scholarly journals Severe аtopic dermatitis: problems in care

2012 ◽  
Vol 9 (4) ◽  
pp. 33-38
Author(s):  
E S Fedenko ◽  
O G Elisyutina ◽  
O V Shtyrbul
Keyword(s):  
Atopic Dermatitis ◽  
Topical Therapy ◽  
Calcineurin Inhibitors ◽  
Intravenous Immunoglobulins ◽  
Difficult Problem ◽  
Severe Atopic Dermatitis ◽  
Complex Treatment ◽  
Topical Calcineurin Inhibitors ◽  
Long Time ◽  
And Control

In this article problems in care of severe atopic dermatitis (AD) are considered. The main medications for AD treatment are topical corticosteroids, topical calcineurin inhibitors and emollients. In spite of adequate topical therapy the disease often gets a severe recurrent course with frequent exacerbations. In such cases treatment is considered to be a difficult problem and quite often it is necessary to use systemic preparations: corticosteroids, immunosupressors, cytostatics. They are able to reduce and control exacerbations fast and effectively, but because of side effects these preparations shouldn’t be applied for a long time. Considering increase of severe AD cases, now great attention is given to immunotherapy. In the article the retrospective analysis of data about 56 severe AD patients who underwent a course of complex treatment including plasmapheresis and intravenous immunoglobulins is presented.

Inhibition of IL-13: A New Pathway for Atopic Dermatitis

2020 ◽  
pp. 120347542098255
Author(s):  
Kayadri Ratnarajah ◽  
Michelle Le ◽  
Anastasiya Muntyanu ◽  
Steve Mathieu ◽  
Simon Nigen ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Atopic Dermatitis ◽  
Severity Index ◽  
Severe Atopic Dermatitis ◽  
Treatment Alternative ◽  
Control Groups ◽  
Rapid Improvement ◽  
Common Receptor ◽  
The Common ◽  
And Control

Dupilumab, a monoclonal antibody against the common receptor of interleukin (IL)-4 and IL-13, was the first biologic therapy approved in Canada for treatment of moderate-to-severe atopic dermatitis (AD). While it is considered safe and effective, dupilumab is not universally effective and 8%-38% of patients develop conjunctivitis, while some patients develop head and neck dermatitis. Thus, new therapeutic options are warranted. While both IL-4 and IL-13 play important roles in the pathogenesis of AD, it has been recently demonstrated that IL-13 is the primary upregulated cytokine in AD skin biopsy samples. A placebo-controlled phase 2b clinical trial evaluating the efficacy and safety of lebrikizumab, an IL-13 inhibitor, in AD demonstrated that, at 16 weeks, Eczema Area and Severity Index (EASI) 75 and Investigator’s Global Assessment (IGA) 0/1 were achieved by 60.6% and 44.6% of patients taking lebrikizumab at its highest dose (vs 24.3% and 15.3% of patients taking placebo, respectively). Moreover, treatment with lebrikizumab was associated with rapid improvement of pruritus and low rates of conjunctivitis (1.4%-3.8%). Another IL-13 monoclonal antibody, tralokinumab, was evaluated for safety and efficacy in moderate-to-severe AD. By week 12, among adults receiving 300 mg tralokinumab, 42.5% achieved EASI-75 and 26.7% achieved IGA 0/1 score (vs 15.5% and 11.8% in the placebo group, respectively). Both lebrikizumab and tralokinumab demonstrated acceptable safety profiles in AD (and non-AD) trials with adverse events often being comparable between treatment and control groups. Thus, IL-13 inhibitors may provide a safe and effective treatment alternative for patients with moderate-to-severe AD.

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 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.

scholarly journals A novel hydrocortisone-ethanol gel ointment for treating atopic dermatitis (eczema) in children: A double blind, randomized, controlled clinical trial

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dale Lawrence Pearlman
Keyword(s):  
Clinical Trial ◽  
Atopic Dermatitis ◽  
Controlled Study ◽  
Controlled Clinical Trial ◽  
Severe Atopic Dermatitis ◽  
Double Blind ◽  
Parental Concerns ◽  
Score Improvement ◽  
Long Time ◽  
Secondary Endpoints

Importance: Current treatments for moderate to severe atopic dermatitis (AD) in children are limited by incomplete efficacy, long time to benefit, and parental concerns about safety. This study evaluated a novel ointment for treating AD containing 0.83% hydrocortisone and 17% dispersed ethanol gel micro bubbles.  Observations:20 children with moderate to severe AD participated in a one-week double blind, randomized, and controlled clinical trial. They were randomly assigned to apply BID either an ointment with 1% hydrocortisone ointment (HC) or a novel ointment containing 1% hydrocortisone and dispersed ethanol gel droplets (HC-EG).   The primary endpoint was superiority of HC-EG over HC ointment in SCORAD score improvement during therapy. A secondary endpoint was improvement in pruritus score during therapy. Both the primary and secondary endpoints were reached in this study. SCORAD score improved 74% on average with HC-EG ointment vs 41% with HC ointment (p=.02). Pruritus score improved 68% on average with HC-EG ointment vs 37% with HC ointment (p=.009). No toxicity requiring stopping therapy was observed in either treatment group.  Conclusions and Relevance: Inthis small controlled study HC-EG ointment was superior to HC ointment both in improving visible rash and pruritus of AD. Parents felt HC-EG ointment was safe because it contains no prescription corticosteroids, prescription immunosuppressants, or antibiotics. Independent larger studies would be a next step in evaluating further this new way to treat AD. 

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.

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