Special paper Atopic dermatitis: current treatment guidelines. Statement of the experts of the Dermatological Section, Polish Society of Allergology, and the Allergology Section, Polish Society of Dermatology

Abstract

Atopic dermatitis (AD) is a condition frequently encountered in medical practices across the country. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). Patients with AD have a unique predisposition to colonization or infection by Staphylococcus aureus. Treatments for AD need to rapidly control symptoms of the disease, improve quality of life and prevent exacerbations. Given the chronic and relapsing nature of the disease, therapies need to encourage good compliance and be well tolerated.

The Turkish guideline for the diagnosis and management of atopic dermatitis-2018

“…Üre içeren nemlendiriciler çocuklar için uygun değildir 1 . Ayrıca 2 yaşın altındaki hastalarda propilen glikol içeren nemlendirici kullanımı iritasyona neden olabildiğinden önerilmemelidir 83 .…”

“…Hem takrolimus hem de pimekrolimusun 2 yaşın altında kullanım onayı yoktur 82,86 .Uygulamaya günde 2 kez başlanır. Aktif dermatit bulguları geriledikten sonra dermatitin en sık tekrarladığı alana haftada 2-3 kez devam edilebilir [82][83][84] . Oklüzyon şeklinde önerilmemelidir.…”

Addressing treatment challenges in atopic dermatitis with novel topical therapies

“…Treating the inflammation that occurs in AD is effective in reducing itch because the overall severity of inflammation correlates with the severity of pruritus (8). Consequently, both TCSs and TCIs can provide some relief from pruritus; however, it may take up to 7-14 d before an improvement in symptoms occurs (42,43). The development of more specific anti-inflammatory treatments that rapidly target the pathophysiology of pruritus in AD could substantially improve clinical outcomes in patients with AD.…”

Hyperbaric Oxygen Therapy (HBOT) as a Therapeutic Option for Patients with Atopic Dermatitis (AD) – Own Experiences and Literature Review

“…Symptomatic treatment involves the use of calcineurin inhibitors -pimecrolimus and tacrolimus (topical), corticosteroids (both topical and general -particularly during exacerbations), antihistamines, photochemotherapy and skin care treatments, and, in severe or refractory cases, also such immunosuppressive drugs as cyclosporine and methotrexate (general). More recently, AD therapy has started to be enhanced with the so-called biological treatment -the main potential is seen in monoclonal antibodies such as omalizumab and dupilumab, as well as mycophenolate mofetil [12,13].…”

“…Atopic dermatitis (AD) is chronic inflammatory skin disease with periods of exacerbation and remission accompanied by persistent and recurrent pruritus and lichenification of the skin [12,13]. The disease is caused by a genetically determined, abnormal immune response to an antigen/antigens (even in low doses), resulting in an excessive production of specific IgE antibodies, and after binding of the antigen with IgE and its "demonstration" to helper lymphocytes T -a proliferation of TH2 lymphocytes secreting proinflammatory cytokines leading in consequence to subjective symptoms (pruritus) and cutaneous lesions of varying advancement [8,11,14].…”