{"title":"特应性皮炎:最好的指南和标准。","authors":"Mark Boguniewicz","doi":"10.2500/aap.2025.46.240087","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Atopic dermatitis (AD), a common chronic inflammatory skin disorder is characterized by a complex pathology with skin-barrier abnormalities, immune dysregulation, and microbial dysbiosis. Patients' quality of life is often negatively impacted by persistent pruritus, sleep disturbance, and recurrent skin infections. In addition, patients may have comorbid atopic as well as nonatopic diseases. <b>Objective:</b> The objective was to help clinicians better manage AD by using new therapies and new indications, including a topical (Janus kinase [JAK]) inhibitor as well as monoclonal antibodies and oral JAK inhibitors, have been approved for AD. <b>Methods:</b> This review presents highlights from the American College of Allergy, Asthma and Immunology AD Yardstick Update, which incorporates Expert Commentary, and from the Joint Task Force (JTF) AD 2023 Guidelines that use Grading of Recommendations, Assessment, Development, and Evaluation methodology. <b>Results:</b> Practical pearls from the AD Yardstick Update Expert Commentary are presented, along with results from systematic reviews and meta-analyses that addressed specific recommendations on the role of (1) dilute bleach baths, (2) dietary avoidance and/or elimination diets, (3) allergen immunotherapy, (4) topical treatments, and (5) systemic treatments, informing the JTF 2023 AD Guidelines. These guidelines are noteworthy for addressing patient values and preferences. <b>Conclusion:</b> The AD Yardstick Update Expert Commentary and JTF 2023 AD Guidelines provide timely, practical, and trustworthy information to help clinicians manage patients with AD.</p>","PeriodicalId":7646,"journal":{"name":"Allergy and asthma proceedings","volume":"46 1","pages":"19-25"},"PeriodicalIF":2.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Atopic dermatitis: Best of guidelines and yardstick.\",\"authors\":\"Mark Boguniewicz\",\"doi\":\"10.2500/aap.2025.46.240087\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> Atopic dermatitis (AD), a common chronic inflammatory skin disorder is characterized by a complex pathology with skin-barrier abnormalities, immune dysregulation, and microbial dysbiosis. Patients' quality of life is often negatively impacted by persistent pruritus, sleep disturbance, and recurrent skin infections. In addition, patients may have comorbid atopic as well as nonatopic diseases. <b>Objective:</b> The objective was to help clinicians better manage AD by using new therapies and new indications, including a topical (Janus kinase [JAK]) inhibitor as well as monoclonal antibodies and oral JAK inhibitors, have been approved for AD. <b>Methods:</b> This review presents highlights from the American College of Allergy, Asthma and Immunology AD Yardstick Update, which incorporates Expert Commentary, and from the Joint Task Force (JTF) AD 2023 Guidelines that use Grading of Recommendations, Assessment, Development, and Evaluation methodology. <b>Results:</b> Practical pearls from the AD Yardstick Update Expert Commentary are presented, along with results from systematic reviews and meta-analyses that addressed specific recommendations on the role of (1) dilute bleach baths, (2) dietary avoidance and/or elimination diets, (3) allergen immunotherapy, (4) topical treatments, and (5) systemic treatments, informing the JTF 2023 AD Guidelines. 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引用次数: 0
摘要
背景:特应性皮炎(AD)是一种常见的慢性炎症性皮肤病,其病理复杂,包括皮肤屏障异常、免疫失调和微生物生态失调。患者的生活质量经常受到持续瘙痒、睡眠障碍和反复皮肤感染的负面影响。此外,患者可能同时患有特应性和非特应性疾病。目的:目的是通过使用新疗法和新适应症帮助临床医生更好地管理AD,包括外用(Janus激酶[JAK])抑制剂以及单克隆抗体和口服JAK抑制剂,已被批准用于AD。方法:本综述介绍了美国过敏、哮喘和免疫学学院AD标准更新的亮点,其中包括专家评论,以及联合工作组(JTF) AD 2023指南,该指南使用分级推荐、评估、开发和评估方法。结果:本文提出了AD标准更新专家评论中的实用要点,以及系统综述和荟萃分析的结果,这些结果涉及(1)稀释漂白剂浴、(2)饮食避免和/或消除饮食、(3)过敏原免疫疗法、(4)局部治疗和(5)全身治疗的具体建议,为JTF 2023 AD指南提供了信息。这些指南对于解决患者的价值和偏好是值得注意的。结论:AD标准更新专家评论和JTF 2023 AD指南为临床医生管理AD患者提供了及时、实用和可信的信息。
Atopic dermatitis: Best of guidelines and yardstick.
Background: Atopic dermatitis (AD), a common chronic inflammatory skin disorder is characterized by a complex pathology with skin-barrier abnormalities, immune dysregulation, and microbial dysbiosis. Patients' quality of life is often negatively impacted by persistent pruritus, sleep disturbance, and recurrent skin infections. In addition, patients may have comorbid atopic as well as nonatopic diseases. Objective: The objective was to help clinicians better manage AD by using new therapies and new indications, including a topical (Janus kinase [JAK]) inhibitor as well as monoclonal antibodies and oral JAK inhibitors, have been approved for AD. Methods: This review presents highlights from the American College of Allergy, Asthma and Immunology AD Yardstick Update, which incorporates Expert Commentary, and from the Joint Task Force (JTF) AD 2023 Guidelines that use Grading of Recommendations, Assessment, Development, and Evaluation methodology. Results: Practical pearls from the AD Yardstick Update Expert Commentary are presented, along with results from systematic reviews and meta-analyses that addressed specific recommendations on the role of (1) dilute bleach baths, (2) dietary avoidance and/or elimination diets, (3) allergen immunotherapy, (4) topical treatments, and (5) systemic treatments, informing the JTF 2023 AD Guidelines. These guidelines are noteworthy for addressing patient values and preferences. Conclusion: The AD Yardstick Update Expert Commentary and JTF 2023 AD Guidelines provide timely, practical, and trustworthy information to help clinicians manage patients with AD.
期刊介绍:
Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.