Monitoring
Proactive Therapy
In patients with moderate atopic dermatitis, intermittent application of a class II-III topical corticosteroid (1-2 times/week) or calcineurin (eg Tacrolimus) (2-3 times/week) as maintenance therapy on areas that commonly flare up may help prevent disease relapse.
Expert Referral
Patients with severe to treatment-refractory atopic dermatitis should be referred to a pediatric subspecialist. Specialist referral is warranted in cases where an allergic component is suspected; flares occur frequently (≥4 annually) despite adequate maintenance therapy; adherence to optimal topical regimens is limited or topical therapy is impractical or interferes with daily functioning; involvement of special sites (eg face, skin folds) does not improve with topical corticosteroids; and disease remains persistent despite optimal topical treatment.