有色人种特应性皮炎患者的皮肤特点及皮肤护理改善结局的作用。

Insights in Skin of Color Patients With Atopic Dermatitis and the Role of Skincare in Improving Outcomes.

出版信息

J Drugs Dermatol. 2022 May 1;21(5):462-470. doi: 10.36849/JDD.6609.

Abstract

BACKGROUND

Research on the role of race and ethnicity in the pathophysiology of atopic dermatitis (AD) is limited. Variations in the epidemiology, clinical presentation, and disease course in skin of color SOC AD patients have been reported. This manuscript seeks to offer insights into distinct features of AD in populations with (SOC) and provide recommendations on the role of skincare in treating AD amongst diverse populations.

METHODS

A literature review followed by panel discussions and an online review process explored best clinical practices in treating AD patients with SOC and providing expert guidance for skincare use, including gentle cleansers and moisturizers.

RESULTS

Some studies have identified differences in skin barrier properties in racial/ethnic groups affected by AD that may have implications for barrier function. Variations in the clinical presentation – including morphology, severity, and distribution – of AD in populations with SOC have been reported. Epidemiologic studies suggest a higher prevalence among self-identified Blacks/African Americans and greater health care utilization for AD among both Blacks/African Americans and Asian/Pacific Islanders. Pigmentary sequelae, including hyper- hypo- and depigmentation is a distinct feature of AD in patients with SOC that may contribute to the quality of life impact of the disorder. Xerosis may be more stigmatizing in SOC due to greater visibility of scale and dryness in the context of melanin-rich skin. Racial/ethnic variations in the prevalence of pruritus have also been reported, which may in turn have implications for AD in SOC. Treatment and maintenance of AD in patients with SOC should be proactive, effectively control inflammation longitudinally, include effective skin barrier protective strategies, and consider cultural practices.

CONCLUSION

Robust comparative studies are needed to better understand racial/ethnic variations in AD. Further research will help to tailor patient education and foster individualized approaches to treatment, prevention, and adjunctive skin care across the diverse spectrum of patient populations. J Drugs Dermatol. 2022;21(5):462-470. doi:10.36849/JDD.6609.

摘要

背景

种族和民族在特应性皮炎（AD）病理生理学中的作用研究有限。有报道称，皮肤色素沉着 AD 患者的流行病学、临床表现和疾病过程存在差异。本文旨在提供 AD 在有色人种（SOC）中的独特特征的见解，并就不同人群中 AD 的皮肤护理治疗提供建议。

方法

文献综述、小组讨论和在线审查过程探讨了治疗 SOC 中 AD 患者的最佳临床实践，并为皮肤护理的使用提供了专家指导，包括温和的清洁剂和保湿剂。

结果

一些研究已经确定了受 AD 影响的种族/民族群体的皮肤屏障特性存在差异，这可能对屏障功能有影响。SOC 人群中 AD 的临床表现——包括形态、严重程度和分布——存在差异。流行病学研究表明，自我认同的黑人/非裔美国人和亚裔/太平洋岛民的 AD 患病率更高，并且黑人/非裔美国人和亚裔/太平洋岛民的 AD 医疗保健利用率更高。色素后遗症，包括色素过度沉着、色素减退和色素脱失，是 SOC 中 AD 的一个独特特征，可能会影响疾病的生活质量。由于黑色素丰富的皮肤中鳞屑和干燥更为明显，SOC 中的干燥可能更具耻辱性。瘙痒在种族/民族中的流行率也存在差异，这可能反过来对 SOC 中的 AD 产生影响。SOC 中 AD 的治疗和维持应积极主动，长期有效控制炎症，包括有效的皮肤屏障保护策略，并考虑文化实践。