FORMULARY MANAGEMENT Formulary Review of Therapeutic Alternatives for Atopic Dermatitis: Focus on Pimecrolimus

topic dermatitis (AD), often called eczema, is characterized by intense pruritus, erythema, dry skin, and inflamma-tion.1-3 The condition is chronic and relapsing and often occurs in patients with a family history of the atopic triad (asthma, allergic rhinitis, and AD). Two main concepts have evolved to explain the pathogenesis of AD: excessive T-cell activation in response to an antigen and hyperstimulation of T cells by atopic Langerhans cells.1,2,4 Prevalence of AD varies by geographic region. An analysis of AD among 155 collaborating centers in 56 countries reported prevalence rates ranging from <1 % to 20%.5 One report concerning schoolchildren in Oregon found 17 % had AD, suggesting that a wide variation by locale is also probable within the United States.6 Societal and Patient Costs Approximately 49 % to 70 % of childhood AD cases occur b