Prevalence of Atopic Dermatitis and Pattern of Drug Therapy in Malaysian Children

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.

Section: Introductionmentioning

confidence: 99%

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

Luk

Hon

Dizon

et al. 2020

“…Among 13- to 14-year-old adolescents in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, AD prevalence for Africa and Latin America was high at 12–14% and 6–10%, respectively, whereas for Asian-Pacific countries, the Eastern Mediterranean region, and the Indian subcontinent values were lower at 3–6%; among 6- to 7-year-old children, AD prevalence for Asian-Pacific countries, Africa, and Latin America was high at approximately 10%, whereas values for the Eastern Mediterranean region and Indian subcontinent were lower at 3–5% [8]. Likewise, prevalence in the first 2 years of life was also high at 7–27% in Asian-Pacific countries, including South Korea [9], China [10], Singapore [11], Malaysia [12], and Taiwan [13–15]. This review presents the diagnosis, treatment, and management of AD in developing countries in Asia, Africa, Latin America, and the Middle East.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Diagnosis, and Treatment of Atopic Dermatitis in the Developing Countries of Asia, Africa, Latin America, and the Middle East: A Review

Carrera¹,

Hammadi

Huang

et al. 2019

Atopic dermatitis (AD), the leading cause of skin-related burden of disease worldwide, is increasing in prevalence in developing countries of Asia, Africa, Latin America, and the Middle East. Although AD presents similarly across racial and ethnic groups as chronic and relapsing pruritic eczematous lesions, some features of the disease may be more or less prominent in patients with darker skin. Despite a similar presentation, consistent diagnostic criteria and consistent treatment guidelines are lacking. Because of these and other challenges, adherence to treatment guidelines is difficult or impossible. Previous studies have stated that many patients with AD receive ineffective or inappropriate care, such as oral antihistamines, oral corticosteroids, or traditional medicines, if they are treated at all; one study showed that approximately one-third of patients received medical care for their dermatologic condition; of those, almost three-quarters received inappropriate or ineffective treatment. In addition, other challenges endemic to developing countries include cost, access to care, and lack of specialists in AD. Furthermore, most of the available diagnostic criteria and treatment guidelines are based on European and North American populations and few clinical trials report the racial or ethnic makeup of the study population. Drug pharmacokinetics in varying ethnicities and adverse effects in different skin physiologies are areas yet to be explored. The objective of this review is to describe the diagnosis, treatment, and management of AD in developing countries in Asia, Africa, Latin America, and the Middle East; to discuss the differences among the countries; and to establish the unmet needs of patients with AD in them. The unmet medical need for treatment of AD in developing countries can be addressed by continuing to train medical specialists, improve Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9918782.

“…EASI and SCORAD are established as the best instruments for evaluation of AD severity based on clinical signs with good reliability [13,14]. SCORAD has sensitivity of 65% and specificity of 64% while objective SCORAD has sensitivity of 55% and specificity of 79% [15,16]. In this study, the mean SCORAD score at baseline was 43.90 in the treatment group (severe AD) and 35.23 in the control group (moderate AD).…”

Section: Discussionmentioning

confidence: 72%

Effectiveness of Cimetidine as Adjuvant Therapy in the Treatment of Acute-Extrinsic Atopic Dermatitis: A Double-Blind Randomized Controlled Trial

Novianto

Jacoeb

Indriatmi

et al. 2022

Introduction: Acute extrinsic atopic dermatitis (AD) requires long-term treatment. Cimetidine could be used as an adjuvant therapy for acuteextrinsic AD due to immunomodulatory effects. This study aims to assess the effectiveness of cimetidine as an adjuvant to standard treatment in acute extrinsic AD. Methods: This is a double-blind randomized controlled trial involving 26 AD patients aged 12-60 years from 2017 to 2020. Effectiveness of cimetidine was assessed by comparing SCORing Atopic Dermatitis (SCORAD) and objective SCORAD changes in both groups at week 2, 4, 6, and 8. Serum levels of immunoglobulin E (IgE), interferon (IFN)-c, interleukin (IL)-12, and IL-4 were also documented. Results: Significant differences were observed in SCORAD changes at week 2, 4, 6, and 8