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关于轻度至中度儿童和成人特应性皮炎的局部治疗的临床见解。

Clinical Insights About Topical Treatment of Mild-to-Moderate Pediatric and Adult Atopic Dermatitis.

机构信息

1 Department of Medicine, University of Toronto; Lynderm Research Inc, Markham, ON, Canada.

2 Department of Dermatology, University of British Columbia, Vancouver, Canada.

出版信息

J Cutan Med Surg. 2019 May/Jun;23(3_suppl):3S-13S. doi: 10.1177/1203475419843108. Epub 2019 Apr 9.

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin condition, also referred to as atopic eczema, that is identified by itching and recurrent eczematous lesions. It often starts in infancy where it affects up to 20% of children but is also highly prevalent in adults. AD inflicts a significant psychosocial burden on patients and their families and increases the risk of other immune-mediated inflammatory conditions, such as asthma and allergic rhinitis, food allergy, and mental health disorders. It is a lifelong condition associated with epidermal barrier dysfunction and altered immune function. Through the use of emollients and anti-inflammatory agents, current prevention and treatment therapies attempt to restore epidermal barrier function. Acute flares are treated with topical corticosteroids. Topical calcineurin inhibitors (TCIs) and topical corticosteroids (TCSs) are used for proactive treatment to prevent remission. There remains a need and opportunity to improve AD care through future research directed toward an improved understanding of the heterogeneity of the disease and its subtypes, the role of autoimmunity in its pathogenesis, the mechanisms behind disease-associated itch and response to specific allergens, and the comparative effectiveness and safety of therapies.

摘要

特应性皮炎(AD)是一种慢性炎症性皮肤疾病,也称为特应性湿疹,其特征为瘙痒和反复出现的湿疹样损伤。它通常在婴儿期开始,影响多达 20%的儿童,但在成年人中也非常普遍。AD 给患者及其家属带来了巨大的心理社会负担,并增加了其他免疫介导的炎症性疾病的风险,如哮喘、过敏性鼻炎、食物过敏和精神健康障碍。它是一种与表皮屏障功能障碍和免疫功能改变相关的终身疾病。通过使用保湿剂和抗炎药物,目前的预防和治疗疗法旨在恢复表皮屏障功能。急性发作时使用局部皮质类固醇治疗。局部钙调磷酸酶抑制剂(TCIs)和局部皮质类固醇(TCSs)用于主动治疗以预防缓解。通过未来的研究,仍有必要和机会改善 AD 的治疗,以更好地了解疾病及其亚型的异质性、自身免疫在其发病机制中的作用、与疾病相关的瘙痒和对特定过敏原的反应背后的机制,以及治疗方法的比较有效性和安全性。

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