[Introduction neurodermatitis and urea]

Neurodermatitis is a multiphasic disease, yet despite intensive research, its etiopathogenesis still remains unclear. A large number of immunological and nonimmunological dysfunctions as well as their diverse interplay lead to very different types of manifestation. Consequently, treatment must also be varied and is mainly determined by the clinical picture. External therapy without glucocorticoids is no longer conceivable in acute and subacute dermatological conditions, although attenuated glucocorticoids which have the least amount of side effects should always be used. Improvement in the therapeutic efficacy of hydrocortisone can be achieved by combining it with urea which, depending on the vehicle used, represents one of the most effective penetration promoters for this glucocorticoid. Fighting the symptoms of dry skin and itching are of central importance in the follow-up treatment and prophylaxis of neurodermatitis. Here, urea preparations have been applied with great success. Urea's efficacy in the skin is largely based on its ability to elevate the water-binding capacity of the corneal layer, on its keratoplastic properties, its antipruriginous effect and its proliferation-suppressant action. However, the intensity and the duration of this therapeutic efficacy are dependent on several factors which must be taken into consideration in the galenics of urea preparations. As a whole, there is a multitude of possibilities for the use of urea in the therapy, follow-up and prophylaxis of neurodermatitis which we have only just begun to exploit in full.