Therapie des atopischen Ekzems im Kindesalter

Atopic eczma is characterized by 4 principal pathogenetic factors: disturbance of the epidermal barrier leading to skin dryness, immune dysregulation inducing chronic inflammation, increased release of pruritogenic mediators, and skin irritability, i.e. an abnormal response towards endogenous and exogenous trigger factors. Since atopic eczema is a genetically determined disorder, “cure” is not feasible, but much can be done to alleviate symptoms and improve the patient's quality of life. Accordingly, therapy is based on the external application of emollients ideally adapted to the actual disease state, wise use of anti-inflammatory agents, and treatment of chronic pruritus and bacterial superinfections resulting from excoriations. Identification and elimination of trigger factors helps to prevent (or confine) frequent relapses. Recent studies suggest that primary prevention might be feasible in the future.