Atopic dermatitis in infancy and childhood: an ongoing challenge

Atopic dermatitis affects more than 10% of young children at least transiently and in general represents the first manifestation of atopy in infancy. Compared to other atopic phenotypes, the role of hereditary factors for the incidence of atopic dermatitis early in life seems to be particularly strong. Considerable progress is currently being made regarding the understanding of the molecular basis of genetic factors for atopic dermatitis. However, the factors determining chronicity, i.e. the persistence of symptoms until adolescence and adulthood, are still poorly understood. Not only the patient’s wellbeing, but also the family’s quality of life, is severely affected by the disease, which leads to a disturbed sleep because of night-time itching and bleeding of the skin. Since there is no cure for the disease so far, the aim of all therapeutic interventions should be the control of symptoms, particularly itching, the provision of undisturbed sleep as well as the prevention of complications, particularly superinfection. There has been considerable progress in topical treatment of atopic dermatitis since non-steroidal anti-inflammatory compounds (FK50G, ascomycin) have become available. A proposed stepwise approach for the management of atopic dermatitis is shown in Fig. 1.