Katayama Ichiro, Kohno Yoichi, Akiyama Kazuo, Aihara Michiko, Kondo Naomi, Saeki Hidehisa, Shoji Shunsuke, Yamada Hidekazu, Nakamura Koichiro
Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
Chiba Rosai Hospital, Chiba, Japan.
Allergol Int. 2014 Sep;63(3):377-98. doi: 10.2332/allergolint.14-RAI-0769.
Given the importance of appropriate diagnosis and appropriate assessment of cutaneous symptoms in treatment of atopic dermatitis, the basics of treatment in this guideline are composed of (1) investigation and countermeasures of causes and exacerbating factors, (2) correction of skin dysfunctions (skin care), and (3) pharmacotherapy, as three mainstays. These are based on the disease concept that atopic dermatitis is a inflammatory cutaneous disease with eczema by atopic diathesis, multi-factorial in onset and aggravation, and accompanied by skin dysfunctions. These three points are equally important and should be appropriately combined in accordance with the symptoms of each patient. In treatment, it is important to transmit the etiological, pathological, physiological, or therapeutic information to the patient to build a favorable partnership with the patient or his/her family so that they may fully understand the treatment. This guideline discusses chiefly the basic therapy in relation to the treatment of this disease. The goal of treatment is to enable patients to lead an uninterrupted social life and to control their cutaneous symptoms so that their quality of life (QOL) may meet a satisfactory level. The basics of treatment discussed in this guideline are based on the "Guidelines for the Treatment of Atopic Dermatitis 2008" prepared by the Health and Labour Sciences Research and the "Guidelines for the Management of Atopic Dermatitis 2012 (ADGL2012)" prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the "Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2013" together with those for other allergic diseases.
鉴于在特应性皮炎治疗中正确诊断和适当评估皮肤症状的重要性，本指南中的治疗基础主要由三个支柱组成：（1）病因及加重因素的调查与应对措施；（2）纠正皮肤功能障碍（皮肤护理）；（3）药物治疗。这些基于特应性皮炎是一种由特应性素质引起的伴有湿疹的炎症性皮肤病的疾病概念，其发病和加重具有多因素性，并伴有皮肤功能障碍。这三点同样重要，应根据每位患者的症状进行适当结合。在治疗中，向患者传达病因、病理、生理或治疗信息以与患者或其家属建立良好的合作关系，使他们能够充分理解治疗，这一点很重要。本指南主要讨论与该疾病治疗相关的基础疗法。治疗目标是使患者能够过上正常的社会生活，并控制其皮肤症状，以使他们的生活质量（QOL）达到令人满意的水平。本指南中讨论的治疗基础原则上基于厚生劳动科学研究编制的《2008年特应性皮炎治疗指南》以及日本变态反应学会特应性皮炎指南咨询委员会编制的《2012年特应性皮炎管理指南（ADGL2012）》。特应性皮炎的治疗指南与其他过敏性疾病的指南一起总结在《2013年日本过敏性疾病诊断和治疗指南》中。
