Willemaers V, Stas I, Piérard-Franchimont C, Cornil F, Piérard G E
Rev Med Liege. 1998 Feb;53(2):67-70.
For the past decades, the prevalence of atopic dermatitis is on the rise. Three phases of the disease are recognized according to the age of the patient, either in the newborn age, in infancy or after puberty. A partial enzymatic defect in delta-6 desaturase has been reported. Such metabolic anomaly would be responsible for the alterations in both the skin barrier function and in the Th2 inflammatory reactions in part mediated through IgE. Some microorganisms colonizing the skin play an important causal role in the clinical exacerbations. The influence of food allergy on atopic dermatitis remains obscure and often unconvincing. By contrast, irritant and allergic challenges from the environment exhibit an undisputable worsening effect. The prevention relies on the eviction of predisposing factors and is favourably influenced by emollients specifically designed for atopic dermatitis. A food supplementation in alpha-linoleic acid and some specific chinese herbal remedies might well be useful. The treatment relies primarily on topical applications of corticoids. Puva-therapy, UVB phototherapy and immunomodulation by cyclosporine are indicated for difficult cases.
在过去几十年中,特应性皮炎的患病率呈上升趋势。根据患者年龄,该病可分为三个阶段,分别为新生儿期、婴儿期或青春期后。据报道,δ-6去饱和酶存在部分酶缺陷。这种代谢异常部分通过IgE介导,会导致皮肤屏障功能和Th2炎症反应的改变。一些皮肤定植微生物在临床病情加重中起重要的因果作用。食物过敏对特应性皮炎的影响仍不明确,且往往缺乏说服力。相比之下,来自环境的刺激性和过敏性因素会产生无可争议的恶化作用。预防措施依赖于排除诱发因素,专为特应性皮炎设计的润肤剂对预防有积极影响。补充α-亚麻酸的食物和一些特定的中药可能会有帮助。治疗主要依靠局部应用皮质类固醇。对于难治性病例,可采用光化学疗法(PUVA)、紫外线B光疗和环孢素免疫调节治疗。