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Korean J Asthma Allergy Clin Immunol. 2010 Dec;30(4):255-270. Korean. Review.
Park JS , Kim BJ , Park Y , Lee SY , Kim WK , Kim JE , Yum HY , Nahm DH , Kim HH , Hong SJ , Oh JW , Lee AY , Kim KH , .
Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Korea.
Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Pediatrics, Wonkwang University College of Medicine, Gunpo, Korea.
Department of Pediatrics, College of Medicine, Hallym University, Anyang, Korea.
Department of Pediatrics, College of Medicine, Inje University, Seoul, Korea.
Department of Allergy and Rheumatology, Ajou University School of Medicine, Suwon, Korea. pyallerg@wonkwang.ac.kr
Atopy Clinic, Seoul Medical Center, Seoul, Korea.
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Pediatrics, College of Medicine, Ulsan University, Seoul, Korea.
Department of Pediatrics, College of Medicine, Hanyang University, Guri, Korea.
Department of Dermatology, College of Medicine, Dongkuk University, Seoul, Korea.
Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
Abstract

BACKGROUND: Management of severe/recalcitrant atopic dermatitis (SRAD) is a difficult task for both patients and clinicians. METHOD: We developed this report to provide experts' opinion on the treatment of SRAD by a literature review and repeated group discussions made at the Work Group on Severe Recalcitrant Atopic Dermatitis in the Korean Academy of Asthma, Allergy and Clinical Immunology. RESULT: Specific aggravating factors, including inhalant allergens or food allergens, should be identified by laboratory tests in patients with SRAD. Patients should be educated about avoidance measures for specific aggravating factors, moisturization of the skin, and control of skin inflammation using low-potency topical corticosteroids and/or topical calcineurin inhibitors. For patients with SRAD who cannot be properly controlled by the above treatments, systemic immunoregulatory treatment such as cyclosporin could be effective. Allergen-specific immunotherapy has been attempted as a useful therapeutic option in selected patients with SRAD sensitized to aeroallergens. Psychological counseling and educational programs should be recommended for the management of patients with SRAD. CONCLUSION: Therapeutic approaches aimed at personalized medicine including stepwise treatment according to clinical severity, combination therapy, proactive therapy and multi-disciplinary approach should be tried to achieve the best outcome for SRAD.

Copyright © 2019. Korean Association of Medical Journal Editors.