Tay Yong Kwang, Chan Yuin Chew, Chandran Nisha Suyien, Ho Madeline Sl, Koh Mark Ja, Lim Yen Loo, Tang Mark By, Thirumoorthy Thamotharampillai
Department of Dermatology, Changi General Hospital, Singapore.
Ann Acad Med Singap. 2016 Oct;45(10):439-450.
Atopic dermatitis is a common, chronic pruritic condition affecting both children and adults, which has a negative impact on the quality of life. These guidelines were developed by an expert workgroup appointed by the Dermatological Society of Singapore, to provide doctors with information to assist in the management of their patients with atopic dermatitis. The workgroup members are experienced dermatologists with interest and expertise in eczemas.
Workgroup members arrived at a consensus on the topics to be included. Relevant studies from the literature were assessed for best evidence, supplemented by the collective experience of the workgroup.
For mild atopic dermatitis, emollients, mild potency topical steroids and topical calcineurin inhibitors are recommended. For moderate-to-severe atopic dermatitis, the use of emollients, moderate-to-potent topical steroids, topical calcineurin inhibitors, wet dressings, antimicrobials for secondary skin infection, phototherapy, and systemic therapy (e.g. prednisolone, cyclosporine, azathioprine or methotrexate) may be warranted. Patients with moderate-to-severe atopic dermatitis should be managed in conjunction with a dermatologist.
Good outcomes can be achieved with an individualised therapeutic approach combined with adequate patient and parental education.
特应性皮炎是一种常见的慢性瘙痒性疾病，影响儿童和成人，对生活质量有负面影响。这些指南由新加坡皮肤病学会任命的一个专家工作组制定，旨在为医生提供信息，以协助管理他们的特应性皮炎患者。工作组成员是对湿疹有兴趣和专业知识的经验丰富的皮肤科医生。
工作组成员就纳入的主题达成共识。对文献中的相关研究进行最佳证据评估，并辅以工作组的集体经验。
对于轻度特应性皮炎，推荐使用润肤剂、低效外用糖皮质激素和外用钙调神经磷酸酶抑制剂。对于中度至重度特应性皮炎，可能需要使用润肤剂、中效至强效外用糖皮质激素、外用钙调神经磷酸酶抑制剂、湿敷、用于继发性皮肤感染的抗菌药物、光疗和系统治疗（如泼尼松龙、环孢素、硫唑嘌呤或甲氨蝶呤）。中度至重度特应性皮炎患者应由皮肤科医生联合管理。
采用个体化治疗方法并结合对患者和家长的充分教育可取得良好效果。
