Management of Difficult-to-Treat Atopic Dermatitis

被引：135

作者：

Arkwright, Peter D. ^{[1
]}

Motala, Cassim ^{[2
]}

Subramanian, Hamsa ^{[3
]}

Spergel, Jonathan ^{[4
]}

Schneider, Lynda C. ^{[5
]}

Wollenberg, Andreas ^{[6
]}

机构：

[1] Univ Manchester, Royal Manchester Childrens Hosp, Manchester M13 9WP, Lancs, England

[2] Univ Cape Town, Red Cross Childrens Hosp, ZA-7925 Cape Town, South Africa

[3] Signature Allergy Immunol, St Louis, MO USA

[4] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[5] Boston Childrens Hosp, Boston, MA USA

[6] Univ Munich, Munich, Germany

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE | 2013年 / 1卷 / 02期

关键词：

Atopic dermatitis; Eczema; Review; Compliance; Corticosteroids; Tacrolimus; Cyclosporine; STAPHYLOCOCCUS-AUREUS COLONIZATION; DOUBLE-BLIND; EDUCATIONAL-PROGRAMS; ALTERNATIVE MEDICINE; COLONIZING FEATURES; CONTACT-DERMATITIS; RANDOMIZED-TRIAL; UNITED-STATES; PATCH TEST; CHILDREN;

D O I：

10.1016/j.jaip.2012.09.002

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Atopic dermatitis is a complex disorder caused by the interplay between multiple genetic and environmental factors. Particularly in patients with severe disease, the effect is not just an itchy rash but also the secondary effects on the psychological well-being of the patient and their carers, particularly disturbed sleep. The aim of this review is to provide health care professionals with a holistic approach to the management of difficult-to-treat atopic dermatitis, defined as atopic dermatitis seemingly unresponsive to simple moisturizers and mild potency (classes VI and VII) topical corticosteroids. The critical importance of education and advice is emphasized, as is the seminal role of secondary bacterial infection and polyclonal T-cell activation in causing acute flares in patients with severe, generalized disease. In atypical cases or those that do not respond to treatment, alternative diagnoses should be considered. (C) 2012 American Academy of Allergy, Asthma & Immunology

引用

页码：142 / 151

页数：10

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