Dismissing the fallacies of childhood eczema management: case scenarios and an overview of best practices

Hon, Kam Lun; Leong, Kin Fon; Leung, T. N.; Leung, Alexander K. C

doi:10.7573/dic.212547

Cited by 14 publications

(14 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A proactive approach by the clinician to openly discuss the content of the black box warning with the patient may help to reduce patient anxiety and subsequently help to improve TCI adherence [ 26 , 63 ]. Nevertheless, misinformation and distrust of TCI and TCS persists in Asian populations [ 64 ].…”

Section: Methodsmentioning

confidence: 99%

Practical Recommendations for the Topical Treatment of Atopic Dermatitis in South and East Asia

Luk

Hon

Dizon

et al. 2020

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Introduction There is some evidence to suggest that the prevalence of atopic dermatitis (AD) in Asia is rising. We have therefore developed an algorithm for the topical treatment of AD throughout South and East Asia for use by primary care physicians, pediatricians and dermatologists. Methods Nine AD experts from South and East Asia and one from Europe developed the algorithm based upon treatment guidelines, relevant literature and local treatment practices. The algorithm outlines current best practice for the use of emollients, topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI), with the intention of simplifying the treatment regimen of mild-to-moderate AD in South and East Asia. Results Patients with AD should bathe and cleanse affected skin to remove crusts and scales daily. Emollients should also be applied daily as a maintenance treatment. When selecting appropriate topical anti-inflammatory treatment for AD flares, several factors should be taken into consideration, including the patient’s age, attitude to treatment options and site of AD lesions. Given the concerns regarding the risk of skin atrophy with use of TCS, a TCI should be used to treat AD lesions in sensitive skin areas: pimecrolimus is recommended for mild-to-moderate AD in these locations, while tacrolimus should be considered for moderate and severe cases. Either pimecrolimus or tacrolimus is recommended for flares in other, non-sensitive body locations. A proactive or intermittent maintenance treatment strategy involving regular emollient use and twice-weekly application of a TCI to previously affected areas is encouraged to reduce the risk of flares. Conclusions The algorithm proposed here is intended to simplify the topical treatment of mild-to-moderate AD in daily practice in South and East Asian countries.

show abstract

Section: Methodsmentioning

confidence: 99%

Practical Recommendations for the Topical Treatment of Atopic Dermatitis in South and East Asia

Luk

Hon

Dizon

et al. 2020

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

show abstract

“…Described as steroid phobia, many parents are reluctant to use steroids on their children. 38 , 53 , 54 …”

Section: Overview Of Therapies For Atopic Dermatitismentioning

confidence: 99%

“…1,[3][4][5] To complicate matters, there are several cultural and psychosocial issues that make AD difficult to manage in some countries. 38 We undertook a structured search of peer-reviewed research articles from PubMed and Google Scholar. Recent and up-to-date studies relevant to the topic were included.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Experimental Drugs with the Potential to Treat Atopic Eczema

Hon¹,

Chan²,

Leung

2021

JEP

Self Cite

View full text Add to dashboard Cite

Introduction: Eczema or atopic dermatitis (AD) is a chronically relapsing dermatosis characterized by pruritus and a significant impact on the quality of life. Methods: The authors undertook a structured search of peer-reviewed research articles from PubMed and Google Scholar. Recent and up-to-date studies relevant to the topic were included. Results: This report overviews current treatment and experimental drug for AD. Topical agents including topical phosphodiesterase E4 (PDE4) inhibitors such as crisaborole are efficacious in the treatment of AD with few side effects. Monoclonal antibodies such as dupilumab given subcutaneously are efficacious for more severe disease. Systemic treatment can ameliorate symptoms in severe and recalcitrant AD. New systemic treatment includes several traditional herbal formulations that have undergone clinical trials using modern research methodology to determine their efficacy and safety. AD is associated with many complicating psychosocial issues. Often suboptimal efficacy is due to unrealistic expectations and poor compliance making treatment difficult in spite of effective treatment and efforts in drug discovery. Randomized trials have shown that novel topical and subcutaneous medications are safe and efficacious. Regarding herbs, a methodology for the investigation of herbal medications is often flawed and scientific evidence is lacking. Experimental drugs include various biologics, PDE4 and JAK inhibitors in topical, oral, subcutaneous or intravenous forms are in various phases of trials. Conclusion: Many novel medications demonstrate efficacy for AD. Experimental drugs include various biologics, PDE4 and JAK inhibitors are in various phases of trials.

show abstract

“…Education of general practitioners and pharmacists may help with adherence. [44][45][46] Appropriate use of TCS, even long term, has not been shown to lead to skin atrophy 47 and patients should be counselled accordingly.…”

Section: Topical Corticosteroidsmentioning

confidence: 99%

Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section III: Treatment Options for Pediatric Atopic Dermatitis

et al. 2019

View full text Add to dashboard Cite

show abstract

Dismissing the fallacies of childhood eczema management: case scenarios and an overview of best practices

Cited by 14 publications

References 92 publications

Practical Recommendations for the Topical Treatment of Atopic Dermatitis in South and East Asia

Practical Recommendations for the Topical Treatment of Atopic Dermatitis in South and East Asia

Experimental Drugs with the Potential to Treat Atopic Eczema

Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section III: Treatment Options for Pediatric Atopic Dermatitis

Contact Info

Product

Resources

About