Management of Itch in Atopic Dermatitis

Abstract

Atopic dermatitis is a common, pruritic, inflammatory skin disorder. Chronic, localized, or even generalized pruritus is the diagnostic hallmark of atopic dermatitis, and its management remains a challenge for physicians. The threshold for itch and alloknesis is markedly reduced in these patients, and infections can promote exacerbation and thereby increase the itch. Modern management consists of anti-inflammatory, occasionally antiseptic, as well as antipruritic therapies to address the epidermal barrier as well as immunomodulation or infection. Mild forms of atopic dermatitis may be controlled with topical therapies, but moderate-to-severe forms often require a combination of systemic treatments consisting of antipruritic and immunosuppressive drugs, phototherapy, and topical compounds. In addition, patient education and a therapeutic regimen to help the patient cope with the itch and eczema are important adjuvant strategies for optimized long-term management. This review highlights various topical, systemic, and complementary and alternative therapies, as well as provide a therapeutic ladder for optimized long-term control of itch in atopic dermatitis.

Addressing treatment challenges in atopic dermatitis with novel topical therapies

“…The goals of treatment for AD include improving the skin's barrier function, suppressing inflammation, and relieving pruritus (4,8).…”

“…In individuals with AD, intense pruritus is the predominant symptom, affecting all patients and representing a significant therapeutic challenge for physicians and dermatologists (7)(8)(9). Often described as ''the itch that rashes,'' pruritus also tends to be the first symptom to become apparent (7,8).…”

“…Often described as ''the itch that rashes,'' pruritus also tends to be the first symptom to become apparent (7,8). Pruritus promotes scratching, which can cause further inflammation, excoriation, aggravation of the underlying disease, and increased risk of infection (7,8,10).…”

“…Pruritus promotes scratching, which can cause further inflammation, excoriation, aggravation of the underlying disease, and increased risk of infection (7,8,10). Pruritic symptoms are often worse at night, which can cause unwitting scratching and disrupted sleep (7,8,10).…”

Anti-Inflammatory Efficacy of Product Containing “Skin Calm Complex” <i>in Vitro</i> Reconstructed Epidermis

“…"ATOPIC SKIN BODY CREAM EXTREME EXTREME BODY CREAM SKIN ATOPIC"-treated samples present a 90% of inhibition in IL-1α levels, while the Dexamethasone's efficiency is about 70%. costeroids associated with adverse side effects [22] [23]. At present, research focuses on the search and combination of more effective new agents with the least side effects.…”