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

Sala-Cunill A1*, Lazaro M2*, Herráez L3, Quiñones MD4, Moro-Moro M5, Sanchez I6, 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
*Both authors contributed equally to the manuscript

J Investig Allergol Clin Immunol 2018; Vol 28(6) : 379-391
doi: 10.18176/jiaci.0293

Atopic dermatitis (AD) is a recurrent and chronic skin disease characterized by dysfunction of the epithelial barrier, skin inflammation, and immune dysregulation, with changes in the skin microbiota and colonization by 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. There is no curative treatment for AD. However, a series of measures are recommended to alleviate the disease and enable patients to improve their quality of life. These include adequate skin hydration and restoration of the skin barrier with the use of emollients, antibacterial measures, specific approaches to reduce pruritus and scratching, wet wrap applications, avoidance of typical AD triggers, and topical anti-inflammatory drugs. Anti-inflammatory treatment is generally recommended during acute flares or, more recently, for preventive management. Nevertheless, the selection of the pharmacologic agent, as well as its potency, duration, and frequency of application must be in accordance with the severity of the disease and the distribution and type of the lesion. The objectives of this review are to emphasize the importance of basic skin care and to describe current and novel topical therapies for AD.

Key words: Eczema, Topical treatment, Atopic dermatitis, Pruritus, Emollients