Clinical Guidelines on Management of Atopic Dermatitis in Children: An Update for practice

Abstract

In 2012, the Hong Kong College of Paediatricians has endorsed the first clinical management guidelines on atopic dermatitis in children taking reference to the National Institute for Health and Clinical Excellence (NICE) guidelines “ Atopic eczema in Children – from birth to 12 years” published in 2007. Subsequently, NICE issued the standards of care based on the guidelines in 2013. International guidelines from USA, Europe and Japan are being updated in past 5 years. Recommendations and recent evidences are reviewed and the following to be discussed for updates of the local guidelines. 1) Documentation of severity or use of clinical scores eg SCORAD (SCORing Atopic Dermatitis) , POEM (Patient oriented Eczema Measure) to guide stepwise management 2) Evidences for an “ideal” emollient, the quantity needed and bath practices. 3) Proactive against reactive approach with use of low potency topical corticosteroids or Topical Calcineurin Inhibitor (TCI) for use as maintenance therapy 4) Safety of TCI in children 5) Steroid phobia and psychological management 6) Prevention of atopic eczema in high risk infants including early use of emollients and probiotics