Abstract

Atopic dermatitis is a common chronic inflammatory skin disease associated with cutaneous hyperreactivity to various environmental triggers. The aim of the treatment should be focused on suppression of chronic inflammation and control of acute exacerbations. Education of the patient is necessary to increase the disease perception and scratch control behaviour modification, that will lead a better skin care and improvement in quality of life. The propriate treatment is also necessary for prevention of microbial colonization, invasive skin infections and further systemic complications. Basic therapy of AD should comprise optimal skin care with regular use of emollients, and avoidance from specific triggering factors. Topical treatments like topical corticosteroids and calcineurin inhibitors are the milestone of the severe atopic dermatitis. The risk of adverse effects induced by TCS could be reduced by proactive treatment modality and balancing risk/benefit ratio. Topical calcineurin inhibitors allow a steroid-free anti-inflammatory topical treatment with a safe use to sensitive skin areas. Further treatment options, on the basis of disease severity, includes the addition of multiple therapeutic agents in a step-wise approach. In severe cases of atopic dermatitis, systemic treatment options including oral steroids, immunosuppressant drugs, wet wrap and immunoglobulin G can be considered. Systemic antibiotic treatment is indicated for widespread bacterial secondary skin infections. The management of atopic dermatitis should be individualized according to the severity of the disease and patients clinical conditions.