Dupilumab is a new treatment option for patients with moderate-to-severe atopic dermatitis. It blocks IL-4/IL13-signaling and thereby inhibits receptor signaling downstream the JAK-STAT-pathway. Three of the main disease mechanisms of atopic dermatitis are affected by blocking this pathway; the decrease of skin barrier function, the class switch to IgE and the TH2-differentiation. Areas Covered: Dupilumab showed promising results in clinical trials of phase I-III. Clinical outcome parameters such as SCORAD, EASI, IGA and BSA improved with dupilumab. A positive effect on patient-reported outcomes like DLQI or pruritus-rating-scales was also demonstrated. The safety profile of dupilumab is superior to conventional immunosuppressive drugs, such as cyclosporine or methotrexate. Injection-site reactions and conjunctivitis were the most relevant side-effects. Skin infections were less frequently observed compared to placebo. Data on the use of dupilumab during pregnancy or in children are not published to date. Expert Commentary: Dupilumab was approved by the FDA in April 2017 for the treatment of adult patients with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
Elastic, lightweight textiles with smooth fibres are comfortable for daily use. Functional textiles rapidly losing their deliverable antimicrobial activity in vitro are not advisable for AD patients. Recommendations for functional textiles should be based on a combination of in vitro analysis of products in their original state and after laundering, together with real-life data obtained from controlled clinical trials.
Background: Perioral dermatitis is a clinically distinctive reaction pattern of facial dermatitis, including redness, dryness, burning, pruritus and skin tightness. A gold standard treatment remains unclear.Objectives: Our study evaluates the clinical value of a skin care cream with the transient receptor potential vanilloid type 1 inhibitor 4-t-butylcyclohexanol in POD patients over 8 weeks.Methods: This open, unblinded 8-week clinical trial included 48 patients. A skin care cream containing 4-t-butylcyclohexanol was applied over a period of 8 weeks.Standardized questionnaires were used at baseline, 4 and 8 weeks, for history documentation, objective and subjective severity scores, and quality of life assessments.Six different skin physiology parameters were assessed at all timepoints.
Results:The perioral dermatitis severity score decreased significantly during the treatment period. This was mirrored by significantly lower patients' subjective numerical rating score and an improved quality of life score. Transepidermal water loss, stratum corneum hydration and skin erythema improved significantly during the treatment period.
Conclusion:This transient receptor potential vanilloid type 1 inhibitor-based skin care cream improved subjective and objective parameters of perioral dermatitis.Decreased transepidermal water loss values and increased stratum corneum hydration demonstrate a restored skin barrier function. Consequently, the topical inhibition of these receptors is a promising management option for POD.
K E Y W O R D S perioral dermatitis, POD severity index, topical therapy, transepidermal water lossThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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