<prompt> Answer this question truthfullyWhat is the medical treatment for atopic dermatitis?  <response>: <reason> Pharmacologic medical therapies for atopic dermatitis can be classified according to several severity scales including SCORAD index, the eczema area and severity index EASI, and the patient-oriented eczema measure POEM which includes characteristics of the rash, questions about itch, sleep, impact on daily activities, and persistence of disease. 1. Mild atopic dermatitis: 1.1 Topical corticosteroids and emollients - mainstay therapy 1.1.1 Adult Preferred regimen 1: Desonide 0.05 top. q12h-q24h for 14-28 days Preferred regimen 2: Hydrocortisone 2.5 top. q12h-q24h for 14-28 days Preferred regimen 3: Fluocinolone acetonide 0.01 top. q12h-q24h for 14-28 days Alternative regimen 1: Tacrolimus 0.1 top. q12h 0.03 for adults who do not tolerate the higher dose Alternative regimen 2: Pimecrolimus 1 top. q12h Alternative regimen 3 Crisaborole 2 top. 1.1.2 Pediatric Preferred regimen 1: Desonide 0.05 top. q12h-q24h for 14-28 days Preferred regimen 2: Hydrocortisone 2.5 top. q12h-q24h for 14-28 days Preferred regimen 3: Fluocinolone acetonide 0.01 top. q12h-q24h for 14-28 days Alternative regimen 1: Tacrolimus 0.03 top. q12h Children 2years Alternative regimen 2: Pimecrolimus 1 top. q12h Alternative regimen 3: Crisaborole 2 top. 2 Moderate atopic dermatitis 2.1 Topical corticosteroids and emollients - mainstay therapy 2.1.1 Adult Preferred regimen 1: Fluocinolone 0.025. q12h-q24h for 14-28 days Preferred regimen 2: Triamcinolone 0.1 top. q12h-q24h for 14-28 days Preferred regimen 3: Fluocinolone acetonide 0.025 top. q12h-q24h for 14-28 days Alternative regimen 1: Tacrolimus 0.1 top. q12h 0.03 for adults who do not tolerate the higher dose Alternative regimen 2: Pimecrolimus 1 top. q12h Alternative regimen 3: Crisaborole 2 top. 2.1.2 Pediatric Preferred regimen 1: Fluocinolone 0.025. q12h-q24h for 14 days Preferred regimen 2: Triamcinolone 0.1 top. q12h-q24h for 14 days Preferred regimen 3: Fluocinolone acetonide 0.025 top. q12h-q24h for 14-28 days Alternative regimen 1: Tacrolimus 0.03 top. q12h Children 2years Alternative regimen 2: Pimecrolimus 1 top. q12h Alternative regimen 3: Crisaborole 2 top. 3. Severe atopic dermatitis 3.1 Phototherapy or systemic immunosuppressant treatment - mainstay therapy 3.1.1 Adult Preferred regimen 1: Phototherapy Ultraviolet light therapy with PUVA psoralens plus ultraviolet A radiation, 3 times a week Preferred regimen 2: Cyclosporine PO 3-5 mgkg o.d. for 6 weeks monitor BP and serum creatinine q2 weeks for three months, fu q month Alternative regimen 1: Methotrexate PO Alternative regimen 2: Azathioprine PO Alternative regimen 3: Mycophenolate mofetil PO Alternative regimen 4: Dupilumab 600 mg SQ once and then 300 mg SQ every 2 weeks thereafter 3.1.2 Pediatric Preferred regimen 1: Phototherapy Ultraviolet light therapy with PUVA psoralens plus ultraviolet A radiation, 3 times a weekolder children 6 years Alternative regimen 1: Cyclosporine PO 3 to 5 mgkg per day o.d. for 6 weeks monitor blood pressure and serum creatinine every 2 weeks for three months, fb every month Alternative regimen 2: Azathioprine PO Alternative regimen 3: Mycophenolate mofetil PO Alternative regimen 4: Dupilumab 600 mg SQ once and then 300 mg SQ every 2 weeks thereafter 4. Severe refractory atopic dermatitis 4.1 Adult Preferred regimen 1: Intensive topical therapy Soak and smear: Soak for 15 minutes in a tub of water. Apply desoximetasone 0.25 top. to the whole body, except the groin, axillae, and face. Wet wrap therapy: Desoximetasone 0.25 top. then occluded with wet wraps q12h Alternative regimen 1: Phototherapy: narrowband ultraviolet B or psoralen plus ultraviolet A two to three times per week Alternative regimen 2: Cyclosporine PO 2.5 to 5 mgkg o.d. CI - abnormal renal function, uncontrolled hypertension or infection, and malignancy Alternative regimen 3: Prednisone 40 to 60 mg o.d. for one week, then taper the dose over the following two to three weeks Alternative regimen 4: Methotrexate 7.5 to 25 mg single weekly dose with folic acid 1 mg o.d. Alternative regimen 5: Azathioprine 2 to 3 mgkg Alternative regimen 6: Mycophenolate mofetil 1 to 2 gday Alternative regimen 7: Mycophenolic acid 720 to 1440 mgday Alternative regimen 8: Dupilumab 600 mg SQ once and then 300 mg SQ every 2 weeks thereafter 4.2 Pediatric Preferred regimen 1: Intensive topical therapy Wet wrap therapy: Desoximetasone 0.05 top. then occluded with wet wraps q12h-q24h for 2 to 14 days Alternative regimen 1 Phototherapy: narrowband ultraviolet B UVB 3 times per week older children 6 years Alternative regimen 2: Cyclosporine PO 2.5 to 5 mgkg o.d. for 2-4 months monitor renal and hepatic function Alternative regimen 3: Methotrexate 0.5 mgkg PO single weekly dose with folic acid 1 mg o.d.up to a maximum of 25 mg per week Alternative regimen 4: Methylprednisolone 0.5 mgkg o.d. for 1-2 weeks tapered over one monthOther Drugs for atopic dermatitis:I nterferon-γ sub-q o.d. for 12 weeks Anti-CD20 therapy Rituximab Anti-IgE Omalizumab Anti-TNFα therapy Infliximab Anti-IL-6 receptor therapy Tocilizumab Adjuvant treatment:Primrose oil Omega-3 Probiotics Chinese herbal medicines Oral vitamin D Management of Infections:Bacterial infections: most common bacteria - S taphylococcus aureus Clinically infected skin: Mupirocin 2 top. BID for one to two weeks More extensive infection: Oral antibiotic therapy with cephalosporins or penicillinase-resistant penicillins for two weeks. Clinically uninfected skin: Liquid chlorine bleach- 0.5 cup or 120 ml of 6 bleach in a full bathtub 40 gallons or 150 L of lukewarm water Viral infections: Herpes simplex virus: Acyclovir 200 or 400 mg PO five times daily Famciclovir 750 mg BID for one day or 1500 mg as a single dose Molluscum contagiosum: Cryotherapy, curettage, cantharidin, and podophyllotoxin as first-line therapeutic options. Fungal infections: Dermatophyte infections - topical or oral antifungals Controlling pruritus:Preferred regimen: Sedatives: Diphenhydramine, hydroxyzine, and cyproheptadine Non-sedatives: Fexofenadine, cetirizine or loratadine Alternative regimen: Topical doxepin Topical calcineurin inhibitors Pimecrolimus 1 cream or tacrolimus 0.03 to 0.1 Potential systemic therapies not yet approved: JAK inhibitors: Abrocitinib JAK1 Gusacitinib pan-JAK, SYK Tofacitinib JAK1 and JAK3 Upadacitinib JAK1 Interleukin-13 receptor antibodies nterleukin-22 receptor antibody Interleukin-31 receptor A antibody Interleukin-33 receptor A antibody Phosphodiesterase-4 inhibitor 