Burden of Disease, Unmet Needs in the Diagnosis and Management of Atopic Dermatitis: An Indian Expert Consensus

Rajagopalan, Murlidhar; Chitkara, A. J.; Dalwai, Samir; De, Abhishek; Gulati, Ram; Mukherjee, Samipa; Mutalik, Sharad; Sharma, Nidhi; Shenoi, Shrutakirthi D; Vaidya, Prakash; Tilak, Amod; Adhav, Charles

doi:10.2147/ccid.s327593

Cited by 4 publications

(3 citation statements)

References 47 publications

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“…Mean inter-group differences increased gradually over 6 months of intervention but they did not achieve significance at any time points (all p >0.05). At 6 months, the inter-group difference was À4.4 (95% CI, À9 4. to 0.6).…”

mentioning

confidence: 95%

“…3 A rising trend in AD has been observed in India in the last four decades. 4 A study from the eastern Indian state of Bihar reported an incidence of 0.38% of the total number of outpatient children; however, true point prevalence data in the community are still scarce. 5 Conventional therapy includes topical corticosteroids and calcineurin inhibitors, emollients, oral antihistamines, and immune suppressants, with varying effectiveness and potential adverse effects.…”

Section: Introductionmentioning

confidence: 99%

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Double-Blind, Randomized, Placebo-Controlled Trial of Individualized Homeopathic Medicines in Atopic Dermatitis in Adults: A Replication Trial with 6 Months' Follow-up

et al. 2023

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Background Atopic dermatitis (AD) is a chronic relapsing and remitting inflammatory skin disease that can have a significant impact on quality of life. During the last four decades, a rising trend in AD has been observed in India. Homeopathic medicines are claimed to be beneficial in AD; however, convincing research evidence has been lacking. We compared the efficacy of individualized homeopathic medicines (IHMs) against placebos in the treatment of AD. Methods In this double-blind, randomized, placebo-controlled trial of 6 months' duration (n = 60), adult patients were randomized to receive either IHMs (n = 30) or identical-looking placebos (n = 30). All participants received concomitant conventional care, which included the application of olive oil and maintaining local hygiene. The primary outcome measure was disease severity using the Patient-Oriented Scoring of Atopic Dermatitis (PO-SCORAD) scale; secondary outcomes were the Atopic Dermatitis Burden Scale for Adults (ADBSA) and Dermatological Life Quality Index (DLQI) – all were measured at baseline and every month, up to 6 months. Group differences were calculated on the intention-to-treat sample. Results After 6 months of intervention, inter-group differences became statistically significant on PO-SCORAD, the primary outcome (−18.1; 95% confidence interval, −24.0 to −12.2), favoring IHMs against placebos (F 1, 52 = 14.735; p <0.001; two-way repeated measures analysis of variance). Inter-group differences for the secondary outcomes favored homeopathy, but were overall statistically non-significant (ADBSA: F 1, 52 = 0.019; p = 0.891; DLQI: F 1, 52 = 0.692; p = 0.409). Conclusion IHMs performed significantly better than placebos in reducing the severity of AD in adults, though the medicines had no overall significant impact on AD burden or DLQI.

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confidence: 95%

Section: Introductionmentioning

confidence: 99%

Double-Blind, Randomized, Placebo-Controlled Trial of Individualized Homeopathic Medicines in Atopic Dermatitis in Adults: A Replication Trial with 6 Months' Follow-up

et al. 2023

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“…4 As per the International Study of Asthma and Allergies in Childhood (ISAAC), the prevalence of atopic dermatitis in India is 2.7% (age 6-7 years) and 3.6% (age 13-14 years). 5 AD can have a profound, negative effect on the quality of life (QoL), including on social life, education, and work. 6 Emollients remain the mainstay treatment for atopic dermatitis as they improve the epidermal barrier function, maintain skin integrity and appearance, reduce trans epidermal water loss, and restore the lipid barrier's ability to attract, hold, and redistribute water.…”

Section: Introductionmentioning

confidence: 99%

Role of Actives in Emollients in Atopic Dermatitis

Chandrashekar,

Luger,

Rajendran

et al. 2024

J Dermatol & Skin Sci

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The prevalence of atopic dermatitis (AD) in India is 2.7% (age 6–7 years) and 3.6% (age 13–14 years). Emollients remain mainstay treatment for atopic dermatitis. The present review article focuses on the role of active ingredients in emollients towards the management of AD. Article were selected by searching in database like Google Scholar and PubMed and were reviewed by the authors. Daily use of emollients from birth may significantly reduce the incidence of AD in a high-risk population. Emollients with a variety of active ingredients to target AD pathophysiology have been developed which contain active ingredients like liquorice extract (anti-inflammatory and anti-pruritic), niacinamide (restoration of barrier function), sterols (restoration of barrier function), laureth-9-polydocanol (anti-pruritic), xylitol (microbiome maintenance) and galacto-oligosaccharide (GOS) (microbiome maintenance). Emollient plus may be a useful adjunct to pharmacological therapy in AD and as maintenance therapy, providing rapid and significant improvements in skin moisture, epidermal barrier function, and signs and symptoms of AD.

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Atopic dermatitis in skin of colour. Part 2: considerations in clinical presentation and treatment options

Gan

Pink

Rodrigues

2023

Clinical and Experimental Dermatology

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Recent advances in atopic dermatitis (AD) present the condition as a heterogenous disease of distinct endotypes across ethnic groups. AD in people with skin of colour may appear psoriasiform, lichenoid, scaly, or papular, with a violaceous colour and there is a higher prevalence of post-inflammatory dyspigmentation compared to affected individuals of Caucasian ethnicity. These differences in clinical presentation may limit the use of AD assessment tools in people with skin of colour, leading to potential for misdiagnosis and underestimation of severity, particularly in relation to assessment of erythema. Recent targeted therapies for AD have been studied in multiple ethnic groups, however ethnicity-based subgroup analysis is often not performed. Further research is required to understand whether treatment responses or safety may differ among ethnic groups.

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Burden of Disease, Unmet Needs in the Diagnosis and Management of Atopic Dermatitis: An Indian Expert Consensus

Cited by 4 publications

References 47 publications

Double-Blind, Randomized, Placebo-Controlled Trial of Individualized Homeopathic Medicines in Atopic Dermatitis in Adults: A Replication Trial with 6 Months' Follow-up

Double-Blind, Randomized, Placebo-Controlled Trial of Individualized Homeopathic Medicines in Atopic Dermatitis in Adults: A Replication Trial with 6 Months' Follow-up

Role of Actives in Emollients in Atopic Dermatitis

Atopic dermatitis in skin of colour. Part 2: considerations in clinical presentation and treatment options

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