Skin Barrier Dysfunction in Contact Dermatitis and Atopic Dermatitis-Treatment Implications

AbstractPurpose of reviewA variety of skin diseases are associated with impaired barrier function. The crucial pillars in therapy of previously mentioned conditions are avoidance of triggers, skin protection and individually adapted medical therapy. Until recently, besides of topical corticosteroids, the treatment options were limited. However, a variety of new therapies of skin barrier-related skin diseases became available over the last years. Our goal was to investigate new findings and treatment options in skin diseases with barrier dysfunction, emphasizing on contact dermatitis, hand eczema and atopic dermatitis.Recent findingsBesides of new relatively nonspecific anti-inflammatory therapies, such as topical calcineurin inhibitors, crisaborole and delgocitinib, also highly specific targeted treatments are currently under investigation, and some already available on the market. Worth mentioning is dupilumab, the first biologic drug approved for treatment of atopic dermatitis, but used also off-label for treatment of hand eczema. There are ongoing trials investigating tralokinumab and lebrikizumab for atopic dermatitis therapy. Anti-IL-31 monoclonal antibodies were reported to improve atopic dermatitis-related pruritus.SummaryThis review focuses on new findings and treatment options for skin diseases with barrier dysfunction regarding their efficacy, safety profile and mechanism of action.
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research

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CONCLUSION: With proper treatment, nummular eczema can be cleared over a few weeks, although the course can be chronic and characterized by relapses and remissions. Moisturizing of the skin and avoidance of identifiable exacerbating factors such as hot water baths and harsh soaps may reduce the frequency of recurrence. Diseases that present with annular lesions may mimic nummular eczema and the differential diagnosis is broad. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made, and appropriate treatment initiated. PMID: 32778043 [PubMed - as supplied by publisher]
Source: Recent Patents on Inflammation and Allergy Drug Discovery - Category: Allergy & Immunology Tags: Recent Pat Inflamm Allergy Drug Discov Source Type: research
CONCLUSION: All patients were misdiagnosed as AD exacerbation. Therefore, EH should be considered in the differential diagnosis of AD exacerbation especially in the infants with moderate to severe AD. PMID: 32558432 [PubMed - in process]
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research
Date: June 15, 2020 Issue #:  1600Summary:  Atopic dermatitis (AD; also known as eczema) is frequently associated with other atopic disorders such as allergic rhinitis, asthma, and food allergy. It commonly presents in infancy and early childhood and has a relapsing course, often improving by adolescence, but sometimes persisting into (or first appearing in) adulthood or even old age.
Source: The Medical Letter - Category: Drugs & Pharmacology Authors: Tags: abrocitinib Alclometasone Amcinonide ApexiCon apremilast Atopic dermatitis Azasan Azathioprine baricitinib Betamethasone Clobetasol Clobex Clocortolone Cloderm Cordran corticosteroids crisaborole Cutivate Cyclosporine Source Type: research
In this study we used HPLC and LC/MS analysis, combined with a BATMAN-TCM platform, for detailed HPLC fingerprint analysis and network pharmacology of QP, and investigated the anti-inflammatory and antipruritic activities of QP on ACD induced by squaric acid dibutylester (SADBE) in mice. The BATMAN-TCM analysis provided information of effector molecules of the main ingredients of QP, and possible chronic dermatitis-associated molecules and cell signaling pathways by QP. In ACD mice, QP treatment suppressed the scratching behavior induced by SADBE in a dose-dependent manner and inhibited the production of Th1/2 cytokines in...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
This study was supported by grants from GSK and the UK Medical Research Council (U105178805). Conflict of Interest Statement AM has grant funding from GSK and AstraZeneca/MedImmune. MB, DJ, AP, DT, and AvO are employees of GSK. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgments We are grateful to the Ares staff, genotyping facility, and flow cytometry core for their technical assistance. We thank Jen Walker for advice on the manuscript. Supplementary Material The Supplem...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
In patients with eczema that is difficult to manage, it is important to consider the possibility that they are allergic to the topical medications or emollients being used to manage their skin disease. This group of patients may have allergic contact dermatitis (ACD) to topical corticosteroids (TCS), antibiotics, or the excipients and preservatives used in their topical medications or emollients being used for skin care. For this group of patients, topical corticosteroids or the excipients in their vehicle may actually worsen their underlying disease and are the focus of this article.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
A 21-year old woman with atopic dermatitis (AD) presented with worsening hand eczema, which was refractory to topical corticosteroids. Specifically, since she became a cook she noted repeated episodes of hand swelling and malaise during contacting fish, including sebastes altus, mackerel, codfish, horse mackerel and pacific saury. The skin prick tests (SPT) were positive to a variety of fish, such as cod fish, salmon, sebastes altus, mackerel, horse mackerel, tuna, floundera flatfish and pacific saury.
Source: Journal of Investigative Dermatology - Category: Dermatology Authors: Tags: Inflammation, Immunity and Infection Source Type: research
CONCLUSIONS: The most important risk factors for developing contact allergy to corticosteroids appear to be chronic inflammatory dermatoses, long disease duration, extended on-and-off topical corticosteroid use, patients presenting two or more positive patch test results and polyvalent contact allergy to metal salts and to other non-steroidal haptens. PMID: 28670256 [PubMed - in process]
Source: Advances in Dermatology and Allergology - Category: Dermatology Tags: Postepy Dermatol Alergol Source Type: research
AbstractAtopic dermatitis (AD) is a chronic inflammatory skin condition that requires a manifold approach to therapy. The goal of therapy is to restore the function of the epidermal barrier and to reduce skin inflammation. This can be achieved with skin moisturization and topical anti-inflammatory agents, such as topical corticosteroids and calcineurin inhibitors. Furthermore, proactive therapy with twice weekly use of both topical corticosteroids and calcineurin inhibitors in previously affected areas has been found to reduce the time to the next eczematous flare. Adjunctive treatment options include wet wrap therapy, ant...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
DISCUSSION SESSION 1: Food allergy (PD01 –PD05)PD01 Allergen-specific humoral and cellular responses in children who fail egg oral immunotherapy due to allergic reactionsMarta Vazquez-Ortiz, Mariona Pascal, Ana Maria Plaza, Manel JuanPD02 FoxP3 epigenetic features in children with cow milk allergyLorella Paparo, Rita Nocerino, Rosita Aitoro, Ilaria Langella, Antonio Amoroso, Alessia Amoroso, Carmen Di Scala, Roberto Berni CananiPD04 Combined milk and egg allergy in early childhood: let them eat cake?Santanu Maity, Giuseppina Rotiroti, Minal GandhiPD05 Introduction of complementary foods in relation to allergy and gut...
Source: Clinical and Translational Allergy - Category: Allergy & Immunology Source Type: research
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