Useful Tools for the Management of Atopic Dermatitis

Abstract

Eczema, frequently named atopic dermatitis, is the most frequent chronic skin disease of early childhood, with a high prevalence in industrialized countries and a relapsing-remitting course that is responsible for a serious burden on affected children and their families. Even though most facets of this disease are nowadays well known and numerous guidelines are available, some confusion still exists regarding certain aspects. First, several names have been proposed for the disorder. We suggest that the name and definition adopted by the World Allergy Organization should be used: 'eczema,' divided into 'atopic,' when an allergic sensitization can be demonstrated, and 'non-atopic,' in the absence of sensitization. Several diagnostic criteria have been proposed, but at present the two most reliable are the 2003 revision by the American Academy of Dermatology of the Hanifin-Rajka criteria, and those by Williams revised in 2005. To date, 20 different clinical scores have been published to assess the severity; however, only the EASI (Eczema Area and Severity Index), the SCORAD (SCORing Atopic Dermatitis), and the POEM (Patient-Oriented Eczema Measure) seem to have been adequately validated and are recommended for use in clinical practice and trials. The diagnostic tests to identify associated allergy or sensitization include skin-prick tests, determination of the specific IgE in serum using different assays, and atopy patch tests; in the case of suspected food allergy, a food challenge may be necessary to define the diagnosis. To evaluate quality of life, tools exist that allow both the child's and family's impairment to be considered. In addition, several algorithms exist to help decide therapy on a step-wise basis. However, such guidelines and algorithms represent only an aid to the physician and not an obligatory directive, since the ultimate judgment regarding any therapy must be performed by the physician and tailored to individual needs. A clear and validated definition of eczema control would permit better monitoring of the disease, similar to the situation with asthma in recent years. Finally, the review examines the role of special textiles in diminishing Staphylococcus aureus skin superinfection, of house dust-mite avoidance measures, and of educational programs for patients and their families, which may all help improve eczema.

The usefulness of combined measurements of squamous cell carcinoma antigens 1 and 2 in diagnosing atopic dermatitis

“…24,25 It has been reported that peripheral eosinophil counts and the quantity of its product, eosinophil cationic protein, are correlated with the clinical severity of AD. 19 -21 However, the correlation between total IgE and disease severity is controversial.…”

Multiple pathways are involved in DNA degradation during keratinocyte terminal differentiation

“…Patients with AD (7 men, mean age 32.7 years) and psoriasis (11 men, mean age 44.6 years) had not received topical steroid treatment or UV therapy for at least 4 weeks before participation in the study. The severity of AD was evaluated by using the Eczema Area and Severity Index (EASI) score 29 that ranged from 13.7 to 48 (mean score=29.9). The severity of psoriasis was evaluated in terms of the PASI score (2.0–52.8, mean score=21.1).…”

Influence of Ag content on the antibacterial properties of SiC doped hydroxyapatite coatings

“…infected immunocompromised patients [47][48][49], venous ulcers [50,51], superinfection of some chronic dermatitis [52,53] etc. ), urinary infections [54,55], and respiratory infections (e.g.…”