Management of severe atopic dermatitis in adult patients

Kobusiewicz, Aleksandra; Zalewska-Janowska, Anna; Lesiak, Aleksandra

doi:10.5114/dr.2020.97785

Cited by 4 publications

(9 citation statements)

References 56 publications

(124 reference statements)

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“…Moderate-to-severe AD can be treated by classical systemic drugs, such as methotrexate or ciclosporin A. Patients suffering from AD also benefit from modern systemic treatments that affect the immune system [1,3,9]. However, the data regarding the safety of biological drugs used in AD should be interpreted with caution, since we do not yet possess data for COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Atopic Dermatitis Patients

Sieniawska

Lesiak

Ciążyński

et al. 2022

IJERPH

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Atopic dermatitis (AD) can have a significantly negative impact on quality of life (QoL). The impact of coronavirus disease 2019 (COVID-19) on the AD population is not yet well established. The study comprised 195 patients with diagnosed AD who were asked about their cognitive and preventive behaviors regarding COVID-19 and the accessibility of medical support, including online consultations. Moreover, the patients responded to the self-reported Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS). Most of the patients were worried about being infected with COVID-19. Most of the patients believed that people suffering from skin disease were more prone to be infected with COVID-19 compared with the general population. Most the patients negatively assessed the availability of dermatological treatment during the pandemic. Furthermore, 66.1% of the patients declared using telemedicine. Nearly 50% of patients were discontented with telemedicine, and 1/3 of the patients did not mind the use of telemedicine. AD during the COVID-19 pandemic was associated with a lower overall health rating and life satisfaction and impaired QoL related to mental health in a Polish population. These results provide original information that can be applied in dermatologic patient screenings to evaluate the state of depression and anxiety during the epidemic period.

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Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Atopic Dermatitis Patients

Sieniawska

Lesiak

Ciążyński

et al. 2022

IJERPH

Self Cite

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“…Phototherapy in combination with proper skin care and suitable topical anti-inflammatory TCS treatment reduces the number and intensity of recurrences. Topical calcineurin inhibitors should be used with caution during phototherapy [79,80].…”

Section: Phototherapymentioning

confidence: 99%

“…The drug can be administered long-term in continuous therapy, up to a maximum of two years, in cycles of an average of 12-16 weeks or in intermittent therapy (so-called weekend therapy) twice a week at adjusted doses. The decision about this treatment should account for possible side effects, possibly even permanent kidney damage [80].…”

Section: Immunomodulatory and Cytostatic Therapymentioning

confidence: 99%

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Atopic dermatitis: Current standards of diagnosis and treatment, including the latest methods of management

Fornal

Książkiewicz

Fornal

et al. 2022

Postępy Higieny I Medycyny Doświadczalnej

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Atopic dermatitis (AD) is a chronic relapsing disease which causes characteristic eczematous skin lesions. The most common symptoms of atopic dermatitis are persistent pruritus, xerosis, and skin lesions with a typical location and appearance that changes with the patient’s age. The prevalence of the disease in the pediatric population is estimated at 10% to 30%, while in adults it ranges from 1% to 3%. The number of people who suffer from AD is rising every year. The pathophysiology of the disease is complex and multifactorial. It involves elements of epidermal barrier dysfunction, alterations in cellular immune response, IgE hypersensitivity, and environmental factors. AD significantly reduces the quality of life of both patients and their families. Patients with AD are at higher risk for neuropsychiatric disorders such as depression, attention-deficit/hyperactivity disorder, and headaches. The decreased quality of life of AD patients and their families is associated with the discomfort of recurrent and chronic inflammatory skin lesions, persistent pruritus, and the inconvenience of long-term therapy. It also affects the psychological development of children, contributes to behavioral disorders (hyperactivity, hypersensitivity) and impacts many areas of family life such as sleep, leisure activities, and relationships between family members. The basic treatment of AD is avoidance of potential harmful factors, proper care in the treatment of exacerbations, topical corticosteroids, and calcineurin inhibitors in proactive therapy. In some patients who meet age criteria, phototherapy and cyclosporine should be considered. In individuals with severe AD who do not respond to topical treatment and who will not benefit from general therapy, dupilumab, a biologic drug, is the treatment of choice. Biologic treatment has an increasingly important place in the effective and modern therapy of AD. Currently, new biologic drugs are being researched, which may bring a therapeutic revolution in AD in the future. Allergen immunotherapy in patients with AD should be carefully evaluated on an individual basis, as proper selection of patients with documented IgE-dependent sensitization is important for the success of this therapy. Close collaboration with the patient and their caregivers, education, and psychological support as appropriate are integral to the treatment.

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“…AD is characterized by pruritus, itching, dry skin, skin wrinkles, eczema, and elevated serum IgE levels [3]. Preventative treatment of AD approaches from a variety of directions such as moisturizing and managing the skin, or training in avoidance of deteriorating factors which may cause symptoms to recur or worsen, or therapeutic in the form of treatment for symptom relief using topical steroid treatment, and use of immunosuppressants [4].…”

Section: Introductionmentioning

confidence: 99%

Effect of Astaxanthin on Anti-Inflammatory and Anti-Oxidative Effects of Astaxanthin Treatment for Atopic Dermatitis-induced Mice

Park

Song

2021

J Acupunct Res

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Background: This study sought to determine whether the antioxidant effects of astaxanthin (AST) could have an anti-inflammatory effect to reduce inflammation caused by atopic dermatitis (AD).Methods: Using a mouse model of AD induced by phtalic acid (PA), the levels of inflammation, inflammatory agents, and evidence of antioxidant activity were examined in PA treated mice (n = 3), PA-AST treated mice (n = 3), and a control group of mice (n = 3). This included measurements of ear thickness, levels of mast cells, IgE, inflammatory cytokine, malondialdehyde (MDA), hydrogen peroxide, HO-1, and GPx-1.Results: AST treatment significantly prevented inflammation as measured by ear thickness (p < 0.05), mast cell count (p < 0.001), and IgE concentration in the blood (p < 0.001). Levels of TNF-α (p < 0.001), IL-1β (p < 0.001), IL-6 (p < 0.001), and MDA (p < 0.05) were also significantly lower. In addition, GSH levels increased significantly (p < 0.001), and the level of hydrogen peroxide significantly reduced (p < 0.01). The expression of HO-1, GPx-1 increased.Conclusion: In this small experimental study, AST acted on inflammatory mechanisms that induced AD, through anti-inflammatory and antioxidant mechanisms, and is a candidate of interest in the clinical treatment of AD.

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Management of severe atopic dermatitis in adult patients

Cited by 4 publications

References 56 publications

Impact of the COVID-19 Pandemic on Atopic Dermatitis Patients

Impact of the COVID-19 Pandemic on Atopic Dermatitis Patients

Atopic dermatitis: Current standards of diagnosis and treatment, including the latest methods of management

Effect of Astaxanthin on Anti-Inflammatory and Anti-Oxidative Effects of Astaxanthin Treatment for Atopic Dermatitis-induced Mice

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