Guidelines for the management of atopic dermatitis (eczema) for pharmacists

Wong, Ian T Y; Tsuyuki, Ross T.; Cresswell-Melville, Amanda; Doiron, Philip; Drucker, Aaron M.

doi:10.1177/1715163517710958

Cited by 35 publications

(56 citation statements)

References 73 publications

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“…The most appropriate formulation for the patient can depend on a variety of factors, including season, tolerability, cost, mechanism of action, fragrance, age, body area and gender (51,57,58). For example, emollients targeting the face aim to be noncomedogenic (64,65). Despite their benefits, patients often find ointment application to be a messy process, which reduces compliance.…”

Section: Emollientsmentioning

confidence: 99%

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

Yosipovitch¹,

Miséry²,

Proksch³

et al. 2019

Acta Derm Venereol

118

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Itch is a common symptom of many skin barrier-related dermatoses and can severely impact quality of life. However, there are a limited number of effective anti-itch topical therapies currently available and several unmet needs not addressed by current itch management strategies. As our knowledge of the mechanisms underlying itch has improved, several novel therapies have recently emerged that can be incorporated into existing regimens to enhance itch therapy and management. Here, we summarise research and current opinion on available topical therapies and give recommendations for the optimal management of itch. Barrier damage, dry skin and itch are intricately linked and form the basis of many common skin diseases. Damage from environmental insults, or genetic or inflammatory causes, can impair the skin barrier, resulting in an increase in transepidermal water loss and activation of itch-associated nerve fibres. The itch-scratch cycle can perpetuate skin barrier damage and itch. Topical therapeutic strategies are utilised to overcome dry skin and itch, primarily in the form of emollients. Recent advances in our understanding of the mechanisms underlying itch have enabled the development of new topical therapies, which may be incorporated into existing treatment regimes. Ultimately, treatment of dry skin and itch must be highly tailored to the individual according to their needs.

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Section: Emollientsmentioning

confidence: 99%

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

Yosipovitch¹,

Miséry²,

Proksch³

et al. 2019

Acta Derm Venereol

118

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“…Participants in all studies were diagnosed with either AE or CE. 1,2 There were no age, gender, or race restrictions.…”

Section: Methodsmentioning

confidence: 99%

“…Atopic eczema (AE) is a common inflammatory, pruritic, and chronically relapsing dermatological disease that results in frequent exudates and severe pruritus. 1,2 In China, AE is also called chronic eczema (CE). The prevalence of AE is approximately 20% in children and 1%–3% in adults in most western countries.…”

Section: Introductionmentioning

confidence: 99%

The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis

et al. 2019

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Objective: The aim of this study was to systematically assess the effectiveness and safety of acupuncture for patients with atopic eczema (AE). Methods: Two reviewers searched 13 databases from their inception through 31 July 2018 for randomized controlled trials (RCTs) of patients with AE. Dichotomous data and continuous data were analyzed using risk ratio (RR) and mean difference (MD), respectively, with 95% confidence intervals (CIs). Results: A total of eight RCTs (with 434 participants) were included. The results of one included RCT showed that acupuncture was better than no treatment at reducing itch intensity measured using a visual analogue scale in patients with AE. The combined results of six RCTs showed that acupuncture was better than conventional medicine at reducing the eczema area and severity index (EASI) (MD: −1.89, 95% CI: −3.04 to −0.75, I2: 78%) and the combined results of seven RCTs showed that acupuncture was better than conventional medicine in terms of global symptom improvement (RR: 1.59, 95% CI: 1.20 to 2.11, I2: 55%) in AE. We had insufficient data to show significant effects of acupuncture on quality of life and AE recurrence rate. No severe adverse events were found related to acupuncture. Limitations: The included RCTs had some methodological limitations, and most of the included trials were conducted in China. This analysis only included studies that compared acupuncture alone with no treatment or positive control (conventional medicine), so the specific effects of acupuncture could not be evaluated. Conclusion: Acupuncture might be effective at reducing itch intensity and may be more effective than conventional medicine at reducing EASI and improving the global symptoms of AE. Protocol registration: PROSPERO CRD42018096261

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“…In general, topical treatment is the first option of choice, being effective for the most patients with mild disease. Systemic therapy may be offered to those with severe disease or treatment-resistant eczema, however, invariably, in the long term, comes along with side effects (Apfelbacher et al, 2013;Wong et al, 2017;Aoki et al, 2019). New therapeutic approaches, such as monoclonal antibodies, are passing through the drug discovery pipeline and may reinforce the therapeutic arsenal against AD in a near future (Weidinger and Novak, 2016;Snast et al, 2018;Pistone et al, 2019).…”

Section: Atopic Dermatitismentioning

confidence: 99%

Mesenchymal Stem Cells and Atopic Dermatitis: A Review

Daltro

Meira

Santos

et al. 2020

Front. Cell Dev. Biol.

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Mesenchymal stem/stromal cells (MSCs) are stromal-derived non-hematopoietic progenitor cells that reside in and can be expanded from various tissues sources of adult and neonatal origin, such as the bone marrow, umbilical cord, umbilical cord blood, adipose tissue, amniotic fluid, placenta, dental pulp and skin. The discovery of the immunosuppressing action of MSCs on T cells has opened new perspectives for their use as a therapeutic agent for immune-mediated disorders, including allergies. Atopic dermatitis (AD), a chronic and relapsing skin disorder that affects up to 20% of children and up to 3% of adults worldwide, is characterized by pruritic eczematous lesions, impaired cutaneous barrier function, Th2 type immune hyperactivation and, frequently, elevation of serum immunoglobulin E levels. Although, in the dermatology field, the application of MSCs as a therapeutic agent was initiated using the concept of cell replacement for skin defects and wound healing, accumulating evidence have shown that MSC-mediated immunomodulation can be applicable to the treatment of inflammatory/allergic skin disorders. Here we reviewed the pre-clinical and clinical studies and possible biological mechanisms of MSCs as a therapeutic tool for the treatment of atopic dermatitis.

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Guidelines for the management of atopic dermatitis (eczema) for pharmacists

Cited by 35 publications

References 73 publications

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

The effectiveness and safety of acupuncture for patients with atopic eczema: a systematic review and meta-analysis

Mesenchymal Stem Cells and Atopic Dermatitis: A Review

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