Recently in Japan, misunderstandings about the pathogenesis of atopic dermatitis (AD) and the strategies for the treatment of this disease, especially about the use of topical steroid, have led to a rapid increase of severe cases of AD caused by inadequate treatment. This prompted us to establish and distribute standard guidelines for AD therapy. In this guideline, the necessity of dermatological training to examine severe cases of AD is emphasized. It is stated that the present standard therapies for AD consist of the use of topical steroid and tacrolimus ointment for inflammation and emollient for dry and barrier-disrupted skin as the first line of attack, anti-histamines and anti-allergic drugs for pruritus, avoidance of apparent exacerbating factors, psychological counseling, and advice about daily life. Tacrolimus ointment was used initially only for adult patients and recently low density ointment is available for 2-15year old patients. The importance of correct selection of topical steroid according to the severity of the lesion is emphasized.
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