From the Guidelines
Topical corticosteroids (TCSs) are recommended for the treatment of neck dermatitis, particularly for atopic dermatitis (AD) 1.
Key Points
- TCSs are considered first-line treatment for flare-ups and are effective in reducing the inflammatory immune response in AD 1.
- Duration of exposure to potent TCSs in sensitive skin areas, such as the neck, should be limited to avoid skin atrophy 1.
- Less potent TCSs should be used in children than those prescribed for adults 1.
- Topical moisturizers can improve skin barrier function and have a short- and long-term steroid-sparing effect in mild to moderate AD 1.
- For radiation dermatitis, topical moisturizers, hydrophilic dressings, and anti-inflammatory emulsions may be used 1.
- In cases of EGFR-inhibitor-induced skin reactions, topical antibiotics, topical steroids, and skin-type-adjusted moisturizers may be used 1.
From the Research
Topical Treatment for Neck Dermatitis
- The current evidence suggests that antifungal agents may be beneficial in the treatment of head and neck dermatitis (HND) 2, 3, 4.
- A study published in 2004 found that oral itraconazole was effective in reducing symptoms of HND, with significant improvement seen in the SCORAD index of the head and neck area 3.
- However, the study did not investigate the use of topical antifungal agents, and the effectiveness of topical treatments for HND is not well established 2, 5.
- Topical steroids and calcineurin antagonists are commonly used to treat atopic dermatitis, but their long-term use can be associated with cutaneous adverse effects or a black box warning 5.
- New and upcoming topical therapies are being developed and investigated, but their safety and efficacy profiles are not yet fully understood 5.
Antifungal Treatment
- The role of Malassezia spp in the pathogenesis of HND has been advocated, and antifungal agents may be effective in treating this condition 2, 3, 4.
- A retrospective single-center study found that a positive response to itraconazole in combination with topical treatments was observed in patients with HND 4.
- However, the study was limited by its single-center retrospective nature and small cohort of patients, and further research is needed to confirm these findings 4.
Treatment Outcomes
- The treatment outcomes for HND can vary depending on the clinical phenotype and the presence of concomitant atopic eczema 4.
- A study found that adolescent-onset HND was associated with a past history of AD and presented with exclusive head and neck involvement, while adult-onset HND was associated with concomitant widespread atopic eczema 4.
- Further research is needed to fully understand the clinical features and treatment response of HND in different patient populations 4.