Med Quizzes
Atopic Dermatitis: Treatment Step-Up
A
Topical Emollients
Drop here
B
Topical Corticosteroids
Drop here
C
Topical Mupirocin
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D
Calcineurin Inhibitors
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Atopic Dermatitis Treatment Cheatsheet
Key Concept:
Honey-colored crusts on eczema = S. aureus superinfection → ADD mupirocin. Pimecrolimus/tacrolimus = for flares where steroids are risky (face). Emollients = daily maintenance.
Treatment
Key Features
Topical Emollients
First-line MAINTENANCE: prevents flares by restoring skin barrier
Applied after bathing; petrolatum or ceramide-containing moisturizers
Topical Corticosteroids
First-line FLARE treatment: reduces inflammation, itching
Low-potency for face/intertriginous areas; medium/high-potency for body
Risk of skin atrophy with prolonged use; taper after control
Topical Mupirocin
When eczema has HONEY-COLORED CRUSTS → S. aureus superinfection
Add topical mupirocin when exam shows impetiginization (secondary bacterial infection)
NOT the same as eczema herpeticum (which needs systemic acyclovir)
Calcineurin Inhibitors
Second-line for flares on FACE or intertriginous areas (where TCS risks atrophy)
No skin atrophy risk; approved age ≥2 years; black box warning (theoretical malignancy)
pimecrolimus (mild-moderate) | tacrolimus (moderate-severe)