Atopic dermatitis in the elderly

Irawan, Yudo; Rihatmadja, Rahadi; Legiawati, Lili; Yusharyahya, Shannaz Nadia; Sularsito, Sri Adi

doi:10.19100/jdvi.v1i2.32

Cited by 4 publications

(4 citation statements)

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“…Elderly patients with AD should choose suitable moisturizing emollients and apply them multiple times a day immediately after bathing to minimize water evaporation and help restore and maintain the skin barrier function. 35 …”

Section: Use Of Topical Moisturizers and Emollients To Maintain The S...mentioning

confidence: 99%

Current and Emerging Therapies for Atopic Dermatitis in the Elderly

Teng,

Zhong,

Yang

et al. 2023

CIA

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Atopic dermatitis (AD) in the elderly has recently emerged as a distinct subgroup of AD, garnering widespread concern due to its increasing global incidence rate. Epidermal barrier dysfunction, inflammatory response, and chronic pruritus interact with each other, contributing to the pathogenesis and pathophysiology of AD in the elderly. Although fundamental medications are essential for managing AD in the elderly, older adults often struggle with regular usage of moisturizing emollients, topical medications, and avoidance of environmental triggers, leading to recurrent or even exacerbated disease progression. Therefore, a systematic medication approach is necessary to control pruritus and skin lesions. Traditional systemic treatments may not adequately meet the treatment needs of moderate and severe AD in the elderly and may even pose certain safety risks. Biologics and Janus kinase (JAK) inhibitors, exhibiting excellent clinical efficacy, have made significant breakthroughs in AD treatment. Existing evidence suggests that dupilumab, a human monoclonal IgG4 antibody, has been confirmed as an effective and safe first-line systematic treatment for moderate to severe AD in the elderly, with no notable differences between adults and the elderly. However, the limited inclusion of elderly patients in related clinical studies hinders the generalizability of these findings. As older patients face a higher risk of adverse events with JAK inhibitors, JAK inhibitors are recommended when no other suitable treatment options are available. Obtaining population-specific data is crucial for making evidence-based treatment choices when managing AD in older adults with JAK inhibitors.

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Section: Use Of Topical Moisturizers and Emollients To Maintain The S...mentioning

confidence: 99%

Current and Emerging Therapies for Atopic Dermatitis in the Elderly

Teng,

Zhong,

Yang

et al. 2023

CIA

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“…Pada percobaan di tikus tua, terjadi penurunan konsentrasi IL-1 α, IL-IR2 dan IL-1ra dibandingkan tikus muda setelah dilakukannya iritasi pada kulit tikus tua (Ye et al, 2002). Respon imun juga ditemukan pada orang lanjut usia dengan dermatitis atopik, berupa peningkatan sel T helper 2 (Th2) dan produksi abnormal Immunoglobulin E (IgE), eosinophilia, aktivasi sel mas dan induksi sitokin lainnya (Irawan et al, 2016).…”

Section: Sawar Kulit Pada Orang Usia Lanjutunclassified

Peran Hidrasi Kulit Dan Perbaikan Sawar Kulit Pada Xerosis Dan Pruritus Di Usia Lanjut

Wijayadi,

Wardoyo

2022

JMMPK

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Pendahuluan: Proses penuaan kulit menyebabkan perubahan kulit pada usia lanjut. Terjadi penurunan kadar hidrasi dan perubahan sawar kulit yang akan bermanifestasi pada perubahan struktur kulit dan menimbulkan xerosis serta pruritus. Metode Penelitian: Literatur dikumpulkan secara elektronik maupun tertulis dari PubMed, Sinta dan buku ajar dermatologi geriatrik dengan total 46 literatur berbahasa Inggris maupun Indonesia. Hasil dan Pembahasan: Pada kulit usia lanjut terjadi penurunan kemampuan kulit untuk mempertahankan air pada stratum korneum, sehingga menyebabkan penurunan kadar hidrasi kulit. Proses diferensiasi sel kulit pada usia lanjut lebih lambat dibandingkan usia muda, hal ini menyebabkan terganggunya permeabilitas kulit dan penurunan fungsi sawar kulit. Perubahan fisiologis tersebut dapat diperberat dengan adanya penyakit metabolik pada usia lanjut berupa diabetes melitus. Tatalaksana xerosis dan pruritus dapat berupa topikal dan oral yang bersifat simptomatik dengan tujuan meningkatkan hidrasi kulit dan menunjang struktural sawar kulit. Kesimpulan dan Saran: Peran hidrasi dan sawar kulit sangat penting dalam menjaga kelembaban kulit pada orang usia lanjut. Penurunan fungsi sawar kulit dan kadar hidrasi kulit dapat disebabkan oleh karena faktor ekternal maupun internal, sehingga dibutuhkan tata laksana yang komprehensif pada kulit orang usia lanjut untuk menjaga kadar hidrasi kulit dan sawar kulit.

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“…A topical PDE4 inhibitor is already approved in North America. However, the efficacy and safety of these new drugs for older patients with AD are still uncertain surfaces, both lesional and non-lesional skin, and use should be continued after the lesion has healed [15].…”

Section: Other Treatments and New Drugsmentioning

confidence: 99%

“…With the increasing recognition of AD as a disease that affects older adults [12][13][14][15][16][17][18], it seems appropriate to review the drug treatment options for this condition in the elderly. In this article, treatment options, including topical, oral, and phototherapies as well as biologics, in the management of elderly AD are reviewed.…”

Section: Introductionmentioning

confidence: 99%

Atopic Dermatitis in Older Adults: A Review of Treatment Options

Tanei

2020

Drugs Aging

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Atopic dermatitis (AD) in older adults (elderly AD) has recently emerged as a newly defined subgroup of AD. When selecting treatment options, clinical characteristics of elderly AD and age-specific factors of older patients must be considered. As in other age groups, regular application of moisturizers in combination with topical corticosteroids and calcineurin inhibitors, adjunctive administration of oral antihistamines/anti-allergic drugs, and avoidance of exacerbating factors comprise basic treatments for elderly AD. For moderate-to-severe cases and/or in those with a decreased ability to use topical treatments, powerful anti-inflammatory treatments may become necessary as additional treatment options. While low-dose oral corticosteroids may be useful for cases of elderly AD, careful attention should be paid to adverse effects. Oral cyclosporine (ciclosporin) is less commonly used due to the increased risk of malignancy and organ toxicity in older patients with AD.

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Atopic dermatitis in the elderly

Cited by 4 publications

References 0 publications

Current and Emerging Therapies for Atopic Dermatitis in the Elderly

Current and Emerging Therapies for Atopic Dermatitis in the Elderly

Peran Hidrasi Kulit Dan Perbaikan Sawar Kulit Pada Xerosis Dan Pruritus Di Usia Lanjut

Atopic Dermatitis in Older Adults: A Review of Treatment Options

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