Department of Dermatology, Saitama Medical University, Saitama, Japan.
Allergy Center, Saitama Medical University, Saitama, Japan.
J Dermatol. 2021 Feb;48(2):140-151. doi: 10.1111/1346-8138.15730. Epub 2020 Dec 30.
The goal of a treatment regimen for atopic dermatitis is to reach and maintain a state where the patient exhibits mild symptoms or an absence of symptoms, and the patient should not experience disturbance during daily activities. The basis of a treatment regimen for atopic dermatitis is topical therapy, and currently there exist topical corticosteroids, tacrolimus and delgocitinib. Using these, proactive therapy is performed as maintenance therapy after remission induction therapy. However, in cases of moderate to severe atopic dermatitis, topical drugs alone cannot induce remission and systemic therapies such as cyclosporin, ultraviolet therapy, and dupilumab should be used in combination. In particular, dupilumab has many advantages such as high efficacy, relatively few adverse reactions, and ease of use in elderly patients with severe atopic dermatitis. In this review, we present a treatment algorithm for atopic dermatitis that emphasizes the importance of maintaining remission after induction of remission, and summarizes the characteristics of current medication therapy for atopic dermatitis in Japan.
特应性皮炎治疗方案的目标是达到并维持患者表现出轻度症状或无症状的状态，且患者在日常生活中不应感到不适。特应性皮炎治疗方案的基础是局部治疗，目前存在局部皮质类固醇、他克莫司和地奈德。使用这些药物，在缓解诱导治疗后进行主动治疗作为维持治疗。然而，对于中重度特应性皮炎，仅使用局部药物无法诱导缓解，应联合使用环孢素、紫外线治疗和度普利尤单抗等全身治疗。特别是，度普利尤单抗在疗效高、不良反应相对较少以及在老年重症特应性皮炎患者中使用方便等方面具有许多优势。在本综述中，我们提出了一个特应性皮炎治疗方案，强调了在诱导缓解后维持缓解的重要性，并总结了日本目前特应性皮炎药物治疗的特点。
