Die systemische therapie im behandlungskonzept des atopischen ekzems. Bewahrte behandlungsverfahren und experimentelle entwicklungen

Our therapeutic approach to atopic eczema consists of a continous topical dermatological basic therapy in combination with an antiinflammatory therapy in phases of exacerbations. In the treatment of exacerbated atopic eczema, systemic agents are added to achieve effective control more rapidly or to induce remissions in cases refractory to standard therapy. Antihistamines to control the pruritus, as well as antibiotics and acyclovir for antimicrobial superinfections are often used. In many patients exacerbations can be successfully controlled with phototherapy, especially with UVA₁ light. The use of systemic immunosuppressants, like glucocorticosteroids, cyclosporine or azathioprine generally can be avoided and is a therapeutic alternative only in few selected cases. In the last years promising new experimental treatments have evolved, which could become therapeutic alternatives for the future.