Dermatology for the internist: optimal diagnosis and management of atopic dermatitis

Narla, Shanthi; Silverberg, Jonathan I.

doi:10.1080/07853890.2021.2004322

Cited by 16 publications

(7 citation statements)

References 133 publications

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“…Many patients also have allergic asthma, food allergies, and allergic rhinitis. In addition, nonimmune factors such as stress, anxiety, and other negative emotions, can also aggravate AD [7][8][9][10][11][12][13][14][15][16]. Its incidence has increased worldwide in recent years, especially in high-income and industrialized countries because of air pollution and household hygiene products [16].…”

Section: Introductionmentioning

confidence: 99%

“…Diagnosis of AD is based on the clinical history and skin symptoms, other tests such as patch testing and food challenge test are also used [15,16]. The worldwide diagnosis criteria are Williams Diagnostic Criteria from the UK and Hanifin-Rajka Diagnostic Criteria [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of AD has been on morphologic features and distribution of skin lesions, associated clinical signs, and medical history [15,16]. The Williams Diagnostic Criteria and Hanifin-Rajka Diagnostic Criteria are the most widely used diagnostic criteria worldwide [17,18].…”

Section: Introductionmentioning

confidence: 99%

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Guidelines for the Management of Atopic Dermatitis in Children: A Systematic Review

Wang

Liu

2022

Int Arch Allergy Immunol

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Introduction: Numerous guidelines have been published for atopic dermatitis management in children in recent years. To date, the quality of the newest guidelines has not been appraised. This study aimed to identify and evaluate guidelines for the management of atopic dermatitis in children. Methods: We reviewed the literature retrieved from PubMed, Web of Science, Ovid, ScienceDirect, Embase, China National Knowledge Infrastructure, WanFang Data, and guidelines websites. Search period from January 1, 2016, to December 31, 2021. The following keywords were used for searching: “atopic dermatitis,” “atopic eczema,” “eczema,” “guideline,” and “consensus.” The quality of the guidelines was assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument independently, and domain scores >60% were considered to have sufficient quality. The guideline recommendations were reviewed. Results: Nineteen guidelines were included in the study. Three guidelines had a graded A level, which was recommended for use in practice. Eleven guidelines had a graded B level, which was recommended for use in revision. The remaining five guidelines were rated with C level, which was not recommended. The average score of six domains of AGREE II was 64.76%, 48.53%, 42.35%, 73.83%, 32.23%, and 70.17%, respectively. A consistency test showed an intraclass correlation coefficient range of 0.497 (95% CI: 0.105, 0.705) to 0.970 (95% CI: 0.93, 0.987) based on the two assessors’ test results for the guidelines. Conclusions: Most guidelines were recommended for use with revision. No significant changes were observed in the primary management of atopic dermatitis in children compared to previous evidence. New biological agents and complementary alternative medicine are increasingly available, but the evidence for the treatment of atopic dermatitis in children is still limited.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Guidelines for the Management of Atopic Dermatitis in Children: A Systematic Review

Wang

Liu

2022

Int Arch Allergy Immunol

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“…Так, в 1983 г. О. Clemmensen и N. Hjorth была опубликована работа, посвященная ассоциации между АтД и грибами рода Malassezia: исследователи обнаружили, что применение кетоконазола у подростков с АтД, сопровождаю щимся эритемой лица и шеи, демонстрирует положительный эффект [5]. Данное открытие положило начало исследованиям роли грибов, которые, наряду с уже известной бактериальной (S. aureus) и вирусной (Herpes simplex) инфекцией, провоцируют развитие вторичного инфицирования у пациентов с АтД, а также выделило специфическое поражение лица и шеи в отдельный фенотип данного заболевания [6].…”

Section: Introductionunclassified

Features of the course of atopic dermatitis with facial and neck lesions (head and neck)

Tamrazova

Glukhova²,

Tamrazova

2022

Medicinskij sovet

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Dermatitis of head and neck, also known as “head-and-neck dermatitis” (HNAD), is one of the specific manifestations of atopic dermatitis (AD) in adolescents and young adults. The epidermal barrier dysfunction, skin pathological immune responses, a direct damaging effect of the malassezial flora through the synthesis of virulence factors and mediated by maintaining immune inflammatory responses, as well as the attachment of secondary bacterial flora caused by scratching form the basis of pathogenetic mechanisms of this condition. The properties that define the HNAD rash is a focus on the seborrheic areas (a face, front surface of the neck, décolleté on the chest), severe itching, prolonged course, exacerbation characterized by excessive sweating. It appears that fungi of the genus Malassezia can play a role in the development of the disease. While they are considered to be part of the normal skin microbiome, a significant increase in the severity of atopic dermatitis was observed in patients with Malassezial flora, which was the reason for the theories devoted to the role of Malassezia spp. as a trigger of the disease. Atopic dermatitis can also develop as a side effect of using targeted therapy with IL4/13 blockers, which is explained at the present day by a shift of the immune response towards a Th-17-mediated reaction. The combination of both infectious and immune-mediated lesions in HNAD determines the necessity of an integrated approach to the therapy, in particular the use of topical combination drugs as the first-line therapy. The topical glucocorticosteroid (TGCS) therapy is aimed at suppressing the immune reactions that are responsible for inflammation in the skin, antifungal therapy is required to suppress the activity of the malassesial flora, and, finally, a secondary bacterial infection requires the prescription of topical antibacterial drugs.

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“…Skin barrier dysfunction, Th2 cell-mediated immunity, microbial colonization, oxidative stress, as well as genetic and environmental factors have all been reported as contributing to the pathogenesis of AD [5][6][7][8] . A total of 46 genes and 34 genetic loci have been reported to be related to sporadic AD worldwide 9 .…”

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confidence: 99%

Identification of novel candidate genes and predicted miRNAs in atopic dermatitis patients by bioinformatic methods

Chen

Xin

Wang

et al. 2022

Sci Rep

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Atopic dermatitis (AD) is a common, chronic inflammatory dermatosis with relapsing eruptions. Our study used bioinformatics to find novel candidate differentially expressed genes (DEGs) and predicted miRNAs between AD patients and healthy controls. The Mesh term “atopic dermatitis” was retrieved to obtain DEGs in GEO datasets. DEGs between AD patients and healthy controls were analyzed using GEO2R. Overlapping DEGs between different datasets were obtained with use of Draw Venn software. GO and KEGG enrichment analyses were conducted by the use of DAVID. STRING and miRWalk were used to individually analyze PPI networks, interactions of candidate genes and predicted miRNAs. A total of 571 skin samples, as retrieved from 9 databases were assessed. There were 225 overlapping DEGs between lesioned skin samples of AD patients and that of healthy controls. Nineteen nodes and 160 edges were found in the largest PPI cluster, consisting of 17 up-regulated and 2 down-regulated nodes. Two KEGG pathways were identified, including the cell cycle (CCNB1, CHEK1, BUB1B, MCM5) and p53 (CCNB1, CHEK1, GTSE1) pathways. There were 56 nodes and 100 edges obtained in the miRNA-target gene network, with has-miR-17-5p targeted to 4 genes and has-miR-106b-5p targeted to 3 genes. While these findings will require further verification as achieved with experiments involving in vivo and in vitro modles, these results provided some initial insights into dysfunctional inflammatory and immune responses associated with AD. Such information offers the potential to develop novel therapeutic targets for use in preventing and treating AD.

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Dermatology for the internist: optimal diagnosis and management of atopic dermatitis

Cited by 16 publications

References 133 publications

Guidelines for the Management of Atopic Dermatitis in Children: A Systematic Review

Guidelines for the Management of Atopic Dermatitis in Children: A Systematic Review

Features of the course of atopic dermatitis with facial and neck lesions (head and neck)

Identification of novel candidate genes and predicted miRNAs in atopic dermatitis patients by bioinformatic methods

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