Novel therapies for atopic eczema.

Atopic dermatitis (AD) has been treated with topical glucocorticosteroids for decades. With the introduction of the topical immune modulators tacrolimus and pimecrolimus, a new treatment era has begun. The knowledge on pathophysiological interactions and immunological disturbances during the chronic inflammatory process in the skin has been continuously increasing and offers new therapeutical approaches. These are discussed in this review based on the current literature, my own research findings and recent patents. Development of members of the glucocortioid family such as retinoids, vitamin D and peroxisome proliferator-activated receptor agonists, are discussed. Molecules from members of this family have profound differentiating, antiproliferative, but also immunomodulatory effects, which make them attractive as anti-eczematous compounds. Furthermore, several anti-infective and antipruritic agents, and preparations which enhance thedisturbed skin barrier function in AD are presented. Phytopharmacological and miscellaneous approaches, including Chinese tea or gamma-linolenic acid, will be critically discussed. Finally, recently patented, experimental compounds are presented, which interfere with several pathways involved in the immune response of AD.