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Mycophenolate mofetil for severe childhood atopic dermatitis: experience in 14 patients
M Heller1, H T Shin, S J Orlow
1Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY 10016, USA.
Background:
Reports of successful treatment of atopic dermatitis (AD) with mycophenolate mofetil (MMF) have thus far been limited to adults. Considering that the condition typically develops during childhood and is most active during this period, MMF would represent a valuable addition to the therapeutic armamentarium for paediatric AD.
Objectives:
To evaluate the safety and efficacy of MMF in the treatment of severe childhood AD.
Methods:
A retrospective analysis was performed of all children treated with MMF as systemic monotherapy for severe, recalcitrant AD between August 2003 and August 2006 at New York University Medical Center. Fourteen patients meeting these criteria were identified.
Results:
Four patients (29%) achieved complete clearance, four (29%) had > 90% improvement (almost complete), five (35%) had 60-90% improvement and one (7%) failed to respond. Initial responses occurred within 8 weeks (mean 4 weeks), and maximal effects were attained after 8-12 weeks (mean 9 weeks) at MMF doses of 40-50 mg kg(-1) daily in younger children and 30-40 mg kg(-1) daily in adolescents. The medication was well tolerated in all patients, with no infectious complications or development of leucopenia, anaemia, thrombocytopenia or elevated aminotransferases.
Conclusions:
This retrospective case series demonstrates that MMF can be a safe and effective treatment for severe, refractory AD in children. MMF represents a promising therapeutic alternative to traditional systemic immunosuppressive agents with less favourable side-effect profiles, and prospective controlled studies are warranted, further to assess its benefits in paediatric AD.
Insights
Mycophenolate mofetil (MMF) is a safe and effective treatment for severe childhood atopic dermatitis (AD). This study shows MMF offers a promising alternative for paediatric AD management.
Area of Science:
- Dermatology
- Pediatric Medicine
- Immunosuppressive Therapy
Background:
- Atopic dermatitis (AD) is a common childhood condition.
- Current treatments for severe pediatric AD have limitations.
- Mycophenolate mofetil (MMF) has shown success in adults but limited data exists for children.
Purpose of the Study:
- To evaluate the safety and efficacy of MMF for severe childhood AD.
- To determine MMF's potential as a treatment option for pediatric patients.
Main Methods:
- Retrospective analysis of 14 children with severe, recalcitrant AD treated with MMF monotherapy.
- Data collected from August 2003 to August 2006 at New York University Medical Center.
Main Results:
- 29% achieved complete clearance, 29% had >90% improvement, 35% had 60-90% improvement.
- Responses occurred within 8 weeks, with maximal effects by 8-12 weeks.
- MMF was well-tolerated with no significant adverse events.
Conclusions:
- MMF is a safe and effective treatment for severe, refractory pediatric AD.
- MMF offers a promising alternative to traditional immunosuppressants.
- Further controlled studies are needed to confirm MMF's benefits in pediatric AD.