Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section I: Pathophysiology of Atopic Dermatitis and Implications for Systemic Therapy

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 6S-9S ◽  
Author(s):  
Mark G. Kirchhof ◽  
Ian Landells ◽  
Chuck W. Lynde ◽  
Melinda J. Gooderham ◽  
Chih-ho Hong
Keyword(s):  
Atopic Dermatitis ◽  
Environmental Factors ◽  
Chronic Inflammation ◽  
Systemic Therapy ◽  
Skin Disease ◽  
Treatment Options ◽  
Adult Patients ◽  
Inflammatory Skin Disease ◽  
Consensus Document ◽  
Systemic Therapies

Atopic dermatitis (AD) is a chronic, relapsing, and remitting inflammatory skin disease whose onset typically occurs early in life. AD pathophysiology includes genetic, immune, and environmental factors contributing to chronic inflammation. A rapidly evolving understanding of the pathogenesis of AD has led to the development of several treatment options for AD in adults, including topicals, phototherapy, and systemic therapies. Here, we provide a concise summary of AD pathophysiology with a focus on implications for systemic therapy.

Review of Systemic Treatment Options for Adult Atopic Dermatitis

2016 ◽  
Vol 21 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Melinda Gooderham ◽  
Charles W. Lynde ◽  
Kim Papp ◽  
Marc Bourcier ◽  
Lyn Guenther ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Immune Responses ◽  
Systemic Therapy ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Skin Barrier ◽  
New Approach ◽  
Systemic Treatments ◽  
Systemic Therapies

Background: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. Objective: To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. Methods: A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. Results: Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. Conclusion: Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.

scholarly journals Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section V: Consensus Statements on the Assessment and Management of Adult Patients With Moderate-to-Severe Atopic Dermatitis

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 30S-35S ◽  
Author(s):  
Chih-ho Hong ◽  
Melinda J. Gooderham ◽  
Lorne Albrecht ◽  
Robert Bissonnette ◽  
Gurbir Dhadwal ◽  
...  
Keyword(s):  
Health Care ◽  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Treatment Options ◽  
Adult Patients ◽  
Severe Atopic Dermatitis ◽  
Care Providers ◽  
Extensive Experience ◽  
Consensus Document ◽  
Consensus Statements

This document is a concise, current, and practical guide for dermatologists and other health care providers managing adult patients with moderate-to-severe atopic dermatitis (AD). The recommendations made here are based on a consensus of specialists with extensive experience managing patients with AD. Topics reviewed in this publication include AD pathophysiology, assessment, comorbidities, and treatment options.

scholarly journals Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 3S-5S ◽  
Author(s):  
Melinda J. Gooderham ◽  
Chih-ho Hong ◽  
Lorne Albrecht ◽  
Robert Bissonnette ◽  
Gurbir Dhadwal ◽  
...  
Keyword(s):  
Health Care ◽  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Expert Panel ◽  
Adult Patients ◽  
Clinical Expertise ◽  
Care Providers ◽  
Consensus Document ◽  
Practical Management ◽  
Consensus Statements

Background: Atopic dermatitis (AD) is a chronic, relapsing, and remitting inflammatory skin disease with complex pathophysiology, primarily driven by type 2 inflammation. Existing guidelines often do not reflect all current therapeutic options and guidance on the practical management of patients with AD is lacking. Objectives: To develop practical, up-to-date guidance on the assessment and management of adult patients with AD. Methods: An expert panel of 17 Canadian experts, including 16 dermatologists and 1 allergist, with extensive clinical experience managing moderate-to-severe AD reviewed the available literature from the past 5 years using a defined list of key search terms. This literature, along with clinical expertise and opinion, was used to draft concise, clinically relevant reviews of the current literature. Based on these reviews, experts developed and voted on recommendations and statements to reflect the practical management of adult patients with AD as a guide for health care providers in Canada and across the globe, using a prespecified agreement cutoff of 75%. Results: Eleven consensus statements were approved by the expert panel and reflected 4 key domains: pathophysiology, assessment, comorbidities, and treatment. Conclusions: These statements aim to provide a framework for the assessment and management of adult patients with AD and to guide health care providers in practically relevant aspects of patient management.

scholarly journals Substantiation of Using Pimecrolimus 1% Cream in Proactive Therapy of Children with Atopic Dermatitis

2021 ◽  
Vol 20 (5) ◽  
pp. 376-382
Author(s):  
Nikolay N. Murashkin ◽  
Roman A. Ivanov ◽  
Eduard T. Ambarchian ◽  
Roman V. Epishev ◽  
Alexander I. Materikin ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Maintenance Therapy ◽  
Skin Disease ◽  
Pediatric Population ◽  
Efficacy And Safety ◽  
Inflammatory Skin Disease ◽  
High Prevalence ◽  
Proactive Therapy ◽  
Term Maintenance

Atopic dermatitis (AtD) is multifactorial inflammatory skin disease with high prevalence in pediatric population. It is crucial to implement long-term maintenance therapy to prevent AtD exacerbations according to current clinical guidelines and expert reports. The article summarizes the results of the major studies on using pimecrolimus 1% cream. Its efficacy and safety in long-term proactive therapy of children with AtD are presented.

scholarly journals Crocin ameliorated skin tissue inflammation in atopic dermatitis in mice

2020 ◽  
Vol 6 (2) ◽  
pp. 142
Author(s):  
Abdullah Alyoussef
Keyword(s):  
Atopic Dermatitis ◽  
Protein Expression ◽  
Skin Disease ◽  
Therapeutic Effects ◽  
Inflammatory Skin Disease ◽  
Mice Model ◽  
Subsequent Reduction ◽  
Gardenia Jasminoides ◽  
Tnf Α ◽  
Gene And Protein Expression

<p class="abstract"><strong>Background:</strong> Atopic dermatitis (AD) is considered a chronic recurrent inflammatory skin disease. In addition, crocin is the major carotenoid compound found in Gardenia jasminoides. It is previously proved to produce anti-inflammatory actions. Therefore, we conducted this research to investigate the therapeutic effects of crocin on a mice model of AD.</p><p class="abstract"><strong>Methods:</strong> Mice were investigated for the number of scratches and dermatitis score. Skin was isolated and used for measurements of gene and protein expression of β-catenin, NFκB, TNF-α and IL-1β.<strong></strong></p><p class="abstract"><strong>Results:</strong> Authors found that crocin significantly reduced the number of scratches, ear thickness and dermatitis score. In addition, crocin ameliorated AD-induced elevation in the expression of β-catenin, NFκB, TNF-α and IL-1β.</p><p class="abstract"><strong>Conclusions:</strong> Crocin ameliorated DNCB-induced AD in mice via blockage of β-catenin with subsequent reduction in inflammatory pathway.</p><p class="abstract"> </p>

scholarly journals Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section III: Treatment Options for Pediatric Atopic Dermatitis

2019 ◽  
Vol 23 (5_suppl) ◽  
pp. 19S-31S
Author(s):  
Perla Lansang ◽  
Joseph M. Lam ◽  
Danielle Marcoux ◽  
Vimal H. Prajapati ◽  
Shanna Spring ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Maintenance Therapy ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Skin Barrier ◽  
Active Therapy ◽  
Disease Treatment ◽  
Consensus Document ◽  
Emerging Therapies ◽  
Clinical Considerations

Because atopic dermatitis (AD) is a chronic, relapsing disease, treatment requires the use of both active therapy to control flares and preventative maintenance therapy to promote integrity of the skin barrier. In this third of four sections, important clinical considerations for the treatment of pediatric AD are reviewed. Emerging therapies in development for pediatric AD are introduced.

scholarly journals Atopic Dermatitis: From Etiology and History to Treatment

2021 ◽  
Vol 48 (3) ◽  
pp. 68-76
Author(s):  
L. Dourmishev ◽  
N. Mironova
Keyword(s):  
Atopic Dermatitis ◽  
Environmental Factors ◽  
Immunoglobulin E ◽  
Clinical Course ◽  
Inflammatory Skin Disease ◽  
Comprehensive Overview ◽  
Common Skin ◽  
Morphological Variants ◽  
Genetic And Environmental Factors ◽  
Developed World

Abstract Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease in patients with atopy. Atopy itself, is defined as a predisposition to develop immune response with overproduction of immunoglobulin E to low doses of allergens. AD is one of the most common skin disorders in the developed world, affecting up to 20% of children and about 3% of adults. The pathogenesis of the disease is complex, with both genetic and environmental factors playing a significant role in it. Clinically, hallmarks of atopic dermatitis include dry, itchy skin and various cutaneous efflorescence, compatible to dermatitis or eczema. Atopic dermatitis subdivides into three morphological variants manifesting during infancy, childhood and adulthood. Various environmental factors and associated diseases may have serious influence on the clinical course or may trigger disease relapses. The aim of this review article is to serve as a comprehensive overview of the etiology, pathogenesis, clinical course and diagnosis, as well as potential challenges facing the successful treatment of atopic dermatitis.

scholarly journals Comorbidities in Iranian Obese Psoriatic Patients Compared With Non-Obese Patients

2019 ◽  
Author(s):  
Omid Zargari ◽  
Seyyede Zeinab Azimi ◽  
Tara Barat ◽  
Vahideh Lajevardi ◽  
Ehsan Kazemnejad ◽  
...  
Keyword(s):  
Blood Sugar ◽  
Systemic Therapy ◽  
Skin Disease ◽  
Serum Lipids ◽  
Inflammatory Disorder ◽  
Obese Patients ◽  
Inflammatory Skin Disease ◽  
Medical Sciences ◽  
Laboratory Findings ◽  
Obese Subjects

Psoriasis is a common chronic inflammatory skin disease, which is gradually being recognized as a systemic inflammatory disorder. Psoriasis and obesity are strongly linked, but there is not enough data whether obese psoriatic patients present differently from non-obese psoriatic patients. To compare the phenotype, clinical features, severity, baseline comorbidities and laboratory findings among psoriatic patients with/without obesity all the psoriatic patients, from three centers, who were receiving systemic therapy were included in the study. Patients were divided into two groups: those with obesity and those without obesity. We included 497 patients: 154 (31%) patients were obese and 343 (69%) were non-obese. Obese patients had more comorbidities, particularly hyperlipidemia, followed by hypertension and diabetes. Fasting blood sugar and serum lipids were significantly higher among obese subjects. Given the differences between obese patients and non-obese patients, the former group should be followed and managed more closely and with specific attention. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(4):253-261.

Therapeutic Approach of Probiotic in Children with Atopic Dermatitis

2020 ◽  
Vol 19 ◽  
Author(s):  
Sangeeta Huidrom
Keyword(s):  
Atopic Dermatitis ◽  
Skin Disease ◽  
Developed Countries ◽  
Current Treatment ◽  
Inflammatory Skin Disease ◽  
Social Burden ◽  
The Family ◽  
Prevention And Treatment ◽  
Inflammatory Skin ◽  
Chronic Skin

: Pediatric atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease affecting 20% of children all over the world especially in developed countries. Recently, there is an increase in the prevalence rate of AD. This chronic inflammatory skin disease causes economic and social burden to the family. The exact cause of AD is not known, however recent studies suggest that imbalance of microflora present in the gut leads to AD. The current treatment of AD involves the application of moisturizer, topical corticosteroids, antihistamines and antibiotics. This line of treatment of AD in children has many side effects. An alternative novel therapeutic approached have to be explored to combat this chronic skin disease. In recent years there is increasing interest in the use of probiotic in the modulation of gut microbiota for the management of AD. Many research studies showed that administration of probiotic give positive results in the prevention and treatment of AD in children, however, the results are not consistent and conclusive. In this review, the dysbiosis of the gut flora contributes to the development of AD is addressed and clinical evidence of probiotics in the prevention and treatment of AD children is also summarises.

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