Atopic Dermatitis in the Year 2009
Authors:
N. Benáková
Authors‘ workplace:
Dermatovenerologická klinika 1. LF UK Praha
přednosta prof. MUDr. Jiří Štork, CSc.
; Dermatoalergologická ordinace Praha
vedoucí lékař MUDr. Radek Klubal
Published in:
Čes-slov Derm, 84, 2009, No. 2, p. 65-85
Category:
Reviews (Continuing Medical Education)
Overview
The author reviews an up-to-date opinion on the atopic dermatitis etiopathogenesis – genetic factors, skin barrier malfunction, immunologic imbalance towards Th2 answer, connection of specific and non-specific immunity, the role of golden staph, 2 phase model of inflammatory reaction, evolution of atopic dermatitis from intrinsic through extrinsic towards autoimmune form. In the chapter dealing with prevention she discusses alimentary and contact allergic triggers. She mentions the gradual therapeutic schema from emollients, corticosteroids, topical immunomodulators towards phototherapy and systemic treatment and the process of examination and therapy management of atopic dermatitis in practice and importance of therapeutic plan. She focusses on the patient education for better compliance and prevention of corticophobia; on importance of compounded forms, coverings and specific hygienic skin care. In the systemic treatment she points out the cyclosporin A as the first choice, azathioprine and methotrexate as the second choice and emphasizes the use of corticosteroids only in emergency case. Finally she outlines prospective local and systemic drugs and stresses out the psychosomatic approach to the patients.
Key words:
atopic dermatitis – etiopathogenesis – diagnostics – therapy – prevention – practical guideline
Sources
1. ABRAMOWITS, W. A clinician paradigm in the tratment of atopic dermatitis. Am Acad Dermatol, 2005, 53, S 70-76.
2. BACHEET, C., ZHANG, N., PATOU, J. et al: Role of staphylococcal superantigens in upper airway disease. Curr Opin Allergy Clin Immunol, 2008, 8, p. 34-38
3. BARCLAY, L. Guidleines for treating atopic eczema in children. Medcsape Continual medical Education, April 2008, www. medscape.com
4. BELTRANI, VS. The clinical spectrum of atopic dermatitis. J Allergy Clin Immunol, 1999, 104 (3), S 87-S 98.
5. BENÁKOVÁ, N.: Ekzémy a dermatitidy. Praha: Maxdorf, 2006, 125 s.
6. BENÁKOVÁ, N. Léčba atopické dermatitidy/ekzému u dospělých. Interní Med, 2007, 5, p. 240 – 246.
7. BIEBER, T. LEUNG DYM. (ed.) Atopic dermatitis. New York: Dekker, 2002, 633 p.
8. BIEBER, T. Mechanism of disease: atopic dermatitis. N Eng J Med, 2008, 358 (14), p.1483-1495
9. BORCHARD, KLA., Orchard, D. Systemic therapy of paediatric atopic dermatitis: an update. Australas J Dermatol, 2008, 49, p. 125-136.
10. CARDONA, ID., CHO, SH., LEUNG DYM. Role of bacterial superantigens in atopic dermatitis. Am J Clin Dermatol, 2006, 7 (5), p. 273-279.
11. CORK, MC., ROBINSON, DA., VASILOPOULOS, Y. et al. New perspectives on epidemal barrier dysfunction in atopic dermatitis: gene – enviroment interactions. J Allergy Clin Immunol, 2006,118 (1), p. 3-20.
12. ČAPKOVÁ, Š. Léčba atopické dermatitidy v roce 2008. Farmakoterapie, 2008, Suppl. 3, p. 22-31.
13. ČAPKOVÁ, Š.: Současné možnosti léčby atopické dermatitidy v dětském věku a poučení rodičů. Referátový výběr z dermatovenerologie, 2004, 46, (S1), p. 5-12.
14. DI CARLO, JB., MCCALL, CO. Pharmacologic alternatives for severe atopic dermatitis. Int J Dermatol, 2001, 40, p. 82-88.
15. GOUJON, C., BÉRARD, F., DAHEL, K. et al. Methotrexate for the treatment of adult atopic dermatitis. Eur J Dermatol, 2006, 16 (2), p. 155-158.
16. HOLOBRADÁ, M: Komplexná liečba atopickej dermatitidy. Derma, 2006, 4, p. 11-15.
17. CHISOLM, SS. Written action plans: potential for improving outcomes in childrem with atopic dermatitis. JAAD, 2008, 59 (4), p. 677-683.
18. CHRISTOPHERS, E., FOLSTER-HOSTZ, R. Atopic versus infantile eczema. J Am Acad Dermatol, 2001, 45, p. 4-6.
19. CHROMEJ, I. Atopický ekzém. Dali Banská Bystrica 2007, 240 p.
20. KAVERI, SV., LACROIX-DESMAZES, S., BAYRY, J. The antiinflammatory IgG. N Eng J Med, 2008, 359 (3), p.307-309.
21. KLUBAL, R. (koordinátor) et al. Workshop on atopic dermatitis. Praha 26. - 28. 4. 2006.
22. KLUBAL, R. (koordinátor) et al. Workshop on atopic dermatitis. Praha 25.-27.5. 2007.
23. LEVIN, C., WARSHAW, E. Protein contact dermatitis: allergens, pathogenesis and management. Dermatitis, 2008, 19 (5), p. 241-251.
24. MACHOVCOVÁ, A. Péče o kůži v dětském věku. Příloha Pediatrie pro praxi 2006, 7, 50 s.
25. MOHRENSCHLAGER, M., DARSOW, U., SCHNOPP, C. et al. Atopic eczema: what is new ? JEADV, 2006, 20, p. 503-511.
26. OFLAZOGLU, E., SIMPSON, EL., TAKIGUCHI, R et al: CD 40 expression of antigen presenting cells and correlation with disease severIty in atopic dermatitis. Eur J Dermatol, 2008, 18 (5), p. 527-533.
27. OLESEN, AB. Atopic dermatitis- has the epidemic stopped or just begun ? EADV Congress news, 2006, p. 4.
28. PÁNKOVÁ, R. Psychosociální souvislosti atopické dermatitidy. Referátový výběr, 2008, 50, (S II), p. 37-40.
29. POLÁŠKOVÁ, S. Proč může selhat léčba u dětí s atopickou dermatitidou. Farmakoterapie, 2008, Suppl. 3, p.32-35.
30. PÓNAYAI, G., HIDVÉGI, B., NÉMETH, I et al. Contact and aeroallergens in adulthood atopic dermatitis. JEADV, 2008, 22, p.1346-1355.
31. SANDILANDIS, A. et al. Prevalent and rare mutations in gene encoding filaggrin cause ichthyosis vulgaris and predispose individuals to atopic dermatitis. J Invest Dermatol, 2006, 126, p. 1770-1775.
32. SCHMIEDBERGEROVÁ, R. Eczema atopicum. Pediatrie pro praxi, 2005, 4, p. 145-150.
33. THESTRUP- PEDERSEN, K. Atopic eczema – new insights in definition, diagnostics and disease management. Acta Derm Venereol, 2005, Suppl. 215, p. 7-48.
34. WILIAMS, H., FLOHR, C. How epidemiology has changed 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol, 2006, 118 (1), p. 209-213.
35. ZÁHEJSKÝ, J.: Zevní dermatologická terapie a kosmetika. Praha: Grada, 2006, 140 s.
36. Kolektiv autorů: Atopic dermatitis: current approaches and future treatment options. Dermatology News, 2007, 9, p. 1-4.
Doporučená literatura pro pacienty:
• Čapková Š., Špičák V., Vosmík F.: Atopický ekzém. Praha : Makropulos, 2005, 138 s.
• Fuchs: Alergie číhá v jídle a pití. Praha: nakl. Adéla, 2005, 189 s.
• doporučení pro pacienty na stránkách České společnosti klinické alergologie a imunologie a České iniciativy pro astma: www. csaki. cz , www. cipa. cz
Labels
Dermatology & STDs Paediatric dermatology & STDsArticle was published in
Czech-Slovak Dermatology
2009 Issue 2
Most read in this issue
- Diffuse Reflectance Spectrophotometry I. Spectrophotometer and Its Engineering Solution
- Atopic Dermatitis in the Year 2009
- Preservatives Releasing Formaldehyde Causing Occupational Eczemas in Metal Cutters
- Hypersensitivity to Nickel – Always Current Topic