A Practical Approach to Recalcitrant Face and Neck Dermatitis in Atopic Dermatitis

Jaros, Joanna; Hendricks, Aleksi J.; Shi, Vivian Y.; Lio, Peter A.

doi:10.1097/der.0000000000000590

Cited by 29 publications

(35 citation statements)

References 52 publications

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“…93 In addition, recent reports have suggested an association between treatment of AD with the biologic dupilumab and development of new regional dermatoses, with a predilection for the face, head, and neck regions. [95][96][97] This rare phenomenon has yet to be fully clinically characterized and a unifying phenotype has not been identified. These reports may represent disparate rashes with multiple underlying aetiologies.…”

Section: Morphologic Ad Phenotypesmentioning

confidence: 99%

Nomenclature and clinical phenotypes of atopic dermatitis

Girolomoni

Bruin‐Weller

Aoki

et al. 2021

Therapeutic Advances in Chronic Disease

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Atopic dermatitis is a heterogeneous disease and resists classification. In this review, we discuss atopic dermatitis nomenclature and identify morphologic phenotypes, which will facilitate correct diagnoses and development of treatment strategies. We support using the term ‘atopic dermatitis’ rather than eczema, because it describes the allergic background and inflammation (‘itis’) as drivers of the disease. Atopic dermatitis has many morphologic manifestations that vary by topographic area affected, age, or race and require consideration in differential diagnosis. Different phenotypes based on morphology and topographic location, ethnicity, and age are discussed. A better-defined phenotype identification for atopic dermatitis will facilitate earlier and correct diagnosis of this complex condition and inform selection of the most appropriate treatment choice in an era in which targeted therapies may generate more individualized patient care.

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Section: Morphologic Ad Phenotypesmentioning

confidence: 99%

Nomenclature and clinical phenotypes of atopic dermatitis

Girolomoni

Bruin‐Weller

Aoki

et al. 2021

Therapeutic Advances in Chronic Disease

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“…Tacrolimus, as a non-hormone immunosuppressant, can block the activation of T lymphocytes, effectively inhibit the transcription of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-3 and interleukin-4 genes, and then inhibit the release of inflammatory mediators, significantly improve the skin barrier function, thus improving the skin symptoms of facial hormone-dependent dermatitis patients. [ 17 , 18 ] However, with the long-term use of tacrolimus ointment, it has been found that the effect of tacrolimus ointment for facial hormone-dependent dermatitis is slow, and it is easy to relapse after stopping the medication. At present, the efficacy and safety of tacrolimus ointment for facial hormone-dependent dermatitis have not been systematically reviewed, which published in English.…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus ointment in the treatment of hormone-dependent dermatitis

Tan

et al. 2020

Medicine

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Background: Long-term use of corticosteroid ointment for external using or skin management products and cosmetics containing corticosteroid will produce a hormone-dependent effect on facial skin and destroy the barrier function of the skin. It is easy to cause repeated attacks of facial skin inflammation after drug withdrawal because corticosteroid hormones can cause the expression of inflammatory factors in the body, which has a serious impact on patients. The general treatment method is to stop using hormone drugs for psychotherapy and inform patients of the basic knowledge of hormone-dependent dermatitis and daily facial care, but the effect is not good. At present, non-steroidal ointment tacrolimus (a calcineurin inhibitor) is widely used in the treatment of hormone-dependent dermatitis. Tacrolimus ointment is effective for corticosteroid-dependent dermatitis, but adverse events can also occur. Methods: We plan to searched all randomized controlled trials (RCTs) fortacrolimus ointment therapy of hormone-dependent dermatitis in: MEDLINE, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Springer and Web of Science, China Biomedical Literature Database (CBM), China Science Journal Database (VIP database) and Wanfang Database, China National Knowledge Infrastructure (CNKI), without the limitation of publication status and language until September 1, 2020. The systematic review will also search will also search for identify publications, meeting minutes, and grey literature (including unpublished meeting articles). Discussion: The systematic review mainly to access the safety and efficacy of tacrolimus ointment for hormone-dependent dermatitis (facial corticosteroid addiction dermatitis and facial steroid dermatitis). The results of our research will facilitate evidence-based management of patients with facial corticosteroid-dependent dermatitis and provide clinical advice on their treatment options. Registration: PROSPERO CRD42020171813.

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“…Jaros et al [ 110 ] provide a useful framework for evaluating dupilumab-associated HND, including exclusion of allergic contact dermatitis, rosacea, periorificial dermatitis, demodex-associated dermatitis, TCS withdrawal, and Malassezia .…”

Section: Methodsmentioning

confidence: 99%

“…In patients who do not respond to the above, those with significant effect on QoL, or for those with severe recalcitrant face and neck involvement, addition of MTX or CsA or a temporary/permanent discontinuation of dupilumab has been reported and can be considered [ 110 ].…”

Section: Methodsmentioning

confidence: 99%

Practical Management of Patients with Atopic Dermatitis on Dupilumab

Papp

Hong

Lansang

et al. 2021

Dermatol Ther (Heidelb)

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Introduction Dupilumab is approved to treat moderate-to-severe atopic dermatitis (AD) in several countries in patients as young as 6 years of age. Since its approval, practical issues related to the use of dupilumab for AD have arisen, with particular interest in transitioning from current therapies and managing medication overlap, considerations for special populations of patients with AD, and management of potential adverse events. Methods This article aims to review the literature addressing several practical management issues related to dupilumab use for AD and to provide a framework for clinical decision-making in these circumstances and sub-populations. Each statement was reviewed, revised and voted on by authors to provide their level of agreement and degree of uncertainty for each statement. Results An agreement level > 80% was achieved for all of the statements. Conclusion The expert panel provides statements considering the practical management of patients with AD taking dupilumab to inform clinical decision-making in specific but frequently encountered clinical situations. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00586-w.

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A Practical Approach to Recalcitrant Face and Neck Dermatitis in Atopic Dermatitis

Cited by 29 publications

References 52 publications

Nomenclature and clinical phenotypes of atopic dermatitis

Nomenclature and clinical phenotypes of atopic dermatitis

Tacrolimus ointment in the treatment of hormone-dependent dermatitis

Practical Management of Patients with Atopic Dermatitis on Dupilumab

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