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1.
An. bras. dermatol ; 99(4): 503-512, Jul.-Aug. 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1563699

ABSTRACT

Abstract Background The treatment for atopic dermatitis (AD) has been the focus of clinical research, and behavioral intervention is considered an indispensable treatment method. To our knowledge, no relevant meta-analysis has evaluated the effects of behavioral interventions on atopic dermatitis. Objectives To evaluate the effects of behavioral interventions on atopic dermatitis. Methods The authors searched PubMed, EMBASE, and Cochrane CENTRAL to retrieve relevant RCTs (up to Feb 2022). The search strategy involved a combination of related keywords. The Cochrane Q and I2 statistics were used to assess heterogeneity. Results Six RCTs involving seven reports with 246 patients were included. The results suggested that behavioral interventions could relieve eczema severity (correlation coefficient [r = −0.39]; p < 0.001) and scratching severity significantly (r = −0.19; p = 0.017), while not affect itching intensity (r = −0.02; p = 0.840). A sensitivity analysis confirmed the robustness of the results. Study limitations An important limitation of this study was the insufficient number of RCTs and the limited sample size. In addition, the study lacked a control group receiving a type of intervention other than the experimental protocol. Another limitation was the short duration of follow-up. Conclusions This study suggests that behavioral interventions could be effective in treating atopic dermatitis by reducing eczema and scratching severity. Additionally, habit-reversal behavioral therapy may be more effective for treating atopic dermatitis.

2.
Pediatr Dermatol ; 2024 Jul 25.
Article in English | MEDLINE | ID: mdl-39049614

ABSTRACT

BACKGROUND/OBJECTIVES: Atopic dermatitis (AD) is a common chronic skin disease in the pediatric population; however, rates of admissions for flares in patients established with dermatology compared to those that are not established have not been fully assessed in prior studies. METHODS: We reviewed electronic medical records of patients hospitalized (billing codes 99221-99223, 99217) with diagnoses encompassing AD, eczema, and dermatitis (ICD-10 codes L20.8-L20.9, L30.8-L30.9) between January 1, 2011, and December 31, 2021, at University Hospitals (UH) in Cleveland, Ohio. Patients were considered established with dermatology if they had been seen by a dermatology provider within 6 months prior to admission. Statistical analysis was performed using chi-square goodness of fit. RESULTS: A total of 95 patient encounters met criteria for inclusion. Fifteen (15.8%) patients were established with dermatology at the time of admission and 80 (84.2%) were not. The chi-square value (x2 = 44.74) was greater than the critical value of 10.828 at one degree of freedom (p < .001). There were 8 patients who had more than one admission for atopic dermatitis flares; 2 of these patients were established with dermatology prior to their first admission, and 4 were established at the time of the second admission. CONCLUSION: The majority of patients admitted with AD flare were not established with dermatology. Many of these patients lived in a low socioeconomic area and missed follow-up appointments. Increasing access to dermatologic care for patients with atopic dermatitis, especially in lower-income areas, could aid in decreasing atopic dermatitis-related hospitalizations.

3.
J Pediatr Nurs ; 77: e401-e410, 2024.
Article in English | MEDLINE | ID: mdl-38760302

ABSTRACT

PURPOSE: To construct a structural model of family management for children with atopic dermatitis. DESIGN AND METHODS: In this cross-sectional study, data were collected using a structured questionnaire. Participants included primary caregivers of children aged 2-12 years who had received a medical diagnosis of atopic dermatitis and had been experiencing the condition for over three months. We used SPSS/WIN 26.0 to analyze the variables and AMOS 23.0 for structural equation modeling. RESULTS: Family functioning resilience, social support, and family coping had significant direct effects on family management. Illness severity, illness duration, and family life difficulty indirectly influenced family management, demonstrating significant total effects. The severity and duration of atopic dermatitis, family life difficulty, family functioning resilience, social support, and family coping explained 78.9% of the model. CONCLUSIONS: The final model was suitable for predicting family management for children with atopic dermatitis. By confirming mediating effects, this study contributes to enhancing family management through nursing interventions. These findings offer valuable insights for developing family-centered nursing strategies to improve family management for children with atopic dermatitis. PRACTICE IMPLICATIONS: Nursing interventions targeting the alleviation of family management challenges and enhancement of family functioning resilience, social support, and family coping are pivotal for improving the well-being of children with atopic dermatitis. Furthermore, tailored intervention development must take into account not only the severity and illness duration of atopic dermatitis in children but also the characteristics of the family. Improving family nursing through such tailored interventions can help enhance children's health and quality of life.


Subject(s)
Adaptation, Psychological , Dermatitis, Atopic , Social Support , Humans , Dermatitis, Atopic/therapy , Dermatitis, Atopic/nursing , Dermatitis, Atopic/psychology , Male , Female , Child , Cross-Sectional Studies , Child, Preschool , Surveys and Questionnaires , Caregivers/psychology , Quality of Life , Models, Structural , Resilience, Psychological
4.
J Dermatolog Treat ; 35(1): 2343072, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38626923

ABSTRACT

BACKGROUND: Systematic reviews (SRs) could offer the best evidence supporting interventions, but methodological flaws limit their trustworthiness in decision-making. This cross-sectional study appraised the methodological quality of SRs on atopic dermatitis (AD) treatments. METHODS: We searched MEDLINE, EMBASE, PsycINFO, and Cochrane Database for SRs on AD treatments published in 2019-2022. We extracted SRs' bibliographical data and appraised SRs' methodological quality with AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. We explored associations between methodological quality and bibliographical characteristics. RESULTS: Among the 52 appraised SRs, only one (1.9%) had high methodological quality, while 45 (86.5%) critically low. For critical domains, only five (9.6%) employed comprehensive search strategy, seven (13.5%) provided list of excluded studies, 17 (32.7%) considered risk of bias in primary studies, 21 (40.4%) contained registered protocol, and 24 (46.2%) investigated publication bias. Cochrane reviews, SR updates, SRs with European corresponding authors, and SRs funded by European institutions had better overall quality. Impact factor and author number positively associated with overall quality. CONCLUSIONS: Methodological quality of SRs on AD treatments is unsatisfactory. Future reviewers should improve the above critical methodological aspects. Resources should be devolved into upscaling evidence synthesis infrastructure and improving critical appraisal skills of evidence users.

5.
An Bras Dermatol ; 99(4): 503-512, 2024.
Article in English | MEDLINE | ID: mdl-38548550

ABSTRACT

BACKGROUND: The treatment for atopic dermatitis (AD) has been the focus of clinical research, and behavioral intervention is considered an indispensable treatment method. To our knowledge, no relevant meta-analysis has evaluated the effects of behavioral interventions on atopic dermatitis. OBJECTIVES: To evaluate the effects of behavioral interventions on atopic dermatitis. METHODS: The authors searched PubMed, EMBASE, and Cochrane CENTRAL to retrieve relevant RCTs (up to Feb 2022). The search strategy involved a combination of related keywords. The Cochrane Q and I2 statistics were used to assess heterogeneity. RESULTS: Six RCTs involving seven reports with 246 patients were included. The results suggested that behavioral interventions could relieve eczema severity (correlation coefficient [r = -0.39]; p < 0.001) and scratching severity significantly (r = -0.19; p = 0.017), while not affect itching intensity (r = -0.02; p = 0.840). A sensitivity analysis confirmed the robustness of the results. STUDY LIMITATIONS: An important limitation of this study was the insufficient number of RCTs and the limited sample size. In addition, the study lacked a control group receiving a type of intervention other than the experimental protocol. Another limitation was the short duration of follow-up. CONCLUSIONS: This study suggests that behavioral interventions could be effective in treating atopic dermatitis by reducing eczema and scratching severity. Additionally, habit-reversal behavioral therapy may be more effective for treating atopic dermatitis.


Subject(s)
Dermatitis, Atopic , Randomized Controlled Trials as Topic , Dermatitis, Atopic/therapy , Dermatitis, Atopic/psychology , Humans , Treatment Outcome , Severity of Illness Index , Behavior Therapy/methods , Pruritus/therapy , Pruritus/psychology , Female
6.
An Bras Dermatol ; 99(5): 706-720, 2024.
Article in English | MEDLINE | ID: mdl-38493053

ABSTRACT

Prurigo is a reactive, hyperplastic skin condition characterized by pruritic papules, plaques, and/or nodules. The temporal classification includes acute/subacute and chronic disease (≥ 6 weeks), with different clinical variants, synonymies, and underlying etiological factors. The immunology of chronic prurigo shows similarities with atopic dermatitis due to the involvement of IL-4 and IL-13, IL-22, and IL-31. Treatment includes antihistamines, topical steroids, dupilumab, and JAK inhibitors. Several conditions manifest clinically as prurigo-like lesions, and the correct clinical diagnosis must precede correct treatment. Furthermore, chronic prurigos represent a recalcitrant and distressing dermatosis, and at least 50% of these patients have atopic diathesis, the treatment of which may induce adverse effects, especially in the elderly. The quality of life is significantly compromised, and topical treatments are often unable to control symptoms and skin lesions. Systemic immunosuppressants, immunobiologicals, and JAK inhibitors, despite the cost and potential adverse effects, may be necessary to achieve clinical improvement and quality of life. This manuscript reviews the main types of prurigo, associated diseases, their immunological bases, diagnosis, and treatment.


Subject(s)
Prurigo , Humans , Prurigo/diagnosis , Prurigo/etiology , Prurigo/therapy , Quality of Life , Chronic Disease
7.
Psychiatry Investig ; 21(1): 52-62, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38198830

ABSTRACT

OBJECTIVE: To evaluate the association between atopic dermatitis (AD) and suicidal behaviors in adolescent defectors among residents who escaped from North Korean (adolescent defectors, n=423) and adolescents with South Korean parents (Korean adolescents, n=540,265). METHODS: The study used data from the Korea Youth Risk Behavior Survey conducted from 2011 to 2019. Differences in general characteristics, health behaviors, suicidal ideation, suicide plans, suicide attempts, and AD between adolescent defectors and Korean adolescents were examined. Multiple logistic regression analysis was used to determine the association between AD and suicidal behaviors. RESULTS: The adolescent defectors group had lower AD (16.3% vs. 24.2%), poorer subjective health (10% vs. 6%), smoked more (47% vs. 18%), drank more (60% vs. 43%), lived with family less frequently (56% vs. 96%), and were more than twice as likely to have depression (42% vs. 27%), suicidal ideation (30% vs. 14%), a suicide plan (23% vs. 5%), or have made a prior suicide attempt (19% vs. 3%) compared with the Korean adolescent group (p<0.001). The adjusted odds ratio for the adolescent defectors group compared to the Korean adolescent group was 1.66 for suicidal ideation, 3.59 for suicide plans, and 4.34 for suicide attempts (p<0.001). AD was found to be associated with suicide plans and attempts in adolescent defectors and associated with suicidal ideation in Korean adolescents. CONCLUSION: AD was significantly associated with suicide plans and suicidal attempts among adolescent defectors and suicidal ideation in Korean adolescents, based on a random sample of middle- and high-school students.

8.
An. bras. dermatol ; 99(1): 72-79, Jan.-Feb. 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1527691

ABSTRACT

Abstract Background: Methotrexate (MTX) is an alternative treatment for patients with moderate/severe atopic dermatitis (AD). Objective: The authors evaluated the effect of MTX on the cutaneous expression of cytokines and chemokines that are involved in the inflammatory response in adult AD patients who received treatment with methotrexate for 24 weeks. Methods: The authors conducted a prospective single-institution cohort study with 12 adults with moderate/severe AD who received oral MTX (15 mg/wk for 24 wks) and 10 non-atopic matched controls. The comparison was made of skin biopsies of lesional and non-lesional skin, pre- and post MTX treatment. The authors analyzed mean epidermal thickness and expression of IL-31, IL-31RA, OSMR, TSLP, Ki67, IL-4 mRNA, IL-6, IL-10, TNF-α, IFN-γ, TARC, and CCL-22. Results: There was a reduction in mean epidermal thickness (p = 0.021), an increase in IL-31RA expression (immunohistochemistry) in the epidermis (p = 0.016) and a decrease in IL-31 gene expression (p = 0.019) on lesional AD skin post-MTX treatment. No significant changes in the cutaneous expression of the other evaluated markers were identified. Study limitations: Small sample size and limited length of follow-up. Conclusions: Treatment with MTX in adults with moderate/severe AD reduced epidermal hyperplasia and changed the cutaneous expression of inflammatory cytokines and receptors that are mainly related to pruritus, including IL-31 and IL-31RA.

9.
Allergol Int ; 73(1): 137-142, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37100717

ABSTRACT

BACKGROUND: Delgocitinib ointment, a topical Janus kinase inhibitor, is used as treatment of patients with atopic dermatitis (AD) aged ≥2 years in Japan. Although initiating appropriate and early treatment upon the onset of AD in childhood is important, the safety and efficacy of delgocitinib ointment in infants with AD have not been established. METHODS: This phase 3 study was conducted from October 2020 to June 2022 (number JapicCTI-205412). Eligible Japanese infants with AD aged 6 to <24 months received 0.25% or 0.5% of delgocitinib ointment twice daily for 52 weeks in an open-label uncontrolled manner. Topical corticosteroids were allowed to apply for worsening AD during the treatment period at the investigators' discretion. RESULTS: A total of 22 infants were enrolled. Adverse events (AEs) were reported in 21 (95.5%) infants and were mostly mild. No treatment-related AEs were reported. The Modified Eczema Area and Severity Index (mEASI) score continuously decreased until week 4, and the score reduction was maintained until week 52. The mean percent changes in the mEASI score from baseline were -73.5% at week 4, -81.7% at week 28, and -81.9% at week 52. Delgocitinib was not detected in the plasma of most infants (68.2%-95.2%). CONCLUSIONS: Delgocitinib ointment is well tolerated and effective for up to 52 weeks when applied to Japanese infants with AD.


Subject(s)
Dermatitis, Atopic , Infant , Humans , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/chemically induced , Ointments/therapeutic use , Treatment Outcome , Pyrroles/adverse effects , Double-Blind Method
10.
An Bras Dermatol ; 99(1): 72-79, 2024.
Article in English | MEDLINE | ID: mdl-37730501

ABSTRACT

BACKGROUND: Methotrexate (MTX) is an alternative treatment for patients with moderate/severe atopic dermatitis (AD). OBJECTIVE: The authors evaluated the effect of MTX on the cutaneous expression of cytokines and chemokines that are involved in the inflammatory response in adult AD patients who received treatment with methotrexate for 24 weeks. METHODS: The authors conducted a prospective single-institution cohort study with 12 adults with moderate/severe AD who received oral MTX (15 mg/wk for 24 wks) and 10 non-atopic matched controls. The comparison was made of skin biopsies of lesional and non-lesional skin, pre- and post MTX treatment. The authors analyzed mean epidermal thickness and expression of IL-31, IL-31RA, OSMR, TSLP, Ki67, IL-4 mRNA, IL-6, IL-10, TNF-α, IFN-γ, TARC, and CCL-22. RESULTS: There was a reduction in mean epidermal thickness (p = 0.021), an increase in IL-31RA expression (immunohistochemistry) in the epidermis (p = 0.016) and a decrease in IL-31 gene expression (p = 0.019) on lesional AD skin post-MTX treatment. No significant changes in the cutaneous expression of the other evaluated markers were identified. STUDY LIMITATIONS: Small sample size and limited length of follow-up. CONCLUSIONS: Treatment with MTX in adults with moderate/severe AD reduced epidermal hyperplasia and changed the cutaneous expression of inflammatory cytokines and receptors that are mainly related to pruritus, including IL-31 and IL-31RA. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03327116.


Subject(s)
Dermatitis, Atopic , Adult , Humans , Dermatitis, Atopic/drug therapy , Methotrexate/therapeutic use , Cohort Studies , Prospective Studies , Cytokines
11.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-1024284

ABSTRACT

Tralokinumab is a selective interleukin-13 inhibitor developed by LEO Pharma in Denmark. It was granted approval by the US Food and Drug Administration on December 27, 2021, for the treatment of patients aged 18 years or older with moderate to severe atopic dermatitis whose disease is refractory to or cannot be fully controlled by local prescription therapy. This article presents a comprehensive review of the recent research progress in the treatment of moderate to severe atopic dermatitis with tralokinumab.

12.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-1018319

ABSTRACT

Based on the introduction of gut-brain-skin axis, this article discussed the relationship between psychological behavior, intestinal flora, and atopic dermatitis. By combing the literature on the treatment of atopic dermatitis with TCM, it is found that TCM therapy can regulate the relative abundance of intestinal flora, participate in immune metabolism and restore skin barrier function by intervening in the gut-brain-skin axis, so as to achieve the purpose of treating atopic dermatitis.

13.
Chinese Journal of Dermatology ; (12): 119-122, 2024.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-1028908

ABSTRACT

In recent years, with the in-depth research on rosacea, dermatologists′ understanding of rosacea has gradually increased. However, misdiagnosis and overdiagnosis emerge as a tendency because some doctors roughly equate erythema with rosacea, neglecting the differential diagnosis with other similar skin problems. This article discusses clinical manifestations and diagnostic criteria of rosacea, elaborates on how to make a correct diagnosis, and lists key points in differential diagnosis between rosacea and other skin diseases, with a view to providing a reference for clinicians in the treatment of rosacea, and to reducing its misdiagnosis and overdiagnosis.

14.
Rev Alerg Mex ; 70(4): 163-166, 2023 Sep.
Article in Spanish | MEDLINE | ID: mdl-37933926

ABSTRACT

Background: Eczema herpeticum is an infection caused by herpes simplex virus in patients with atopic dermatitis, among its complications we can find meningitis, encephalitis, acute liver failure, and Staphylococcus aureus infection. Case report: We report the case of a female patient of 5 years of age, with a history of atopic dermatitis complicated by eczema herpeticum, who was treated initially without relief. Her hospital stay was complicated with cross infections, which prolonged her course. Dermatology diagnosed eczema herpeticum. Immediately after the start of treatment, the patient showed improvement. Conclusions: Eczema herpeticum is a rare complication of atopic dermatitis, it must be suspected based on patient history and physical examination. Therefore, early recognition and diagnosis are of clinical importance. Without an appropriate approach, these patients can present shock, sepsis, and death.


Antecedentes: El eccema herpético es una infección causada por el virus del herpes simple, que afecta a pacientes con dermatitis atópica. Las principales complicaciones son meningitis, encefalitis, insuficiencia hepática aguda e infección por Staphylococcus aureus. Reporte de caso: Paciente pediátrica de 5 años, con antecedente de dermatitis atópica complicada con eccema herpético, que recibió tratamiento sin reacción satisfactoria. Durante la hospitalización tuvo infecciones nosocomiales que prolongaron su estancia. Luego de la evaluación por personal del servicio de Dermatología se estableció el diagnóstico de eccema herpético, con adecuado tratamiento, seguimiento y egreso sin complicaciones. Conclusiones: El eccema herpético es una complicación rara de la dermatitis atópica, que debe diagnosticarse con base en los antecedentes personales patológicos y la exploración física adecuada. La atención oportuna es de relevancia clínica, pues los pacientes pueden tener complicación serias (choque, sepsis, incluso la muerte). Palabras clave: Eccema herpético; dermatitis atópica; infección nosocomial; Staphylococcus aureus.


Subject(s)
Dermatitis, Atopic , Kaposi Varicelliform Eruption , Staphylococcal Infections , Female , Humans , Dermatitis, Atopic/drug therapy , Kaposi Varicelliform Eruption/complications , Kaposi Varicelliform Eruption/diagnosis , Kaposi Varicelliform Eruption/drug therapy , Child, Preschool
15.
Allergy Asthma Immunol Res ; 15(5): 545-561, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37827976

ABSTRACT

Allergic diseases are increasing both in morbidity and mortality. Genetic, environmental, and dietary factors may all be involved in this increase. Nutrition during pregnancy, breastfeeding, and early life may play a particularly important role in preventing allergic diseases. Based on current systematic reviews, the intake of specific nutrients has failed to prevent allergic disease. Prevention strategies have shifted their focus to the overall diet which can be described using diet diversity. Infant and maternal diet diversity in pregnancy has been associated with reduced allergy outcomes in childhood. Overall, diet also seems to have a marked effect on the microbiome compared to single foods. Factors that may negate the allergy-preventative effect of overall diet diversity include the addition of emulsifiers, advanced glycation end-product content, and overuse of commercial baby foods. There is a need to perform randomized controlled trials using overall dietary intake to support international food allergy guidelines. These studies should ideally be conducted by multi-professional teams.

17.
J Tradit Chin Med ; 43(5): 887-896, 2023 10.
Article in English | MEDLINE | ID: mdl-37679976

ABSTRACT

OBJECTIVE: To investigate the efficacy of Zhenxin Anshen formula (, ZXAS) on atopic dermatitis (AD) by transient receptor potential vanilloid 1 (TRPV1) and transient receptor potential ankyrin 1 (TRPA1) signalling pathway in mice and . METHODS: AD-like lesions were induced by 1-chloro-2,4-dinitrobenzene (DNCB) to the shaved dorsal skin of BALB/c mice. BALB/c mice were divided into five groups: normal control, model control, cetirizine, low-, medium-, and high-dose of ZXAS. After ZXAS in-tervention, the skin lesions and blood samples were collected for hematoxylin and eosin-stained and measuring the concentrations of inflammatory cytokines. Immun-oglobulin E (IgE), interleukin (IL)-4, IL-5, IL-13, and thymic stromal lymphopoietin (TSLP) were de-tected by Enzyme-linked immunosorbent assay (ELISA). The spinal cords were collected for measuring the expression of gastrin-releasing peptide receptor (GRPR), TRPV1, and TRPA1 by using immunohistochemistry, western blotting, and quantitative real-time polymerase chain reaction (qRT-PCR) analyses. In addition, 3-(4,5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay, flow cytometry, ELISA, and Western blotting were conducted for analysis of primary dorsal root ganglia (DRG) neurons . RESULTS: ZXAS treatment improved DNCB-induced AD-like lesions through reducing dermatitis score, number of scratching and epidermal thickness, accompanied by the de-creased IgE and Th2 inflammatory cytokines. ZXAS also supressed the mRNA and protein expression of GRPR, TRPV1, and TRPA1 in the spinal cord. The medicated sera of ZXAS decreased capsaicin-induced Ca influx and downregulated the expression of TRPV1, TRPA1, and phospholipase C in DRG neurons. CONCLUSIONS: The therapeutic effect of ZXAS on AD may be related to the regulation of TRPV1 and TRPA1 and inhibition of Ca2+ signals in neurons.


Subject(s)
Antineoplastic Agents , Dermatitis, Atopic , Animals , Mice , Ankyrins , Dinitrochlorobenzene , Dermatitis, Atopic/chemically induced , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/genetics , Cytokines/genetics , Neural Pathways , Dinitrobenzenes , Immunoglobulin E
18.
Yonsei Med J ; 64(7): 423-432, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37365736

ABSTRACT

PURPOSE: The favorable clinical efficacies of intramuscular injection of autologous blood in patients with atopic dermatitis (AD) and intramuscular injection of autologous serum in patients with chronic urticaria have been demonstrated by randomized clinical trials. In this study, we assessed the clinical effectiveness and safety of the intramuscular injection of autologous serum in patients with AD. MATERIALS AND METHODS: In this randomized, placebo-controlled, and double-blind trial, 23 adolescent and adult patients with moderate-to-severe AD were enrolled. The patients were randomized to receive eight intramuscular injections of 5 mL of autologous serum (n=11) or saline (n=12) over 4 weeks, and were followed up until week 8. Changes in the clinical severity scores of AD assessed by SCORing Atopic Dermatitis (SCORAD), patient-reported Dermatology Life Quality Index (DLQI) score, and incidence of adverse events were assessed from baseline to week 8. RESULTS: One patient in the treatment group and two patients in the placebo group were lost to follow-up before week 8. The intramuscular administration of autologous serum, compared with saline, decreased the SCORAD clinical severity score (-14.8% vs. 10.7%, p=0.006) and improved the DLQI score (-32.6% vs. 19.5%, p=0.01) from baseline to week 8. Serious adverse events were not observed. CONCLUSION: Intramuscular injection of autologous serum may be effective in treating AD. Further studies are needed to evaluate the clinical usefulness of this intervention for AD (KCT0001969).


Subject(s)
Dermatitis, Atopic , Humans , Adult , Adolescent , Dermatitis, Atopic/therapy , Injections, Intramuscular , Treatment Outcome , Double-Blind Method , Severity of Illness Index
19.
Rev. cuba. reumatol ; 25(2)jun. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1565530

ABSTRACT

Introducción: La dermatitis atópica es una enfermedad cutánea inflamatoria, crónica y pruriginosa. De etiología multifactorial que se produce con mayor frecuencia durante la lactancia y en la infancia temprana. Objetivos: Describir la evidencia científica sobre el efecto de los inhibidores de janus quinasa sobre la mejoría clínica y la remisión de la dermatitis atópica. Métodos: Se realizará una revisión sistemática y metaanálisis. Esta revisión sistemática se regirá de acuerdo con las directrices PRISMA. Se realizó una búsqueda en PubMed, Scopus, Web of Science. Resultados: Se incluyeron 14 artículos en la revisión. Conclusiones: El tratamiento con inhibidores del janus cinasas, como el abrocitinib, está siendo investigado como una opción potencial para el tratamiento de la dermatitis atópica y los artículos incluidos en esta revisión han demostrado resultados prometedores. El abrocitinib mostró una mejora sostenible de los síntomas de la dermatitis atópica, ha demostrado ser bien tolerado en los ensayos clínicos, con menor cantidad e intensidad de efectos secundarios, respeto a otros fármacos como cremas o corticoides sistémicos, y hasta el momento sugieren que los inhibidores de la janus cinasas son bien tolerados por la mayoría de los pacientes. Es importante destacar que el abrocitinib aún es una terapia relativamente nueva y su uso a largo plazo en el tratamiento de la dermatitis atópica requieren más investigaciones.


Introduction: Atopic dermatitis is an inflammatory, chronic, pruritic skin disease. It has a multifactorial etiology and occurs most frequently during infancy and early childhood. Aims: To describe the scientific evidence on the effect of janus kinase inhibitors on clinical improvement and remission of atopic dermatitis. Methods: A systematic review and meta-analysis will be performed. This systematic review will be conducted according to PRISMA guidelines. A search will be performed in Pubmed, Scopus, Web of Science. Results: 14 articles were included in the review. Conclusions: Treatment with janus kinase inhibitors, such as abrocitinib, is being investigated as a potential option for the treatment of atopic dermatitis and the articles included in this review have shown promising results. abrocitinib showed a sustainable improvement of atopic dermatitis symptoms, has been shown to be well tolerated in clinical trials, with fewer and less intense side effects compared to other drugs such as creams or systemic corticosteroids, and so far suggest that janus kinase inhibitors are well tolerated by most patients. Importantly, abrocitinib is still a relatively new therapy and its long-term use in the treatment of atopic dermatitis requires further investigations.

20.
Biomédica (Bogotá) ; 43(1): 107-120, mar. 2023. tab, graf
Article in English | LILACS | ID: biblio-1533910

ABSTRACT

Introduction: Atopic dermatitis, also known as eczema or atopic eczema, is a chronic inflammatory skin disorder characterized by the presence of pruritus accompanied by itching. In Colombia, epidemiological and healthcare resource utilization information regarding this pathology is limited. Objective: To describe atopic dermatitis epidemiological characteristics and healthcare resource utilization patterns in Colombia. Materials and methods: A retrospective database study using real-world data obtained from the national claims database SISPRO (Sistema de Información para la Protección Social) for the 2015-2020 period was carried out. Sociodemographic (age, and health services delivery), epidemiological (incidence, prevalence, and comorbidities), and healthcare resource utilization data were extracted from the SISPRO database. Results: The epidemiological results showed increased incidence and prevalence of atopic dermatitis in Colombia in the 2018-2019 period compared to 2015-2017. Accordingly, the number of medical consultations (particularly with specialists), the number of procedures, and the number of hospitalizations of patients with atopic dermatitis increased. Topic and systemic corticoids were the most frequently prescribed drugs. Conclusions: Diagnoses of atopic dermatitis in Colombia increased with a concomitant increase in healthcare resource utilization during 2015-2020, which was possibly slowed down by the arrival of the Covid-19. This study may help physicians gaining a better understanding of the disease, improving atopic dermatitis patient management.


Introducción. La dermatitis atópica, también conocida como eczema o eczema atópico, es un trastorno inflamatorio crónico de la piel caracterizado por la presencia de prurito acompañado de picor. En Colombia, la información epidemiológica y de utilización de recursos sanitarios sobre esta enfermedad es limitada. Objetivo. Describir las características epidemiológicas y los patrones de utilización de recursos sanitarios para la dermatitis atópica en Colombia. Materiales y métodos. Se trata de un estudio retrospectivo en el cual se utilizan datos de la práctica clínica real obtenidos del registro nacional SISPRO (Sistema de Información para la Protección Social) en el período 2015-2020. Se extrajeron datos sociodemográficos (incluida la edad y la prestación de servicios de salud), epidemiológicos (incluidos la incidencia, la prevalencia y las comorbilidades) y los correspondientes a la utilización de los recursos sanitarios. Resultados. Los resultados epidemiológicos han demostrado un aumento de la incidencia y prevalencia de la dermatitis atópica en Colombia en el periodo 20182019, en comparación con el periodo 2015-2017. Aumentó el número de consultas médicas (particularmente, con especialistas) de pacientes con dermatitis atópica, el de procedimientos y el de hospitalizaciones. Los corticoides tópicos y sistémicos fueron los medicamentos más prescritos. Conclusiones. Los diagnósticos de dermatitis atópica en Colombia aumentaron con un incremento concomitante en la utilización de recursos sanitarios durante 2015-2020, que posiblemente se vio atenuado por la llegada del Covid-19. Este estudio puede ayudar a los médicos a tener un mejor conocimiento de la enfermedad y, por lo tanto, mejorar el tratamiento de los pacientes con dermatitis atópica.


Subject(s)
Dermatitis, Atopic/epidemiology , Utilization Review , Colombia , Drug Therapy , COVID-19
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