The European guidelines (EuroGuiDerm) on atopic eczema (AE) have proposed certain recommendations on non- systemic treatment for special populations such as pregnant women, lactating women, and paediatric patients.¹

Pregnancy

AE is one of the most frequently occurring general skin diseases in pregnancy. It may be:¹

(i) worsening in women with a chronic condition or
(ii) reactivated in patients with a past AE history or
(iii) occur in women with no AE history (atopic eruption of pregnancy)

Table 1: EuroGuiDerm recommendations for pregnant women¹

E: Atopic eczema; NB: Newborn; TCI: Topical calcineurin inhibitors; TCS: Topical corticosteroid; UVB: Ultraviolet B.

Adapted from: Wollenberg A, et al. Acad Dermatol Venereol. 2023

Lactating women
The below table provides a list of recommendations for breastfeeding mothers.¹

Table 2: EuroGuiDerm recommendations for lactating women¹

AE: Atopic eczema; TCS: Topical corticosteroid.

Adapted from: Wollenberg A, et al. Acad Dermatol Venereol. 2023.

Paediatric population
AE can show up quite early in life, and most of the patients show symptoms of AE before the age of 5 years.¹

Treatment includes:¹

• Bathing of AE infants without harsh soaps and detergents and using bath emollients to aid skin hydration and emollients as soap substitutes to aid barrier function. This also gives essential psychological advantages between parent and child.
• Use of wet wraps for additional skin hydration, particularly in young children.
• Use of topical corticosteroids about two to three times a week.
• Some topical calcineurin inhibitors are approved down to 3 months of age.

Occupational aspects

AE patients portray a significant risk of developing occupational contact dermatitis, as atopy worsens the effects of irritant and allergen exposure in several professions.¹

For such patients, the guidelines suggest individual pre-employment counselling on the choice of profession, including risk assessment, avoidance strategies, and protective measures.¹

Conclusion

The EuroGuiDerm guidelines recommend separate guidelines for the non-systemic treatment of AE in special patient populations which includes pregnant women, lactating mothers, paediatric population, and people with occupational hazard risk to develop AD.¹

Key takeaway

EuroGuiDerm guidelines recommend safe and personalised administration of topical treatment for the four patient categories.¹