A novel non-steroidal treatment approach for moderate Atopic dermatitis in a 13-month-old infant using SNEPI: a case report.

Abstract

Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin condition with increasing prevalence in infancy. Standard treatments rely heavily on topical corticosteroids, but concerns about long-term side effects and limited efficacy in some cases highlight the need for alternative therapeutic strategies.

Methods: We present a 13-month-old male with moderate AD refractory to moisturizers and hydrocortisone ointments. Sympathetic Nerve Entrapment Point Injection (SNEPI) was administered bilaterally at the T7 paraspinal level using 1 mL of normal saline once weekly for three sessions. Clinical outcomes were monitored during treatment and over a six-year follow-up period.

Results: Pruritus resolved and sleep normalized after the first treatment. By the third session, complete remission of skin lesions was achieved without corticosteroid use, with no recurrence observed during four weeks of follow-up. During a six-year follow-up, the child maintained stable skin with only occasional mild pruritus, suggesting sustained therapeutic benefit.

Conclusions: This case demonstrates the potential of SNEPI as a safe, effective, and steroid-free neuromodulatory treatment for pediatric AD, supporting the role of autonomic modulation in inflammatory skin disorders. Further clinical studies are warranted to evaluate the broader applicability of SNEPI in pediatric dermatology.