Atopic dermatitis and alternative management strategies

被引:26
作者
Anderson, P. Chris [1 ]
Dinulos, James G. [1 ]
机构
[1] Dartmouth Hitchcock Med Ctr, Dermatol Sect, Dartmouth Med Sch, Lebanon, NH 03756 USA
关键词
allergic contact dermatitis; atopic dermatitis; atopic diathesis; atopic eczema; eczema; steroid sparing; PIMECROLIMUS CREAM 1-PERCENT; PEDIATRIC-PATIENTS; FOOD ALLERGY; CHILDREN; ECZEMA; MAS063DP; THERAPY; INFANTS;
D O I
10.1097/MOP.0b013e32832130a9
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose of review To discuss the significance of studies published over the previous year regarding the pathogenesis and treatment of atopic dermatitis, including prevention, skin care, environmental modifications, nutrition, education, and anti-inflammatory medications. Recent findings Recent evidence shows that 42.5% of the caregivers of children with atopic dermatitis had used alternative therapies, most commonly due to fears of topical steroid side-effects and dissatisfaction with conventional treatment. Common questions, such as the potential utility of prenatal probiotics for prevention of atopic dermatitis, as well as the interplay of food allergies and eczema will be discussed in detail. New research continues to show the efficacy and safety of topical calcineurin inhibitors and atopiclair. We will review advances in the understanding of the pathogenesis of atopic dermatitis, and the latest research on therapies available to clinicians to aid them in discussions with their patients. Summary Atopic dermatitis impacts negatively the quality of life of both patients and their families. General pediatricians play a pivotal role in the management of this chronic condition. Management should focus on providing sound advice and easing fears regarding topical steroids, as well as pursuing conservative treatments that have the potential to prevent flares.
引用
收藏
页码:131 / 138
页数:8
相关论文
共 29 条
[1]   Microanalysis of an antimicrobial peptide, β-defensin-2, in the stratum corneum from patients with atopic dermatitis [J].
Asano, S. ;
Ichikawa, Y. ;
Kumagai, T. ;
Kawashima, M. ;
Imokawa, G. .
BRITISH JOURNAL OF DERMATOLOGY, 2008, 159 (01) :97-104
[2]  
BATHHEXTALL F, 2007, COCHRANE DB SYST REV
[3]   Which children should we patch test? [J].
Beattie, P. E. ;
Green, C. ;
Lowe, G. ;
Lewis-Jones, M. S. .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2007, 32 (01) :6-11
[4]   Expert consensus: time for a change in the way we advise our patients to use topical corticosteroids [J].
Bewley, A. .
BRITISH JOURNAL OF DERMATOLOGY, 2008, 158 (05) :917-920
[5]   MAS063DP is effective monotherapy for mild to moderate atopic dermatitis in infants and children: A multicenter, randomized, vehicle-controlled study [J].
Boguniewicz, Mark ;
Zeichner, Joshua A. ;
Eichenfield, Lawrence F. ;
Hebert, Adelaide A. ;
Jarratt, Michael ;
Lucky, Anne W. ;
Paller, Amy S. .
JOURNAL OF PEDIATRICS, 2008, 152 (06) :854-859
[6]   Intermittent therapy for flare prevention and long-term disease control in stabilized atopic dermatitis: A randomized comparison of 3-times-weekly applications of tacrolimus ointment versus vehicle [J].
Breneman, Debra ;
Fleischer, Alan B., Jr. ;
Abramovits, William ;
Zeichner, Joshua ;
Gold, Michael H. ;
Kirsner, Robert S. ;
Shull, Toni E. ;
Crowe, Andrew W. ;
Jaracz, Eileen ;
Hanifin, Jon M. .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2008, 58 (06) :990-999
[7]   Outside-to-Inside (and now back to "Outside") pathogenic mechanisms in atopic dermatitis [J].
Elias, Peter M. ;
Steinhoff, Martin .
JOURNAL OF INVESTIGATIVE DERMATOLOGY, 2008, 128 (05) :1067-1070
[8]   Solid food introduction in relation to eczema: Results from a four-year prospective birth cohort study [J].
Filipiak, Birgit ;
Zutavern, Anne ;
Koletzko, Sibylle ;
von Berg, Andrea ;
Brockow, Inken ;
Gruebl, Armin ;
Berdel, Dietrich ;
Reinhardt, Dietrich ;
Bauer, Carl Peter ;
Wichmann, H.-Erich ;
Heinrich, Joachim .
JOURNAL OF PEDIATRICS, 2007, 151 (04) :352-358
[9]   The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: A randomized controlled study [J].
Grimalt, Ramon ;
Mengeaud, Valerie ;
Cambazard, Frederic .
DERMATOLOGY, 2007, 214 (01) :61-67
[10]   The use of alternative medicine in pediatric patients with atopic dermatitis [J].
Hughes, R. ;
Ward, D. ;
Tobin, A. M. ;
Keegan, K. ;
Kirby, B. .
PEDIATRIC DERMATOLOGY, 2007, 24 (02) :118-120