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Atopic dermatitis and therapy and remission

A Hernández-Martín, L Noguera-Morel, B Bernardino-Cuesta, A Torrelo, M A Pérez-Martin, C Aparicio-López, C de Lucas-Collantes
BACKGROUND: Cyclosporin A (CSA) is an immunosuppressant agent widely used in severe atopic dermatitis (AD). However, experience in children is limited. OBJECTIVES: To assess the efficacy and adverse events of CSA therapy in children. METHODS: Retrospective study of children with severe AD treated with CSA between January 2009 and December 2015. RESULTS: Data from 63 patients were collected. Mean age at the beginning of treatment was 8...
November 29, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Elio Rossi, Marco Picchi, Paola Bartoli, Marialessandra Panozzo, Chiara Cervino, Linda Nurra
AIM: To study the outcomes of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy) and related long-term results after approximately an 8-year period. MATERIALS AND METHODS: Our data derive from an observational longitudinal study carried out on 857 pediatric patients who consecutive visited from 1998 to 2014. Children with atopic diseases were 325 (37.9%), 126 (39%) suffered from atopic dermatitis, 72 (22%) from allergic rhinitis, and 127 (39%) from asthma...
August 2016: Homeopathy: the Journal of the Faculty of Homeopathy
David N Ginsberg, Lawrence F Eichenfield
Atopic dermatitis (AD) is a common chronic skin condition in children that has a proven association with other atopic conditions and allergies. These associations, like the general pathophysiology of AD, are complex and not fully understood. While there is evidence for the efficacy of specific immunotherapy (SIT) in pediatric asthma and allergic rhinitis (AR), there is a lack of strong data to support its use in AD. IgE has been shown to be elevated in many patients with AD, but it is an unreliable biomarker due to variability and great fluctuation over time, poor positive predictive value for clinically relevant allergy, and poor correlation with disease state...
2016: World Allergy Organization Journal
Tatsuki Fukuie, Satoshi Hirakawa, Masami Narita, Ichiro Nomura, Kenji Matsumoto, Yoshiki Tokura, Yukihiro Ohya
Proactive therapy for atopic dermatitis (AD) effectively prevents exacerbation. However, its role in preventing subsequent sensitization to allergens has not been prospectively studied. We investigated whether proactive therapy for AD can effectively impact immunological parameters in a randomized, investigator-blinded, parallel group study. Thirty patients aged 3 months to 7 years with moderate to severe AD who had undergone an AD educational program were allocated to a proactive treatment group or a reactive treatment group...
November 2016: Journal of Dermatology
Jungsoo Lee, Hemin Lee, Seongmin Noh, Byung Gi Bae, Jung U Shin, Chang Ook Park, Kwang Hoon Lee
PURPOSE: In extrinsic atopic dermatitis (AD), house dust mites (HDM) play a role in eliciting or aggravating allergic lesions. The nature of skin inflammation in AD has raised a growing interest in allergen-specific immunotherapy (SIT). Thus, we assessed clinical improvement and laboratory parameters for evaluation of the benefit of long-term SIT. MATERIALS AND METHODS: A total of 217 AD patients who were treated with SIT for at least 3 years were retrospectively assessed, by using their investigator global assessment, pruritus scores, loss of sleep (LOS), total serum IgE, and eosinophil counts collected...
March 2016: Yonsei Medical Journal
Ana M Lourenço, Vanessa Schmidt, Berta São Braz, Diana Nóbrega, Telmo Nunes, José H Duarte-Correia, Daniela Matias, Emi Maruhashi, Christophe A Rème, Tim Nuttall
BACKGROUND: Long-term remission between flares of canine atopic dermatitis (CAD) can be difficult to achieve. Therefore, additional strategic forms of treatment are needed in order to target flare prevention. The concept of proactive therapy is recommended in the European guidelines for the treatment of human atopic eczema. OBJECTIVES: To evaluate the efficacy of a proactive treatment regimen with a 0.0584% hydrocortisone aceponate (HCA) spray for CAD. ANIMALS: Client-owned dogs with spontaneous atopic dermatitis (AD) (n = 41)...
April 2016: Veterinary Dermatology
Stephan Weidinger, Natalija Novak
Atopic dermatitis (also known as atopic eczema) is a chronic inflammatory skin disease that is characterised by intense itching and recurrent eczematous lesions. Although it most often starts in infancy and affects two of ten children, it is also highly prevalent in adults. It is the leading non-fatal health burden attributable to skin diseases, inflicts a substantial psychosocial burden on patients and their relatives, and increases the risk of food allergy, asthma, allergic rhinitis, other immune-mediated inflammatory diseases, and mental health disorders...
March 12, 2016: Lancet
Edyta Machura, Beata Chodór, Magdalena Kleszyk, Małgorzata Pindycka-Piaszczyńska, Ewelina Chrobak, Jacek Białkowski
In recent years, we have been observing an increased proportion of atopic diseases in children after solid organ transplantation. The pathogenesis of post-transplantation allergy is not completely understood and probably involves several factors, including immunosuppressive therapy. In this paper we present a case of 3-year old boy, after orthotopic heart transplantation at 6 months of age, with symptoms of food allergy associated with atopic dermatitis and changes in the orofacial area. The mentioned symptoms and elevated levels of total and specific IgE occurred with a year of transplant...
June 2015: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Dong-Ho Nahm
The current standard medical therapy for atopic dermatitis (AD) mainly focuses on symptomatic relief by controlling skin inflammation with topical corticosteroids and/or topical calcineurin inhibitors. However, the clinical efficacy of pharmacological therapy is often disappointing to both patients and physicians. The terminology of AD contains a historical meaning of eczematous dermatitis caused by hypersensitivity reaction to environmental inhalant or food allergen. Complex interrelationships among genetic abnormalities, environmental triggers, skin barrier defects, and immune dysfunction resulting in a vicious domino-circle seem to be involved in the development and maintenance of AD...
August 2015: Annals of Dermatology
Manisha Lalan, Jitendra Baweja, Ambikanandan Misra
In this review, we describe the very basic of atopic dermatitis (AD), the established management strategies, and the advances in drug delivery approaches for successful therapeutic outcomes. The multifactorial pathophysiology of AD has given rise to the clinician's paradigm of topical and systemic therapy and potential combinations. However, incomplete remission of skin disorders like AD is a major challenge to be overcome. Recurrence is thought to be due to genetic and immunological etiologies and shortcomings in drug delivery...
2015: Critical Reviews in Therapeutic Drug Carrier Systems
J P X Ng, H M Liew, S B Ang
Atopic dermatitis (AD) is a common inflammatory skin disorder that has strong financial and psychosocial impacts. Its pathogenesis is related to increased transepidermal water loss due to a defective skin epidermal barrier. Emollients serve as first-line therapy during both acute flares and remission. However, their use is poorly characterized, posing therapeutic challenges to clinicians and patients. In this article, we review available evidence to provide recommendations, aiming to standardize and optimize the use of emollients in AD...
May 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
Sabela Atencia, Stratos Papakonstantinou, Bernadette Leggett, Hester McAllister, Carmel T Mooney
A three year old male entire Staffordshire bull terrier was referred to University College Dublin Veterinary Hospital, with a two week history of fever, inflammation of the right hock, lameness on the right hindlimb, peripheral lymphadenopathy and gastrointestinal signs (vomiting and diarrhoea). For the preceding three months the dog had been treated for atopic dermatitis with oral ciclosporin (5 mg/kg, PO, q 24 hours). Cytological analysis of the affected lymph nodes demonstrated fungal-like organisms predominantly contained within macrophages...
2014: Irish Veterinary Journal
Cathryn Sibbald, Elena Pope, Nhung Ho, Miriam Weinstein
Cyclosporine is a systemic therapy used for control of severe atopic dermatitis (AD) in children. Although traditionally recommended at a dose of 5 mg/kg/day for 6 months, a longer duration of treatment may be necessary to bring a child with active and severe disease into remission. There are few data on the short- and long-term effectiveness of longer courses of therapy. This was a retrospective chart review of children treated with cyclosporine at a Canadian hospital-affiliated clinic between 2000 and 2013...
January 2015: Pediatric Dermatology
Zygmunt Nowacki
Atopic eczema/atopic dermatitis (AD) is very frequently the first clinical manifestation of allergic disease. The interactions between environmental and genetic factors are considered to play the most important role in the pathogenesis of this condition. Atopic eczema is one of the most frequently observed clinical manifestations in allergic food hypersensitivity. Clinical symptoms and signs are non-specific and vary greatly. Even though in each case of cow's milk protein allergy a similar group of allergenic proteins is responsible for adverse reactions, the clinical response in each patient, i...
2013: Przegla̧d Lekarski
Ting Seng Tang, Thomas Bieber, Hywel C Williams
BACKGROUND: Atopic dermatitis (AD) treatment is often initiated by symptoms or visible erythema. The role of induction of remission or treatment of inflammation that is not visible is unclear. OBJECTIVE: We investigated whether (1) the notion of subclinical inflammation is scientifically sound, (2) treatment corrects subclinical inflammation, and (3) different strategies for initial clearance of AD affect long-term disease control. METHODS: We conducted a systematic review based on searching MEDLINE, Embase, the Cochrane register of randomized controlled trials, and the Global Resource of Eczema Trials from inception to the end of October 2012...
June 2014: Journal of Allergy and Clinical Immunology
Leni George, Ian Hamann, Keng Chen, James Choi, Pablo Fernandez-Peñas
BACKGROUND: Mycophenolate mofetil (MMF) is increasingly being used by dermatologists to treat various skin conditions, but limited evidence exists regarding its efficacy. OBJECTIVE: To evaluate safety and efficacy of MMF in the treatment of dermatological conditions. METHODS: A retrospective chart review of all the dermatology patients treated with MMF between October 1999 and July 2008 at a university-based teaching hospital in Australia...
February 2015: Journal of Dermatological Treatment
Shigeki Inui, Fumihito Noguchi, Takeshi Nakajima, Satoshi Itami
Serum thymus and activation-regulated chemokine/CCL17 (sTARC) is known as a good indicator for atopic dermatitis severity. Herein, we investigate whether sTARC correlates with severity and therapeutic response for alopecia areata (AA) in our 121 patients. The sTARC mean of AA totalis and universalis was significantly higher than mild AA. Next, we compared sTARC of diffuse AA (n = 14) and severity-controlled patchy AA (n = 32) and found that sTARC in diffuse AA (564.2 ± 400.0 pg/mL) was significantly higher than that of the patchy type (344...
November 2013: Journal of Dermatology
S Darné, S N Leech, A E M Taylor
BACKGROUND: There is only retrospective evidence for the efficacy of narrowband ultraviolet B (NB-UVB) in children with eczema. OBJECTIVES: To measure the difference in means for objective scores [Six Area Six Sign Atopic Dermatitis score (SASSAD), percentage surface area] and quality-of-life scores, between patients treated with NB-UVB and unexposed cohorts at the end of treatment, and 3 and 6 months post-treatment. METHODS: Twenty-nine children aged 3-16 years for whom NB-UVB was indicated, were scored prospectively using SASSAD and percentage surface area involvement at baseline, at 12 weeks (end of treatment) and 3 and 6 months post-NB-UVB...
January 2014: British Journal of Dermatology
Claresa Levetan, Paolo Pozzilli, Lois Jovanovic, Desmond Schatz
BACKGROUND: Over the past decade, many immune tolerance agents have shown promise in the non-obese diabetic mouse model for prevention and reversal of type 1 diabetes but have not been successful in clinical trials among recently diagnosed type 1 patients. The trials from decades ago using Cyclosporine A in significantly lower dosages than used for organ transplantation and in similar dosages that have increased T regulatory cell populations in conditions such as atopic dermatitis, demonstrated very high initial insulin-free remission rates when administered immediately after diagnosis...
November 2013: Diabetes/metabolism Research and Reviews
Rosanna Marsella
Skin barrier dysfunction exists in both human and canine atopic dermatitis, leading to increased water loss and potentially facilitating allergen penetration and sensitization. Both lipid (e.g. ceramides) and protein (e.g. filaggrin) abnormalities have been described. Some are genetically inherited (e.g. filaggrin mutations are one of the major risk factors in humans) and some are secondary and linked to inflammation. In humans, numerous studies have shown efficacy of emollients and moisturizers in barrier restoration, and this approach has been for years the mainstay of therapy...
February 2013: Veterinary Dermatology
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