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Management of atopic dermatitis

Management of atopic dermatitis
For examples of low-, medium-, and high-potency topical corticosteroids, please refer to the UpToDate table on topical corticosteroids.
TCS: topical corticosteroid; TCI: topical calcineurin inhibitor.
* Trigger/exacerbating factors:
  • Irritants (soaps, detergents)
  • Skin infections (Staphylococcus aureus, herpes simplex)
  • Contact, inhalant, or food allergens
¶ Mild atopic dermatitis – Areas of dry skin, infrequent itching (with or without small areas of redness); little impact on everyday activities, sleep, and psychosocial wellbeing.
Δ Moderate atopic dermatitis – Areas of dry skin, frequent itching, redness (with or without excoriation and localized skin thickening); moderate impact on everyday activities and psychosocial wellbeing, frequently disturbed sleep.
Severe atopic dermatitis – Widespread areas of dry skin, incessant itching, redness (with or without excoriation, extensive skin thickening, bleeding, oozing, cracking, and alteration of pigmentation); severe limitation of everyday activities and psychosocial functioning, nightly loss of sleep.
§ Crisaborole is approved for mild to moderate atopic dermatitis in adults and children >3 months.
¥ TCIs are approved for mild to moderate atopic dermatitis in adults and children >2 years. TCIs include tacrolimus and pimecrolimus.
‡ Dupilumab is approved for moderate to severe atopic dermatitis in adults and children ≥12 years whose disease is not adequately controlled with topical prescription therapies.
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