BMJ  2006;332:584-588 (11 March), doi:10.1136/bmj.332.7541.584

Clinical review

Atopic and non-atopic eczema

¹ Department of Dermatology, Royal Victoria Infirmary, and Dermatological Sciences, Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH

The first 150 words of the full text of this article appear below.

Introduction

Atopic eczema is a chronic, relapsing, inflammatory skin condition associated with epidermal barrier dysfunction. This article provides a summary of current knowledge on eczema and its management.

Sources and selection criteria

We used the following sources of information to write this review:

• PubMed search using the key words "atopic eczema", "atopic dermatitis", "incidence", "genetics", "pathogenesis", "treatment", and "management". We gave preference to original articles published in the past three years and recent review articles published in high impact journals
  
• Search of the following Cochrane Library databases: Cochrane Database of Systemic Reviews; Database of Abstracts and Reviews of Effectiveness; Cochrane Central Register of Controlled Trials
  
• Personal archive of references.
  

How do we define atopic eczema?

Atopic eczema and atopic dermatitis are terms that have been used synonymously (for a clinical definition see box), but a review committee by the World Allergy Organisation has published its recommended terminology (see fig 1).¹

View larger version (31K): [in this window] [in a new window]   Fig 1 Subgroups of dermatitis. Some patients may have a combination of . . . [Full text of this article]

 

Why is eczema important?

Epidemiology

Prevalence and incidence of atopic eczema
Importance of environmental factors

Pathophysiology—what do we know?

Immune dysfunction
Are allergies important?
Non-allergic factors

Genetic factors in atopic eczema

How to treat atopic eczema

Mild to moderate eczema: emollients and topical steroids
Moderate to severe eczema: second line treatments
Topical calcineurin inhibitors
UV phototherapy: UVB v UVA
Systemic immunosuppressants: ciclosporin and azathioprine
Other systemic agents
Do probiotics help to prevent atopic eczema?

Conclusion

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