Guideline on the Management
of Atopic Eczema in
Children
(2007)
Philippine Dermatological Society
Rm. 1015 South Tower, Cathedral Heights Building Complex
St. Luke’s Medical Center
E. Rodriguez Avenue, Quezon City, Philippines 1102
Telephone No.: (632) 723-0101 loc 2015
Telefax No.: 727-7309
E-mail: pds_org@pldtdsl.net, pds_org@yahoo.com
Website: www.pds.org.ph
Eczema
Philippine Dermatological Society
Rm. 1015 South Tower, Cathedral Heights Building Complex
St. Luke’s Medical Center
E. Rodriguez Avenue, Quezon City, Philippines 1102
Telephone No.: (632) 723-0101 loc 2015
Telefax No.: 727-7309
E-mail: pds_org@pldtdsl.net, pds_org@yahoo.com
Website: www.pds.org.ph
Officers and Board of Directors (2013-2014)
President
Vice-President
Secretary
Treasurer
Immediate Past President
Directors
Rosalina E. Nadela, MD
Daisy K. Ismael, MD
Ma. Juliet E. Macarayo, MD
Ma. Angela T. Medina-Lavadia, MD
Ma. Teresita G. Gabriel, MD
Bernadette B. Arcilla, MD
Ma. Angela T. Cumagun, MD
Lonabel A. Encarnacion, MD
Roberto Antonio B. Pascual, MD
Noemie S. Ramos, MD
Francisco D. Rivera IV, MD
Donna Marie M. Sarrosa, MD
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231
Eczema
Stepped-care plan
Diagnosis
Holistically assess a child's atopic
eczema at each consultation,
considering severity and quality of life
Physical assessment
Clear
•Normal skin
•No evidence of active
atopic eczema
Mild
•Areas of dry skin
•Infrequent itching (with
or without small areas
of redness)
Impact on quality of life and
psychosocial wellbeing
•None – no impact
•Mild – little impact on everyday activities,
sleep and psychosocial wellbeing
•Moderate – moderate impact on everyday
activities and psychosocial wellbeing,
frequently disturbed sleep
•Severe – severe limitation of everyday
activities and psychosocial functioning,
nightly loss of sleep
Moderate
•Areas of dry skin
•Frequent itching
•Redness (with or
without excoriation
and localized skin
thickening)
Severe
•Widespread areas of
dry skin
•Incessant itching
•Redness (with or
without excoriation,
extensive skin thickening, bleeding, oozing,
cracking and alteration
of pigmentation)
Treat areas of
differing severity
independently
Emollients
Body
Emollients
Emollients
Emollients
Mild potency topical
corticosteroids or
emollients alone
Moderate potency topical
corticosteroids (use for
axillae and groin flares
for 7-14 days only)
Potent topical corticosteroids (use for exillae
and groin flares for 7-14
days only)
Tacrolimus
Bandages
Tacrolimus
Phototherapy
Bandages
Systemic therapy
Step treatment up or down according to physical severity
See treatment recommendations
Face and neck
Emollients
Emollients
Emollients
Mild potency topical
corticosteroids or
emollients alone
Moderate potency topical
corticosteroids.
For severe flares, use
moderate potency topical corticosteroids for
3-5 days only
Topical calcineurin
inhibitors
Bandages
Emollients
Tacrolimus
Bandages
Phototherapy
Systemic therapy
Step treatment up or down according to physical severity
See treatment recommendations
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233
Eczema
Guideline on the Management of
Atopic Eczema in Children
not yet been answered sufficiently. Other research
questions, and their importance or relevance, are
discussed in the full document.
Management of Atopic Eczema in Children
from Birth up to the Age of 12 Years
This guideline has been subjected to peer review. The
GDG also included lay people among its members to
ensure patient representation.
Issued by
Date of Issue Date of Expiry
National Collaborating Centre for
Women’s and Children’s Health
Commissioned by the National Insti- tute for Health and Clinical Excellence, United Kingdom
(NICE)
Citation
2007
Between 2011 and
2013 (review date
is 4 years from
publication date,
or earlier; latest
evidence considered was
21 March 2007)
It should be noted that for managing bottle-fed infants
under 6 months, the guideline failed to discuss the
option of breastfeeding (re-lactation) and instead limited
the recommendation to extensively hydrolysed protein
formula or amino acid formula. Furthermore, in addition
to the identified key research areas, the guideline also
pointed out that the UK diagnostic criteria have not been
tested extensively in non-white ethnic groups in the UK.
Validation of this diagnostic criteria among Filipinos may
be necessary.
Summary of Recommendations
Link to full text
http://www.nice.org.uk/nicemedia/
live/11901/38559/38559.pdf;
http://www.ga2len.net/464D9d01.pdf
Summary of Critical Appraisal
This guideline considered important options and
outcomes in terms of diagnosis and management of
atopic dermatitis in children. It should be noted however
that the guideline does not intend to discuss primary
prevention of AD among high risk individuals.
An explicit process was followed by the Guideline
Development Group (GDG) in accordance with the NICE
guideline development process. Published literature
was searched systematically but the grey literature
was not. Stakeholder organizations were invited to
submit evidence for review. Appraisal of evidence was
done using established standard methods prescribed
in the NICE Guidebook. A level of evidence was
assigned for each study, and to the body of evidence
for each question. For each clinical question, informal
consensus methods were used to draft clinical and costeffectiveness evidence statements. Afterwards, formal
consensus methods using modified Delphi technique
were utilized for the final recommendations. Nominal
group technique was used to shortlist the key or priority
recommendations In the process, the GDG excluded
recommendations that covered important aspects of
the management of atopic eczema in children but which
were thought to already reflect current practice in the
UK. Therefore, the reader is advised to refer to the full
text since locally relevant recommendations may have
been excluded from the key or priority recommendations
which are covered in this summary. The reader
should also note that the strength of recommendation
for the other items outside the eleven key areas for
implementation are not indicated.
Five priority research recommendations were also
identified by the GDG. These research topics are listed
in this summary to alert the reader that at the time this
Guideline was issued, these research questions have
Recommendations
Strength
Level
of Recom-
of
mendations Evidence
Diagnosis:
A range of diagnostic criteria
for atopic eczema in children
have been described in the
literature, but only the UK
Working Party criteria have
been assessed adequately for
validity and repeatability. Atopic
eczema should be diagnosed
when a child has an itchy skin
condition plus three or more of
the following:
2+
DSII to III
• visible flexural dermatitis
involving the skin creases,
such as the bends of the
elbows or behind the knees
(or visible dermatitis on the
cheeks and/or extensor
areas in children aged 18
months or under)
• personal history of flexural
dermatitis (or dermatitis on
the cheeks and/or extensor
areas in children aged 18
months or under)
• personal history of dry skin in
the last 12 months
• personal history of asthma
or allergic rhinitis (or history
of atopic disease in a firstdegree relative of children
aged under 4 years)
• onset of signs and symptoms
under the age of 2 years (this
criterion should not be used
in children aged under 4
years).
Healthcare professionals
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235
Eczema
should be aware that in Asian,
black Caribbean and black
African children, atopic eczema
can affect the extensor surfaces
rather than the flexures, and
discoid (circular) or follicular
(around hair follicles) patterns
may be more common.
atopic eczema and their
parents or carers that children
with atopic eczema can often
develop asthma and/or allergic
rhinitis and that sometimes
food allergy is associated with
atopic eczema, particularly in
very young children.
Assessment of severity,
psychological and psychosocial wellbeing and
quality of life
Identification and
management of trigger
factors
PRIORITY/
Healthcare professionals
KEY
should adopt a holistic RECOMapproach when assessing MENDATION
a child’s atopic eczema at
each consultation, taking
into account the severity
of the atopic eczema and
the child’s quality of life,
including everyday activities
and sleep, and psychosocial
wellbeing (see Table on
Holistic assessment below).
There is not necessarily a
direct relationship between
the severity of the atopic
eczema and the impact of
the atopic eczema on quality
of life.
3
When clinically assessing
children with atopic eczema,
healthcare professionals
should seek to identify
potential trigger factors
including:
• irritants, for example soaps PRIORITY/
KEY
and detergents (including
shampoos, bubble baths, RECOMshower gels and washing- MENDATION
up liquids)
• skin infections
• contact allergens
• food allergens
• inhalant allergens
Epidemiology
Healthcare professionals
should inform children with
atopic eczema and their
parents or carers that the
condition often improves with
time, but that not all children
will grow out of atopic eczema
and it may get worse in teenage
or adult life.
3
Healthcare professionals
should inform children with
3
DS III
2
Healthcare professionals
should consider a diagnosis
of food allergy in children
with atopic eczema who have
reacted previously to a food
with immediate symptoms,
or in infants and young
children with moderate or
severe atopic eczema that
has not been controlled
by optimum management,
particularly if associated
with gut dysmotility (colic,
vomiting, altered bowel
habit) or failure to thrive.
Healthcare professionals
Holistic assessment
Skin/physical severityImpact on quality of life and psychological wellbeing
Clear
Normal skin, no evidence of active atopic
eczema
Mild
Areas of dry skin, infrequent itching (with Mild
or without small areas of redness)
Moderate Areas of dry skin, frequent itching, red-
Moderate Moderate impact on everyday activities ness (with or without excoriation and local-
and psychosocial wellbeing
ized skin thickening)
Severe
Widespread areas of dry skin, incessant Severe
itching, redness (with or without excoria- tion, extensive skin thickening, bleeding, oozing, cracking and alteration of pigmentation)
236
None
No impact on quality of life
Little impact on everyday activities, sleep
and psychological wellbeing
Moderate impact on everyday activities
and psychosocial functioning, nightly loss
of sleep
Eczema
Treatment options
Mild atopic eczema
Moderate atopic eczema
Severe atopic eczema
Emollient Emollients Emollients
Mild potency topical corticosteroids Moderate potency topical corticosteroids
Potent topical corticosteroids
Topical calcineurin inhibitors Topical calcineurin inhibitors
Bandages Bandages
should consider a diagnosis
of inhalant allergy in children
with seasonal flares of atopic
eczema, children with atopic
eczema associated with
asthma or allergic rhinitis, and
children aged 3 years or over
with atopic eczema on the face,
particularly around the eyes.
Healthcare professionals
should consider a diagnosis
of allergic contact dermatitis in
children with an exacerbation
of previously controlled atopic
eczema or with reactions to
topical treatments.
Healthcare professionals
should reassure children
with mild atopic eczema and
their parents or carers that
most children with mild atopic
eczema do not need to have
tests for allergies.
Treatment
Stepped approach to management
Healthcare professionals
should use a stepped approach for managing ato­pic
eczema in children. This
means tailoring the treatment step to the severity of
the atopic eczema. Emollients should form the basis PRIORITY/
KEY
of atopic eczema management and should always be RECOMused, even when the atopic MENDATION
eczema is clear. Management can then be stepped
up or down, according to
the severity of symptoms,
with the addition of the other
treatments listed in Table
on Treatment options (See
above).
Phototherapy
Emollients
Healthcare professionals
should offer children with
atopic eczema a choice
of unperfumed emollients
to use every day for
moisturising, washing and
bathing. This should be
suited to the child’s needs
and preferences, and may
include a combination of
products or one product
for all purposes. Leaveon emollients should be
prescribed in large quantities (250–500 g weekly)
and easily available to use
at nursery, pre-school or
school.
Topical corticosteroids
3
1- to 1+
The potency of topical corticosteroids should be tailored
to the severity of the child’s
atopic eczema, which may
vary according to body site.
They should be used as
follows:
•use mild potency for mild
atopic eczema
•use moderate potency for
moderate atopic eczema
•use potent for severe atopic
eczema
•use mild potency for the
face and neck, except for
short-term (3–5 days) use
of moderate potency for
severe flares
•use moderate or potent
preparations for short
periods only (7–14 days)
for flares in vulnerable
sites such as axillae and
groin
•do not use very potent
preparations in children
without specialist dermatological advice.
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4
237
Eczema
Calcineurin inhibitors
Topical tacrolimus and pimecrolimus are not recommended
for the treatment of mild atopic
eczema or as first-line treatments for atopic eczema of
any severity.
Topical tacrolimus is recommended, within its licensed
indications, as an option for
the second-line treatment of
moderate to severe atopic
eczema in adults and children
aged 2 years and older that
has not been controlled by
topical corticosteroids, where
there is a serious risk of important adverse effects from
further topical corticosteroid
use, particularly irreversible
skin atrophy.
Pimecrolimus is recommended
as an option for the second-line
treatment of moderate atopic
eczema on the face and neck
in children aged 2–16 years
that has not been controlled by
topical corticosteroids
Dry Bandages and Medicated Dressings (including
wet wrap therapy)
Occlusive medicated dressings
and dry bandages should not
be used to treat infected atopic
eczema in children.
Localised medicated dressings or dry bandages can
be used with emollients as a
treatment for areas of chro­
nic lichenified (localised skin
thickening) atopic eczema in
children.
Whole-body (limbs and trunk)
occlusive dressings (including
wet wrap therapy) with topical
corticosteroids should only be
used to treat atopic eczema
in children for 7–14 days
(or for longer with specialist
dermatological advice), but can
be continued with emollients
alone until the atopic eczema
is controlled.
Antihistamines
Oral antihistamines should
not be used routinely in the
management of atopic eczema
in children.
238
Healthcare professionals
should offer a 1 month trial of
a non-sedating antihistamine
to children with severe atopic
eczema or children with mild
or moderate atopic eczema
where there is severe itching
or urticaria. Treatment can
be continued, if successful,
while symptoms persist, and
should be reviewed every 3
months.
Healthcare professionals
should offer a 7–14 day trial of
an age-appropriate sedating
antihistamine to children aged
6 months or over during an
acute flare of atopic eczema
if sleep disturbance has a
significant impact on the child
or parents or carers. This
treatment can be repeated
during subsequent flares if
successful.
Treatment for infections
a s sociated with atopic
eczema
Children with atopic
eczema­ and their parents
or carers should be offered
information on how to
recognise the symptoms and
signs of bacterial infection
with staphy­lococcus and/or
streptococcus (weeping,
pustules, crusts, atopic
­eczema failing to respond to
therapy, rapidly worsening
atopic eczema, fever
and malaise). Healthcare
professionals should provide
clear information on how to
access appropriate treatment
when a child’s atopic eczema
becomes infected.
Children with atopic eczema
and their parents or carers
should be offered information
on how to recognise eczema
herpeticum. Signs of eczema
herpeticum are:
•areas of rapidly worsening,
painful eczema
•clustered blisters consist ent with early-stage cold
sores
•punched-out erosions (circular, depressed, ulcerated
lesions) usually 1–3 mm
that are uniform in appearance (these may coalesce
to form larger areas of erosion with crusting)
Eczema
•possible fever, lethargy or
distress.
Phototherapy and Systemic
treatments
Phototherapy should be
considered before systemic
treatments unless there are
contraindications such as very
fair skin or family history of skin
malignancies.
Phototherapy and systemic
treatments should be used
only in severe cases of atopic
eczema in children where other
management options have
failed or are not appropriate,
and where the atopic eczema
has a significant impact on
quality of life. It is the GDG’s
view that assessment and
documentation of severity and
quality of life should always be
undertaken prior to initiating
treatment with systemic
treatments or phototherapy.
Complementary Therapy
Children with atopic eczema
and their parents or carers
should be informed that the
effectiveness and safety of
complementary therapies
such as homeopathy, herbal
medicine, massage, and food
supple­ments for the management of atopic eczema have
not yet been adequately asses­
sed in clinical studies.
Children with atopic eczema
and their parents or carers
should be informed that:
•they should be cautious with
the use of herbal medicines
in children and be wary of
any herbal product that is not
labelled in English or does
not come with information
about safe usage
•topical corticosteroids are
deliberately added to some
herbal products intended for
use in children with atopic
eczema*
•liver toxicity has been asso­
ciated with the use of some
Chinese herbal medicines
intended to treat atopic
eczema.
Children with atopic eczema
and their parents or carers
should be asked to inform
their healthcare professionals if
they are using or intend to use
complementary therapies.
Children with atopic eczema
and their parents or carers
should be informed that if they
plan to use complementary
therapies, they should
keep using emollients as
well.
Children with atopic eczema
and their parents or carers
should be advised that regular
massage with emollients
may improve the atopic
eczema.
Education and adherence
to therapy
PRIORITY/
KEY
RECOMHealthcare professionals
should spend time educating MENDATION
children with atopic eczema
and their parents or carers
about atopic eczema and
its treatment. They should
provide information in verbal
and written forms, with
practical demonstrations,
and should cover:
•how much of the treat ments to use
•how often to apply treatments
•when and how to step
treatment up or down
• how to treat infected
atopic eczema.
This should be reinforced at
every consultation, addres­
sing factors that affect adherence.
Monitoring growth
The GDG believes that it is
cost-effective to monitor growth
in children with atopic eczema
that requires ongoing treatment.
The aim of monitoring should
be to identify failure to thrive
(which may reflect the severity
of the atopic eczema), and
therefore inform treatment
decisions, including referral.
Failure to thrive in atopic
eczema often indicates another
problem (such as nutritional
deficiency or food allergy).
Early identification of failure to
thrive (discrepancy between
height and weight, or stunted
growth) may prevent later
morbidity
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Eczema
Indications for referral
Referral for specialist derma­
tological advice is recommended for children with
atopic eczema if:
•the diagnosis is, or has
PRIORITY/
become, uncertain
KEY
•management has not con- RECOMtrolled the atopic eczema MENDATION
satisfactorily based on a
subjective assessment by
the child, parent or carer
(for example, the child is
having 1–2 weeks of flares
per month or is reacting
adversely to many emollients)
•atopic eczema on the face
has not responded to appro­
priate treatment
•the child or parent/carer
may benefit from specialist advice on treatment
application (for example,
bandaging techniques)
•contact allergic dermatitis
is suspected (for example,
persistent atopic eczema
or facial, eyelid or hand
atopic eczema)
•the atopic eczema is giving
rise to significant social or
psychological problems
for the child or parent/
carer (for example, sleep
disturbance, poor school
attendance)
•atopic eczema is asso­
ciated with severe and recurrent infections, especial­
ly deep abscesses or pneumonia.
Key Priorities for Research
1.What is the optimal feeding regimen in the first
year of life for children with established atopic
eczema?
2.Which are the best, most cost-effective treatment
strategies for managing and preventing flares in
children with atopic eczema?
3.What effect does improving the control of atopic
eczema in the first year of life have on the longterm control and severity of atopic eczema and the
subsequent development and severity of food allergy,
asthma and allergic rhinitis?
4.What are the long-term effects (when used for between
1 and 3 years) of typical use of topical corticosteroids
in children with atopic eczema?
5.How effective and cost-effective are different models
of educational programmes in the early management
of atopic eczema in children, in terms of improving
adherence to therapy and patient outcomes such as
disease severity and quality of life?
240
Levels of Evidence
Levels of evidence for intervention studies
Level Source of evidence
1++
1+
1-
2++
2+
2-
3
4
High-quality meta-analyses, systematic
reviews of randomized controlled trials (RCTs)
or RCTs with a very low risk of bias
Well-conducted meta-analyses, systematic
reviews of RCTs or RCTs with a low risk of
bias
Meta-analyses, systematic reviews of RCTs
or RCTs with a high risk of bia
High quality systematic reviews of casecontrol or cohort studies; high-quality case
control or cohort studies with a very low
risk of confounding, bias or chance and
a high probability that the relationship is
casual
Well-conducted case-control or cohort
studies with a low risk of confounding, bias or
chance and a moderate probability that the
relationship is causal
Case-control or cohort studies with a high
risk of confounding, bias or chance and a
significant risk that the relationship is not
causal
Non-analytical studies (for example case
reports, case series)
Expert opinion, formal consensus
Levels of evidence for the studies of the accuracy
of diagnostic tests
Level
Type of evidence
Ia
Ib
II
III
IV
Systematic reviews (with homogeneity)a of
level-1 studiesb
Level-1 studiesb
Level-2 studiesc; systematic reviews of
level-2 studies
Level-3 studiesd; systematic reviews of
level-3 studies
Consensus, expert committee reports or
opinions and/or clinical experience without
explicit critical appraisal; or based on physiology, bench research or ‘first
principles’
a Homogeneity
means there are no or minor variations in the
directions and degrees of results between individual studies
that are included in the systematic review.
b Level-1 studies are studies that use a blind comparison of the
test with a validated reference standard (gold standard) in a
sample of patients that reflects the population to whom the
test would apply.
c Level-2 studies are studies that have only one of the
following:
• narrow population (the sample does not reflect the
population to whom the test would apply)
• use a poor reference standard (defined as that where the
‘test’ is included in the ‘reference’, or where the ‘testing’
affects the ‘reference’)
• the comparison between the test and reference standard
is not blind
• case-control studies
d Level-3 studies are studies that have at least tow or three of
the features listed above
Eczema
Index of Drugs/Drug Classes mentioned in the Guideline
This index is not part of the guideline. It lists the products and/or their therapeutic classes as mentioned in the guideline. For
the doctor's convenience, brands available in the PPD references are listed under each of the classes. For drug information,
refer to the PPD references (PPD, PPD Pocket Version, PPD Text, PPD Tabs, and www.TheFilipinoDoctor.com).
Emollients, Demulcents & Protectants
Cetaphil Daily Advance Ultra
Hydrating Lotion
Cetaphil Restoraderm
Ezerra Cream
Aloe extract + Vitamin E
Elovera
Benzalkonium chloride + Triclosan +
Light Liquid Paraffin
Butylmethoxybenzoylmethane + Padimate O + Oxybenzone
Calamine + Diphenhydramine
Caladryl Lotion
Calamine + Zinc Oxide
Calmoseptine Ointment
Ceramide
Ceraklin
Hyaluronic acid, telmesteine,
Vitis vinifera, glycyrrhetinic
acid
Atopiclair
Lactacid + Sodium pyrrolidone
carboxylate
Lacticare Lotion
Lactoserum + Lactic Acid
Lactacyd Baby Bath
Light Liquid Paraffin
Oilatum Shower Gel
Saccharide isomerate + Dipalmitoyl
hydroxyproline
Ellgy H2O ARR Hydro Replenishing Cream
and Lotion
Clioquinol
Quadriderm
Titanium dioxide
Innobloc
Betamethasone + Mupirocin
Foskina-B
Urea
Nutraplus
Betamethasone + Neomycin sulfate
Betnovate-N
Vitamin A
Vandol
Betamethasone + Salicylic Acid
Beprosalic
Diprosalic
Zinc oxide
Desitin
Rashfree
Topical Corticosteroid
Betamethasone
Beprosone Ointment/Cream
Betacrem
Betacin
Betnelan
Betnovate/ Betnovate Scalp
Applications
Celestone
Diprolene
Diprospan
Diprosone
Innodesone
Betamethasone + Chlorpheniramine
maleate
Betamethasone + Clioquinol
Mineral oil + cetyl and stearyl
alcohol
Nutraderm
Betamethasone + Clotrimazole
Clotrasone
N-palmitoyl-ethanolamine + Physiological lipids
Physiogel Al Cream
Physiogel AI Sun Cream
Betamethasone + Clotrimazole + Gentamicin sulfate
Canison Plus
Topicrem
Triderm
Paraffin
Oilatum
Oilatum Shower Gel
Petroleum Jelly
Apollo Petroleum Jelly
Betamethasone + Dexchlorphenamine maleate
Celestamine
Physiological lipids
Physiogel Cream/Lotion
Betamethasone + Fusidic
acid/Sodium fusidate
Fucicort
Hoebedic
Physiological lipids + N-palmitoylethanolamine
Physiogel AI Cream
Physiological lipids + N-palmitoyl-ethanolamine + Tinosorb +
Titanium Dioxide
Physiogel AI Sun Cream
Betamethasone + Ebastine
Co-Aleva
Betamethasone + Loratadine
Claricort
Clobetasol propionate
Clobex
Clonate
Dermovate/Dermovate Scalp
Glevate
Desonide
Desowen Cream/Lotion
Diflucortolone valerate
Flume­tasone pivalate +
Salicylic acid
Locasalen
Fluocinolone + Neomycin
Aplosyn 10-N
Aplosyn N
Fluocinolone + Clioquinol
Aplosyn C
Fluocinonide
Fluocinonide + Neomycin sulfate +
Gramicidin + Nystatin
Fluocortolone
Fluticasone
Avamys
Cutivate
Flixotide
Flixotide Aqueous Nasal Spray
Nasoflo
Hydrocortisone
Cortizan
Lacticare-HC
Pharex Hydrocortisone
Hydrocortisone + Fusidic acid
Fucidin H
Betamethasone + Gentamicin
sulfate
Diprogenta
Hydrocortisone + Bacitracin +
Polymixin B + Neomycin
Trimycin-H
Betamethasone + Gentamicin
sulfate + Tolnaftate +
Mometasone
Elica
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241
Eczema
Mezo
Momate
Nasonex AQ Nasal Spray
Prednisolone
Histacort Cream
Triamcinolone
Triamcinolone + Neomycin sulfate +
Gramicidin + Nystatin
Hydrocortisone
Cortizan
Hyzonate
Lacticare-HC
Pharex Hydrocortisone
Solu-Cortef
Hydrocortisone + Polymyxin B +
Neomycin sulfate
Cortisporin
Hydrocortisone + Bacitracin + Polymyxin B + Neomycin
sulfate
Trimycin-H
Hydrocortisone + Clotrimazole
Candacort
Hydrocortisone + Fusidic acid
Fucidin H
Hydrocortisone + Miconazole nitrate
Daktacort
Feminine Care Cream
Topical Calcineurin Inhibitors
Tacrolimus
Protopic
Pimecrolimus
Elidel 1% Cream
Antihistamines
Cetirizine
Aforvir/Aforvir Syrup
Aletor
Allerkid
Allermed
Alnix/Alnix Plus
Antrazine
Avec
Benadryl One
Cetirizine Sandoz
Prixlae
Rhinitrin
RiteMED Cetirizine
Dihydrochloride
Sitizine
Texzine
Virlix
Welcet
Zericin
Zetrix
Zinex
Zyriz
Zyrrigin
Zyrtec
Chlorphenamine
Chlorphenoxamine
242
Clemastine fumarate
Marsthine
Clemastine hydrogen fumarate
Tavegyl
Tavist
Desloratadine
Aerius
Dimethindene maleate
Diphenhydramine HCl
Benadryl
Rabaphen
Soniphen
Diphenhydramine + Calamine
Caladryl Lotion
Ebastine
Aleva
Ebastine/Betamethasone
Co-Aleva
Fexofenadine
Neofex
Sensitin
Telfast
Hydroxyzine diHCl
Iterax
Levocetirizine diHCl
Glencet
Lerizine-5
Lisinex
Sensitrin
Tecovel
Xyzal
Zestra
Loratadine
Allerta
Claritin
L. Meyerf Loratadine
Loradaze
Lorange
Lorano
Loratyne
Lorfast
Lorid
Prevahist
UHP Loratadine
Zantih
Zylohist
Mequitazine
Primalan