Background: There is a paucity of literature to direct physicians in the prescribing of immunomodulators for patients with severe atopic dermatitis (AD).

The TOPICOP score can be feasibly applied across countries and may therefore be useful for obtaining qualitative and quantitative data from international studies and for adapting patient education and treatment.

For most children and adolescents who have developed symptomatic scars, cosmetic concerns are only a portion of the motivation that drives them and their caregivers to obtain treatment. In addition to the potential for cosmetic disfigurement, scars may be associated with a number of physical comorbidities including hypertrichosis, dyshidrosis, tenderness/pain, pruritus, dysesthesias, and functional impairments such as contractures, all of which may be compounded by psychosocial factors. Although a plethora of options for treating scars exists, specific management guidelines for the pediatric and adolescent populations do not, and evidence must be extrapolated from adult studies. New modalities such as the scar team approach, autologous fat transfer, and ablative fractional laser resurfacing suggest a promising future for children who suffer symptomatically from their scars. In this state-of-the-art review, we summarize cutting-edge scar treatment strategies as they relate to the pediatric and adolescent populations.

SummaryAtopic dermatitis (AD) is considered the most prevalent chronic inflammatory condition in very young children, with a prevalence approaching 20% in some industrialized countries. Recent advances in the understanding of the aetiology and pathogenesis of AD -particularly in relation to genetically determined skin barrier dysfunction and the role of microbial infections in AD flares -have helped to galvanize thinking on approaches to treatment in young patients. Topical anti-inflammatory medicines (corticosteroids and calcineurin inhibitors) in addition to emollients are the mainstay of therapy in children, but parents need help to understand how and when to apply them and reassurance to allay their fears about the long-term effects of these treatments. At the same time, more work is required in order to identify which clinical signs, symptoms, long-term control of flares, and quality of life measures are the best outcome domains for AD clinical trials in order to continue to improve control of AD in children.Atopic dermatitis (AD) is considered the most prevalent chronic inflammatory condition in children. In the U.S.A. and other industrialized countries, the estimated prevalence of AD is between 10% and almost 20% in the first few years of life, with persistence into adulthood in 1-3% of individuals.1 In the past few years, new advances in research have helped strengthen our understanding of the epidemiology and pathogenesis of AD, the effects of microbial colonization and infection, the comorbidities associated with AD, and treatment strategies. This article aims to review this new information as it relates to improving outcomes in paediatric AD.