The therapy of atopic dermatitis in acute phase and in remission
Atopic dermatitis is a prevalent chronic skin condition affecting over 10 % of the pediatric population, with its pathogenesis rooted in immunological factors. Despite the advancements in understanding its triggers and pathophysiology, the frequency of AD remains high, necessitating a multidisciplin...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Global Pediatrics |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667009723000829 |
| _version_ | 1827317826511175680 |
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| author | Arianna Giannetti Giampaolo Ricci |
| author_facet | Arianna Giannetti Giampaolo Ricci |
| author_sort | Arianna Giannetti |
| collection | DOAJ |
| description | Atopic dermatitis is a prevalent chronic skin condition affecting over 10 % of the pediatric population, with its pathogenesis rooted in immunological factors. Despite the advancements in understanding its triggers and pathophysiology, the frequency of AD remains high, necessitating a multidisciplinary approach for effective management. This article discusses therapeutic strategies, emphasizing the collaboration between pediatric dermatologists and allergists, along with the potential role of psychologists for addressing the psychosocial impact. The severity of AD is assessed using validated clinical scores, such as SCORAD and EASI, guiding treatment decisions. The article provides a detailed overview of acute phase management for mild cases, highlighting the importance of topical corticosteroids based on potency and absorption considerations. Additionally, it explores the use of topical calcineurin inhibitors in sensitive areas. For moderate cases with relapses, proactive therapy and considerations for bacterial over-infection are discussed. Lately there has been a shift from immunosuppressants to biologic drugs like dupilumab for severe forms, demonstrating efficacy even in pediatric cases. The article outlines approved dosing for dupilumab across different age groups. In the remission phase, environmental measures and psychological support are crucial, while emollient therapy, categorized by occlusive, humectant, and emollient actions, remains a cornerstone. Furthermore, the incorporation of non-medicated active ingredients in emollients is explored. The multidisciplinary approach and stepwise therapeutic strategies outlined in this article aim to assist clinicians in managing AD cases effectively based on clinical severity, ensuring optimal outcomes for pediatric patients. |
| first_indexed | 2024-03-08T14:19:56Z |
| format | Article |
| id | doaj.art-31ae8b0e9e2141508ba55adc2ea46b72 |
| institution | Directory Open Access Journal |
| issn | 2667-0097 |
| language | English |
| last_indexed | 2024-04-24T23:46:22Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Global Pediatrics |
| spelling | doaj.art-31ae8b0e9e2141508ba55adc2ea46b722024-03-15T04:44:51ZengElsevierGlobal Pediatrics2667-00972024-03-017100116The therapy of atopic dermatitis in acute phase and in remissionArianna Giannetti0Giampaolo Ricci1Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Corresponding author at: Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti, 11 - 40138 Bologna, Italy.Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, ItalyAtopic dermatitis is a prevalent chronic skin condition affecting over 10 % of the pediatric population, with its pathogenesis rooted in immunological factors. Despite the advancements in understanding its triggers and pathophysiology, the frequency of AD remains high, necessitating a multidisciplinary approach for effective management. This article discusses therapeutic strategies, emphasizing the collaboration between pediatric dermatologists and allergists, along with the potential role of psychologists for addressing the psychosocial impact. The severity of AD is assessed using validated clinical scores, such as SCORAD and EASI, guiding treatment decisions. The article provides a detailed overview of acute phase management for mild cases, highlighting the importance of topical corticosteroids based on potency and absorption considerations. Additionally, it explores the use of topical calcineurin inhibitors in sensitive areas. For moderate cases with relapses, proactive therapy and considerations for bacterial over-infection are discussed. Lately there has been a shift from immunosuppressants to biologic drugs like dupilumab for severe forms, demonstrating efficacy even in pediatric cases. The article outlines approved dosing for dupilumab across different age groups. In the remission phase, environmental measures and psychological support are crucial, while emollient therapy, categorized by occlusive, humectant, and emollient actions, remains a cornerstone. Furthermore, the incorporation of non-medicated active ingredients in emollients is explored. The multidisciplinary approach and stepwise therapeutic strategies outlined in this article aim to assist clinicians in managing AD cases effectively based on clinical severity, ensuring optimal outcomes for pediatric patients.http://www.sciencedirect.com/science/article/pii/S2667009723000829Atopic dermatitistOpical corticosteroidsMoisturizersChildrenTopical calcineurin inhibitorsDupilumab |
| spellingShingle | Arianna Giannetti Giampaolo Ricci The therapy of atopic dermatitis in acute phase and in remission Global Pediatrics Atopic dermatitis tOpical corticosteroids Moisturizers Children Topical calcineurin inhibitors Dupilumab |
| title | The therapy of atopic dermatitis in acute phase and in remission |
| title_full | The therapy of atopic dermatitis in acute phase and in remission |
| title_fullStr | The therapy of atopic dermatitis in acute phase and in remission |
| title_full_unstemmed | The therapy of atopic dermatitis in acute phase and in remission |
| title_short | The therapy of atopic dermatitis in acute phase and in remission |
| title_sort | therapy of atopic dermatitis in acute phase and in remission |
| topic | Atopic dermatitis tOpical corticosteroids Moisturizers Children Topical calcineurin inhibitors Dupilumab |
| url | http://www.sciencedirect.com/science/article/pii/S2667009723000829 |
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