Clinical approach to the patient with refractory atopic dermatitis

Izadi, Neema; Leung, Donald Y.M.

doi:10.1016/j.anai.2017.09.061

Cited by 15 publications

(9 citation statements)

References 66 publications

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“…138 Before starting a systemic treatment, it is important to rule out differential diagnoses such as cutaneous T-cell lymphoma, potential trigger factors such as allergic contact dermatitis and behavioural and educational reasons for poor responses. 74,139 Until recently, rather broad-acting immunosuppressants, such as systemic corticosteroids (SCS), cyclosporine A (CyA), azathioprine (AZA), mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS) and methotrexate (MTX), were the only systemic treatment options for difficult-to-treat AD. 140 These systemic immunosuppressants can roughly be divided into two groups: SCS and CyA have a rapid onset of action and can be used to treat flares of AD or to bridge the time until onset of action of slow-acting systemic immunosuppressants such as MTX, AZA and MMF/EC-MPS.…”

Section: Systemic Anti-inflammatory Therapymentioning

confidence: 99%

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

Wollenberg

Christen-Zäch

Taı̈eb

et al. 2020

Acad Dermatol Venereol

298

360

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Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and pathogenic variabilities, the patient's age and also target flare prevention. Basic therapy includes hydrating and barrierstabilizing topical treatment universally applied, as well as avoiding specific and unspecific provocation factors. Visible skin lesions are treated with anti-inflammatory topical agents such as corticosteroids and calcineurin inhibitors (tacrolimus and pimecrolimus), which are preferred in sensitive locations. Topical tacrolimus and some mid-potency corticosteroids are proven agents for proactive therapy, which is defined as the long-term intermittent anti-inflammatory therapy of frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is a rapidly changing † See Appendix section.

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Section: Systemic Anti-inflammatory Therapymentioning

confidence: 99%

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

Wollenberg

Christen-Zäch

Taı̈eb

et al. 2020

Acad Dermatol Venereol

298

360

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“…Wet dressings and short-term hospitalizations are other options for patients with severe, recalcitrant AD whose multiple therapies have failed. 9,53,54,[96][97][98] These treatments also are sometimes used for patients for whom treatment choices are limited due to costs and/ or insurer considerations. More information is provided in current guidance documents and several excellent reviews.…”

Section: Other Treatmentsmentioning

confidence: 99%

“…More information is provided in current guidance documents and several excellent reviews. 9,53,54,[96][97][98]…”

Section: Other Treatmentsmentioning

confidence: 99%

“…47 The chronic and relapsing nature of AD and limitations of current therapeutic approaches can be overwhelming for patients and caregivers. By nature of the disease, treatment is multifactorialencompassing skin hydration and protection and addressing the immunopathology 9,10,17,53,54 (Fig 2). It requires time and commitment on the part of the patient and family.…”

Section: Introductionmentioning

confidence: 99%

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Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape

Boguniewicz

Fonacier

Guttman‐Yassky

et al. 2018

Annals of Allergy, Asthma & Immunology

243

217

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The implementation of treatment guidelines for atopic dermatitis is challenging, in part because of different guidance documents being used by different groups of specialists and in part because the language of guidelines often reflects the evidence base rather than the practical "how to." The Atopic Dermatitis Yardstick is part of a series developed in response to the need to proactively address the loss of disease control for atopic illnesses at all levels of severity. It presents a comprehensive update on how to conduct a sustained step-up in therapy for the patient with inadequately controlled or poorly controlled atopic dermatitis. Patient profiles, based on current guidelines and the authors' combined clinical experience, provide a practical and clinically meaningful guide to aid physicians in helping their patients achieve the goal of clear to almost clear. The intent is not to replace guidelines but to complement their recommendations incorporating the latest research and therapies.

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“…10 Our understanding of mechanisms that lead to AD must be considered in the management of this common skin disease. 11 Importantly, the focus on AD has shifted from exclusive evaluation of the skin lesion to changes that occur in nonlesional AD skin. 12 It has now been demonstrated that skin barrier abnormalities occur before the onset of clinical AD, supporting the concept that epicutaneous allergen sensitization with a predisposition to food allergy may occur very early in life.…”

mentioning

confidence: 99%

The Best of 2018 in the Annals of Allergy, Asthma, and Immunology

Marshall

Leung

Ellis

et al. 2019

Annals of Allergy, Asthma & Immunology

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The editors of the Annals of Allergy, Asthma, and Immunology considered more than 750 submissions for publication in 2018. From that number, we accepted 323 articles, letters, and other features to be included in the 12 issues of the 2018 Annals. Every feature was carefully scrutinized before acceptance, and there were multiple articles that were acceptable but were not used because of space constraints (ie, we do not have room to publish all of the acceptable manuscripts we received). Accordingly, the 323 are already the "best" of the submissions that were submitted last year. We are grateful to all the authors who submitted and those whose articles were published. At the end of the year, all the Annals editors provided their assessments of features published in the Annals from various areas of our specialty based on the individual interests and expertise of the editors. The results of these efforts produced mentions of the "best of the best" that we want to make sure you, our readership, had the opportunity to see, and we hope, read. The following is written with this aim in mind. Atopic DermatitisDuring the past year, there have been several highlighted themes on atopic dermatitis (AD) published in the Annals. Importantly, the multidimensional burden of AD was well documented, 1 including the effect of AD on quality of life, low self-esteem, increased sick days, reduced physical activity, and adverse effects

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Clinical approach to the patient with refractory atopic dermatitis

Cited by 15 publications

References 66 publications

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children

Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape

The Best of 2018 in the Annals of Allergy, Asthma, and Immunology

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