Recent developments in the treatment of childhood atopic eczema

Even with the most careful application of conventional treatment, atopic eczema can be a disabling handicap in severely affected children. In refractory cases the conventional therapeutic options--potent topical steroids or the use of systemic steroids--are potentially hazardous and associated with relapse after therapy has been discontinued. The main drawbacks to recent experimental approaches, such as oral cyclosporin, photochemotherapy or interferon-gamma, are relapse after cessation of therapy and potentially serious side-effects. Avoidance of certain foods, pets and house dust mites is an option, the major drawbacks being the lack of tests to identify triggers or predict response, and the possible nutritional or psychological hazards of elimination diets. Difficulties with these approaches emphasis the need for close attention to the details of conventional treatment.