ZUR THERAPIE DES ATOPISCHEN EKZEMS

When a decision is being made on the therapy of atopic eczema, the complex pathogenetic interactions involved in this disease have to be taken into consideration. The acute inflammatory changes respond to short-term glucocorticoid steroid treatment (topical); long-term steroid therapy should be avoided. In chronic lichen-type lesions, non-steroid topical applications can be helpful. Frequent acute infections of the skin require the application of antimicrobials. Intense pruritus is treated by antihistamines (possibly also H₂-antagonists). Due to the well-known psychosomatic influence in this disease, careful counseling of the patient (and if a child, of the family) is necessary. Pathogenetically relevant allergic reactions of the immediate type can be treated successfully in some cases by hyposensitization. Prophylactic measures include allergen avoidance (clima therapy, no pets, well-established food allergens, etc.). Possible new perspectives may be seen in the development of agents acting on the disturbed T-cell regulation, as well as by the introduction of mast-cell-blocking substances. The basis of every therapeutic approach in atopic eczema is, however, intensive skin care, using emollients and oil baths, especially during the remission phase.