Knop M, Gürtler A, Heratizadeh A, Aszodi N, Werfel Th, Wollenberg A
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland.
Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
Hautarzt. 2018 Mar;69(3):210-216. doi: 10.1007/s00105-018-4135-4.
Atopic eczema is a chronic recurrent inflammatory skin disease characterized by intensive pruritus and a high burden of disease. Based on a genetically determined skin barrier dysfunction, xerosis cutis and a tendency towards microbial skin infections are the leading clinical features. Mild and moderate disease manifestations are common, and usually treated with topical agents only. Treatment concepts are usually based on a combination of (i) topical basic therapy consisting of skin cleansing and barrier stabilizing emollients and (ii) topical anti-inflammatory therapy of visible skin lesions with topical corticosteroids and topical calcineurin inhibitors. Proactive therapy of the commonly affected and usually relapsing areas of skin is an important therapeutic option for long-term maintenance treatment of moderate to severe disease. Patients should be actively involved in planning of treatment, which should be adapted to individual patient factors such as age, involved body areas, type of skin lesions, as well as seasonal and climatic factors. New promising treatment options including topical phosphodiesterase inhibitors and topical Janus kinase inhibitors are currently being evaluated in clinical trials and may become a future treatment option for atopic eczema. This review article summarizes the current topical treatment options and new perspectives in the topical therapy of atopic eczema.
特应性皮炎是一种慢性复发性炎症性皮肤病，其特征为剧烈瘙痒和高疾病负担。基于基因决定的皮肤屏障功能障碍，皮肤干燥和皮肤微生物感染倾向是主要临床特征。轻度和中度疾病表现常见，通常仅用外用药物治疗。治疗方案通常基于以下两者的组合：（i）由皮肤清洁和屏障稳定润肤剂组成的外用基础治疗，以及（ii）用外用糖皮质激素和外用钙调神经磷酸酶抑制剂对可见皮肤病变进行外用抗炎治疗。对常见受累且通常复发的皮肤区域进行积极治疗是中重度疾病长期维持治疗的重要治疗选择。患者应积极参与治疗计划，治疗应根据个体患者因素进行调整，如年龄、受累身体部位、皮肤病变类型以及季节和气候因素。包括外用磷酸二酯酶抑制剂和外用 Janus 激酶抑制剂在内的新的有前景的治疗选择目前正在临床试验中进行评估，可能成为特应性皮炎未来的治疗选择。这篇综述文章总结了特应性皮炎外用治疗的当前选择和外用治疗的新观点。
