Pruritus in Atopic Dermatitis: Pathophysiology and Treatment Options

2014 ◽  
pp. 93-105
Author(s):  
Tejesh Surendra Patel ◽  
Gil Yosipovitch
Keyword(s):  
Atopic Dermatitis ◽  
Treatment Options

scholarly journals Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section III: Treatment Options for Pediatric Atopic Dermatitis

2019 ◽  
Vol 23 (5_suppl) ◽  
pp. 19S-31S
Author(s):  
Perla Lansang ◽  
Joseph M. Lam ◽  
Danielle Marcoux ◽  
Vimal H. Prajapati ◽  
Shanna Spring ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Maintenance Therapy ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Skin Barrier ◽  
Active Therapy ◽  
Disease Treatment ◽  
Consensus Document ◽  
Emerging Therapies ◽  
Clinical Considerations

Because atopic dermatitis (AD) is a chronic, relapsing disease, treatment requires the use of both active therapy to control flares and preventative maintenance therapy to promote integrity of the skin barrier. In this third of four sections, important clinical considerations for the treatment of pediatric AD are reviewed. Emerging therapies in development for pediatric AD are introduced.

scholarly journals Atopic Dermatitis: Drug Delivery (Management) and Approaches (Strategies) in Perspective

2018 ◽  
Vol 54 (02) ◽  
pp. 078-089
Author(s):  
Virendra N. Sehgal
Keyword(s):  
Drug Delivery ◽  
Atopic Dermatitis ◽  
Treatment Options ◽  
Calcineurin Inhibitors ◽  
Cutaneous Manifestations ◽  
Topical Calcineurin Inhibitors ◽  
Systemic Corticosteroids ◽  
Age Related ◽  
Management Approaches ◽  
Minor Criteria

ABSTRACTAge-related cutaneous manifestations are definitive pointer to the diagnosis of atopic dermatitis, the confirmation of which is solicited by 3 major and 3 minor criteria. Its unpredictable course is punctuated by exacerbations and remissions. Several treatment options, namely: 1st, 2nd and 3rd line are in vogue ever since. The 1st line envisages general measures, 2nd encompasses topical applications, while the 3rd take into account drug therapy comprising, systemic Corticosteroids, Cyclosporin, Azathioprine, Thymopentin, Interferon–therapy, Topical Calcineurin inhibitors: Tacrolimus and Pimecrolimus. The mode of action, their dosages and adverse drug reaction (ADR), in particular, have been focused in this paper with special attention to refresh their drug delivery (management) approaches (strategies) in perspective. An endeavor to focus attention to emerging etio-pathogenesis, and its application in the contemporary context has also been made.

scholarly journals Pediatric Atopic Dermatitis: Update on the Treatment Options

2020 ◽  
Vol 25 (4) ◽  
pp. 60-62
Author(s):  
Corina Adelina Zah ◽  
Andreea Emiliana Toporău ◽  
Paul Grama
Keyword(s):  
Atopic Dermatitis ◽  
Chronic Treatment ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Chronic Inflammatory Disease ◽  
Term Treatment ◽  
Phosphodiesterase 4 ◽  
Systemic Corticosteroids ◽  
Long Term Treatment

Abstract Atopic dermatitis (AD) is a chronic inflammatory disease characterized by skin dryness, pruritus and eczematous lesions with various periods of relapse. Symptomatology can appear in childhood and can persist in adulthood. Chronic treatment is required with corticosteroids being the standard options. The side effects of this type of long-term treatment represent a major concern for the pediatric patients. This review aims to give an update of the options used for treatment, apart from the systemic corticosteroids. Mild-to-moderate AD had a good response to creams containing fig and oatmeal extracts and inhibitors of phosphodiesterase-4 (crisaborole). In cases of severe AD, future treatment options could include monoclonal antibodies such as omalizumab and dupilumab

scholarly journals Neutrophils promote CXCR3-dependent itch in the development of atopic dermatitis

eLife ◽  
2019 ◽  
Vol 8 ◽  
Author(s):  
Carolyn M Walsh ◽  
Rose Z Hill ◽  
Jamie Schwendinger-Schreck ◽  
Jacques Deguine ◽  
Emily C Brock ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Sensory Neurons ◽  
Treatment Options ◽  
Cellular Interactions ◽  
Immune Systems ◽  
Chronic Itch ◽  
Enhanced Expression ◽  
Neutrophil Depletion ◽  
Induced Genes ◽  
Neuropathic Itch

Chronic itch remains a highly prevalent disorder with limited treatment options. Most chronic itch diseases are thought to be driven by both the nervous and immune systems, but the fundamental molecular and cellular interactions that trigger the development of itch and the acute-to-chronic itch transition remain unknown. Here, we show that skin-infiltrating neutrophils are key initiators of itch in atopic dermatitis, the most prevalent chronic itch disorder. Neutrophil depletion significantly attenuated itch-evoked scratching in a mouse model of atopic dermatitis. Neutrophils were also required for several key hallmarks of chronic itch, including skin hyperinnervation, enhanced expression of itch signaling molecules, and upregulation of inflammatory cytokines, activity-induced genes, and markers of neuropathic itch. Finally, we demonstrate that neutrophils are required for induction of CXCL10, a ligand of the CXCR3 receptor that promotes itch via activation of sensory neurons, and we find that that CXCR3 antagonism attenuates chronic itch.

Glucocorticoid-resistant atopic dermatitis: treatment options

2020 ◽  
Vol 15 (3) ◽  
pp. 87-89 ◽  
Author(s):  
O.N. Zainullina ◽  
◽  
Z.R. Khismatullina ◽  
D.V. Pechkurov ◽  
◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Treatment Options

Does an Eczema Action Plan Improve Atopic Dermatitis? A Single-Site Randomized Controlled Trial

2018 ◽  
Vol 57 (14) ◽  
pp. 1624-1629 ◽  
Author(s):  
Julia Brown ◽  
Nicole W. Weitz ◽  
Amy Liang ◽  
Melissa S. Stockwell ◽  
Suzanne Friedman
Keyword(s):  
Randomized Controlled Trial ◽  
Atopic Dermatitis ◽  
Positive Impact ◽  
Action Plan ◽  
Controlled Trial ◽  
Treatment Options ◽  
Single Site ◽  
Care Group ◽  
Randomized Controlled ◽  
The Impact

The multitude of treatment options for atopic dermatitis (AD) makes management frustrating for providers and patients. Eczema action plans (EAPs) have been proposed to improve parental and provider management. We developed a single-site randomized controlled trial to evaluate the impact of an EAP on quality of life (QOL), provider knowledge, and comfort with AD management. Providers were randomized into an EAP-use group and a traditional care group. All patients completed validated AD QOL surveys, and those with AD were verbally administered the survey 1 month later. Providers’ perceptions on managing AD were compared in the EAP and usual use groups. Parents in the EAP group demonstrated a significantly increased understanding of AD treatment, and providers in the EAP group had a significantly increased understanding and management of AD. The EAP is a feasible tool that can be integrated into a busy clinic practice with a positive impact on physicians and patients.

Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section I: Pathophysiology of Atopic Dermatitis and Implications for Systemic Therapy

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 6S-9S ◽  
Author(s):  
Mark G. Kirchhof ◽  
Ian Landells ◽  
Chuck W. Lynde ◽  
Melinda J. Gooderham ◽  
Chih-ho Hong
Keyword(s):  
Atopic Dermatitis ◽  
Environmental Factors ◽  
Chronic Inflammation ◽  
Systemic Therapy ◽  
Skin Disease ◽  
Treatment Options ◽  
Adult Patients ◽  
Inflammatory Skin Disease ◽  
Consensus Document ◽  
Systemic Therapies

Atopic dermatitis (AD) is a chronic, relapsing, and remitting inflammatory skin disease whose onset typically occurs early in life. AD pathophysiology includes genetic, immune, and environmental factors contributing to chronic inflammation. A rapidly evolving understanding of the pathogenesis of AD has led to the development of several treatment options for AD in adults, including topicals, phototherapy, and systemic therapies. Here, we provide a concise summary of AD pathophysiology with a focus on implications for systemic therapy.

A Treatment Algorithm for Moderate to Severe Atopic Dermatitis in Adults

2017 ◽  
Vol 22 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Charles W. Lynde ◽  
Marc Bourcier ◽  
Melinda Gooderham ◽  
Lyn Guenther ◽  
Chih-ho Hong ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Systemic Treatment ◽  
Topical Therapy ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Current Evidence ◽  
Severe Atopic Dermatitis ◽  
Routine Practice ◽  
Clinical Criteria ◽  
Systemic Treatments

Background: Atopic dermatitis (AD) is a common and chronic inflammatory skin disease. Approximately 10% of adults with AD do not respond adequately to topical therapies and require phototherapy and/or systemic therapy. Objective: To provide a patient-focused approach to the identification and management of adults with AD who require systemic treatment. Methods: A working group of clinicians experienced in managing AD was convened to review and discuss current evidence on the identification and clinical management of adults with moderate to severe AD. Results: We propose a set of simple and practical clinical criteria for selecting candidates for systemic treatment of AD based on their response to first-line topical therapy and 4 clinical measures that are easily incorporated into routine practice. We also suggest a framework for evaluating systemic treatments according to attributes that are important from both a clinician’s and a patient’s perspective. An algorithm was developed proposing a pathway for treatment of moderate to severe AD in adults. Conclusion: Adults with moderate to severe AD that does not respond adequately to topical therapies currently have few safe and effective treatment options. A clinical algorithm could help guide treatment decisions.

scholarly journals Comparative Analysis of the Microbiome across the Gut–Skin Axis in Atopic Dermatitis

2021 ◽  
Vol 22 (8) ◽  
pp. 4228
Author(s):  
Dong-Hoon Park ◽  
Joo-Wan Kim ◽  
Hi-Joon Park ◽  
Dae-Hyun Hahm
Keyword(s):  
Atopic Dermatitis ◽  
Comparative Analysis ◽  
Emotional Disorders ◽  
Treatment Options ◽  
Integration Theory ◽  
Depression And Anxiety ◽  
Response Factors ◽  
New Information ◽  
Skin Symptoms ◽  
Microbial Strains

Atopic dermatitis (AD) is a refractory and relapsing skin disease with a complex and multifactorial etiology. Various congenital malformations and environmental factors are thought to be involved in the onset of the disease. The etiology of the disease has been investigated, with respect to clinical skin symptoms and systemic immune response factors. A gut microbiome–mediated connection between emotional disorders such as depression and anxiety, and dermatologic conditions such as acne, based on the comorbidities of these two seemingly unrelated disorders, has long been hypothesized. Many aspects of this gut–brain–skin integration theory have recently been revalidated to identify treatment options for AD with the recent advances in metagenomic analysis involving powerful sequencing techniques and bioinformatics that overcome the need for isolation and cultivation of individual microbial strains from the skin or gut. Comparative analysis of microbial clusters across the gut–skin axis can provide new information regarding AD research. Herein, we provide a historical perspective on the modern investigation and clinical implications of gut–skin connections in AD in terms of the integration between the two microbial clusters.

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