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Contemporary Practice in Paediatrics Management of Atopic Dermatitis in Children: 2020 Review by the Guidelines Development Panel of Hong Kong College of Paediatricians TNH Leung, JWCH Cheng, SCW Chan, CM Chow, PY Chow, KL Hon, KM Ho, YY Lam, DCK Luk, SC Ng, VK Sugunan Abstract The Guidelines Development Panel on "Management of Atopic Dermatitis (AD) in Children" has performed the first updated review on the topic since the publication of the management guidelines by the Hong Kong College of Paediatricians in 2013. While most of the recommendations of the original guidelines are still valid, various management issues are further elaborated based on recent evidences in addition to the latest international and regional guidelines. Using validated clinical scores for assessment of severity of AD are advocated by the European guidelines to guide stepwise management and monitor progress. There are more evidences to support the proactive approach with use of topical anti-inflammatory agents as long-term treatment for the control of chronic recurrent AD. Topical corticosteroids remain first line topical agents for AD, while topical calcineurin inhibitors are indicated for sensitive areas and can be used as maintenance treatment. The role of newer therapeutic agents including topical phosphodiasterase 4 inhibitors, biologics and allergen immunotherapy for use in paediatric patients are deliberated. Management of itch, tackling issues of steroid phobia and compliance remain challenges in AD management. The concepts of skin barrier dysfunction in AD and targeting the skin for allergy prevention strategies are discussed. Keyword : Allergy; Atopic Dermatitis; Child; Guidelines |
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