治疗特应性皮炎的实用方法。

E N Charlesworth
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引用次数: 12

摘要

特应性皮炎是一种慢性瘙痒性皮肤病,发生率为总人口的0.5%至1%,影响近10%的儿童。由于这是一种与总IgE水平非常高和过敏性呼吸系统疾病高发相关的疾病,因此执业过敏症医师有必要熟悉特应性皮炎的诊断和治疗。下面的讨论将集中在疾病的主要和次要临床特征的识别上,并回顾这些患者经常看到的免疫失调的频谱。本综述的主要重点将是根据美国皮肤病学会出版的实践指南和美国过敏与免疫学会目前正在制定的实践指南,确定过敏症专科医生可用的治疗方案。特应性皮炎是一种“会发疹的瘙痒,而不是会发痒的皮疹”,因此,任何患者的治疗方案都应解决引起这种瘙痒的潜在触发因素的多样性。这些因素包括热、湿度和出汗,以及摄入某些食物过敏原和局部暴露于尘螨抗原和动物皮屑。最近的研究表明,变应性疾病的发病机制涉及一个复杂的炎症过程,其中TH2淋巴细胞可能在将免疫反应转向有利于疾病的过程中发挥重要作用。因此,最近的免疫调节治疗,如干扰素和环孢素,可能为医生提供标准局部治疗形式之外的治疗选择。(摘要删节250字)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Practical approaches to the treatment of atopic dermatitis.

Atopic dermatitis is a chronic pruritic cutaneous disease that occurs in 0.5% to 1% of the general population and affects almost 10% of all children. Since this is a disease that is associated with both a very high level of total IgE and a high incidence of allergic respiratory disease, it behooves the practicing allergist to become familiar with the diagnosis and treatment of atopic dermatitis. This following discussion will focus on the identification of major and minor clinical features of the disease and review the spectrum of immune dysregulation that is frequently seen with these patients. The primary focus of this review will be directed at the identification of treatment options available to allergists within the published practice guidelines of the American Academy of Dermatology and practice guidelines that are currently being developed by the American Academy of Allergy & Immunology. Atopic dermatitis is an "itch which rashes and not a rash which itches" and therefore, any patient treatment program should address the multiplicity of potential trigger factors that provoke this itching. These factors include heat, humidity, and perspiration, in addition to the ingestion of certain food allergens and the topical exposure to both dust mite antigen and animal dander. Recent studies suggest that the pathogenesis of allergic disease entails a complex inflammatory process in which the TH2 lymphocyte might play a major role in shifting the immune response in favor of disease. Accordingly, recent immunomodulating treatments, such as interferon gamma and cyclosporine, might offer therapeutic options to the physician beyond the standard topical forms of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

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