Guidelines of care for the management of atopic dermatitis : Section 4. Prevention of disease flares and use of adjunctive therapies and approaches - 15/11/14

Doi : 10.1016/j.jaad.2014.08.038

Work Group:Robert Sidbury, MD ^a : Co-chair, Wynnis L. Tom, MD ^b, James N. Bergman, MD ^c, Kevin D. Cooper, MD ^d, Robert A. Silverman, MD ^e, Timothy G. Berger, MD ^f, Sarah L. Chamlin, MD, MSCI ^g, David E. Cohen, MD ^h, Kelly M. Cordoro, MD ^f, Dawn M. Davis, MD ⁱ, Steven R. Feldman, MD, PhD ^j, Jon M. Hanifin, MD ^k, Alfons Krol, MD ^k, David J. Margolis, MD, PhD ^l, Amy S. Paller, MD ^g, Kathryn Schwarzenberger, MD ^m, Eric L. Simpson, MD ^k, Hywel C. Williams, DSc ⁿ, Craig A. Elmets, MD ^o, Julie Block, BA ^p, Christopher G. Harrod, MS ^q, Wendy Smith Begolka, MBS ^q,^⁎ , Lawrence F. Eichenfield, MD ^b : Co-chair
^a Department of Dermatology, Seattle Children's Hospital, Seattle, Washington
^b University of California, San Diego and Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California
^c Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
^d Department of Dermatology, Case Western University, Cleveland, Ohio
^e private practice, Fairfax, Virginia
^f Department of Dermatology, University of California San Francisco, San Francisco, California
^g Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^h Department of Dermatology, New York University School of Medicine, New York, New York
ⁱ Department of Dermatology, Mayo Clinic, Rochester, Minnesota
^j Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina
^k Department of Dermatology, Oregon Health & Science University, Portland, Oregon
^l Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
^m Kaplan-Amonette Department of Dermatology, University of Tennessee Health Science Center, Memphis, Tennessee
ⁿ Centre of Evidence-Based Dermatology, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
^o Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
^p National Eczema Association, San Rafael, California
^q American Academy of Dermatology, Schaumburg, Illinois

^∗Reprint requests: Wendy Smith Begolka, MBS, American Academy of Dermatology, 930 E Woodfield Rd, Schaumburg, IL 60173.

Abstract

Atopic dermatitis is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on use are given based on available evidence.

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Key words : aeroallergens, allergy testing, atopic dermatitis, calcineurin inhibitors, complementary therapy, corticosteroids, diet, education, flare, food allergy, topicals

Abbreviations used : AAD, ACD, AD, APT, HDM, IgE, ICD, NIAID, SCORAD, SPT, TCI, TCM, TCS, RCT

Plan

Prevention of disease flares

Educational interventions

Coexisting allergic disease and allergy testing

Food allergies

Inhalant/aeroallergens

Allergic contact dermatitis

Dietary interventions

Food elimination/avoidance diets

Probiotics/prebiotics

Other dietary supplements

Environmental modifications

Other allergen-based interventions

Complementary therapies

Gaps in research

	Funding sources: None.
	The management of conflict of interest for this guideline series complies with the Council of Medical Specialty Societies' Code of Interactions with Companies. The authors' conflict of interest/disclosure statements appear at the end of this article.

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Vol 71 - N° 6

P. 1218-1233 - décembre 2014 Retour au numéro

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Guidelines of care for the management of atopic dermatitis : Section 4. Prevention of disease flares and use of adjunctive therapies and approaches - 15/11/14

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