Practical algorithm to inform clinical decision-making in the topical treatment of atopic dermatitis.

Autor: Luger T; Department of Dermatology, University of Münster, Münster, Germany., Adaskevich U; Vitebsk State Medical University, Vitebsk, Belarus., Anfilova M; National Pirogov Memorial Medical University, Vinnytsya, Ukraine., Dou X; Peking University Shenzhen Hospital, Shenzhen, China., Murashkin NN; Medical Research Center for Children's Health, Federal State Autonomous Institution of the Ministry of Health of the Russian Federation, Moscow, Russia.; I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.; Paediatric and Child Health Research Institute of the Central Clinical Hospital of the Russian Academy of Sciences, Ministry of Science and Higher Education, Moscow, Russia., Namazova-Baranova L; Paediatric and Child Health Research Institute of the Central Clinical Hospital of the Russian Academy of Sciences, Ministry of Science and Higher Education, Moscow, Russia.; Russian National Research Medical University, Moscow, Russia., Nitochko O; Odessa National Medical University, Odessa, Ukraine., Reda A; Mediclinic Welcare Hospital, Dubai, United Arab Emirates., Svyatenko TV; Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine., Tamay Z; Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey., Tawara M; Ishtar Center for Dermatology, Aesthetics and Laser Surgery, Eye Specialty Hospital, Amman, Jordan., Vishneva EA; Paediatric and Child Health Research Institute of the Central Clinical Hospital of the Russian Academy of Sciences, Ministry of Science and Higher Education, Moscow, Russia.; Russian National Research Medical University, Moscow, Russia., Vozianova S; P.L. Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine., Wang H; Children's Hospital of Chongqing Medical University, Chongqing, China., Zhao Z; Department of Dermatology and Venereology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, National Clinical Research Center for Skin and Immune Diseases, Beijing, China.
Jazyk: angličtina
Zdroj: The Journal of dermatology [J Dermatol] 2021 Aug; Vol. 48 (8), pp. 1139-1148. Date of Electronic Publication: 2021 May 07.
DOI: 10.1111/1346-8138.15921
Abstrakt: Atopic dermatitis is a chronic relapsing, inflammatory skin disorder associated with skin barrier dysfunction, the prevalence of which has increased dramatically in developing countries. In this article, we propose a treatment algorithm for patients with mild-to-moderate and severe atopic dermatitis flares in daily clinical practice. An international panel of 15 dermatology and allergy experts from eight countries was formed to develop a practical algorithm for the treatment of patients with atopic dermatitis, with a particular focus on topical therapies. In cases of mild-to-moderate atopic dermatitis involving sensitive skin areas, the topical calcineurin inhibitor pimecrolimus should be applied twice daily at the first signs of atopic dermatitis. For other body locations, patients should apply a topical calcineurin inhibitor, either pimecrolimus or tacrolimus, twice daily at the first signs of atopic dermatitis, such as pruritus, or twice weekly in previously affected skin areas. Emollients should be used regularly. Patients experiencing acute atopic dermatitis flares in sensitive skin areas should apply a topical corticosteroid twice daily or alternate once-daily topical corticosteroid/topical calcineurin inhibitor until symptoms improve. Following improvement, topical corticosteroid therapy should be discontinued and patients switched to a topical calcineurin inhibitor. Maintenance therapy should include the use of pimecrolimus once daily for sensitive areas and tacrolimus for other body locations. This treatment algorithm can help guide clinical decision-making in the treatment of atopic dermatitis.
(© 2021 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.)
Databáze: MEDLINE
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