Guidelines of care for the management of atopic dermatitis in adults with topical therapies

Cochrane corner: Phototherapy for atopic eczema

“…Although individual sessions are short, starting with a few seconds and building up to several minutes; most regimens require three sessions weekly for 6 weeks minimum (usually longer). 4 Long-term evidence on the effectiveness of phototherapy in symptom control is lacking, as the studies referenced only followed up patients for 6-12 weeks.…”

“…They include skin sensitivity, erythema, burning, pruritis and herpes simplex reactivation. [4][5][6] There is a risk of skin cancer demonstrated in the use of PUVA for psoriasis; but the risk was not increased with UVA1, BB-UVB and NB-UVB for other indications, mainly psoriasis. 6 There is no evidence comparing phototherapy with other systemic treatments such as ciclosporin, methotrexate or biologics.…”

“…For the minority with refractory symptoms, most adult and paediatric guidelines in Europe, USA and Australia recommend a trial of phototherapy, before progressing to systemic immunosuppressants or biologics. [2][3][4][5][6] Phototherapy has been used to treat AE since the 1970s. 7 In 1994 there were at least 115 phototherapy centres in the UK.…”

Skin atrophy caused by topical glucocorticoids is less common in patients with atopic dermatitis than in those with psoriasis

“…Treatments such as topical glucocorticoids (TGCs), immunosuppressive drugs and phototherapy have been used for both diseases. Among them, TGCs have been commonly used to treat mild‐to‐moderate cases of AD and PSO 4‐9 . Although corticosteroids are primarily produced in the adrenal gland, they can also be produced in extra‐adrenal tissues, such as those of the immune system, and the skin, brain and intestine 10 .…”

“…Among them, TGCs have been commonly used to treat mild-to-moderate cases of AD and PSO. [4][5][6][7][8][9] Although corticosteroids are primarily produced in the adrenal gland, they can also be produced in extra-adrenal tissues, such as those of the immune system, and the skin, brain and intestine. 10 In the skin, glucocorticoid synthesis begins with cholesterol, and steroidogenesis is regulated in a complex fashion.…”