Atopic dermatitis made easy: The Schachner Ladder

Abstract

The vast majority of atopic dermatitis follows a mild, chronic relapsing course. In this article, we highlight the art and practice of treating atopic dermatitis based upon a foundation of maintenance care and a ladder of therapy that can teach patients and their families how to best tailor their pharmaceutical options to optimize the management of their disease.

Recent Developments and Advances in Atopic Dermatitis: A Focus on Epidemiology, Pathophysiology, and Treatment in the Pediatric Setting

“…A range of treatments are recommended for AD, including emollients (e.g., creams, lotions, ointments), topical corticosteroids (e.g., hydrocortisone, triamcinolone acetonide), topical calcineurin inhibitors (tacrolimus, pimecrolimus), PDE4 inhibitors (crisaborole 2%), systemic oral and injectable treatments, and phototherapy. AD is typically treated as a single entity despite its heterogeneous nature [68], with numerous guidelines recommending stepwise therapy initiated according to disease severity [60,[68][69][70][71][72][73]. Current practice has evolved away from an emphasis solely on controlling acute flares to a more holistic, long-term approach that focuses on comprehensive disease management via the combination of baseline maintenance treatments in tandem with intermittent use of topical corticosteroids (TCS), topical calcineurin inhibitors (TCI), or a PDE4 inhibitor (crisaborole 2%) as needed for more acute manifestations of AD.…”