Royal North Shore Hospital, Sydney, NSW
Royal North Shore Hospital, Sydney, NSW.
Med J Aust. 2017 Oct 16;207(8):351-356. doi: 10.5694/mja17.00463.
Atopic dermatitis (AD) is the most common inflammatory skin condition in adults and children. AD is a chronic disease that has a considerable negative impact on the quality of life of patients and their families. Most cases of AD may be effectively treated with topical therapies that are directed at decreasing cutaneous inflammation and alleviating pruritus. These therapies include emollients, antihistamines, topical corticosteroids, topical calcineurin inhibitors and antimicrobial and antiseptic measures; more refractory cases may require additional oral immunosuppression (eg, cyclosporine, azathioprine, methotrexate and mycophenolate). Improved understanding of the immune pathogenesis of AD, including the role of T helper cells and the inflammatory pathways involved, has led to breakthrough translational clinical research and treatment. New targeted immunotherapies, such as inhibitors of interleukin (IL)-4, IL-13, IL-31, Janus associated kinase and phosphodiesterase, have had promising results from phase 2 and 3 trials for patients with moderate to severe AD.
特应性皮炎（AD）是成人和儿童中最常见的炎症性皮肤病。AD 是一种慢性疾病，会对患者及其家属的生活质量产生重大负面影响。大多数 AD 病例可通过针对减少皮肤炎症和缓解瘙痒的局部治疗得到有效治疗。这些治疗方法包括保湿剂、抗组胺药、局部皮质类固醇、局部钙调神经磷酸酶抑制剂以及抗菌和防腐措施；更难治的病例可能需要额外的口服免疫抑制治疗（例如环孢素、硫唑嘌呤、甲氨蝶呤和霉酚酸酯）。对 AD 的免疫发病机制的深入了解，包括辅助性 T 细胞的作用和涉及的炎症途径，推动了突破性的转化临床研究和治疗。新型靶向免疫疗法，如白细胞介素（IL）-4、IL-13、IL-31、Janus 相关激酶和磷酸二酯酶抑制剂，在中重度 AD 患者的 2 期和 3 期临床试验中取得了可喜的结果。
