Atopic dermatitis in infancy and childhood:an ongoing challenge

Wahn U. Atopic dermatitis in infancy and childhood: an ongoingchallenge.Pediatr Allergy Immunol 2001: 12(suppl 14): 60–61. # Munksgaard2001.

Ulrich WahnDepartment of Pediatric Pneumology and

Immunology, Humboldt University, Berlin,

Germany

Key words: atopic dermatitis; infancy;

childhood; diagnosis; treatment

Ulrich Wahn, Department of Pediatric

Pneumology and Immunology, Humboldt

University, Charite, Kinderklinik,Augustenburger Platz 1, DE-13353 Berlin,

Germany

Atopic dermatitis affects more than 10% ofyoung children at least transiently and ingeneral represents the first manifestation ofatopy in infancy. Compared to other atopicphenotypes, the role of hereditary factors forthe incidence of atopic dermatitis early in lifeseems to be particularly strong. Considerableprogress is currently being made regarding theunderstanding of the molecular basis of geneticfactors for atopic dermatitis. However, thefactors determining chronicity, i.e. the persis-tence of symptoms until adolescence andadulthood, are still poorly understood.

Not only the patient’s wellbeing, but also thefamily’s quality of life, is severely affected bythe disease, which leads to a disturbed sleepbecause of night-time itching and bleeding ofthe skin. Since there is no cure for the diseaseso far, the aim of all therapeutic interventionsshould be the control of symptoms, particularlyitching, the provision of undisturbed sleep aswell as the prevention of complications, parti-cularly superinfection. There has been consider-able progress in topical treatment of atopicdermatitis since non-steroidal anti-inflammatorycompounds (FK50G, ascomycin) have becomeavailable.

A proposed stepwise approach for themanagement of atopic dermatitis is shown inFig. 1..

Fig. 1. Proposed stepwise approach to atopic dermatitismanagement.

Pediatr Allergy Immunol 2001: 12 (Suppl. 14): 60–61

Printed in UK. All rights reservedCopyright # Munksgaard 2001

PEDIATRIC ALLERGYAND IMMUNOLOGY

ISSN 0905-6157

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In most cases, families and their children withatopic dermatitis are helped by a multidisciplin-ary approach involving a paediatric allergist, adietician and a psychologist. Structured educa-tional programmes such as the Berlin parent’sschool have been evaluated in controlled studiesand found to be most helpful tools in a holisticmanagement of the disease.

References

1. WAHN U, NILSSON L. Atopic eczema: how to tackle themost common atopic symptom. Pediatr Allergy Immunol1999: 10.

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