scholarly journals Atopic Dermatitis: Drug Delivery (Management) and Approaches (Strategies) in Perspective

2018 ◽  
Vol 54 (02) ◽  
pp. 078-089
Author(s):  
Virendra N. Sehgal
Keyword(s):  
Drug Delivery ◽  
Atopic Dermatitis ◽  
Treatment Options ◽  
Calcineurin Inhibitors ◽  
Cutaneous Manifestations ◽  
Topical Calcineurin Inhibitors ◽  
Systemic Corticosteroids ◽  
Age Related ◽  
Management Approaches ◽  
Minor Criteria

ABSTRACTAge-related cutaneous manifestations are definitive pointer to the diagnosis of atopic dermatitis, the confirmation of which is solicited by 3 major and 3 minor criteria. Its unpredictable course is punctuated by exacerbations and remissions. Several treatment options, namely: 1st, 2nd and 3rd line are in vogue ever since. The 1st line envisages general measures, 2nd encompasses topical applications, while the 3rd take into account drug therapy comprising, systemic Corticosteroids, Cyclosporin, Azathioprine, Thymopentin, Interferon–therapy, Topical Calcineurin inhibitors: Tacrolimus and Pimecrolimus. The mode of action, their dosages and adverse drug reaction (ADR), in particular, have been focused in this paper with special attention to refresh their drug delivery (management) approaches (strategies) in perspective. An endeavor to focus attention to emerging etio-pathogenesis, and its application in the contemporary context has also been made.

Evidence Review of Topical Calcineurin Inhibitors for the Treatment of Adult Atopic Dermatitis

2019 ◽  
Vol 23 (4_suppl) ◽  
pp. 5S-10S ◽  
Author(s):  
Chih-ho Hong ◽  
Melinda Gooderham ◽  
Robert Bissonnette
Keyword(s):  
Atopic Dermatitis ◽  
Treatment Options ◽  
Calcineurin Inhibitors ◽  
Term Treatment ◽  
Effective Treatment Option ◽  
Short Term Treatment ◽  
Topical Calcineurin Inhibitors ◽  
Recommended Treatment ◽  
The Face ◽  
Contemporary Management

Topical calcineurin inhibitors (TCIs) were approved in the early 2000s for the treatment of atopic dermatitis (AD), and despite the recent introduction of newer topical and systemic therapies for AD, TCIs such as tacrolimus ointment (0.03% and 0.1%) and pimecrolimus cream (1%), remain recommended treatment options in contemporary management guidelines. The goal of this article is to review the evidence supporting the approved indications for TCIs in adults with AD, including short-term treatment of active disease and as intermittent or maintenance treatment for the prevention of flares. Other evidence reviewed in this article includes the treatment of specific body areas (such as the face and eyelids), combination or sequential use of TCIs with topical corticosteroids, and the comparative efficacy of the 2 commercially available TCIs. This review of the evidence confirms that TCIs remain an effective treatment option for the management of adult AD.

scholarly journals Breaking the Itch–Scratch Cycle: Topical Options for the Management of Chronic Cutaneous Itch in Atopic Dermatitis

Medicines ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. 76 ◽  
Author(s):  
Ian P. Harrison ◽  
Fabrizio Spada
Keyword(s):  
Atopic Dermatitis ◽  
Treatment Options ◽  
Calcineurin Inhibitors ◽  
Cost Of Treatment ◽  
Topical Calcineurin Inhibitors ◽  
Chronic Itch ◽  
Itch Sensation ◽  
Chronic Pruritus

Chronic itch is an unpleasant sensation that triggers a desire to scratch that lasts for six weeks or more. It is a major diagnostic symptom of myriad diseases, including atopic dermatitis for which it is the most prominent feature. Chronic itch can be hugely debilitating for the sufferer, damaging in terms of both the monetary cost of treatment and its socioeconomic effects, and few treatment options exist that can adequately control it. Corticosteroids remain the first line treatment strategy for atopic dermatitis, but due to the risks associated with long-term use of corticosteroids, and the drawbacks of other topical options such as topical calcineurin inhibitors and capsaicin, topical options for itch management that are efficacious and can be used indefinitely are needed. In this review, we detail the pathophysiology of chronic pruritus, its key features, and the disease most commonly associated with it. We also assess the role of the skin and its components in maintaining a healthy barrier function, thus reducing dryness and the itch sensation. Lastly, we briefly detail examples of topical options for the management of chronic pruritus that can be used indefinitely, overcoming the risk associated with long-term use of corticosteroids.

Atopic Dermatitis: Case Series of Individualized Homoeopathic Treatment

2021 ◽  
Vol 11 (11) ◽  
pp. 115-123
Author(s):  
Mousumi Das
Keyword(s):  
Atopic Dermatitis ◽  
Family History ◽  
Case Series ◽  
Calcineurin Inhibitors ◽  
Loss Of Function ◽  
Key Words Atopic Dermatitis ◽  
Topical Calcineurin Inhibitors ◽  
History Of ◽  
Allergic Disorders ◽  
Positive Results

Atopic dermatitis is a common, chronic, intensely pruritic, relapsing inflammatory skin disease that affects both children and adults. Atopic dermatitis is often the originating of a series of allergic disorders, mentioned as the "atopic march".There are numerous risk factors correlated with AD development. However, only two have always been related, and they are (1) family history of atopy and (2) loss of function mutations in the FLG gene. Topical anti-inflammatory therapy with topical corticosteroids or topical calcineurin inhibitors treatment are available in conventional therapy but sometimes it has been reported that patients are also benefited from Homoeopathic treatment. Four patients who presented at the outpatient department at National Institute of Homoeopathy, Saltlake, Kolkata with Atopic dermatitis and a family history of asthma, allergic rhinitis were treated with constitutional homoeopathic medicine. Details of consultations, treatment and assessment are summarized. A constitutional treatment thus eliminates the symptoms locally and internally as well as long-lasting relief from complaints. Common remedies include Mercuris Solubilis, Sulphur. This case series shows positive results of homoeopathy in the treatment of Atopic dermatitis. Key words: Atopic dermatitis, Family history, Individualized Homoeopathic treatment, Case series, repertorisation.

Clinical Insights About Topical Treatment of Mild-to-Moderate Pediatric and Adult Atopic Dermatitis

2019 ◽  
Vol 23 (3_suppl) ◽  
pp. 3S-13S ◽  
Author(s):  
Charles W. Lynde ◽  
James Bergman ◽  
Loretta Fiorillo ◽  
Lyn Guenther ◽  
Jill Keddy-Grant ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Calcineurin Inhibitors ◽  
Skin Condition ◽  
Future Research ◽  
Barrier Dysfunction ◽  
Psychosocial Burden ◽  
Epidermal Barrier ◽  
Topical Corticosteroids ◽  
Topical Calcineurin Inhibitors ◽  
Inflammatory Conditions

Atopic dermatitis (AD) is a chronic inflammatory skin condition, also referred to as atopic eczema, that is identified by itching and recurrent eczematous lesions. It often starts in infancy where it affects up to 20% of children but is also highly prevalent in adults. AD inflicts a significant psychosocial burden on patients and their families and increases the risk of other immune-mediated inflammatory conditions, such as asthma and allergic rhinitis, food allergy, and mental health disorders. It is a lifelong condition associated with epidermal barrier dysfunction and altered immune function. Through the use of emollients and anti-inflammatory agents, current prevention and treatment therapies attempt to restore epidermal barrier function. Acute flares are treated with topical corticosteroids. Topical calcineurin inhibitors (TCIs) and topical corticosteroids (TCSs) are used for proactive treatment to prevent remission. There remains a need and opportunity to improve AD care through future research directed toward an improved understanding of the heterogeneity of the disease and its subtypes, the role of autoimmunity in its pathogenesis, the mechanisms behind disease-associated itch and response to specific allergens, and the comparative effectiveness and safety of therapies.

scholarly journals LONG-TERM CONTROL OF SKIN ALLERGIC INFLAMMATION IN ATOPIC DERMATITIS PATIENTS

2014 ◽  
Vol 11 (3) ◽  
pp. 30-36
Author(s):  
O G ELISYUTINA ◽  
E S FEDENKO
Keyword(s):  
Atopic Dermatitis ◽  
Topical Treatment ◽  
Allergic Inflammation ◽  
Calcineurin Inhibitors ◽  
Intermittent Treatment ◽  
Topical Corticosteroids ◽  
Topical Calcineurin Inhibitors ◽  
Proactive Therapy

Modern approaches to topical treatment of atopic dermatitis (ad) are presented in the review. the application of different proactive therapy patterns like topical corticosteroids intermittent treatment and topical calcineurin inhibitors as antirecurrent therapy of ad patients are discussed.

scholarly journals Pediatric Atopic Dermatitis: Update on the Treatment Options

2020 ◽  
Vol 25 (4) ◽  
pp. 60-62
Author(s):  
Corina Adelina Zah ◽  
Andreea Emiliana Toporău ◽  
Paul Grama
Keyword(s):  
Atopic Dermatitis ◽  
Chronic Treatment ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Chronic Inflammatory Disease ◽  
Term Treatment ◽  
Phosphodiesterase 4 ◽  
Systemic Corticosteroids ◽  
Long Term Treatment

Abstract Atopic dermatitis (AD) is a chronic inflammatory disease characterized by skin dryness, pruritus and eczematous lesions with various periods of relapse. Symptomatology can appear in childhood and can persist in adulthood. Chronic treatment is required with corticosteroids being the standard options. The side effects of this type of long-term treatment represent a major concern for the pediatric patients. This review aims to give an update of the options used for treatment, apart from the systemic corticosteroids. Mild-to-moderate AD had a good response to creams containing fig and oatmeal extracts and inhibitors of phosphodiesterase-4 (crisaborole). In cases of severe AD, future treatment options could include monoclonal antibodies such as omalizumab and dupilumab

scholarly journals Position statement: topical calcineurin inhibitors in atopic dermatitis

2018 ◽  
Vol 32 (12) ◽  
pp. 2074-2082 ◽  
Author(s):  
A. Remitz ◽  
O. De Pità ◽  
A. Mota ◽  
E. Serra-Baldrich ◽  
E. Vakirlis ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Calcineurin Inhibitors ◽  
Position Statement ◽  
Topical Calcineurin Inhibitors
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