Optimizing outcomes for paediatric atopic dermatitis.

Atopic dermatitis (AD) is considered the most prevalent chronic inflammatory condition in very young children, with a prevalence approaching 20% in some industrialized countries. Recent advances in the understanding of the aetiology and pathogenesis of AD - particularly in relation to genetically determined skin barrier dysfunction and the role of microbial infections in AD flares - have helped to galvanize thinking on approaches to treatment in young patients. Topical anti-inflammatory medicines (corticosteroids and calcineurin inhibitors) in addition to emollients are the mainstay of therapy in children, but parents need help to understand how and when to apply them and reassurance to allay their fears about the long-term effects of these treatments. At the same time, more work is required in order to identify which clinical signs, symptoms, long-term control of flares, and quality of life measures are the best outcome domains for AD clinical trials in order to continue to improve control of AD in children.