What is new in atopic dermatitis/eczema?

Abstract

Basic therapy consists of hydrating topical treatment and avoidance of specific and unspecific provocation factors. For acute eczematous skin lesions, anti-inflammatory treatment consists mainly of topical glucocorticoids and topical calcineurin inhibitors. Microbial colonization and superinfection may induce skin exacerbation, which can be treated by either topical or systemic antimicrobial treatment. Systemic anti-inflammatory therapy is limited to severe cases and consists of systemic steroids, cyclosporine A or mycophenolate mofetil. Novel anti-inflammatory concepts that go beyond corticosteroids are in the early phases of development. There are targeted therapeutic approaches, such as cytokine and chemokine modulators, and it remains to be investigated how effective they will be and what side effects they may carry. Existing treatment modalities such as barrier repair therapy, topical immunosuppressive agents, antiseptic treatment as well as systemic treatment options are discussed.

From the morphological to the transcriptomic characterization of a compromised three-dimensionalin vitromodel mimicking atopic dermatitis

“…Atopic dermatitis (AD) is the most common inflammatory disease of the skin, affecting up to 3% of adults and 25% of children . This disease is characterized by a broad spectrum of clinical manifestations including dry skin, red patches, itching, rash and swelling, whose course is cyclic with alternating crisis and lull periods.…”

Phototherapy in the treatment of microbial eczema

“…В экзематозных очагах поражения в большом количестве выявляются клетки Лангерганса и дендритные клетки, экспрессирующие IgE и играющие центральную роль в презентации аллергенов при дерматозах атопической группы. Эпидермальные клетки Лангерганса (и на пораженной, и на видимо здоровой коже) экспрессируют на своей клеточной поверхности высокоаффинные IgE-рецепторы и связываются с IgE в значительно большем количестве по сравнению со здоровыми пациентами [21].…”

“…Эпидермальные кератиноциты пациентов, страдающих заболеваниями группы атопических дерматозов, продуцируют уникальные цитокины и хемокины в ответ на механическую стимуляцию (например, расчесы) [22]. Речь идет об избыточной экспрессии IL-16, RANTES, хемоаттрактантного белка для макрофагов 1 (МСР-1), хемоаттрактанта для CD4, эотаксина, что может способствовать хемотаксису эозинофилов, макрофагов и Т-лимфоцитов [21].…”

Non-topical management of recalcitrant paediatric atopic dermatitis

“…Atopic dermatitis (AD) is a chronic pruritic skin disease 1. A holistic approach to management involves assessment of the physical severity of AD as well as its impact on the quality of life (QoL) 2.…”

“…A holistic approach to management involves assessment of the physical severity of AD as well as its impact on the quality of life (QoL) 2. Uncontrolled AD impairs growth, development,3 QoL4 and contributes to the burden of healthcare costs 1. Children who present at infancy with a greater severity of disease, with other atopic illnesses or a family history of atopy3 tend to have severe AD.…”