Brief Academic Review and Clinical Practice Guidelines for Pediatric Atopic Dermatitis

Title:Brief Academic Review and Clinical Practice Guidelines for Pediatric Atopic Dermatitis

Volume: 17 Issue: 3

Author(s): Yue Bo Yang, Amir Gohari and Joseph Lam*

Affiliation:

• Departments of Paediatrics and Dermatology and Skin Sciences, Faculty of Medicine, University of British Columbia, Vancouver,Canada

Keywords: Pediatrics, atopic dermatitis, guideline, treatment, review, dupilumab.

Abstract: In this clinical guidelines article, we first include a brief review of the epidemiology, pathogenesis, clinical diagnoses, and scoring-scales for pediatric atopic dermatitis (AD). We then offer a set of pharmacologic treatment guidelines for infants and toddlers (<2 years), children (2-12 years), and adolescents (>12 years). We recommend irritant avoidance and liberal emollient usage as the cornerstone of treatment in all age-groups. In infants <2 years, we recommend topical corticosteroids as first-line medication-based therapy. In infants as young as 3 months, pimecrolimus, a topical calcineurin inhibitor, may also be used. As a last resort in patients <2 years, non-traditional therapies, such as the Aron regime, may be a safer option for refractory or resistant AD before off- label medications are considered. In children and adolescents >2 years, topical corticosteroids are still considered first-line therapies, but there is sufficient safety data to utilize topical calcineurin inhibitors and topical PDE4 inhibitors as well. In children ages 2-12 years whose atopic dermatitis fails to respond to prior treatments, oral systemic immunosuppressants can be used. For adolescents >12, the biologic, dupilumab, is an additional therapeutic option. A trial of phototherapy may also be utilized in children, particularly in adolescents >12 years, if they have access to treatment. Although not currently approved for the treatment of AD, Janus-kinase (JAK) inhibitors represent a promising new class of biologics with recently completed phase III clinical trials (JADE-- MONO1/2).

Cite this article as:

Yang Bo Yue, Gohari Amir and Lam Joseph*, Brief Academic Review and Clinical Practice Guidelines for Pediatric Atopic Dermatitis, Current Pediatric Reviews 2021; 17 (3) . https://dx.doi.org/10.2174/1573396316999200820163434