Q:

11/12/2013
I am seeing a 2.5 yo AA boy with severe atopic dermatitis who continues to be poorly controlled on high potency topical steroids for his body, elidel for his face, and wet to dry wraps. Before I started seeing him, he had been on oral steroids for a period of time which cleared his skin completely. Mom is interested in using a systemic agent. I did a literature search but could not find any data on a child this young with the use of cyclosporine, azathioprine or methotrexate. I was wondering if you had any experience with a systemic agent in a child this young.

A:

Thank you for your inquiry.

No, I have no experience with the use of alternative agents in a child this age. Therefore I am referring your question to Dr. Donald Leung who is an internationally known expert in atopic dermatitis. As soon as we receive Dr. Leung’s response, we will forward it to you.

Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

We received a response from Dr. Donald Leung. Thank you again for your inquiry, and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

Response from Dr. Donald Leung:
As you know most of these systemic drugs have not been studied in children. If this was my patient, I would refer them to National Jewish Day Program for full evaluation of potential triggers and to be certain that skin care is being done as prescribed BEFORE considering systemic immunosuppressives since it is highly unusual that someone this young would need to undergo this approach.  

Best regards,
Donald Leung

AAAAI - American Academy of Allergy Asthma & Immunology