François Sandy, Felix Kayla, Cardwell Leah, Edwards Taylor, Rice Zakiya
Department of Dermatology, Emory School of Medicine, Atlanta, GA, USA.
Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Adv Exp Med Biol. 2017;1027:121-137. doi: 10.1007/978-3-319-64804-0_11.
The pathogenesis of atopic dermatitis (AD) is complex and multifactorial. However, recent advancements in the genetics and pathophysiology of AD suggest that epidermal barrier dysfunction is paramount in the development and progression of the condition (Boguniewicz and Leung, Immunol Rev 242(1):233-246, 2011). In addition to standard therapy for AD, there are a plethora of non-prescription treatment modalities which may be employed. Over-the-counter treatments for atopic dermatitis can come in the form of topical corticosteroids, moisturizers/emollients, and oral anti-histamines. Though these treatments are beneficial, prescription treatments may be quicker acting and more efficacious in patients with moderate to severe disease or during flares. OTC agents are best used for maintenance between flares and to prevent progression of mild disease. Alternative and complementary treatments lack strong efficacy evidence. However, wet wraps, bleach baths, and other treatments appear to be promising when used in conjunction with conventional treatments. With the financial burden of atopic dermatitis ranging from 364 million to 3.8 billion dollars each year in the United States, we suspect this topic will gain further research attention.
特应性皮炎（AD）的发病机制复杂且具有多因素性。然而，AD遗传学和病理生理学方面的最新进展表明，表皮屏障功能障碍在该病的发生和发展过程中至关重要（博古涅维茨和梁，《免疫评论》242(1):233 - 246，2011年）。除了AD的标准治疗方法外，还有大量非处方治疗方式可供采用。特应性皮炎的非处方治疗可以采用局部用皮质类固醇、保湿剂/润肤剂和口服抗组胺药的形式。虽然这些治疗方法有益，但对于中重度疾病患者或病情发作期间，处方治疗可能起效更快且更有效。非处方药最适合在发作间期进行维持治疗以及预防轻度疾病的进展。替代疗法和补充疗法缺乏有力的疗效证据。然而，湿裹法、漂白浴和其他治疗方法与传统治疗联合使用时似乎很有前景。在美国，特应性皮炎每年的经济负担在3.64亿美元至38亿美元之间，我们怀疑这个话题将获得更多的研究关注。
