Chu Chia-Yu, Yao Tsung-Chieh, Shih I-Hsin, Yang Chin-Yi, Chin Chan Lee, Ibrahim Sabeera Begum Binti Kader, Thevarajah Suganthi, Fon Leong Kin, Ho Marco Hok-Kung, Mo Chow Chung, Yu Chow Pok, Loo Steven King-Fan, Luger Thomas
Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Dermatol Ther (Heidelb). 2023 Mar;13(3):717-727. doi: 10.1007/s13555-022-00886-9. Epub 2023 Feb 3.
Atopic dermatitis (AD) is a common chronic, multisystem inflammatory skin disease in pediatric patients. There has been an increase in the incidence of AD in the pediatric population of the Asia-Pacific region. Studies have shown that genetic, epigenetic, environmental and cultural factors may lead to differences in the clinical manifestation and prevalence of AD between races. Early treatment of AD is necessary to prevent the atopic march leading to comorbidities such as asthma and allergic rhinitis. Topical corticosteroids (TCS) are used as first-line therapy for the treatment of AD, but their long-term usage poses a risk to the patient's health. Pimecrolimus (1%) is a topical calcineurin inhibitor (TCI) that is indicated for the treatment of mild to moderate AD. Pimecrolimus has no apparent increase in adverse events compared to TCS, and it causes less of a burning sensation than tacrolimus. The safety and efficacy of pimecrolimus has been established through various clinical trials; yet, in many Asian countries, the use of pimecrolimus in infants is still restricted due to safety concerns. Based on the available evidence, the expert panel recommends pimecrolimus in infants between 3 months and 2 years of age in the Asian population.
特应性皮炎（AD）是儿科患者中一种常见的慢性多系统炎症性皮肤病。亚太地区儿科人群中AD的发病率有所上升。研究表明，遗传、表观遗传、环境和文化因素可能导致不同种族之间AD的临床表现和患病率存在差异。AD的早期治疗对于预防导致哮喘和过敏性鼻炎等合并症的特应性进程至关重要。外用糖皮质激素（TCS）被用作治疗AD的一线疗法，但其长期使用对患者健康构成风险。吡美莫司（1%）是一种外用钙调神经磷酸酶抑制剂（TCI），适用于治疗轻度至中度AD。与TCS相比，吡美莫司的不良事件没有明显增加，并且其引起的灼痛感比他克莫司小。吡美莫司的安全性和有效性已通过各种临床试验得到证实；然而，在许多亚洲国家，由于安全担忧，婴儿使用吡美莫司仍然受到限制。基于现有证据，专家小组建议在亚洲人群中3个月至2岁的婴儿使用吡美莫司。
