Use of Complementary and Alternative Therapies in Outpatients with Atopic Dermatitis from a Dermatological University Department

Dermatology ◽  
2019 ◽  
Vol 235 (3) ◽  
pp. 189-195 ◽  
Author(s):  
Jesper Grønlund Holm ◽  
Maja-Lisa Clausen ◽  
Tove Agner ◽  
Simon Francis Thomsen

Background: Treatment of atopic dermatitis (AD) may be challenging, therefore some patients seek complementary and alternative medications (CAM). We determined prevalence and predictors for CAM use in a hospital cohort of AD patients. Material and Methods: Between January 1, 2012, and December 31, 2017, AD patients referred to the dermatological outpatient clinic at Bispebjerg Hospital were included in the study. Information on CAM use, demographics and disease characteristics were obtained by questionnaire, and associations were determined by χ2 and t test separately for children (< 16 years) and adults (≥16 years). Results: In total 441 filled in the questionnaire on AD, and 433 patients responded to the questions about CAM use: 198 children and 235 adults. A total of 137 (31.6%) had used one or more CAM. CAM use in children was significantly associated with prior use of ≥2 conventional treatments (p = 0.047) and topical calcineurin inhibitors (p = 0.021), a higher number of affected eczema sites (p < 0.001) including more frequent affection of the face and extremities, a higher SCORAD score (p = 0.045), and low mean overall self-rated health (p = 0.003). CAM use in adults was significantly associated with lower age of onset of AD (p = 0.004), comorbid allergic rhinoconjunctivitis (p = 0.039), frequent use of moisturizing cream (p = 0.024), facial and neck eczema (p = 0.005) and high educational level (p = 0.043). Conclusion: CAM use is frequent in both children and adult AD patients. CAM users are characterized by long disease duration, a significant disease burden and by having a longer education. The high prevalence of CAM may indicate that patients’ expectations regarding treatment of AD are not redeemed in the conventional health care system.

2020 ◽  
Author(s):  
Ahmed Abdul-aziz Ahmed ◽  
Hayder Saad Ahmed ◽  
Mustafa Hameed Mohammed ◽  
Mohammed Shanshal

Background: Vitiligo is an acquired depigmentary disorder of the skin, mucous membrane and hair follicle resulting from selective destruction of melanocytes. Aims of Study: Identify the clinico-epidemiological characteristics of childhood vitiligo. Patients and Methods: A retrospective study carried out at the dermato-venereology clinic of Salah Al-Din Hospital. A total of 120 vitiligo patients, all younger than 17 years old, were enrolled. Results: Among included patients, (40%) were male and (60%) were female (M:F=2:3). The mean age of onset was (11.5 SD 6.4 years) with (60.8%) of patients were (11-17) years old, (25%) were (6-11) years and (14.2%) were (0-5) years old. Majority of patients were from urban area (87.5%). Generalized types of vitiligo account for (56.7%) besides (22.5%), (17.5%) and (3.3%) represented focal, acrafacial and segmental vitiligo, respectively. Only (8.3%) have nail changes, presented as longitudinal ridging followed by leukonychia. Family history was positive in (37.5%) of vitiligo patients. Treatment used for vitiligo were topical corticosteroids (92.5%), topical calcineurin inhibitors (55%), NB-UVB (84.2%), and systemic steroids (30.8%). Conclusions: Majority of childhood vitiligo develops after puberty and predominantly affects female. Generalized vitiligo is the most frequent type. Atopic dermatitis is the most common associated disease.


2019 ◽  
Vol 23 (4_suppl) ◽  
pp. 5S-10S ◽  
Author(s):  
Chih-ho Hong ◽  
Melinda Gooderham ◽  
Robert Bissonnette

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.


2021 ◽  
Vol 11 (11) ◽  
pp. 115-123
Author(s):  
Mousumi Das

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.


2019 ◽  
Vol 23 (3_suppl) ◽  
pp. 3S-13S ◽  
Author(s):  
Charles W. Lynde ◽  
James Bergman ◽  
Loretta Fiorillo ◽  
Lyn Guenther ◽  
Jill Keddy-Grant ◽  
...  

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.


Author(s):  
Kalpana D. Shere-Wolfe

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not currently considered part of conventional medicine. If a non-mainstream practice is used together with conventional medicine, it is considered “complementary.” If a non-mainstream practice is used in place of conventional medicine, it is considered “alternative.” Many patients use CAM approaches to their care. Often, patients do not disclose what methods they are using, and providers may have little knowledge of the effects of alternative medications. Interactions with antiretroviral therapy and other medications are important to the care of the patient. Physicians need to routinely ask about CAM use, particularly herbal medicines and supplements.


2018 ◽  
Vol 54 (02) ◽  
pp. 078-089
Author(s):  
Virendra N. Sehgal

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.


2014 ◽  
Vol 11 (3) ◽  
pp. 30-36
Author(s):  
O G ELISYUTINA ◽  
E S FEDENKO

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.


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