Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal.
Immunoallergology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Eur Ann Allergy Clin Immunol. 2020 Jan;52(1):4-14. doi: 10.23822/EurAnnACI.1764-1489.125. Epub 2019 Dec 2.
Atopic Dermatitis affects both children and adults and is a serious health concern in many countries. AD is a complex disease with host and environmental factors underlying its pathology. Its treatment is multidimensional reflecting the diverse nature of its triggers and includes emollients, topical steroids and calcineurin inhibitors among others. Immunological dysfunction can be addressed broadly with systemic immunosupressors and specifically with monoclonal antibodies. Dupilumab, which targets IL-4 and IL-13 was granted approval for treatment of moderate-to-severe AD. Biologics targeting IgE/Th2 pathways may have its role in patients with overlapping AD and asthma. Psychological distress can exacerbate symptoms and is associated with increased severity of AD. Environmental triggers, such as, allergens can be addressed in selected cases with allergic immunotherapy. In this paper, we discuss AD treatment and propose a new step-by-step approach aiming at maintaining disease control and improving quality of life.
特应性皮炎影响儿童和成人，是许多国家的严重健康问题。AD 是一种复杂的疾病，其发病机制涉及宿主和环境因素。其治疗是多维度的，反映了其触发因素的多样性，包括保湿剂、局部皮质类固醇和钙调磷酸酶抑制剂等。免疫功能障碍可以用全身性免疫抑制剂广泛治疗，也可以用单克隆抗体特异性治疗。靶向 IL-4 和 IL-13 的 Dupilumab 已被批准用于治疗中重度 AD。针对 IgE/Th2 途径的生物制剂可能在 AD 和哮喘重叠的患者中有其作用。心理困扰会加重症状，并与 AD 的严重程度增加有关。在某些情况下，可以使用变应原特异性免疫疗法来解决环境触发因素，如过敏原。在本文中，我们讨论了 AD 的治疗方法，并提出了一种新的分步骤方法，旨在维持疾病控制并改善生活质量。
