Omalizumab‐Therapie atopischer Dermatitis: IgE‐Depletion führt nicht zur klinischen Besserung – eine randomisierte, placebo‐kontrollierte, doppelblinde Pilotstudie

This chapter on systemic dermatological therapy aims to provide practising dermatologists with sufficient information about the most frequently used systemic medications to enable these to be used for treating skin disease to the maximum benefit and minimum detriment to their patients. The introduction covers general aspects of systemic therapy, including patient selection and education, risk reduction measures and the importance of good record keeping. Thereafter follows a detailed review of immunomodulatory and antimicrobial drugs, including antihistamines, antimalarial agents, azathioprine, ciclosporin, colchicine, dapsone, fumaric acid esters, glucocorticoids, hydroxycarbamide, methotrexate, mycophenolate mofetil, potassium iodide, protein therapies (biological drugs and intravenous immunoglobulin), retinoids, thalidomide, antibiotics, antifungal agents and antiviral drugs. The profile of each individual drug includes its pharmacological properties (formula and structure, pharmacodynamics, pharmacokinetics and, where relevant, pharmacogenetic aspects), potential adverse effects, contraindications, cautions, drug–drug interactions, pre‐treatment screening, dosage regimens, monitoring requirements and its range of licensed and off‐label dermatological usage.

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Atopic Eczema (Atopic Dermatitis)

Ardern‐Jones

2016

Rook's Textbook of Dermatology, Ninth Edition

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Atopic eczema is a chronic, relapsing, inflammatory skin condition characterized by itch which affects 20–30% of schoolchildren and 5–10% of adults in the UK. The increased prevalence in both western industrialized countries and developing nations over the last 20 years highlights the strong role of environmental factors in mediating the disease. However, the identification of a strong association between atopic eczema and mutations in the gene encoding filaggrin in 2006 has provided a paradigm shift in our understanding of the role of genetics in this condition and the importance of the function of the epidermal barrier. Indeed, interventions to repair the epidermal barrier show promise in both the treatment and prevention of atopic eczema and its complications. T‐helper 2 cells are central to mediating atopic eczema inflammation and specific targeted interventions are progressing well in clinical trials. Further developments in our understanding of disease pathogenesis, including the role of thymic stromal lymphopoeitin, and recently discovered subsets of immunocytes, are exciting targets and provide an optimistic future for the management of this challenging disease. However, topical therapy with emollients, corticosteroids and calcineurin inhibitors remains the mainstay of treatment. Thus, for more severe disease, current therapeutic options remain limited. As a result, atopic eczema still contributes a significant quality of life and financial burden on society and health care systems worldwide.

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Omalizumab‐Therapie atopischer Dermatitis: IgE‐Depletion führt nicht zur klinischen Besserung – eine randomisierte, placebo‐kontrollierte, doppelblinde Pilotstudie

Abstract: The interference with immediate and delayed type skin tests may imply that a therapeutic benefit of omalizumab treatment, if present at all, would be seen in patients with acute rather than chronic forms of the disease.

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Atopic Eczema

Atopic Eczema

Principles of Systemic Therapy

Atopic Eczema (Atopic Dermatitis)

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