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.

Review of Atopic Dermatitis and Topical Therapies

2016 ◽  
Vol 21 (3) ◽  
pp. 227-236 ◽  
Author(s):  
Julia N. Mayba ◽  
Melinda J. Gooderham
Keyword(s):  
Atopic Dermatitis ◽  
Kinase Inhibitors ◽  
Calcineurin Inhibitors ◽  
Janus Kinase ◽  
Treatment Modalities ◽  
Comprehensive Overview ◽  
Topical Corticosteroids ◽  
Topical Calcineurin Inhibitors ◽  
Common Skin ◽  
New Treatments

Atopic dermatitis is one of the most common skin disorders in the developed world, affecting up to 20% of children and 1% to 3% of adults. This review concisely explains the pathophysiology and epidemiology of atopic dermatitis, as well as potential challenges facing its successful treatment. Furthermore, mainstay topical treatment modalities are evaluated, such as emollients, topical corticosteroids, and topical calcineurin inhibitors. The use of topical corticosteroids and topical calcineurin inhibitors in combination is discussed, as studies have indicated encouraging results. The proactive use of topical corticosteroids and topical calcineurin inhibitors is also investigated, in order to bring attention to a new possibility in long-term management of atopic dermatitis. Last, new and upcoming topical medications are described, including Janus kinase inhibitors, phosphodiesterase-4 inhibitors, and benvitimod. Although topical corticosteroids and topical calcineurin inhibitors can be very effective in the treatment of atopic dermatitis, it is important that practitioners are aware of mechanistically unique and new treatments for patients for whom more traditional topical therapies have failed. Overall, this review article hopes to serve as a comprehensive overview of currently available topical treatments for atopic dermatitis, while shedding light on new treatments coming in the future.

A review on atopic dermatits

2021 ◽  
Vol 6 (2) ◽  
pp. 63-70
Author(s):  
Ashwini A Zanke ◽  
Hemant H Gangurde ◽  
Ananta B Ghonge ◽  
Pavan R Hiwale
Keyword(s):  
Allergic Rhinitis ◽  
Atopic Dermatitis ◽  
Calcineurin Inhibitors ◽  
Skin Barrier ◽  
Skin Disorders ◽  
Multifaceted Approach ◽  
Topical Corticosteroids ◽  
Topical Calcineurin Inhibitors ◽  
Care Practices

(AD) is common, chronic skin disorders that can significantly quality of life of affected individuals as well as their families. Although the pathogenesis of the disorder is not completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental & infectious agents, & immune deregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that corticosteroids, Topical calcineurin inhibitors Atopic dermatitis(AD) is a chronic, highly pruritic(itchy) inflammatory skin disease, & is one of the most common skin disorders in children. The disorder results in significant morbidity & adversely affects quality of life.Not only are patients affected by the social stigma of a visible skin condition, but the intense itching characteristic of the disease often leads to skin trauma & significant sleep disturbances. In addition, management of the condition necessitates the frequent application of emollients (agents that soothe, moisturize take into account the patient’s history & clinical manifestations. Successful management of the disorder requires a multifaceted approach that involves education, optimal skin care practices, anti-inflammatory treatment with topical corticosteroids and/or topical calcineurin inhibitors, the management of pruritus, & the treatment of skin infections. Systemic immunosuppressive agents may also be used, but are generally reserved for severe flare-ups or more difficult-to-control disease. Topical corticosteroids are the first-line pharmacologic treatments for AD, & evidence suggests that these agents may also be beneficial for the prophylaxis of disease flare-ups. Although the prognosis for patients with AD is generally favourable, those patients with severe, widespread disease & concomitant atopic conditions, such as asthma & allergic rhinitis, are likely to experience poorer outcomes. Keywords: Atopic dermatitis, Diagnosis & management, Emollients, Skin care practices, Topical & soften the skin) & topical medications, as well as physician visits. AD also poses a significant economic burden with an estimated annual cost in Canada of $1.4 billion. Current evidence suggests that AD is a primary skin barrier defect that facilitates the development of other atopic conditions., In fact, AD is often the initial step in the “atopic march” (the sequential development of allergic disease manifestations during early childhood), which leads to asthma and/or allergic rhinitis in the majority of afflicted patients.Early AD may also be a causative factor in the development of food allergy. Newer insights into AD suggest that both structural abnormalities of the skin & immune dyregulation play important roles in the pathophysiology of the disease. Therefore, optimal management of AD requires a multifaceted approach aimed at healing & protecting the skin barrier & addressing the complex immune pathogenesis of the disease., This article provides an overview of current literature related to the epidemiology, pathophysiology, diagnosis, & appropriate management of AD

ATOPIC DERMATITIS – AN OVERVIEW

2021 ◽  
pp. 40-42
Author(s):  
Jayakar Thomas
Keyword(s):  
Atopic Dermatitis ◽  
Environmental Factors ◽  
Genetic Susceptibility ◽  
Skin Disorder ◽  
Immunosuppressive Treatment ◽  
Skin Lesions ◽  
Skin Care ◽  
Barrier Dysfunction ◽  
Epidermal Barrier ◽  
Topical Corticosteroids

Atopic dermatitis is a chronic relapsing inammatory skin disorder with a complex pathogenesis involving genetic susceptibility, immunologic and epidermal barrier dysfunction, and environmental factors. Pruritus is a primary symptom; skin lesions range from mild erythema to severe lichenication to erythroderma. Diagnosis is by history and examination. Treatments include counseling on appropriate skin care, avoidance of triggers, and topical corticosteroids and immunosuppressants. Control of pruritus and superinfections is also important. Severe cases may require systemic immunosuppressive treatment. Childhood atopic dermatitis frequently resolves or lessens signicantly by adulthood.

scholarly journals The efficacy and safety of local therapy of atopic dermatitis in infants and school-age children

2020 ◽  
pp. 54-59
Author(s):  
O. I. Sidorovich ◽  
A. A. Tsyvkina ◽  
G. D. Abdullaeva
Keyword(s):  
Atopic Dermatitis ◽  
Local Therapy ◽  
Calcineurin Inhibitors ◽  
Skin Inflammation ◽  
School Age Children ◽  
Skin Barrier Function ◽  
Barrier Dysfunction ◽  
Epidermal Barrier ◽  
Atopic March ◽  
Age Related

Atopic dermatitis is a multifactorial genetic inflammatory skin disease associated with disturbances of skin barrier function affected by predisposition to IgE-mediated hypersensitivity, which is characterized by itching, chronic recurrent course of the disease, age-related features of localization and lesion morphology, and requires the long-term and permanent treatment.Treatment is based on the continuous use of emollients, topical calcineurin inhibitors, topical glucocorticoids, and hygienic skin care.The mechanisms of the atopic dermatitis development are primarily based on a genetic predisposition to allergies, failure of the normal development of congenital and acquired factors of the immune system, as well as the influence of environmental factors and various trigger factors, such as allergenic (food, indoor, epidermal, fungal allergens, etc.). and non-allergenic (tobacco smoke, pollutants, psycho-emotional stress, concomitant chronic and acute diseases, mainly ARVI, etc.).It has been established that atopic dermatitis is characterized by the epidermal barrier dysfunction leading to excessive tran-sepidermal water loss, increased permeability of the epidermis, the penetration of allergens and microbial agents via the skin and eventually to sensitization to allergens and the development of specific allergic skin inflammation and atopic march with the sequential development of other atopic diseases.Modern therapeutic strategies are actively aimed at repairing the epidermal barrier, preventing sensitization and atopic march development. This article describes the features of the epidermal barrier dysfunction in atopic dermatitis, lists the methods of its restoration and ways to prevent subsequent exacerbations using local therapy and emollients, and presents 3 clinical cases.

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