Emergency Department Management of Pediatric Atopic Dermatitis Requires Accurate Triage and Structured Discharge Planning

Atopic dermatitis (AD), the most common inflammatory skin disease of childhood, affects up to 20% of children in the United States and remains a frequent reason for emergency department (ED) visits, according to a recent review focused on acute management strategies.

The authors emphasize that one of the primary challenges in the ED is differentiating uncomplicated disease flares from secondary infections or treatment-related complications. Accurate assessment is critical because management strategies differ substantially depending on the underlying cause of symptom worsening.

Current evidence supports the use of topical corticosteroids as the foundation of acute treatment for most pediatric patients. According to the review, “evidence supports the judicious use of topical corticosteroids,” while systemic therapies should generally be reserved for patients with severe or refractory disease.

The expanding therapeutic landscape for AD also has implications for emergency clinicians. The authors note that newer biologic and targeted therapies are increasingly used in long-term disease management. Although these agents are typically initiated in specialty care settings, awareness of their use is important when evaluating patients who present to the ED with flares, complications, or treatment-related concerns.

Beyond acute intervention, the review highlights the importance of discharge planning as a key component of care. Families benefit from clear, structured instructions that support ongoing disease management after leaving the emergency setting.

Specifically, the authors recommend provision of an “Eczema Action Plan” along with detailed guidance regarding topical medication use, moisturization strategies, and appropriate follow-up with primary care clinicians and dermatologists. Such education may help families better recognize worsening disease, improve adherence to treatment regimens, and reduce future healthcare utilization.

The review also emphasizes the role of communication in long-term disease control. According to the authors, “emphasis on communication and education helps prevent recurrence, reduces unscheduled visits, and fosters adherence to outpatient management.”

Reference
Ch'en PY, McQueen A, Lio PA. Update on the clinical management of atopic dermatitis in the pediatric emergency department. Pediatr Emerg Care. 2026;42(6):483-490. doi:10.1097/PEC.0000000000003557