医学
特应性皮炎
皮密莫司
杜皮鲁玛
皮肤病科
重症监护医学
钙调神经磷酸酶
全身疗法
疾病
过敏性
药物治疗
他克莫司
过敏
免疫学
外科
内科学
乳腺癌
癌症
移植
作者
Kanokvalai Kulthanan,Papapit Tuchinda,Rattanavalai Nitiyarom,Amornsri Chunharas,Hiroshi Chantaphakul,Kobkul Aunhachoke,Leena Chularojanamontri,Natta Rajatanavin,Orathai Jirapongsananuruk,Pakit Vichyanond,Pantipa Chatchatee,Pasuree Sangsupawanich,Siriwan Wananukul,Srisupalak Singalavanija,Suphattra Trakanwittayarak,Ticha Rerkpattanapipat,Torpong Thongngarm,Wanee Wisuthsarewong,Wanida Limpongsanurak,Wasu Kamchaisatian,Nopadon Noppakun
出处
期刊:Asian Pacific Journal of Allergy and Immunology
[Allergy, Asthma, and Immunology Association of Thailand]
日期:2021-01-01
被引量:40
标识
DOI:10.12932/ap-010221-1050
摘要
Atopic dermatitis (AD), a chronic, relapsing dermatitis, is characterized by dry and pruritus skin in patients with a personal or family history of atopy. It affects up to 20% of children and 1-3% of adults in most countries worldwide, and leads to significant treatment costs and morbidity. These guidelines are developed in accordance with evidence-based publications and expert opinions. Following simple algorithms, the guidelines aim to assist adult and pediatric physicians in the better care of patients with AD. As with other diseases, there have been several diagnosis criteria proposed over time. Nonetheless, the classical Hanifin and Rajka criterion with no pathognomonic laboratory biomarkers is still the most widely used worldwide for the diagnosis of AD. The management of AD must be considered case by case to provide suitable care for each patient. Basic therapy is focused on avoiding specific/unspecific provoking factors and hydrating skin. Topical anti-inflammatory treatments such as glucocorticoids and calcineurin inhibitors are suggested for disease flare, and proactive therapy is best for long-term control. Other therapies, including antimicrobial agents, systemic antihistamines, systemic anti-inflammatory agents, immunotherapy, phototherapy, and psychotherapy, are reviewed in these guidelines. Crisaborole, a new topical phosphodiesterase 4 inhibitor, can be used twice daily in AD patients over three months old. Dupilumab, a biological drug for patients with moderate-to-severe AD, may be considered in patients with no improvement from other systemic treatments.