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儿童特应性皮炎的治疗

Treatment of Atopic Dermatitis in Children.

作者信息

Sid Idris Faten

机构信息

Pediatrics, California Institute of Behavioral Neurosciences and Psychology, California, USA.

出版信息

Cureus. 2024 Sep 14;16(9):e69416. doi: 10.7759/cureus.69416. eCollection 2024 Sep.

Abstract

Atopic dermatitis (AD), also called eczema, is a common inflammatory skin condition that causes itchy lesions and is widespread globally, especially in wealthy countries. It is the most prevalent skin disorder among children. A small percentage of children's eczema persists into adulthood, and a few of them exhibit a severe form of the condition. The development of AD is influenced by immune, environmental, and genetic factors; mutations in the filaggrin gene and a family history of atopy are regarded as risk factors that cause a hyperimmune response, which in turn increases the production of interleukin-13 and interleukin-4. As a result, the skin barrier is compromised, the T-helper 2 immune response is subsequently triggered, and atopic dermatitis develops. Diagnosing and treating AD are mostly dependent on primary care physicians. Nonetheless, treating AD is still challenging, and most pediatricians send even patients with mild eczema to dermatologists for management. To conduct this review, we posed the central question, 'How to treat atopic dermatitis in children?' utilizing 'atopic dermatitis in children: what is the best treatment?' as the primary keywords. A comprehensive search strategy was employed, incorporating reputable databases such as PubMed, Google Scholar, and Elsevier. The inclusion criteria were set to encompass articles published in the 21st century; however, some cross-references were from the 20th century, focusing exclusively on pediatric populations worldwide. We exclusively considered articles within the realm of pediatrics to ensure relevance to our target audience, pediatricians. The overarching objective of this review article is to elucidate the challenges encountered by pediatricians in managing even mild cases of AD and to delineate the impact on the daily lives of children and caregivers. Furthermore, this article seeks to explore the spectrum of available treatments, providing valuable insights for primary care providers to enhance the efficacy of AD management in pediatric populations.

摘要

特应性皮炎(AD),也称为湿疹,是一种常见的炎症性皮肤病,会导致皮肤出现瘙痒性病变,在全球范围内广泛存在,尤其是在富裕国家。它是儿童中最普遍的皮肤疾病。一小部分儿童湿疹会持续到成年期,其中一些人会表现出严重的病症形式。特应性皮炎的发展受免疫、环境和遗传因素影响;丝聚合蛋白基因突变和特应性家族史被视为导致免疫反应过度的风险因素,进而增加白细胞介素-13和白细胞介素-4的产生。结果,皮肤屏障受损,随后触发辅助性T细胞2免疫反应,特应性皮炎随之发展。特应性皮炎的诊断和治疗主要依赖于初级保健医生。尽管如此,治疗特应性皮炎仍然具有挑战性,大多数儿科医生甚至会将轻度湿疹患者转诊给皮肤科医生进行管理。为了进行本综述,我们提出了核心问题:“如何治疗儿童特应性皮炎?”,并使用“儿童特应性皮炎:最佳治疗方法是什么?”作为主要关键词。我们采用了全面的检索策略,纳入了如PubMed、谷歌学术和爱思唯尔等知名数据库。纳入标准设定为涵盖21世纪发表的文章;然而,一些交叉引用来自于二十世纪,专门关注全球范围内的儿科人群。我们只考虑儿科领域内的文章,以确保与我们的目标受众——儿科医生相关。这篇综述文章的总体目标是阐明儿科医生在管理即使是轻度特应性皮炎病例时遇到的挑战,并描述对儿童及其照顾者日常生活的影响。此外,本文旨在探索可用治疗方法的范围,为初级保健提供者提供有价值的见解,以提高儿科人群中特应性皮炎管理的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16ec/11473049/bdacdbaa038e/cureus-0016-00000069416-i01.jpg

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