Prezzano James C, Beck Lisa A
Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Department of Dermatology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Dermatol Clin. 2017 Jul;35(3):335-349. doi: 10.1016/j.det.2017.02.007. Epub 2017 May 6.
Many patients with mild to moderate atopic dermatitis (AD) are managed by identifying and avoiding allergens and irritants, ensuring skin moisturization, and graded use of topical corticosteroids and/or calcineurin inhibitors. There is little consensus on the next step. Most systemic therapies are "off label" in the United States and include phototherapy, cyclosporine, mycophenolic acid precursors, azathioprine, and methotrexate. The decision to use these therapies should be based on efficacy and safety readouts from well designed, long-term trials. This article reviews the long-term randomized, controlled trials examining safety and/or efficacy of interventions recommended for patients with mild to severe AD.
许多轻至中度特应性皮炎（AD）患者通过识别和避免过敏原及刺激物、确保皮肤保湿以及分级使用外用糖皮质激素和/或钙调神经磷酸酶抑制剂来进行治疗。对于下一步治疗，目前几乎没有共识。在美国，大多数全身治疗都是“非适应证用药”，包括光疗、环孢素、霉酚酸前体、硫唑嘌呤和甲氨蝶呤。使用这些治疗方法的决定应基于精心设计的长期试验的疗效和安全性结果。本文综述了针对轻至重度AD患者推荐的干预措施的安全性和/或疗效的长期随机对照试验。
