71 Role of food hypersensitivity in mild to severe atopic dermatitis

1988 ◽  
Vol 81 (1) ◽  
pp. 186
Author(s):  
A.W. Burks ◽  
M.A. Sherrill ◽  
S.B. Mallory ◽  
L.W. Williams
Keyword(s):  
Atopic Dermatitis ◽  
Food Hypersensitivity ◽  
Severe Atopic Dermatitis

scholarly journals Participation of Neuropeptides and β-endorphin in Pathogenesis of Atopic Dermatitis. Evaluation of Levocetirizine Effectiveness upon Neuropeptides' Levels at Children with Atopic Dermatitis

2009 ◽  
Vol 7 (2) ◽  
pp. 74-80
Author(s):  
V A Revyakina ◽  
A S Agaphonov ◽  
T B Sentsova ◽  
M P Phabrika
Keyword(s):  
Atopic Dermatitis ◽  
Clinical Symptoms ◽  
Signs And Symptoms ◽  
Severe Atopic Dermatitis ◽  
Neurokinin A ◽  
Double Blind ◽  
Developmental Mechanisms ◽  
Days Of Therapy

Objective. Determination of the role of neuropeptides and p-endorphin in developmental mechanisms of atopic dermatitis, and assessment of the effectiveness of levocetirizine, a modern Hl-antihistamine, on atopic dermatitis symptoms and its influence on the SCORAD index in children with atopic dermatitis. Materials and methods. 84 children with atopic dermatitis of moderate-to-severe or severe clinical nature, aged 1 to 17 years, were enrolled in this (double-blind or open, randomised, etc.) study. Patients were treated with levocetirizine 5 mg once daily during 14 days. The levels of P substance, neurokinin A, neurokinin B, and p-endorphin in blood serum, as well as levocetirizine effectiveness on disease symptoms and the SCORAD index were evaluated. Results. Lower neuropeptide levels were associated with disease severity; children with severe atopic dermatitis had lower neuropeptide values. Before treatment, SCORAD index in children with severe atopic dermatitis was 76,5±11,3, and after 7 days of therapy SCORAD index was 14±6,2 points (p< 0,01). By the 7th day after treatment initiation, the acute atopic dermatitis became of subacute nature and was accompanied by a regression of the cutaneous eruption in the form of significant decreasing of skin manifestations and pruritus, absence of new eruption and normalized sleep. In children with moderate-to-severe atopic dermatitis the SCORAD index before levocetirizine treatment was 44,2±3,4 points; on the 3rd day, this index was 20,4±2,6 points; and on the 7th day there was a complete absence of clinical symptoms of the main disease. Levocetirizine administration led to the disappearance of the disease clinical symptoms and pruritus in children with moderate-to-severe atopic dermatitis. Conclusion. This trial demonstrated that neuropeptides are involved in the developmental mechanisms of atopic dermatitis and that levocetirizine can significantly improve the signs and symptoms of children with moderate-to-severe or severe atopic dermatitis.

scholarly journals The role of the nurse in the care and management of patients with atopic dermatitis

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Harmieke van Os-Medendorp ◽  
Elfie Deprez ◽  
Nele Maes ◽  
Sheila Ryan ◽  
Karina Jackson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Treatment Adherence ◽  
Self Management ◽  
Severe Atopic Dermatitis ◽  
Main Body ◽  
Wide Range

Abstract Background The purpose of this paper is to provide an overview of key aspects of specialised dermatology nursing practice in the management of patients with moderate to severe atopic dermatitis. The role of dermatology nurse specialists in supporting patients and promoting disease understanding, education and treatment adherence continues to evolve. As features of specialised nursing care can also inform other nursing staff in a wide range of care settings, an overview of key components is examined. Observations presented are from a pan-European perspective and represent the collected view of a group of dermatology nurse specialists, dermatologists and patient advocates following two round-table discussions. Main body Atopic dermatitis is a common, chronic, inflammatory disease characterised by erythematous/scaling skin lesions, with often intense pruritus. Disease course is cyclic with periodic disease flares of varying intensity, presenting management challenges to patients and families. Dermatology nurse specialists play a key role in providing education and substantial patient support to improve treatment outcomes and quality of life to patients and their family, delivered within a multidisciplinary team framework. Nurse-led education and 'eczema schools’ are of benefit in reducing disease severity and improving quality of life by enhancing self-management, adherence and patient engagement. eHealth tools, such as patient portals or online training platforms, can provide online learning, individualised education, and help to improve engagement. These and other initiatives, such as written action plans, are all essential to improve or maintain treatment adherence, self-management and quality of life. Conclusions Dermatology nurse specialists play a central role in the assessment and management of moderate to severe atopic dermatitis patients and families. This places them in an ideal position to build strong and often long-term relationships with patients and parents. Such engagement promotes trust, assists in setting realistic expectations of treatment and outcomes, and enhances self-management and engagement in their own care. Providing emotional support, as well as formal and systematic education (including individualised practical advice) all contribute to improved treatment adherence and can enhance the quality of life of patients and their families throughout the course of this long-term condition.

Novel Therapeutic Approaches and Targets for the Treatment of Atopic Dermatitis

2020 ◽  
Vol 22 (1) ◽  
pp. 73-84
Author(s):  
Leonardo Pescitelli ◽  
Elia Rosi ◽  
Federica Ricceri ◽  
Nicola Pimpinelli ◽  
Francesca Prignano
Keyword(s):  
Atopic Dermatitis ◽  
Monoclonal Antibodies ◽  
Small Molecules ◽  
Cell Activation ◽  
Skin Diseases ◽  
Severe Atopic Dermatitis ◽  
Efficacy And Safety ◽  
Inflammatory Skin Diseases ◽  
Th2 Cell

Background: Atopic Dermatitis is one of the most common inflammatory skin diseases, with an estimated prevalence of 2.1-4.9% in adults. Recently, advances in Atopic Dermatitis understanding have highlighted the role of inappropriate Th2 cell activation as principally involved in its pathogenesis. Other immune pathways seem to play a key role in the complex Atopic Dermatitis pathophysiology. The anti-IL-4/IL-13 was the first monoclonal antibody approved for the treatment of moderate to severe atopic dermatitis in adult patients whose disease is resistant to other therapies. Following its interesting results in terms of efficacy and safety, new therapies are in development. Methods: Monoclonal antibodies targeting IL-5, IL-13, IL-17, IL-22, IL-23, IL-31 and TSLP are currently under investigation on patients with moderate to severe Atopic Dermatitis patients. Moreover, small molecules like anti-PDE4 and JAK inhibitors may also represent other treatment possibilities. Results: In this section, we present data available on the efficacy and safety of newer molecules for the treatment of Atopic Dermatitis. Conclusion: The extreme clinical heterogeneity and the chronic progression of Atopic Dermatitis need for newer, safer and more effective treatments, able to control the disease and to improve the quality of life of affected patients. Dupilumab, and the other monoclonal antibodies and small molecules currently under investigation aim to improve the clinical management of Atopic Dermatitis.

scholarly journals Biological treatment of severe asthma: new objectives and new treatment options

2019 ◽  
pp. 50-61
Author(s):  
N. M. Nenasheva
Keyword(s):  
Monoclonal Antibody ◽  
Atopic Dermatitis ◽  
Severe Asthma ◽  
Biological Treatment ◽  
Treatment Options ◽  
Severe Atopic Dermatitis ◽  
Α Subunit ◽  
Main Emphasis ◽  
New Treatment

This article is devoted to the main characteristics of severe bronchial asthma (SBA) and its heterogeneity, in particular, T2 asthma is characterized and the role of the main cytokines forming T2-inflammation is presented. The main emphasis is made on the role of the IL-4 and IL-13 in the pathogenesis of AD as the key cytokines in the initiation and maintenance of T2-inflammation, as well as on a new biological molecule – monoclonal antibody – dupilumab, directed to the α-subunit of IL-4 receptor, thus blocking the pathways of IL-4 and IL-13. Dupilumab has recently been registered in our country for the treatment of moderate and severe BA, as well as moderate and severe atopic dermatitis. The article presents the clinical efficacy and tolerability of dupillumab in patients with moderate and severe BA.

scholarly journals Uses of Antidepressant as Adjunct Treatment of Very Severe Atopic Dermatitis

2021 ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Atopic Dermatitis ◽  
Severe Depression ◽  
The Body ◽  
Severe Atopic Dermatitis ◽  
Vicious Cycle ◽  
Adjunct Treatment ◽  
Married Male ◽  
Game Changer

This is a case of severe atopic dermatitis in a young married male age 37 years. This patient was very anxious and frustrated. The patient was using all the standard treatments for severe atopic dermatitis for e.g azathioprine, cyclosporine, tab deltacortril, applying emollients with clobetasol in it but he was not getting better. By chance the patient's family dragged him to visit a psychiatrist and the patient was advised to start venlafaxine and within 15 days the patient started getting better miraculously. Atopic Dermatitis is a very frustrating disease and patients face severe depression and bouts of severe itching exacerbated by exposure to dust, stress, sweating, changing and wearing clothes, etc. The use of antidepressants is not common practice in treating atopic dermatitis. Most general practitioners and dermatologists don't pay attention to how much a patient is suffering not only physically but also mentally and because of this, they don't suggest antidepressants. The role of antidepressants as an anti-inflammatory is still needed to be educated among physicians. This is a vicious cycle. The stress causes the exacerbation of this disease in which patients start itching all over the body and because of itching, lesions all over the body start getting infected as during itching staphylococcus aureus which resides under the nail enter in the lesion and cause infection and because of infection patients have a fever, lethargy, and weakness. The use of antidepressants is a game-changer in the management of atopic eczema.

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