Skill Checkup: An 11-Year-Old Girl With Severe Nighttime Itchiness

Diamant Thaçi, MD, PhD


April 14, 2022

Topical steroids are currently the mainstay of treatment for AD. In association with moisturizers, responses are often excellent. Hydrocortisone as a cream for the face and one daily is sufficient. A mid-strength steroid ointment (triamcinolone or betamethasone valerate) may be applied two times daily to lesions on the trunk until the eczematous lesions clear. Steroids are discontinued when lesions disappear and are resumed when new patches arise.

The calcineurin inhibitors pimecrolimus and tacrolimus are preferred in sensitive skin areas and for long-term use in AD in nonimmunocompromised adults and children ≥ 2 years of age. Crisaborole, the only PDE-4 inhibitor available, is intended for use only for mild to moderate AD. Ruxolitinib, a topical JAK inhibitor, is approved in the United States for AD, but not in the European Union.


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