BACKGROUND
Atopic dermatitis is a highly prevalent inflammatory and pruritic dermatosis
with a multifactorial etiology, which includes skin barrier defects, immune
dysfunction, and microbiome alterations. Atopic dermatitis is mediated by
genetic, environmental, and psychological factors and requires therapeutic
management that covers all the aspects of its complex pathogenesis.
OBJECTIVES
The aim of this article is to present the experience, opinions, and
recommendations of Brazilian dermatology experts regarding the therapeutic
management of atopic dermatitis.
METHODS
Eighteen experts from 10 university hospitals with experience in atopic
dermatitis were appointed by the Brazilian Society of Dermatology to
organize a consensus on the therapeutic management of atopic dermatitis. The
18 experts answered an online questionnaire with 14 questions related to the
treatment of atopic dermatitis. Afterwards, they analyzed the recent
international guidelines on atopic dermatitis of the American Academy of
Dermatology, published in 2014, and of the European Academy of Dermatology
and Venereology, published in 2018. Consensus was defined as approval by at
least 70% of the panel.
RESULTS/CONCLUSION
The experts stated that the therapeutic management of atopic dermatitis is
based on skin hydration, topical anti-inflammatory agents, avoidance of
triggering factors, and educational programs. Systemic therapy, based on
immunosuppressive agents, is only indicated for severe refractory disease
and after failure of topical therapy. Early detection and treatment of
secondary bacterial and viral infections is mandatory, and hospitalization
may be needed to control atopic dermatitis flares. Novel target-oriented
drugs such as immunobiologicals are invaluable therapeutic agents for atopic
dermatitis.
Oral treatment with ivermectin of crusted (Norwegian) scabies in two immunosuppressed patients is reported. There was resolution of symptoms and signs of the cutaneous parasitosis on administration of 18-36 mg ivermectin (total doses) in 2- and 3-week periods of treatment, with remission periods of 3 and 4 months, respectively.
Lichen nitidus is a disease of unknown etiology, characterized by flesh-colored, shiny papules of 1-2 mm and generally asymptomatic or with mild pruritus. The most common sites of occurrence are genitalia, upper limbs, trunk and abdomen. The generalized form is rare. This is the fourth reported case of lichen nitidus associated with Down Syndrome. Keywords: Down syndrome; Lichen nitidus; Lichenoid eruptions; Lichens Resumo: Líquen nítido é uma doença de etiologia desconhecida, caracterizada por pápulas normocrô-micas, brilhantes medindo de 1 a 2 milímetros de diâmetro, geralmente assintomáticas ou com leve prurido. A forma mais comum é a localizada nos genitais, membros superiores, tronco e abdome. A forma generalizada é rara. Este é o quarto relato de caso descrito de líquen nítido associado à Síndrome de Down.
Dermoscopy performed on molluscum contagiosum lesions proved superior to dermatological examination even in cases in which clinical diagnosis was difficult. The presence of orifices, vessels and specific vascular patterns aids diagnosis, including differential diagnosis with other types of skin lesion.
The prevalence of atopic dermatitis associated with molluscum contagiosum was low. There was no statistically significant difference in the recurrence rates associated with molluscum contagiosum or in the number of lesions between the patients who had atopic dermatitis and those who did not. The number of anatomical areas affected by the molluscum contagiosum lesions and the presence of surrounding eczema and pruritus were higher in the patients with atopic dermatitis. There was no statistically significant difference in the occurrence of secondary bacterial infection between the groups with and without atopic dermatitis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.