Fast Five Quiz: Pediatric Atopic Dermatitis

Dirk M. Elston, MD


June 07, 2021

Cessation of systemic corticosteroid use after an initial dramatic improvement in symptoms in the first few days is associated with a rebound effect. Tapering oral steroids over 10-14 days is recommended to mitigate this effect, plus a focus on hydration with bathing and appropriate use of topical steroids.

Elimination diets are rarely indicated because most positive results against food allergens do not seem to cause disease flares in clinical trials. AD flares are frequently misattributed to food-related issues. Food allergies may coexist and may trigger a subset of patients with AD (usually those with moderate to severe disease), but the true frequency of food allergies causing an isolated flare of disease must be closely investigated.

The most common reason for treatment failure is nonadherence due to fear of side effects. Treatment also frequently fails when patients do not use the optimal amount of medication.

Dupilumab, a monoclonal antibody that inhibits IL-4 and IL-13 signaling by blocking the shared IL-4 receptor alpha, is indicated for patients aged 6 years or older with moderate to severe AD whose disease is not adequately controlled with topical prescription therapies.

Learn more about treatment of AD.


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