A Rational Aproach to Diagnosis and Treatment of Atopic Dermatitis

Yıl 2019, Cilt: 11 Sayı: 2, 86 - 93, 07.03.2019

Uzm. Dr.şule Çağlayan Sözmen

Öz

Abstract

Atopic dermatitis (AD) is one of the most common skin diseases inchildhood . It is achronic inflammatory  disease with repeated exacerbation and remission characterized bydry and itchy skin. The cause of AD is due to a number of factors: disrupted skin barrierfunction, genetic predispotion, dysregulation of the immune system, and allergic reactions to food and environmental allergens. The aim of this review is to evaluate the rational diagnosis and treatment of AD in childhood with a clinical case.

Anahtar Kelimeler

atopic dermatitis, child, treatment, diagnosis

Atopik Dermatitin Tanı ve Tedavisine Akılcı Yaklaşım

Öz

Öz

Atopik dermatit çocukluk döneminin en sık deri hastalığıdır. Kuru ve kaşıntılı cilt ile karakterize tekrarlayan egzezerbasyon ve remisyonun olduğu kronik inflamatuar bir hastalıktır. Atopik dermatit bir dizi faktöre bağlı olur: bozulmuş deri bariyeri, genetik eğilim, immun sistem disregülasyonu ve çevresel ve besin alerjenlerine alerjik reaksiyon. Bu derlemenin amacı, AD'in çocukluk çağında akılcı tanı ve tedavisini  klinik bir olgu ile değerlendirmektir.

Anahtar Kelimeler

atopik dermatit, çocuk, tanı, tedavi

Kaynakça

• Kaynaklar 1.Wuthrich, B. and P. Schmid-Grendelmeier, The atopiceczema/dermatitis syndrome. Epidemiology, natural course,and immunology of the IgE-associated ("extrinsic") and the no-nallergic ("intrinsic") AEDS. J Investig Allergol Clin Immunol,2003. 13(1): p. 1-5. 2.Eichenfield, L.F., et al., Guidelines of care for the management ofatopic dermatitis: section 1. Diagnosis and assessment of atopicdermatitis. J Am Acad Dermatol, 2014. 70(2): p. 338-51. 3.Cork, M.J., et al., Epidermal barrier dysfunction in atopic der-matitis. J Invest Dermatol, 2009. 129(8): p. 1892-908. 4.Rawlings, A.V., et al., Effect of lactic acid isomers on kerati-nocyte ceramide synthesis, stratum corneum lipid levels andstratum corneum barrier function. Arch Dermatol Res, 1996.288(7): p. 383-90. 5.Akdis, C.A., et al., Diagnosis and treatment of atopic dermatitisin children and adults: European Academy of Allergology andClinical Immunology/American Academy of Allergy, Asthmaand Immunology/PRACTALL Consensus Report. J Allergy ClinImmunol, 2006. 118(1): p. 152-69. 6.Kobayashi, T., et al., Dysbiosis and Staphylococcus aureus Co-lonization Drives Inflammation in Atopic Dermatitis. Immunity,2015. 42(4): p. 756-66. 7.Tamari, M. and T. Hirota, Genome-wide association studies ofatopic dermatitis. J Dermatol, 2014. 41(3): p. 213-20. 8.Severity scoring of atopic dermatitis: the SCORAD index. Con-sensus Report of the European Task Force on Atopic Dermati-tis. Dermatology, 1993. 186(1): p. 23-31. 9.Wollenberg, A., et al., Consensus-based European guidelines fortreatment of atopic eczema (atopic dermatitis) in adults and child-ren: part I. J Eur Acad Dermatol Venereol, 2018. 32(5): p. 657-682. 10.Kim, J., et al., Effects of Indoor Air Pollutants on Atopic Der-matitis. Int J Environ Res Public Health, 2016. 13(12). 11.Kramer, U., et al., The effect of environmental tobacco smokeon eczema and allergic sensitization in children. Br J Derma-tol, 2004. 150(1): p. 111-8. 12.Hidaka, T., et al., The aryl hydrocarbon receptor AhR links ato-pic dermatitis and air pollution via induction of the neurotrop-hic factor artemin. Nat Immunol, 2017. 18(1): p. 64-73. 13.Takai, T. and S. Ikeda, Barrier dysfunction causedby environmental proteases in the pathogenesis ofallergic diseases. Allergol Int, 2011. 60(1): p. 25-35 14.Pelucchi, C., et al., Pet exposure and risk of atopic dermatitisat the pediatric age: a meta-analysis of birth cohort studies. JAllergy Clin Immunol, 2013. 132(3): p. 616-622 e7. 15.Flohr, C. and L. Yeo, Atopic dermatitis and the hygiene hypot-hesis revisited. Curr Probl Dermatol, 2011. 41: p. 1-34. 16.Glines, K.R., et al., An update on the topical and oral therapyoptions for treating pediatric atopic dermatitis. Expert OpinPharmacother, 2019: p. 1-9. 17.Wong, S.M., T.G. Ng, and R. Baba, Efficacy and safety of sodiumhypochlorite (bleach) baths in patients with moderate to severe ato-pic dermatitis in Malaysia. J Dermatol, 2013. 40(11): p. 874-80. 18.Galli, E., et al., Consensus Conference on Clinical Managementof pediatric Atopic Dermatitis. Ital J Pediatr, 2016. 42: p. 26. 19.Kapur, S., W. Watson, and S. Carr, Atopic dermatitis. AllergyAsthma Clin Immunol, 2018. 14(Suppl 2): p. 52. 20.Gelmetti, C. and A. Wollenberg, Atopic dermatitis - all you cando from the outside. Br J Dermatol, 2014. 170 Suppl 1: p. 19-24. 21.Sicherer, S.H. and H.A. Sampson, Food hypersensitivity and atopicdermatitis: pathophysiology, epidemiology, diagnosis, and manage-ment. J Allergy Clin Immunol, 1999. 104(3 Pt 2): p. S114-22. 22.Sampson, H.A., et al., Food allergy: a practice parameter upda-te-2014. J Allergy Clin Immunol, 2014. 134(5): p. 1016-25 e43. 23.Yavuz, S.T., et al., Factors that predict the clinical reactivityand tolerance in children with cow's milk allergy. Ann AllergyAsthma Immunol, 2013. 110(4): p. 284-9. 24.Caglayan Sozmen, S., et al., Diagnostic accuracy of patch testin children with food allergy. Pediatr Allergy Immunol,2015. 26(5): p. 416-22. 25.Nowak-Wegrzyn, A., et al., Work Group report: oral foodchallenge testing. J Allergy Clin Immunol, 2009. 123(6Suppl): p. S365-83. 26.Matricardi, P.M., et al., EAACI Molecular Allergology User's Gui-de. Pediatr Allergy Immunol, 2016. 27 Suppl 23: p. 1-250. 27.Clark, A.T., et al., British Society for Allergy and ClinicalImmunology guidelines for the management of egg allergy.Clin Exp Allergy, 2010. 40(8): p. 1116-29. 28.Irvine, A.D. and P. Mina-Osorio, Disease trajectories inchildhood atopic dermatitis: an update and practitioner'sguide. Br J Dermatol, 2019.