Open Access Peer-reviewed Review

The Management of Atopic Dermatitis in Primary Care Paediatrics

Main Article Content

Hiba Al-Rawi corresponding author

Abstract

Atopic dermatitis in children is a common presentation within the primary care setting. Atopic dermatitis has general symptoms, but presentation may vary among individuals. A systematic approach of treatment for atopic dermatitis is explored- topical emollients, corticosteroids and calcineurin inhibitors, as well as phototherapy, immunosuppression and immunotherapy. Owing to limited dermatological experience and condition-specific expertise, primary care doctors are reluctant to use specific treatments, particularly when it comes to children. The first stage of atopic dermatitis management is its diagnosis. Following this, comes treatment. Recognising and having familiarity with the condition in both these aspects is essential. It is a lifelong condition, hence optimising its management should be a priority. All recommended treatments show great efficacy when it comes to management. Knowing when to use what treatment, depending on circumstance and severity is essential for improving its overall prognosis. An area with growing research in particular is the use of immunotherapy for its management, with studies proving its significant improvements on patient outcomes.

Keywords
atopic dermatitis, emollients, corticosteroids, phototherapy, immunotherapy

Article Details

How to Cite
Al-Rawi, H. (2026). The Management of Atopic Dermatitis in Primary Care Paediatrics. Advances in General Practice of Medicine, 7(1), 1-8. https://doi.org/10.25082/AGPM.2026.01.001

References

  1. NHS. Overview --- Atopic Eczema. 2024. https://www.nhs.uk/conditions/atopic-eczema
  2. National Eczema Society. Atopic eczema. 2020. https://eczema.org/information-and-advice/types-of-eczema/atopic-eczema
  3. Eczema Council. (2022). Global atopic dermatitis atlas: Global report on atopic dermatitis 2022. 2022. https://www.eczemacouncil.org/assets/docs/global-report-on-atopic-dermatitis-2022.pdf
  4. El Hachem M, Di Mauro G, Rotunno R, et al. Pruritus in pediatric patients with atopic dermatitis: a multidisciplinary approach - summary document from an Italian expert group. Italian Journal of Pediatrics. 2020, 46(1). https://doi.org/10.1186/s13052-020-0777-9
  5. Skinsight. Eczema (Atopic Dermatitis). Condition, Treatments and Pictures for Infants. 2022. https://skinsight.com/skin-conditions/atopic-dermatitis-eczema/infant
  6. Mayo Clinic. Atopic dermatitis (eczema) -- Symptoms and causes. Atopic dermatitis (eczema). 2023. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
  7. British Association of Dermatologists. Emollient use in skin conditions. 2023. https://www.bad.org.uk/pils/emollient-use-in-skin-conditions
  8. Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. British Journal of Dermatology. 2000, 142(5): 931-936. https://doi.org/10.1046/j.1365-2133.2000.03473.x
  9. National Eczema Society. (n.d.). Home. 2025. https://eczema.org
  10. Connelly D. Managing childhood eczema: a visual guide. The Pharmaceutical Journal. 2021. https://pharmaceutical-journal.com/article/feature/managing-childhood-eczema-a-visual-guide
  11. TX. McGraw Hill Medical. 2025. https://fadavispt.mhmedical.com/content.aspx?bookid=3124§ionid=262406556
  12. NHS Greater Glasgow and Clyde. Management of atopic eczema in children. Clinical Guidelines Scotland. 2025. https://www.clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-paediatric-guidelines/dermatology/management-of-atopic-eczema-in-children-356
  13. Fishbein AB, Mueller K, Lor J, et al. Systematic Review and Meta-analysis Comparing Topical Corticosteroids With Vehicle/Moisturizer in Childhood Atopic Dermatitis. Journal of Pediatric Nursing. 2019, 47: 36-43. https://doi.org/10.1016/j.pedn.2019.03.018
  14. van Zuuren EJ, Fedorowicz Z, Lavrijsen A, et al. Emollients and moisturisers for eczema. van Zuuren EJ, ed. Cochrane Database of Systematic Reviews. Published online March 11, 2016. https://doi.org/10.1002/14651858.cd012119
  15. National Eczema Society. Topical calcineurin inhibitors (TCIs). 2020. https://eczema.org/information-and-advice/treatments-for-eczema/topical- calcineurin-inhibitors/#what-are
  16. Boguniewicz M, Fiedler VC, Raimer S, et al. A randomized, vehicle-controlled trial of tacrolimus ointment for treatment of atopic dermatitis in children. Journal of Allergy and Clinical Immunology. 1998, 102(4): 637-644. https://doi.org/10.1016/s0091-6749(98)70281-7
  17. Schachner LA, Lamerson C, Sheehan MP, et al. Tacrolimus Ointment 0.03% Is Safe and Effective for the Treatment of Mild to Moderate Atopic Dermatitis in Pediatric Patients: Results From a Randomized, Double-Blind, Vehicle-Controlled Study. Pediatrics. 2005, 116(3): e334-e342. https://doi.org/10.1542/peds.2004-2638
  18. Wahn U, Bos JD, Goodfield M, et al. Efficacy and Safety of Pimecrolimus Cream in the Long-Term Management of Atopic Dermatitis in Children. Pediatrics. 2002, 110(1): e2-e2. https://doi.org/10.1542/peds.110.1.e2
  19. Kaufmann R, Fölster-Holst R, Höger P, et al. Onset of action of pimecrolimus cream 1% in the treatment of atopic eczema in infants. Journal of Allergy and Clinical Immunology. 2004, 114(5): 1183-1188. https://doi.org/10.1016/j.jaci.2004.08.015
  20. Chia SY, Chee EEC, Wee LWY, et al. Phototherapy for the treatment of atopic dermatitis in Singaporean children and adolescents. Photodermatology, Photoimmunology & Photomedicine. 2024, 40(4). https://doi.org/10.1111/phpp.12986
  21. Tan E, Lim D, Rademaker M. Narrowband UVB phototherapy in children: A New Zealand experience. Australasian Journal of Dermatology. 2010, 51(4): 268-273. https://doi.org/10.1111/j.1440-0960.2010.00701.x
  22. Elsgaard S, Danielsen AK, Thyssen JP, et al. Drug survival of systemic immunosuppressive treatments for atopic dermatitis in a long-term pediatric cohort. International Journal of Women’s Dermatology. 2021, 7(5): 708-715. https://doi.org/10.1016/j.ijwd.2021.07.005
  23. Cherney K. Your Complete Guide to Immunotherapy for Eczema. Healthline. Healthline Media; 2023. https://www.healthline.com/health/eczema/immunotherapy-for-eczema#available-treatments
  24. Paller AS, Simpson EL, Siegfried EC, et al. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet. 2022, 400(10356): 908-919. https://doi.org/10.1016/S0140-6736(22)01539-2
  25. Paller AS, Siegfried EC, Thaçi D, et al. Efficacy and safety of dupilumab with concomitant topical corticosteroids in children 6 to 11 years old with severe atopic dermatitis: A randomized, double-blinded, placebo-controlled phase 3 trial. Journal of the American Academy of Dermatology. 2020, 83(5): 1282-1293. https://doi.org/10.1016/j.jaad.2020.06.054