Eczema (also known as atopic dermatitis) affects 20% of United Kingdom children, with 16% experiencing moderate-to-severe eczema. Eczema impacts patients’ quality of life, mainly through intense itching and sleep disturbance. Most caregivers are able to control their children’s eczema with topical treatments, including emollients, topical corticosteroids or calcineurin inhibitors. For those who do not respond to these topical treatments, or who require consistent use of high potency topical corticosteroids to maintain control, systemic therapies should be considered. Ciclosporin is the most commonly used systemic treatment for paediatric patients, but methotrexate is a widely used promising alternative. Currently, there is not enough evidence to inform guidance about which treatment (methotrexate or ciclosporin) should be used to treat severe atopic eczema in children and young people.
