Meeting the Needs of Patients With Atopic Dermatitis: A Multidisciplinary Approach

Russo, Filomena; Santi, Francesco; Cioppa, Vittoria; Orsini, Corinne; Lazzeri, Laura; Cartocci, Alessandra; Rubegni, Pietro

doi:10.1097/der.0000000000000907

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…3 Food allergies and eosinophilic esophagitis are early components of atopic march, where such cutaneous manifestations may precede the onset of secondary pathologies and dermatologists represent the sentinels for the early identification of this group of patients with AD. 4 Significant medical, personal, societal, and financial burdens are also associated with AD. Estimated annual costs for families to care for a child with AD are comparable to those of a child with insulin-dependent diabetes and much higher than those of a child with asthma.…”

Section: Introductionmentioning

confidence: 99%

The Application of Dupilumab to Pediatric Patients Aged 6–11yrs with Moderate-to-Severe Atopic Dermatitis Whose Disease is Not Adequately Controlled: The Clinical Data so Far

Balboul¹,

Kahn²,

Tracy³

et al. 2023

DDDT

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Background: While dupilumab has shown efficacy in improving atopic dermatitis, few studies have assessed the long-term clinical data of dupilumab use in pediatric patients. Objective: In the present study, we reviewed the current literature to assess reported efficacies, side effects, and risks of using dupilumab to treat atopic dermatitis in pediatric populations. Methods: Using PRISMA guidelines, the authors searched PubMed/MEDLINE and Embase for studies related to dupilumab treatment for atopic dermatitis in pediatric patients aged 6-11 years old. Results: A total of 512 pediatric patients (ages 6-11) were included. Outcome measures assessed by EASI, SCORAD, P-NRS, IGA and C-DLQI showed significant improvements in scores from those observed at baseline to the last treatment of dupilumab. Most reported adverse effects on dupilumab were conjunctivitis and infection site reactions. All studies reported that dupilumab was welltolerated. Limitations: Limitations include the low number of studies available and observation periods of up to 16 weeks, which may be too short to evaluate the drug's effectiveness and occurrence of adverse effects. This also limits our knowledge on whether there are sustained benefits and/or diminished efficacy as well as long-term side effects. Conclusion: Thus far, the data demonstrates dupilumab to be safe and effective in the management of moderate-to-severe atopic dermatitis in children aged 6-11 years. Future studies should evaluate long-term dupilumab use and sustained effects.

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Section: Introductionmentioning

confidence: 99%

The Application of Dupilumab to Pediatric Patients Aged 6–11yrs with Moderate-to-Severe Atopic Dermatitis Whose Disease is Not Adequately Controlled: The Clinical Data so Far

Balboul¹,

Kahn²,

Tracy³

et al. 2023

DDDT

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“…In most cases, cutaneous manifestations precede the onset of type 2 (t2)-driven diseases ( 11 ). Based on the development of t2 pathologies in atopic march, in general, dermatologists and pediatricians represent the sentinels for the early identification and treatment of patients with AD.…”

Section: Introductionmentioning

confidence: 99%

Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis

Andre,

Ben Shmuel,

Yahav

et al. 2023

Transl Pediatr

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Background Atopic dermatitis (AD) is a chronic dermatological condition, often diagnosed and managed by pediatricians. However, pediatricians have difficulties with adhering to guidelines, which recommend the use of topical corticosteroids (TCS) as a first-line treatment and oral corticosteroids (OCS) for resistant cases. Our aim was to assess pediatricians’ self-confidence in using steroids in the management of pediatric AD, and investigate which characteristics are related to high self-confidence in prescribing corticosteroids (CS). Methods We conducted a cross-sectional questionnaire study among Israeli pediatricians between April 2022 and June 2022. Participants were asked to answer questions dealing with self-assessment of prescribing CS in the management of AD. Results A total of 171 residents and pediatricians participated in the survey; 86.6% and 28.1% admitted feeling either average or below-average confidence in the prescription of OCS and TCS, respectively. Physicians who were exposed to higher AD patients (P=0.048) and worked at the clinics (88.2% vs. 60.4%, P<0.001) had high self-confidence in treating AD with TCS. Males (20.3% vs. 8%, P=0.03), and having gone to medical school outside Israel (22.2% vs. 10.4%, P=0.09) were all related to high self-efficacy in prescribing OCS. In total, 11.7% of participants confessed to refraining from prescribing steroids because of fear of side effects. Conclusions Most pediatricians have below-average confidence in prescribing OCS for the treatment of AD. Males, working in a community setting, and previous exposure improve the confidence level and can be easily considered in future pediatric training programs.

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“…Some scholars have reported that AD is a multidisciplinary disease. 46,47 El Hachem et al indicated that medical specialists' and even psychologists' support should be provided to adolescent patients, and treatment education programs should also be provided to patients/families to treat AD. 47 Although anti-inflammatory and antimicrobial treatments such as emollients, Fusidic acid, and calcineurin inhibitors can be one of the treatments for AD, [48][49][50] the study found that health-related behaviors (drinking and smoking) and psychological factors in adolescents are related to AD, and it will be needed more multidisciplinary efforts to treat AD.…”

mentioning

confidence: 99%

Health-Related Behaviors and Psychological Status of Adolescent Patients with Atopic Dermatitis: The 2019 Korea Youth Risk Behavior Web-Based Survey

Park¹,

Prochnow²,

Kim³

2023

PPA

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Objective Atopic dermatitis (AD) is one of the common chronic diseases that occur in children and adolescents as a chronic relapsing pruritic inflammatory skin disease. This study investigated how AD is associated with stress and depressive symptoms in a large representative sample of adolescents in South Korea. Methods The Korea Youth Risk Behavior Web-based Survey 2019 was used in this study (n = 57,069, weighted national estimates = 2,672,170). Multivariate logistic regression was used to determine significant associations between AD and mental health, measured by stress and depressive symptoms. Sub-group analysis was also conducted using various socio-economic variables. Results Among the present sample, 6.5% of adolescents (n = 173,909) were diagnosed with AD in the past 12 months. After adjusting for other variables, AD diagnosis was associated with significantly higher odds of experiencing stress (OR = 1.43) and depressive symptoms (OR = 1.32) as compared to adolescents without AD. A similar trend is found in subgroup model analysis using socio-economic variables (ie, education levels, parent’s income levels, and residence area). Specifically, female adolescents with AD, adolescents of low socio-economic status, those reporting smoking and drinking experience, and who do not participate in regular physical activity are more vulnerable to stress and depressive symptoms. Conclusion This is a noteworthy finding because it denotes that AD may lead to negative outcomes, like depressive symptoms or stress, which could be prevented if suspected early.

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Meeting the Needs of Patients With Atopic Dermatitis: A Multidisciplinary Approach

Cited by 6 publications

References 5 publications

The Application of Dupilumab to Pediatric Patients Aged 6–11yrs with Moderate-to-Severe Atopic Dermatitis Whose Disease is Not Adequately Controlled: The Clinical Data so Far

The Application of Dupilumab to Pediatric Patients Aged 6–11yrs with Moderate-to-Severe Atopic Dermatitis Whose Disease is Not Adequately Controlled: The Clinical Data so Far

Is corticophobia spreading among pediatricians?—Insights from a self-efficacy survey on the management of pediatric atopic dermatitis

Health-Related Behaviors and Psychological Status of Adolescent Patients with Atopic Dermatitis: The 2019 Korea Youth Risk Behavior Web-Based Survey

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