Figure legends
Figure 1 – Medical algorithm for the therapeutic management of Atopic Dermatitis (AD) in early childhood, based on severity. Adapted from: Wollenberg A et al, J Eur Acad Dermatol Venereol, 20183
AFor criteria, see part I of this medical algorithm.
BDisease severity scales can be used but might not be practical. Severity (global assessment) can alternatively be assessed by body surface area involvement, lesional features and locations, and disease impact on quality of life.
CPlease refer to part I of this medical algorithm.
1In cases of recurrent skin infections sodium hypochlorite can be added to the bathwater (1mL of 5% household bleach per 1L of water) – conflicting data.
2Not commonly used in early childhood (feasibility). Preference for narrowband ultraviolet B (311 nm) or ultraviolet A1.
3Cyclosporine is licensed from age 16 and dupilumab from age 12 in Europe. All other systemic options are off-label.
#Choice depending on local cofactors. For moderate-severe AD it is recommended to start with a corticosteroid. Choice of corticosteroid class (European classification shown) depending on age and local cofactors.
%Off-label treatment option.
*Special attention if age <3 months or recurring infections: in early-onset severe AD, certain primary immunodeficiency syndromes such as Omenn syndrome, selective IgA-deficiency, Hyper-IgE-syndromes and Wiskott Aldrich syndrome, genetic disorders with an impaired barrier function, such as Comel-Netherton syndrome and peeling skin syndrome, and some inherited metabolic diseases such as biotin deficiency or phenylketonuria should be considered as differential diagnoses.