrant to standard therapy, systemic corticosteroids and other oral immunosuppressants can be administered. The systemic administration of purine synthesis inhibitors, such as ciclosporin, and drugs that inhibit the enzyme dihydrofolate reductase, such as methotrexate, are also indicated for the treatment of severe atopic dermatitis. Systemically acting treatments may be administered when patients do not respond to the topical treatments described above. It should be noted however that the use of systemic drugs should be considered as treatments of last resort. The decision to use any of these oral treatments should not be taken lightly as they are all associated with significant adverse reactions. Table 4 lists the most commonly utilised oral therapies for treating severe atopic dermatitis and highlights the side-effects associated with each one.
| Drug | Possible adverse effects | |
|---|---|---|
| Oral steroid therapies |
|
|
| Oral ciclosporin |
|
|
| Oral methotrexate |
|
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References:
3. Eichenfield LF. Consensus guidelines in diagnosis and treatment of atopic dermatitis. Allergy 2004; 59 Suppl 78: 86–92.
8. Correale CE, Walker C, Murphy L, et al. Atopic dermatitis: a review of diagnosis and treatment. Am Fam Physician 1999; 60: 1191–8, 1209–10.
© February 2010 Astellas Pharma Europe LTD.
Disclaimer:
The Atopic Dermatitis Knowledge centre contained within www.epgonline.org and available at www.atopicdermatitisinfo.org is intended to be for educational use only and not designed to provide medical advice or professional services.