Pruritus and Atopic Dermatitis: from Etiological Features to Management

Pruritus is one of the main clinical manifestations of atopic dermatitis, and it significantly reduces the quality of life of patients in childhood. Scientific images on its pathophysiological basis have now undergone significant changes. The histamine exceptional role in pruritus development was confounded, as well as data on immune system involvement in its maintenance was given. This article presents current data on differential approaches to pruritus management depending on its etiopathogenetic characteristics. The role of dermocosmetics in restoration of the skin barrier as the first stage prevention of pruritus in atopic dermatitis was considered. The results of clinical studies showing efficacy of topical agents (innovative component with anti-pruritic action — STIMU-TEX) application are presented.

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Atopic Dermatitis Severity, Patient Perception of the Disease, and Personality Characteristics: How Are They Related to Quality of Life?

Life ◽

10.3390/life11121434 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1434

Author(s):

Liborija Lugović-Mihić ◽

Jelena Meštrović-Štefekov ◽

Iva Ferček ◽

Nives Pondeljak ◽

Elvira Lazić-Mosler ◽

...

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Anxiety Disorder ◽

Personality Traits ◽

Clinical Manifestations ◽

Personality Characteristics ◽

World Health ◽

Patient Specific ◽

World Health Organization Quality

Introduction: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition that greatly affects patients’ quality of life, psychological condition, and social relationships. Materials And Methods: To analyze different aspects of AD patients’ quality of life, we used the SCORing Atopic Dermatitis (SCORAD) index (for AD severity), the Dermatology Life Quality Index (DLQI), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), the Brief Illness Perception Questionnaire (Brief IPQ), and the Crown–Crisp Experiential Index (CCEI) to analyze personality traits. The study included 84 AD patients, 42 with clinical manifestations and 42 in remission. Results: SCORAD values correlated positively and linearly with DLQI (r = 0.551; p < 0.001) and with disease impact on life, disease control, and disease symptoms (r = 0.350–0.398; p ≤ 0.023). DLQI was also related to certain personality characteristics (free-floating anxiety disorder, obsession, somatization, and depression (p ≤ 0.032)). Symptomatic AD patients had a significantly more impaired DLQI than asymptomatic patients (p < 0.001) and the two groups differed in some IPQ dimensions, but they did not differ significantly concerning the WHOQOL-BREF dimensions and personality traits (CCEI). Conclusion: Since AD patient quality of life was dependent not only on disease severity but was also influenced by patient personality characteristics (anxiety disorder, obsession, somatization, depression), many factors need to be taken into account to create effective, patient-specific therapy regimens.

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The Role of Probiotics in Preventing Allergic Disease

Children ◽

10.3390/children6020024 ◽

2019 ◽

Vol 6 (2) ◽

pp. 24 ◽

Cited By ~ 11

Author(s):

Helen T. Wang ◽

Sara Anvari ◽

Katherine Anagnostou

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Atopic Dermatitis ◽

Optimal Dosing ◽

Atopic Individual ◽

Prevention And Treatment ◽

Microbiome Research ◽

Allergic Disorders

The prevalence of allergic disorders has been increasing worldwide and significantly impacts the quality of life of the atopic individual. There has been an increased interest in the role of probiotics for the prevention and treatment of allergic disorders, given the recent evidence that atopy risk may be associated with a dysbiosis of the gut microbiome. Research in this area is ongoing with some studies showing possible benefits of probiotics, with seemingly little to no risk. While these studies suggest that there may be a promise in probiotic use for the prevention or treatment of allergy, further evidence is needed to determine its efficacy, optimal dosing, and strains needed for treatment. In this review, we discuss recently published studies examining the benefits, risks, and role of probiotics in preventing atopic dermatitis, asthma, allergic rhinitis, and food allergy.

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Neuroimmune mechanisms of pruritus in atopic dermatitis

Medical alphabet ◽

10.33667/2078-5631-2021-41-12-16 ◽

2022 ◽

pp. 12-16

Author(s):

Y. A. Kandrashkina ◽

E. A. Orlova ◽

A. A. Pribytkov

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Skin Disease ◽

Neurogenic Inflammation ◽

New Methods ◽

Neuroimmune Interactions ◽

High Prevalence ◽

Depth Study

Atopic dermatitis is a chronic hereditary recurrent skin disease. One of the most pronounced symptoms of this dermatosis is itchy skin. Pruritus accompanies atopic dermatitis in more than 80% of cases. This review presents modern data on the mechanisms of pruritus formation in atopic dermatitis. The issues of etiological factors, neuroimmune interactions, peculiarities of skin dysfunction, as well as the role of stress are considered. The relevance of studying the topic is due to the high prevalence of atopic dermatitis among the population, a decrease in the quality of life and the lack of effective therapy. Analysis of the literature indicates the need for a comprehensive assessment of the pathogenetic mechanisms of the development of pruritus in atopic dermatitis. A more in-depth study of the mechanisms of neurogenic inflammation in atopic dermatitis will contribute to the development of new methods of diagnosis and treatment.

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

BMC Nursing ◽

10.1186/s12912-020-00494-y ◽

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.

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Atopic dermatitis: advancement and problems in understanding the essence of the disease and its treatment

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-9-10-650-655 ◽

2021 ◽

Vol 98 (9-10) ◽

pp. 650-655

Author(s):

N. A. Voronkova ◽

E. V. Dontsova ◽

L. A. Novikova ◽

L. N. Borzunova

Keyword(s):

Atopic Dermatitis ◽

Skin Diseases ◽

Skin Barrier ◽

Regulatory Peptides ◽

Cochrane Library ◽

Gene Encoding ◽

Common Skin ◽

The Cochrane Library

The review represents the analysis of modern data on the pathogenesis and methods of treatment of atopic dermatitis (AtD). The literature search was carried out using the Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, e-library databases. AtD is one of the most common skin diseases, aff ecting about 20% of children and 5% of adults in advanced countries. The disease is multifactorial by its etiology. Among the genetic factors, the main attention is paid to the mutation of the gene encoding the synthesis of fi laggrin-protein involved in the functioning of the skin barrier. The role of cytokines regulating the synthesis of IgE — interleukins (IL) -4, -5, -12, -13, -31 is studied in the genesis of immune disorders in AtD. Steady-state stress accompanying pruritic dermatitis contributes to the development of anxiodepressive сonditions degrades quality of life, and stress-related increase of cortisol level may be essential in impairing the barrier function of the skin. Among the new approaches to the treatment of patients with AtD, the possibilities of using Selank, which represents the group of regulatory peptides and narrow-band phototherapy of the 311 nm range, are discussed.

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New Cosmetic Formulation for Treatment of Mild to Moderate Infantile Atopic Dermatitis

10.20944/preprints201812.0257.v1 ◽

2018 ◽

Author(s):

Raul de Lucas ◽

Cristina García Millán ◽

Azahara Pérez-Davó ◽

Esther Moreno ◽

Pedro Redondo

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Adverse Events ◽

Skin Barrier ◽

Clinical Severity ◽

Inflammatory Disorder ◽

Life Index ◽

Quality Of Life Index ◽

Cosmetic Formulation

Atopic dermatitis (AD) is a chronic cutaneous inflammatory disorder, characterized by skin barrier disruption. Dermacare is a new cosmetic formulation which enhances moisturization, reinforces and repairs the skin barrier and prevents cutaneous microbiota imbalance. To demonstrate its safety and efficacy a prospective, open-label and multicenter study was carried out on patients diagnosed with mild to moderate AD. Transepidermal water loss (TEWL), clinical severity, Desquamation Index, Patient/Investigator Global Assessments, quality of life index and tolerance were assessed. Adverse events were recorded. Daily application of the new treatment was well tolerated, and adverse events were absent. After 14 days, TEWL showed a 36.7% significant decrease (p = 0.035). At the end of the 28-day Dermacare treatment, the Desquamation Index showed a reduction in 70% of patients; Eczema Area and Severity Index were reduced by 70.4% (p = 0.002); and skin irritation showed a significant reduction (p = 0.024). Likewise, Patient and Investigator Global Assessments reported a significant improvement in conditions and an overall global worsening when patients restarted their normal treatment. Parent’s Index of Quality of Life Index significantly increased by 36.4% (p < 0.05) with Dermacare. In conclusion, Dermacare’s regular use helped reduce the risk of relapse and extend the steroid-free treatment periods.

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Efficacy of Dupilumab on Different Phenotypes of Atopic Dermatitis: One-Year Experience of 221 Patients

Journal of Clinical Medicine ◽

10.3390/jcm9092684 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2684

Author(s):

Simona Tavecchio ◽

Luisa Angileri ◽

Francesco Pozzo Giuffrida ◽

Francesca Germiniasi ◽

Angelo Valerio Marzano ◽

...

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Rating Scale ◽

Numerical Rating Scale ◽

Clinical Manifestations ◽

Life Quality ◽

Daily Practice ◽

Severity Index ◽

Efficacy And Safety

Background: The clinical features of adult-onset atopic dermatitis (AD) are heterogeneous and the diagnosis can be a challenge. A new biologic drug (dupilumab) has been approved for moderate to severe AD in adult patients. The efficacy and safety have been demonstrated in clinical trials, but these studies do not reflect conditions in daily practice and do not consider the different clinical manifestations of AD. Objectives: Analyzing the dupilumab activity in a real-world setting and comparing its efficacy on different AD phenotypes. Methods: We retrospectively evaluated 221 AD patients treated with dupilumab, stratified into six clinical phenotypes: classic, generalized eczema inflammatory and lichenoid patterns, prurigo, nummular eczema, and erythroderma. At baseline and at weeks 4, 16, and 52, the disease severity was assessed through the Eczema Area and Severity Index (EASI) and the quality of life was assessed through the Dermatology Life Quality Index (DLQI) questionnaire, Peak Pruritus Numerical Rating Scale (itch NRS), and Peak Sleep NRS. Results: We found a significant improvement after 16 weeks of treatment (p < 0.0001) in all six phenotypes for all the assessed scores mentioned above, persisting up to week 52. The best improvement was seen in the more severe phenotypes, particularly the erythrodermic one. Conclusions: The present study confirmed the efficacy and safety of dupilumab in the treatment of severe AD. Its strength was in the stratification of AD patients in six different phenotypes based on their clinical presentation, all of whom markedly improved in terms of both clinically evident and reported symptoms, as well as their quality of life.

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CLINICAL AND LABORATORY PARALLELS IN ATOPIC DERMATITIS IN ADULTS

СИСТЕМНЫЙ АНАЛИЗ И УПРАВЛЕНИЕ В БИОМЕДИЦИНСКИХ СИСТЕМАХ ◽

10.36622/vstu.2020.19.4.004 ◽

2020 ◽

pp. 30-36

Author(s):

Елена Владимировна Донцова ◽

Любовь Анатольевна Новикова ◽

Лариса Николаевна Борзунова ◽

Наталья Александровна Воронькова ◽

Андрей Алексеевич Бахметьев

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Clinical Manifestations ◽

Inverse Correlation ◽

Control Group ◽

Blood Profile ◽

Blood Cytokines ◽

Reactive Anxiety ◽

Relationship Of

Целью исследования было изучить взаимосвязи клинических проявлений среднетяжелой формы атопического дерматита (АтД) с цитокиновым профилем крови, психонейрогормональным статусом и качеством жизни пациентов. В исследование включено 124 больных с АтД (61 мужчина и 63 женщины) в возрасте от 18 до 40 лет. Контрольную группу составили 30 здоровых лиц. Индекс SCORAD у больных составил 39,8±3,25 балла, что соответствует среднетяжелой форме АтД, а значение дерматологического индекса качества жизни (ДИКЖ), равное 23,2±5,1 балла, свидетельствовало низкому его уровню. В результате корреляционного анализа было установлено наличие прямой связи средней силы между индексом SCORAD и уровнями циркулирующих цитокинов крови (ИЛ-1β, ИЛ-4, ИЛ-10, ИЛ-13), выраженностью личностной и реактивной тревожностей и качеством жизни пациентов по индексу ДИКЖ. Прямая слабая связь обнаружена с уровнями IgE, γ- ИНФ, АКТГ, кортизола и алекситимией. Обратная корреляция клинических проявлений АтД слабой степени найдена с уровнем в крови β-эндорфина. Таким образом, для больных АтД средней степени тяжести характерно повышение в крови антител класса IgE, цитокинов (ИЛ-1β, ИЛ-4, ИЛ-10 ИЛ-13, γ-ИНФ), отражающих активность воспалительного процесса, а также повышенная активность гормонов гипоталамо-гипофизарной оси (АКТГ, кортизол), снижение уровня эндогенного β-эндорфина, повышение уровней личностной, реактивной тревожностей и алекситимии, выраженность которых коррелирует со значением индекса SCORAD The aim of the study was to assess the relationship of the clinical manifestations of moderate atopic dermatitis (AD) with the cytokine blood profile, psycho-neuro-hormonal status and patient’s quality of life. The study included 124 patients with AD (61 men and 63 women) aged 18 to 40 years. The control group consisted of 30 healthy individuals. The SCORAD index in patients was 39.8 ± 3.25 points, which corresponds to the moderate form of AD, and the value of the dermatological index of quality of life (DQL), equal to 23.2 ± 5.1 points, indicated its low level. As a result of the correlation analysis, it was established that there was a direct relationship of average strength between the SCORAD index and the levels of circulating blood cytokines (IL-1β, IL-4, IL-10, IL-13), the severity of personal and reactive anxiety and the quality of life of patients according to the DQL index. A weak direct link was found with the levels of IgE, INF-γ, ACTH, cortisol and alexithymia. An inverse correlation of the mild AD clinical manifestations was found with the level of β-endorphin in the blood. Thus, patients with moderate AD are characterized by an increase of antibodies of the IgE class, cytokines (IL-1β, IL-4, IL-10 IL-13, INFγ), reflecting the activity of the inflammatory process, as well as increased activity of hypothalamic-pituitary hormones axes (ACTH, cortisol), a decrease in the level of endogenous β-endorphin, an increase in the levels of personal, reactive anxiety and alexithymia, the severity of which correlates with the value of the SCORAD index

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The role of hormones in the pathogenesis of psoriasis vulgaris

Medicine and Pharmacy Reports ◽

10.15386/cjmed-505 ◽

2015 ◽

Vol 89 (1) ◽

pp. 11-18 ◽

Cited By ~ 4

Author(s):

Iulia Ioana Roman ◽

Anne-Marie Constantin ◽

Mihaela Elena Marina ◽

Remus Ioan Orasan

Keyword(s):

Quality Of Life ◽

Psoriasis Vulgaris ◽

Clinical Manifestations ◽

Endocrine System ◽

Systemic Diseases ◽

Hormonal Changes ◽

Common Skin ◽

Exogenous Factors

Psoriasis vulgaris is a chronic, common skin disease, which affects the patient’s quality of life to the highest degree. Several exogenous factors and endogenous hormonal changes may act as triggers for psoriasis.The skin possesses a true endocrine system, which is very important in multiple systemic diseases. A number of conditions are associated with psoriasis, and its severity can also be influenced by hormones. Even though the sex hormones and prolactin have a major role in psoriasis pathogenicity, there are a lot of other hormones which can influence the psoriasis clinical manifestations: glucocorticoids, epinephrine, thyroid hormones, and insulin.

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New Cosmetic Formulation for the Treatment of Mild to Moderate Infantile Atopic Dermatitis

Children ◽

10.3390/children6020017 ◽

2019 ◽

Vol 6 (2) ◽

pp. 17 ◽

Cited By ~ 1

Author(s):

Raúl de Moreno ◽

Cristina Redondo ◽

Azahara Pérez-Davó ◽

Esther Moreno ◽

Pedro Redondo

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Adverse Events ◽

Skin Barrier ◽

Clinical Severity ◽

Inflammatory Disorder ◽

Life Index ◽

Quality Of Life Index ◽

Cosmetic Formulation

Atopic dermatitis (AD) is a chronic cutaneous inflammatory disorder, characterized by skin barrier disruption. Dermacare is a new cosmetic formulation, which enhances moisturization, reinforces and repairs the skin barrier, and prevents cutaneous microbiota imbalance. To demonstrate its safety and efficacy, a prospective, open-label, and multicenter study was carried out on patients diagnosed with mild to moderate AD. Transepidermal water loss (TEWL), clinical severity, Desquamation Index, Patient/Investigator Global Assessments, quality of life index, and tolerance were assessed. Adverse events were recorded. Daily application of the new treatment was well tolerated, and adverse events were absent. After 14 days, TEWL showed a 36.7% significant decrease (p = 0.035). At the end of the 28-day treatment, the Desquamation Index showed a reduction in 70% of patients; Eczema Area and Severity Index were reduced by 70.4% (p = 0.002); and skin irritation showed a significant reduction (p = 0.024). Likewise, Patient and Investigator Global Assessments reported a significant improvement in conditions and an overall global worsening when patients restarted their normal treatment. Parent’s Index of Quality of Life Index significantly increased by 36.4% (p < 0.05) with Dermacare. In conclusion, a regular use of this new formulation can reduce the risk of relapse and extend the steroid-free treatment periods.

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