Allergy Section, Internal Medicine Department, Hospital Universitario Vall d´Hebron, Barcelona, Spain.
Allergy Department, Hospital Universitario de Salamanca, Alergoasma, Salamanca, Spain.
J Investig Allergol Clin Immunol. 2018 Dec;28(6):379-391. doi: 10.18176/jiaci.0293. Epub 2018 Jul 13.
Atopic dermatitis (AD) is a recurrent and chronic skin disease characterized by dysfunction of the epithelial barrier, skin inflammation, and immune dysregulation, with changes in the skin microbiota and colonization by Staphylococcus aureus being common. For this reason, the therapeutic approach to AD is complex and should be directed at restoring skin barrier function, reducing dehydration, maintaining acidic pH, and avoiding superinfection and exposure to possible allergens. There is no curative treatment for AD. However, a series of measures are recommended to alleviate the disease and enable patients to improve their quality of life. These include adequate skin hydration and restoration of the skin barrier with the use of emollients, antibacterial measures, specific approaches to reduce pruritus and scratching, wet wrap applications, avoidance of typical AD triggers, and topical anti-inflammatory drugs. Anti-inflammatory treatment is generally recommended during acute flares or, more recently, for preventive management. Nevertheless, the selection of the pharmacologic agent, as well as its potency, duration, and frequency of application must be in accordance with the severity of the disease and the distribution and type of the lesion. The objectives of this review are to emphasize the importance of basic skin care and to describe current and novel topical therapies for AD.
特应性皮炎（AD）是一种复发性、慢性皮肤病，其特征为上皮屏障功能障碍、皮肤炎症和免疫失调，皮肤微生物群改变和金黄色葡萄球菌定植较为常见。因此，AD 的治疗方法较为复杂，应针对恢复皮肤屏障功能、减少脱水、维持酸性 pH 值以及避免继发感染和接触可能的过敏原。目前尚无 AD 的治愈方法。但是，推荐了一系列措施来缓解疾病，使患者能够提高生活质量。这些措施包括充分的皮肤保湿和使用保湿剂恢复皮肤屏障功能、抗菌措施、减少瘙痒和搔抓的特定方法、湿包应用、避免典型的 AD 诱因以及局部抗炎药物。一般建议在急性发作期间进行抗炎治疗，或者更近期的情况下进行预防性管理。然而，药物的选择以及其效力、持续时间和应用频率必须根据疾病的严重程度以及病变的分布和类型来确定。本文的目的是强调基础皮肤护理的重要性，并描述 AD 的现有和新型局部治疗方法。
