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Basic Skin Care and Topical Therapies for Atopic Dermatitis: Beyond Essential Approaches

Sala- Cunill A1*, Lazaro M2*, Herráez L3, Quiñones MD4, Moro-Moro M5, Sanchez I6

*Both authors contributed equally to the manuscript
On behalf of the Skin Allergy Committee of Spanish Society of Allergy and Clinical Immunology (SEAIC)
1Allergy Section. Internal Medicine Department. Hospital Universitario Vall d'Hebron. Barcelona. Spain
2Allergy Department. Hospital Universitario de Salamanca. Alergoasma, Salamanca. Spain
3Allergy Department. Hospital Universitario 12 de Octubre. Madrid. Spain
4Allergy Section. Hospital Monte Naranco. Oviedo. Spain
5Allergy Department. Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
6Clínica Dermatología y Alergia. Badajoz. Spain

J Investig Allergol Clin Immunol 2018; Vol. 28(6)
doi: 10.18176/jiaci.0293

Atopic dermatitis (AD) is a recurrent and chronic skin disease characterised by dysfunction in the epithelial barrier, skin inflammation and immune dysregulation with changes in the skin microbiota and colonisation of Staphylococcus aureus being common. For this reason, the therapeutic approach to AD is complex and should be directed at restoring skin barrier function, reducing dehydration, maintaining acidic pH and avoiding superinfection and exposure to possible allergens. No curative treatment for AD currently exists. However, a series of measures are recommended to alleviate the disease and enable patients to improve their quality of life, including adequate skin hydration and restoration of the skin barrier with the use of emollients, antibacterial measures, specific approaches reducing pruritus and scratching, wet wrap applications, avoidance of typical AD triggers and topical anti-inflammatory drugs. Anti-inflammatory treatment will be, generally, recommended during the acute flares or more recently, for preventive management. Nevertheless, the selection of the pharmacologic agent, its potency, duration and the frequency of application must be in accordance with the severity of the disease, the distribution or the type of lesion. The purpose of this review is emphasising the importance of basic skin care as well as describing the current and novel topical therapies for atopic dermatitis.

Key words: Eczema, Topical treatment, Atopic dermatitis, Pruritus, emollients.