AIM:To examine the incidence of ocular abnormalities in children with atopic dermatitis(AD)in Saudi Arabia and its association with the severity of AD.METHODS:This is a cross-sectional study on 50 children with AD who...AIM:To examine the incidence of ocular abnormalities in children with atopic dermatitis(AD)in Saudi Arabia and its association with the severity of AD.METHODS:This is a cross-sectional study on 50 children with AD who were between 5 and 16 years of age.The severity of AD was evaluated using the SCORing Atopic Dermatitis(SCORAD)index.All the children underwent slit lamp exams,visual acuity assessment,intraocular pressure measurement,and corneal topography.The children were considered to have an ophthalmic abnormality if one or more of the following signs were present:glaucoma,keratoconus suspicion,in addition to lid,conjunctival,corneal,lenticular,or retinal abnormalities.RESULTS:Based on the SCORAD severity index,14%of children had mild AD(7/50),38%had moderate AD(19/50),and nearly half had severe AD.More than half the children exhibited facial involvement,and half had peri-orbital signs.The mean SCORAD index was 35.75.The mean age was 10.48±3.6y,and the cohort showed a slight male predominance(54%males).Both eyes of the 50 children in the cohort were studied.Based on the ocular examinations,92%of the patients showed ocular abnormalities:lid abnormalities(27/50)followed by keratitis(22/50).Four patients had moderate risk for keratoconus in one eye and eight patients were suspected to have keratoconus.However,SCORAD severity index was not associated with age,sex,or the number or presence of ophthalmic abnormalities.CONCLUSION:This is the first study in Saudi Arabia to evaluate the prevalence of ocular manifestations in children with AD.The results indicate that the majority of children with AD have ocular abnormalities that mainly include lid abnormalities.Based on these findings,larger scale studies are needed to affirm whether regular screening for ophthalmic abnormalities would be beneficial for children with AD in terms of early intervention and prevention of sight-threatening complications.展开更多
BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated ...BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.展开更多
BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associat...BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.展开更多
Atopic dermatitis(AD)is a chronic,relapsing,multifactorial inflammatory disease with genetic,environmental,and immunological characteristics.The quality of life and sleep of patients and their families are affected by...Atopic dermatitis(AD)is a chronic,relapsing,multifactorial inflammatory disease with genetic,environmental,and immunological characteristics.The quality of life and sleep of patients and their families are affected by AD,which triggers stress,described as one of the factors that worsens AD.Salivary biomarkers such as cortisol,alpha-amylase,chromogranin A,and melatonin have been associated with stress and sleep disturbances.Therefore,the evaluation of stress and sleep disorders using salivary biomarkers in AD patients is important.This review aims to describe the possible relationship between atopic dermatitis and stress,sleep disorders,and salivary biomarkers,seeking to contribute to better understanding and clinical management of AD.This descriptive study is characterized as a narrative literature review.A literature search was conducted of studies published in English and Portuguese between January 2012 and October 2022 that are available in electronic media from various databases,such as Scientific Electronic Library Online,Latin American and Caribbean Literature on Health Sciences,and PubMed.AD is associated with different degrees of impact on the lives of individuals who present with the disease.Psychological stress may induce changes in saliva composition and worsen AD;at the same time,the severity of the disease may be associated with emotional impact.Further studies are needed to assess and correlate AD severity,stress,and sleep disturbances with salivary biomarkers in order to better understand this association.展开更多
Objective: To reveal the mechanism of Mahuang Lianqiao Chixiaodou decoction and its disassembled formula for improving the skin barrier function in a mouse model of atopic dermatitis(AD).Methods: Sixty specific-pathog...Objective: To reveal the mechanism of Mahuang Lianqiao Chixiaodou decoction and its disassembled formula for improving the skin barrier function in a mouse model of atopic dermatitis(AD).Methods: Sixty specific-pathogen free male BALB/c mice were randomly divided into the control group,model group, whole formula group(WF), exterior-releasing formula group(ERF), interior-clearing formula group(ICF), and positive control group(PC). A mouse model of AD was established using the semiantigen 2,4-dinitrofluorobenzene induction method. The lesion scores, transepidermal water loss and p H, and skin histopathology of mice in each group were observed. The expressions of filaggrin, loricrin,and involucrin were detected by the streptavidin peroxidase immunohistochemical method and western blotting, and their mRNA expressions were detected by quantitative polymerase chain reaction.Results: Mice in the WF, ERF, ICF, and PC groups showed reduced skin lesion performance, improved histopathology, decreased skin lesion score, transepidermal water loss and pH, and upregulated expressions of proteins including filaggrin, loricrin, and involucrin, and their mRNAs. The most obvious regulatory effect was observed in the WF group, followed by the ICF, ERF, and PC groups, accordingly.Conclusions: Mahuang Lianqiao Chixiaodou decoction and its disassembled formula can improve the skin barrier function in a mouse model of AD by upregulating filaggrin, loricrin, and involucrin, and their mRNA expressions, and the most optimal effect was noted in the WF group, followed by the ICF and ERF groups, which suggests that the effect of clearing heat and resolving dampness in improving the skin barrier function of AD is more obvious and is one of the key treatments for AD.展开更多
Objective:To explore the anti-inflammatory and antioxidant effects of caraway on atopic dermatitis(AD)in mice.Methods:AD was induced in two stages,including sensitization and challenge with the application of 2,4 dini...Objective:To explore the anti-inflammatory and antioxidant effects of caraway on atopic dermatitis(AD)in mice.Methods:AD was induced in two stages,including sensitization and challenge with the application of 2,4 dinitrochlorobenzene 2% and 0.2%,respectively.Clinical symptoms and histological analysis of the skin were assessed.The effects of caraway on oxidant/antioxidant parameters as well as Th1-and Th2-related cytokines were also evaluated.Results:Caraway reduced the severity of dermatitis in AD-induced mice,as evidenced by significant inhibition of Th2-related cytokines(IL-4 and IL-13)and increased Th1-related cytokine(IFN-γ).Additionally,treatment with caraway significantly increased superoxide dismutase and catalase activity and decreased the malondialdehyde level in the serum of AD mice.Furthermore,caraway inhibited the differentiation of Th2 cells while favoring Th1 cell differentiation in the spleen via regulating their master transcription factors GATA3 and T-bet.Conclusions:Caraway could improve AD autoimmune responses and could be considered a potential candidate to treat AD disease.展开更多
Atopic dermatitis(AD)is a common skin disorder difficult to be treated with medication.This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in...Atopic dermatitis(AD)is a common skin disorder difficult to be treated with medication.This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in vivo models.We found that,in canine macrophage cell line DH82,lipopolysaccharide(LPS)upregulated the expression of genes associated with inflammation and pruritic responses through activating calcium and interleukin-31(IL-31)signaling,and the upregulation could be suppressed by ovalicin,with an effect significantly stronger than dexamethasone.Ovalicin also reduced the expression of IL-31 downstream genes,including JAK2(Janus kinase 2),TRPV1(transient receptor potential vanilloid receptor-1),and HRH2(histamine receptor H2).Ovalicin significantly alleviated the allergic symptoms in the AD mouse model.Histologically,the number of macrophages and mast cells infiltrated in the dermis was significantly reduced by ovalicin treatment.In the skin tissue of AD mice,reduction of IL-31 receptor was observed in the ovalicin treated group compared to the group without ovalicin treatment.To our knowledge,this is the first study to elucidate the anti-atopic mechanism of ovalicin,which could be an alternative to steroidal drugs commonly used for AD treatment.展开更多
Atopic dermatitis(AD)is a chronic cutaneous inflammatory disease caused by an interaction between genetic,immune and epidermal barrier factors.Several treatments can be used to treat this disease but there are patient...Atopic dermatitis(AD)is a chronic cutaneous inflammatory disease caused by an interaction between genetic,immune and epidermal barrier factors.Several treatments can be used to treat this disease but there are patients that do not respond to actual drugs.So,there is a need to develop effective therapies for AD.Mesenchymal stem cells(MSCs)are non-hematopoietic multipotent adult progenitor cells with immunomodulatory power and self-regenerating capacity to repair tissue damage,so they could be a potential effective treatment for AD.MSCs-Conditioned Medium(CM)and MSCs-exosomes are cell-free preparation with molecules secreted by stem cells that could be also beneficial for AD.This viewpoint reviews the actual development of MSCs,MSCs-CM and MSCs-exosomes for treating patients with AD.展开更多
Objective:To explore the potential mechanism of intervention on the immune imbalance of atopic dermatitis(AD) by studying the effects of Mahuang Lianqiao Chixiaodou decoction(MLCD) on skin damage and inflammation fact...Objective:To explore the potential mechanism of intervention on the immune imbalance of atopic dermatitis(AD) by studying the effects of Mahuang Lianqiao Chixiaodou decoction(MLCD) on skin damage and inflammation factors in an AD-like mouse model.Methods:Ninety-six male BALB/c mice were divided into normal,model,positive control(mometasone furoate),and traditional Chinese medicine treatment(MLCD) groups by a random number table.2,4-dinitrofluorobenzene was used to induce AD-like mice in all groups except the normal group.The treatment or intervention was administered for seven consecutive days on days 4,18,32,and 39.The mRNA relative expressions of interleukin-4(IL-4),IL-10,interferon-γ(IFN-γ),thymic stromal lymphopoietin(TSLP),and the TSLP receptor(TSLPR) were measured using quantitative real-time polymerase chain reaction,and the serum immunoglobulin E,IL-4,IL-10,and IFN-γ levels were detected using enzyme-linked immunosorbent assay.Results:Compared with the normal group,the hematoxylin-eosin staining of the skin lesions of the mice in the model group was significantly thickened on days 11,25,and 39.Compared with the model group,the epidermal thickness of the positive control group was significantly alleviated on day 39(P <.001),and that of the MLCD group was significantly improved on days 25 and 39(P <.001).Compared with the four observation time points,MLCD had the best treatment effect on day 39 of the experiment and significantly improved the skin damage performance and relieved pathological lesions.On day 39,compared with the model group,MLCD downregulated the skin mRNA relative expressions of IL-4(P=.009),TSLP(P=.030),and TSLPR(P <.001),and reduced the mouse serum levels of IL-4(P=.003).For other serum indicators,no significant difference was observed between the model and MLCD groups.Conclusion:MLCD improved AD-like mice skin damage by regulating the Th1/Th2 immune imbalance.展开更多
<span style="font-family:;" "=""><strong>Introduction</strong>:</span><span><span><span style="font-family:;" "=""> <i>...<span style="font-family:;" "=""><strong>Introduction</strong>:</span><span><span><span style="font-family:;" "=""> <i>Momordica charantia</i> (MC) has been reported to possess various beneficial effects. Improvement in natural aging of the skin has been observed with the use of MC. However, few studies have detailed the effects of MC on atopic dermatitis (AD). Therefore, in this study, we investigated the effects of MC on the skin symptoms of AD. <b>Methods:</b> Specific pathogen-free <span>and conventional NC/Nga mice were orally administered a 50 mg/kg/day</span> dose of MC every day for 2 weeks. <b>Results:</b> The expression levels of lipopolysaccharide (LPS), inducible nitric oxidase synthase (iNOS), and prostaglandin E2 (PGE2) remarkably increased in AD, but were suppressed by MC administration. As a result, the degradation of filaggrin by PGE2 was suppressed. Furthermore, in AD, iNOS induced macrophage type 1 and increased NO levels. <span>In contrast, due to suppression of iNOS with MC administration, macro</span><span>phages shifted to type 2 and an increase in L-ornithine was observed, which</span> subsequently promoted filaggrin synthesis. <b>Conclusions:</b> </span></span></span><span><span><span style="font-family:;" "="">These findings indicate that the AD-like skin symptoms were decelerated by MC via the regu<span>lation of the LPS/iNOS/PGE2/filaggrin and LPS/iNOS/Arginase 1/L-ornithine/ </span>filaggrin signaling pathways.</span></span></span>展开更多
Introduction: The presence of mould as a source of perennial allergens and bacteria products has been related to the appearance of respiratory symptoms in several studies. Yet, its role in eczema has not been elucidat...Introduction: The presence of mould as a source of perennial allergens and bacteria products has been related to the appearance of respiratory symptoms in several studies. Yet, its role in eczema has not been elucidated. The aim of this study was to investigate the association between exposure to indoor visible molds/dampness and the manifestation of eczema in children. Methods: The study is part of the Greek contribution to ISAAC IΙ that includes 2023 students of randomly selected public primary schools in Athens and Thessaloniki, aged 9 - 10 years old. The children represented a general population sample and were evaluated according to ISAAC II questionnaire, validated for Greek language. Additionally, skin prick tests to aero-allergens were performed and children were examined for active skin lesions. Results: 13% had suffered from eczema in the past, 9% had current and 2% had atopic eczema (positive at least one skin prick test). Out of the children examined, half reported that eczema first appeared after the age of five years old whereas 70% mentioned persistence of eczema. Dampness was reported in 10.8% and visible mould in 6.4% of all cases during infancy, while continued exposure until the age of 10 years old was reported in 38% and 33% out of them respectively. 10.8% of the sensitized children were positive to house dust mites and Alternaria, however, sensitization was not related to indoor exposure. In logistic regression analysis evaluating 20 environmental risk factors, a significant association was noted between the presence of indoor visible mold and dampness in infancy, and the presence of current eczema OR 1, 89 (95%CI 1.18 - 3.03). This association remained significant irrespective of the family history of eczema and sensitization. Conclusions: Frequently eczema first appears at early school age. The presence of visible mold and dampness at home during infancy appears to be an initial enhancing risk factor for the development but also for the persistence of the disease throughout school age.展开更多
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by elevated immunoglobulin E (IgE), mast cell infiltration and skin lesions including pruritus, erythema and eczema. Cudrania tricuspidata ex...Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by elevated immunoglobulin E (IgE), mast cell infiltration and skin lesions including pruritus, erythema and eczema. Cudrania tricuspidata extracts have been clinically administered for a long time in the East Asia including Korean and China as a home-remedy to diminish the inflammation of gastritis and hepatitis. To examine whether it works on AD or not, an AD-like animal model was experimented in this study. AD was induced by applying Dermatophagoides farinae (D. farinae) extract to the backs of 9-week old NC/Nga mice for 21 days. Following this, an ethanol extract of C. tricuspidata stems (EECT) was applied topically for 14 days to the sensitized skin, while distilled water was used as a control (EECT0 mice). Anti-AD effects of EECT were evaluated using scores for AD-like skin lesions, serum IgE levels and mast cell counts in the skin dermal layers to assess inflammation. Topically applied ethanol extract of Cudrania tricuspidata stems (EECT 7.5, 25 and 75 mg/mL) markedly reduced AD-like skin lesions after 4 days (by 30.1%, 31.4% and 38.5%, respectively) and also after 14 days (by 63.6%, 66.1% and 49.6%, respectively), while distilled water improved AD by 17.8% and 38.7%, respectively (p D. farinae extract (p = 0.003) and EECT attenuated the mast cell overproduction, and reduced mast cell degranulation markedly. Attenuation was most obvious in the early stage of EECT treatment when the AD was most acute.展开更多
<strong>Background:</strong> Dupilumab is the biological drug approved for the treatment of moderate to severe atopic dermatitis (AD) and has demonstrated impressive clinical effect and quality of life-enh...<strong>Background:</strong> Dupilumab is the biological drug approved for the treatment of moderate to severe atopic dermatitis (AD) and has demonstrated impressive clinical effect and quality of life-enhancing capacity in clinical trials. The most commonly observed adverse effects of dupilumab therapy included upper respiratory tract infection, headache, nasopharyngitis, injection-site reaction, herpes viral infection, and conjunctivitis. Lacrimal duct obstruction or punctal stenosis is rarely reported side effect of dupilumab therapy and not fully documented. <strong>Aim:</strong> To document a new case presentation of a young female with a history of AD without previous significant ocular manifestations who developed right eye punctal stenosis while she was on Dupilumab therapy for a one-year duration. <strong>Case Report:</strong> A 19-year-old female with a long-standing history of AD and on dupilumab therapy for one year duration who developed severe punctal stenosis and continued tearing from her right eye in the last two months not responded to conservative ophthalmological medications but completely improved on discontinuation dupilumab injection over 6 months followed-up. <strong>Conclusions:</strong> Conjunctivitis is a well-known adverse effect of Dupilumab injection of a patient with AD. However, persistent conjunctivitis and tearing from the eye not improving on ophthalmology treatment might rule out punctal stenosis and discontinuation of dupilumab should be considered.展开更多
Atopic dermatitis (AD) is a common chronic, pruritic, relapsing inflammatory skin disease that affects about two to three percent of the adult population in Sweden. It is characterized by dry, itchy skin and is aggrav...Atopic dermatitis (AD) is a common chronic, pruritic, relapsing inflammatory skin disease that affects about two to three percent of the adult population in Sweden. It is characterized by dry, itchy skin and is aggravated by stress. This study examined if relaxation through movement and body awareness can reduce stress and eczema in patients with AD. Nine pa-tients with atopic dermatitis whose condition worsened due to stress were treated with a body balance relaxation method. Estimation of extent of skin lesions, pruritus, salivary cortisol, as an objective marker for chronic stress, and subjective stress, and DLQI, were performed. Of these parameters, the extent of skin lesions, pruritus, and the subjective stress were de-creased as well as chronic stress. This study indicated that relaxation using body balance reduced stress and eczema in patients with stress-related atopic dermatitis.展开更多
Atopic dermatitis is a skin disease characterized by inflammation, pruritus, and chronic or relapsing eczematous lesions. Recently, ampholytic polysaccharide sacran has attracted a particular focus of attention as a n...Atopic dermatitis is a skin disease characterized by inflammation, pruritus, and chronic or relapsing eczematous lesions. Recently, ampholytic polysaccharide sacran has attracted a particular focus of attention as a novel biomaterial. In the present study, we investigated the effect of sacran solution on atopic dermatitis in the clinical study. Almost all of the average scores for atopic dermatitis symptoms of each patient treated with sacran solutions were improved. In addition, the scores of sleep disorder and itching were also significantly ameliorated by the sacran treatment for 4 weeks, compared with those of initial states. In immatured dermal skin model stimulated with 2,4-dinitrofluorobenzene (DNFB), the sacran treatment markedly down-regulated inflammatory cytokine and chemokine mRNA levels such as MCP-1, TNF-α, IL-1β, and IL-6 mRNAs, compared with that of DNFB alone. Furthermore, a sacran solution significantly suppressed the mRNA expression of TNF-α and COX-2 in RAW264.7 cells, a murine macrophage-like cell line, stimulated with phorbol-12-myristate-13-acetate (PMA). In RBL-2H3 cells, a rat basophilic leukemia cell line, a sacran solution significantly lowered β-hexosaminidase release, indicating the suppression of allergic response. These results suggest that a sacran solution may have the potential to improve atopic dermatitis through the impairment of production of inflammatory cytokine and chemokine mRNA.展开更多
Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease characterized by a reduced microbiome diversity which favours the skin colonization with pathogenic bacteria, mainly with Staphylococc...Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease characterized by a reduced microbiome diversity which favours the skin colonization with pathogenic bacteria, mainly with Staphylococcus aureus. A novel approach to the management of several skin diseases, including AD, involves the use of specific beneficial probiotic bacteria aimed at restoring the skin microbiome balance and decreasing the skin colonization with pathogens. Objective: This study assessed the soothing efficacy and tolerability of a new probiotic-based skin care product combining two live Lactobacillus rhamnosus strains and berry seed oils on eczematous lesions in subjects with atopic skin. Patients and Methods: Twenty-five adults with atopic skin and presenting at least one inflammatory lesion applied the product on the defined lesion for 28 days, once to twice daily. Severity of eczema signs (EASI score) and intensity of pruritus (VAS) were assessed, and digital images were captured following treatment. Cutaneous tolerability and subject satisfaction were also investigated. Results: A statistically significant decrease in mean EASI score was observed after 28 days (-27%, p = 0.011). A visible improvement in skin aspect was observed in 67% of the subjects on week 4. On average, the intensity of pruritus decreased by 57% as compared to baseline (p = 0.011). This effect was observed in 86% of the subjects. No relevant adverse reactions were observed following treatment with the skin care product and the majority of the subjects appreciated the product for its general characteristics, properties, and efficacy. Conclusion: The results suggest that this skin care product containing two live Lactobacillus rhamnosus strains and berry seed oils could be used for the treatment of eczematous lesions in subjects with atopic skin.展开更多
Atopic dermatitis(AD)is a complex disease characterized by recurrent eczematous lesions and refractory pruritus that drastically impairs quality of life.Due to the chronic and relapsing course,patients are easily trap...Atopic dermatitis(AD)is a complex disease characterized by recurrent eczematous lesions and refractory pruritus that drastically impairs quality of life.Due to the chronic and relapsing course,patients are easily trapped in the debilitating condition.Classical therapies show limitations,especially for patients with moderate-to-severe phenotypes.Advanced new insights in targeted therapies exhibit great application prospects which were reinforced by the more profound understanding of the disease pathogenesis.However,the sustained efficiency,biosafety,and long-term benefits still remain in further exploration.This review summarizes recent clinical studies on oral small-molecule inhibitors and biological agents for pediatric AD patients,which provides the latest frontiers to clinicians.展开更多
Many skin diseases,such as atopic dermatitis(AD),are featured with the dysbiosis of skin microbiota.The clinically recommended options for AD treatments suffer from poor outcomes and high side-effects,leading to sever...Many skin diseases,such as atopic dermatitis(AD),are featured with the dysbiosis of skin microbiota.The clinically recommended options for AD treatments suffer from poor outcomes and high side-effects,leading to severe quality-of-life impairment.To deal with this long-term challenge,we develop a living bacterial formu-lation(Hy@Rm)that integrates skin symbiotic bacteria of Roseomonas mucosa with poly(vinyl pyrrolidone),poly(vinyl alcohol)and sodium alginate into a skin dressing by virtue of the Ca^(2+)-mediated cross-linking and the freezing-thawing(F-T)cycle method.Hy@Rm dressing creates a favorable condition to not only serve as extrinsic culture harbors but also as nutrient suppliers to support R.mucosa survival in the harsh microenvi-ronment of AD sites to defeat S.aureus,which predominantly colonizes AD skins as an indigenous pathogen,mainly through the secretion of sphingolipids metabolites by R.mucosa like a therapeutics bio-factory.Mean-while,this elaborately designed skin dressing could accelerate wound healing,normalize aberrant skin char-acters,recover skin barrier functions,alleviate AD-associated immune/inflammation responses,functioning like a combinational therapy.This study offers a promising means for the topical bacteria transplant to realize effective microbe biotherapy toward the skin diseases feature with microbe milieu disorders,including but not limited to AD disease.展开更多
Importance:Preserving skin health is crucial for atopic dermatitis control as well as for the thriving of children.However,a well-developed and validated tool that measures the knowledge,attitude,and practice of skin ...Importance:Preserving skin health is crucial for atopic dermatitis control as well as for the thriving of children.However,a well-developed and validated tool that measures the knowledge,attitude,and practice of skin care is lacking.Objective:To develop and validate the atopic dermatitis and infant skincare knowledge,attitude,and practice(ADISKAP 1.0)scale that measures parental health literacy on atopic dermatitis and skin care.Methods:We conducted a review of the literature,a focus group(two dermatologists and 12 parents),and a panel discussion in order to generate the ADISKAP prototype.Two samples of parents with knowingly superior(dermatologists,n=59)and inferior(general population,n=395)knowledge traits participated in the validation of ADISKAP.Cronbach’s alpha was reported as a measure of internal consistency,and the intraclass correlation coefficient(ICC)was calculated to assess the test-retest validity.The known-groups technique was used to evaluate construct validity.Results:The ADISKAP scale contained 17 items after content and face validity validation.After removing items that displayed poor test-retest reliability(n=4)and construct validity(n=3),12 items were retained in the ADISKAP 1.0.Interpretation:ADISKAP 1.0 is a reliable and valid tool for assessing parental knowledge,attitude,and practice on infantile atopic dermatitis and skin care.展开更多
Atopic dermatitis(AD)is the most common inflammatory skin disease,and it is considered a complex and heterogeneous condition.Different phenotypes of AD,defined according to the patient age at onset,race,and ethnic bac...Atopic dermatitis(AD)is the most common inflammatory skin disease,and it is considered a complex and heterogeneous condition.Different phenotypes of AD,defined according to the patient age at onset,race,and ethnic background;disease duration;and other disease characteristics,have been recently described,underlying the need for a personalized treatment approach.Recent advancements in understanding AD pathogenesis resulted in a real translational revolution and led to the exponential expansion of the therapeutic pipeline.The study of biomarkers in clinical studies of emerging treatments is helping clarify the role of each cytokine and immune pathway in AD and will allow addressing the unique immune fingerprints of each AD subset.Personalized medicine will be the ultimate goal of this targeted translational research.In this review,we discuss the changes in the concepts of both the pathogenesis of and treatment approach to AD,highlight the scientific rationale behind each targeted treatment and report the most recent clinical efficacy data.展开更多
文摘AIM:To examine the incidence of ocular abnormalities in children with atopic dermatitis(AD)in Saudi Arabia and its association with the severity of AD.METHODS:This is a cross-sectional study on 50 children with AD who were between 5 and 16 years of age.The severity of AD was evaluated using the SCORing Atopic Dermatitis(SCORAD)index.All the children underwent slit lamp exams,visual acuity assessment,intraocular pressure measurement,and corneal topography.The children were considered to have an ophthalmic abnormality if one or more of the following signs were present:glaucoma,keratoconus suspicion,in addition to lid,conjunctival,corneal,lenticular,or retinal abnormalities.RESULTS:Based on the SCORAD severity index,14%of children had mild AD(7/50),38%had moderate AD(19/50),and nearly half had severe AD.More than half the children exhibited facial involvement,and half had peri-orbital signs.The mean SCORAD index was 35.75.The mean age was 10.48±3.6y,and the cohort showed a slight male predominance(54%males).Both eyes of the 50 children in the cohort were studied.Based on the ocular examinations,92%of the patients showed ocular abnormalities:lid abnormalities(27/50)followed by keratitis(22/50).Four patients had moderate risk for keratoconus in one eye and eight patients were suspected to have keratoconus.However,SCORAD severity index was not associated with age,sex,or the number or presence of ophthalmic abnormalities.CONCLUSION:This is the first study in Saudi Arabia to evaluate the prevalence of ocular manifestations in children with AD.The results indicate that the majority of children with AD have ocular abnormalities that mainly include lid abnormalities.Based on these findings,larger scale studies are needed to affirm whether regular screening for ophthalmic abnormalities would be beneficial for children with AD in terms of early intervention and prevention of sight-threatening complications.
文摘BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.
基金Supported by National Natural Science Foundation of China,No.81803160Scientific Development Program of Jilin Province,No.20200801078GH.
文摘BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.
文摘Atopic dermatitis(AD)is a chronic,relapsing,multifactorial inflammatory disease with genetic,environmental,and immunological characteristics.The quality of life and sleep of patients and their families are affected by AD,which triggers stress,described as one of the factors that worsens AD.Salivary biomarkers such as cortisol,alpha-amylase,chromogranin A,and melatonin have been associated with stress and sleep disturbances.Therefore,the evaluation of stress and sleep disorders using salivary biomarkers in AD patients is important.This review aims to describe the possible relationship between atopic dermatitis and stress,sleep disorders,and salivary biomarkers,seeking to contribute to better understanding and clinical management of AD.This descriptive study is characterized as a narrative literature review.A literature search was conducted of studies published in English and Portuguese between January 2012 and October 2022 that are available in electronic media from various databases,such as Scientific Electronic Library Online,Latin American and Caribbean Literature on Health Sciences,and PubMed.AD is associated with different degrees of impact on the lives of individuals who present with the disease.Psychological stress may induce changes in saliva composition and worsen AD;at the same time,the severity of the disease may be associated with emotional impact.Further studies are needed to assess and correlate AD severity,stress,and sleep disturbances with salivary biomarkers in order to better understand this association.
基金supported by the Natural Science Foundation of Beijing Municipality Surface Project(7192114)。
文摘Objective: To reveal the mechanism of Mahuang Lianqiao Chixiaodou decoction and its disassembled formula for improving the skin barrier function in a mouse model of atopic dermatitis(AD).Methods: Sixty specific-pathogen free male BALB/c mice were randomly divided into the control group,model group, whole formula group(WF), exterior-releasing formula group(ERF), interior-clearing formula group(ICF), and positive control group(PC). A mouse model of AD was established using the semiantigen 2,4-dinitrofluorobenzene induction method. The lesion scores, transepidermal water loss and p H, and skin histopathology of mice in each group were observed. The expressions of filaggrin, loricrin,and involucrin were detected by the streptavidin peroxidase immunohistochemical method and western blotting, and their mRNA expressions were detected by quantitative polymerase chain reaction.Results: Mice in the WF, ERF, ICF, and PC groups showed reduced skin lesion performance, improved histopathology, decreased skin lesion score, transepidermal water loss and pH, and upregulated expressions of proteins including filaggrin, loricrin, and involucrin, and their mRNAs. The most obvious regulatory effect was observed in the WF group, followed by the ICF, ERF, and PC groups, accordingly.Conclusions: Mahuang Lianqiao Chixiaodou decoction and its disassembled formula can improve the skin barrier function in a mouse model of AD by upregulating filaggrin, loricrin, and involucrin, and their mRNA expressions, and the most optimal effect was noted in the WF group, followed by the ICF and ERF groups, which suggests that the effect of clearing heat and resolving dampness in improving the skin barrier function of AD is more obvious and is one of the key treatments for AD.
文摘Objective:To explore the anti-inflammatory and antioxidant effects of caraway on atopic dermatitis(AD)in mice.Methods:AD was induced in two stages,including sensitization and challenge with the application of 2,4 dinitrochlorobenzene 2% and 0.2%,respectively.Clinical symptoms and histological analysis of the skin were assessed.The effects of caraway on oxidant/antioxidant parameters as well as Th1-and Th2-related cytokines were also evaluated.Results:Caraway reduced the severity of dermatitis in AD-induced mice,as evidenced by significant inhibition of Th2-related cytokines(IL-4 and IL-13)and increased Th1-related cytokine(IFN-γ).Additionally,treatment with caraway significantly increased superoxide dismutase and catalase activity and decreased the malondialdehyde level in the serum of AD mice.Furthermore,caraway inhibited the differentiation of Th2 cells while favoring Th1 cell differentiation in the spleen via regulating their master transcription factors GATA3 and T-bet.Conclusions:Caraway could improve AD autoimmune responses and could be considered a potential candidate to treat AD disease.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education,Science and Technology(Grant No.2020R1A2C1010215)the Brain Korea 21 Future Veterinary Medicine Leading Education and Research Center,College of Veterinary Medicine,Seoul National University.
文摘Atopic dermatitis(AD)is a common skin disorder difficult to be treated with medication.This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in vivo models.We found that,in canine macrophage cell line DH82,lipopolysaccharide(LPS)upregulated the expression of genes associated with inflammation and pruritic responses through activating calcium and interleukin-31(IL-31)signaling,and the upregulation could be suppressed by ovalicin,with an effect significantly stronger than dexamethasone.Ovalicin also reduced the expression of IL-31 downstream genes,including JAK2(Janus kinase 2),TRPV1(transient receptor potential vanilloid receptor-1),and HRH2(histamine receptor H2).Ovalicin significantly alleviated the allergic symptoms in the AD mouse model.Histologically,the number of macrophages and mast cells infiltrated in the dermis was significantly reduced by ovalicin treatment.In the skin tissue of AD mice,reduction of IL-31 receptor was observed in the ovalicin treated group compared to the group without ovalicin treatment.To our knowledge,this is the first study to elucidate the anti-atopic mechanism of ovalicin,which could be an alternative to steroidal drugs commonly used for AD treatment.
文摘Atopic dermatitis(AD)is a chronic cutaneous inflammatory disease caused by an interaction between genetic,immune and epidermal barrier factors.Several treatments can be used to treat this disease but there are patients that do not respond to actual drugs.So,there is a need to develop effective therapies for AD.Mesenchymal stem cells(MSCs)are non-hematopoietic multipotent adult progenitor cells with immunomodulatory power and self-regenerating capacity to repair tissue damage,so they could be a potential effective treatment for AD.MSCs-Conditioned Medium(CM)and MSCs-exosomes are cell-free preparation with molecules secreted by stem cells that could be also beneficial for AD.This viewpoint reviews the actual development of MSCs,MSCs-CM and MSCs-exosomes for treating patients with AD.
基金This study was supported by the Beijing Natural Science Foundation(7192114).
文摘Objective:To explore the potential mechanism of intervention on the immune imbalance of atopic dermatitis(AD) by studying the effects of Mahuang Lianqiao Chixiaodou decoction(MLCD) on skin damage and inflammation factors in an AD-like mouse model.Methods:Ninety-six male BALB/c mice were divided into normal,model,positive control(mometasone furoate),and traditional Chinese medicine treatment(MLCD) groups by a random number table.2,4-dinitrofluorobenzene was used to induce AD-like mice in all groups except the normal group.The treatment or intervention was administered for seven consecutive days on days 4,18,32,and 39.The mRNA relative expressions of interleukin-4(IL-4),IL-10,interferon-γ(IFN-γ),thymic stromal lymphopoietin(TSLP),and the TSLP receptor(TSLPR) were measured using quantitative real-time polymerase chain reaction,and the serum immunoglobulin E,IL-4,IL-10,and IFN-γ levels were detected using enzyme-linked immunosorbent assay.Results:Compared with the normal group,the hematoxylin-eosin staining of the skin lesions of the mice in the model group was significantly thickened on days 11,25,and 39.Compared with the model group,the epidermal thickness of the positive control group was significantly alleviated on day 39(P <.001),and that of the MLCD group was significantly improved on days 25 and 39(P <.001).Compared with the four observation time points,MLCD had the best treatment effect on day 39 of the experiment and significantly improved the skin damage performance and relieved pathological lesions.On day 39,compared with the model group,MLCD downregulated the skin mRNA relative expressions of IL-4(P=.009),TSLP(P=.030),and TSLPR(P <.001),and reduced the mouse serum levels of IL-4(P=.003).For other serum indicators,no significant difference was observed between the model and MLCD groups.Conclusion:MLCD improved AD-like mice skin damage by regulating the Th1/Th2 immune imbalance.
文摘<span style="font-family:;" "=""><strong>Introduction</strong>:</span><span><span><span style="font-family:;" "=""> <i>Momordica charantia</i> (MC) has been reported to possess various beneficial effects. Improvement in natural aging of the skin has been observed with the use of MC. However, few studies have detailed the effects of MC on atopic dermatitis (AD). Therefore, in this study, we investigated the effects of MC on the skin symptoms of AD. <b>Methods:</b> Specific pathogen-free <span>and conventional NC/Nga mice were orally administered a 50 mg/kg/day</span> dose of MC every day for 2 weeks. <b>Results:</b> The expression levels of lipopolysaccharide (LPS), inducible nitric oxidase synthase (iNOS), and prostaglandin E2 (PGE2) remarkably increased in AD, but were suppressed by MC administration. As a result, the degradation of filaggrin by PGE2 was suppressed. Furthermore, in AD, iNOS induced macrophage type 1 and increased NO levels. <span>In contrast, due to suppression of iNOS with MC administration, macro</span><span>phages shifted to type 2 and an increase in L-ornithine was observed, which</span> subsequently promoted filaggrin synthesis. <b>Conclusions:</b> </span></span></span><span><span><span style="font-family:;" "="">These findings indicate that the AD-like skin symptoms were decelerated by MC via the regu<span>lation of the LPS/iNOS/PGE2/filaggrin and LPS/iNOS/Arginase 1/L-ornithine/ </span>filaggrin signaling pathways.</span></span></span>
文摘Introduction: The presence of mould as a source of perennial allergens and bacteria products has been related to the appearance of respiratory symptoms in several studies. Yet, its role in eczema has not been elucidated. The aim of this study was to investigate the association between exposure to indoor visible molds/dampness and the manifestation of eczema in children. Methods: The study is part of the Greek contribution to ISAAC IΙ that includes 2023 students of randomly selected public primary schools in Athens and Thessaloniki, aged 9 - 10 years old. The children represented a general population sample and were evaluated according to ISAAC II questionnaire, validated for Greek language. Additionally, skin prick tests to aero-allergens were performed and children were examined for active skin lesions. Results: 13% had suffered from eczema in the past, 9% had current and 2% had atopic eczema (positive at least one skin prick test). Out of the children examined, half reported that eczema first appeared after the age of five years old whereas 70% mentioned persistence of eczema. Dampness was reported in 10.8% and visible mould in 6.4% of all cases during infancy, while continued exposure until the age of 10 years old was reported in 38% and 33% out of them respectively. 10.8% of the sensitized children were positive to house dust mites and Alternaria, however, sensitization was not related to indoor exposure. In logistic regression analysis evaluating 20 environmental risk factors, a significant association was noted between the presence of indoor visible mold and dampness in infancy, and the presence of current eczema OR 1, 89 (95%CI 1.18 - 3.03). This association remained significant irrespective of the family history of eczema and sensitization. Conclusions: Frequently eczema first appears at early school age. The presence of visible mold and dampness at home during infancy appears to be an initial enhancing risk factor for the development but also for the persistence of the disease throughout school age.
文摘Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by elevated immunoglobulin E (IgE), mast cell infiltration and skin lesions including pruritus, erythema and eczema. Cudrania tricuspidata extracts have been clinically administered for a long time in the East Asia including Korean and China as a home-remedy to diminish the inflammation of gastritis and hepatitis. To examine whether it works on AD or not, an AD-like animal model was experimented in this study. AD was induced by applying Dermatophagoides farinae (D. farinae) extract to the backs of 9-week old NC/Nga mice for 21 days. Following this, an ethanol extract of C. tricuspidata stems (EECT) was applied topically for 14 days to the sensitized skin, while distilled water was used as a control (EECT0 mice). Anti-AD effects of EECT were evaluated using scores for AD-like skin lesions, serum IgE levels and mast cell counts in the skin dermal layers to assess inflammation. Topically applied ethanol extract of Cudrania tricuspidata stems (EECT 7.5, 25 and 75 mg/mL) markedly reduced AD-like skin lesions after 4 days (by 30.1%, 31.4% and 38.5%, respectively) and also after 14 days (by 63.6%, 66.1% and 49.6%, respectively), while distilled water improved AD by 17.8% and 38.7%, respectively (p D. farinae extract (p = 0.003) and EECT attenuated the mast cell overproduction, and reduced mast cell degranulation markedly. Attenuation was most obvious in the early stage of EECT treatment when the AD was most acute.
文摘<strong>Background:</strong> Dupilumab is the biological drug approved for the treatment of moderate to severe atopic dermatitis (AD) and has demonstrated impressive clinical effect and quality of life-enhancing capacity in clinical trials. The most commonly observed adverse effects of dupilumab therapy included upper respiratory tract infection, headache, nasopharyngitis, injection-site reaction, herpes viral infection, and conjunctivitis. Lacrimal duct obstruction or punctal stenosis is rarely reported side effect of dupilumab therapy and not fully documented. <strong>Aim:</strong> To document a new case presentation of a young female with a history of AD without previous significant ocular manifestations who developed right eye punctal stenosis while she was on Dupilumab therapy for a one-year duration. <strong>Case Report:</strong> A 19-year-old female with a long-standing history of AD and on dupilumab therapy for one year duration who developed severe punctal stenosis and continued tearing from her right eye in the last two months not responded to conservative ophthalmological medications but completely improved on discontinuation dupilumab injection over 6 months followed-up. <strong>Conclusions:</strong> Conjunctivitis is a well-known adverse effect of Dupilumab injection of a patient with AD. However, persistent conjunctivitis and tearing from the eye not improving on ophthalmology treatment might rule out punctal stenosis and discontinuation of dupilumab should be considered.
文摘Atopic dermatitis (AD) is a common chronic, pruritic, relapsing inflammatory skin disease that affects about two to three percent of the adult population in Sweden. It is characterized by dry, itchy skin and is aggravated by stress. This study examined if relaxation through movement and body awareness can reduce stress and eczema in patients with AD. Nine pa-tients with atopic dermatitis whose condition worsened due to stress were treated with a body balance relaxation method. Estimation of extent of skin lesions, pruritus, salivary cortisol, as an objective marker for chronic stress, and subjective stress, and DLQI, were performed. Of these parameters, the extent of skin lesions, pruritus, and the subjective stress were de-creased as well as chronic stress. This study indicated that relaxation using body balance reduced stress and eczema in patients with stress-related atopic dermatitis.
文摘Atopic dermatitis is a skin disease characterized by inflammation, pruritus, and chronic or relapsing eczematous lesions. Recently, ampholytic polysaccharide sacran has attracted a particular focus of attention as a novel biomaterial. In the present study, we investigated the effect of sacran solution on atopic dermatitis in the clinical study. Almost all of the average scores for atopic dermatitis symptoms of each patient treated with sacran solutions were improved. In addition, the scores of sleep disorder and itching were also significantly ameliorated by the sacran treatment for 4 weeks, compared with those of initial states. In immatured dermal skin model stimulated with 2,4-dinitrofluorobenzene (DNFB), the sacran treatment markedly down-regulated inflammatory cytokine and chemokine mRNA levels such as MCP-1, TNF-α, IL-1β, and IL-6 mRNAs, compared with that of DNFB alone. Furthermore, a sacran solution significantly suppressed the mRNA expression of TNF-α and COX-2 in RAW264.7 cells, a murine macrophage-like cell line, stimulated with phorbol-12-myristate-13-acetate (PMA). In RBL-2H3 cells, a rat basophilic leukemia cell line, a sacran solution significantly lowered β-hexosaminidase release, indicating the suppression of allergic response. These results suggest that a sacran solution may have the potential to improve atopic dermatitis through the impairment of production of inflammatory cytokine and chemokine mRNA.
文摘Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease characterized by a reduced microbiome diversity which favours the skin colonization with pathogenic bacteria, mainly with Staphylococcus aureus. A novel approach to the management of several skin diseases, including AD, involves the use of specific beneficial probiotic bacteria aimed at restoring the skin microbiome balance and decreasing the skin colonization with pathogens. Objective: This study assessed the soothing efficacy and tolerability of a new probiotic-based skin care product combining two live Lactobacillus rhamnosus strains and berry seed oils on eczematous lesions in subjects with atopic skin. Patients and Methods: Twenty-five adults with atopic skin and presenting at least one inflammatory lesion applied the product on the defined lesion for 28 days, once to twice daily. Severity of eczema signs (EASI score) and intensity of pruritus (VAS) were assessed, and digital images were captured following treatment. Cutaneous tolerability and subject satisfaction were also investigated. Results: A statistically significant decrease in mean EASI score was observed after 28 days (-27%, p = 0.011). A visible improvement in skin aspect was observed in 67% of the subjects on week 4. On average, the intensity of pruritus decreased by 57% as compared to baseline (p = 0.011). This effect was observed in 86% of the subjects. No relevant adverse reactions were observed following treatment with the skin care product and the majority of the subjects appreciated the product for its general characteristics, properties, and efficacy. Conclusion: The results suggest that this skin care product containing two live Lactobacillus rhamnosus strains and berry seed oils could be used for the treatment of eczematous lesions in subjects with atopic skin.
文摘Atopic dermatitis(AD)is a complex disease characterized by recurrent eczematous lesions and refractory pruritus that drastically impairs quality of life.Due to the chronic and relapsing course,patients are easily trapped in the debilitating condition.Classical therapies show limitations,especially for patients with moderate-to-severe phenotypes.Advanced new insights in targeted therapies exhibit great application prospects which were reinforced by the more profound understanding of the disease pathogenesis.However,the sustained efficiency,biosafety,and long-term benefits still remain in further exploration.This review summarizes recent clinical studies on oral small-molecule inhibitors and biological agents for pediatric AD patients,which provides the latest frontiers to clinicians.
基金National Natural Science Foundation of China(52131302,51973164,22135005 and 51833007)Fundamental Research Funds for the Central Universities(2042021kf0037)+1 种基金All of the animal experiments were conducted under protocols(AUP,WP20210510)Institutional Animal Care and Use Committee(IACUC)of the Animal Experiment Center of Wuhan University(Wuhan,China).
文摘Many skin diseases,such as atopic dermatitis(AD),are featured with the dysbiosis of skin microbiota.The clinically recommended options for AD treatments suffer from poor outcomes and high side-effects,leading to severe quality-of-life impairment.To deal with this long-term challenge,we develop a living bacterial formu-lation(Hy@Rm)that integrates skin symbiotic bacteria of Roseomonas mucosa with poly(vinyl pyrrolidone),poly(vinyl alcohol)and sodium alginate into a skin dressing by virtue of the Ca^(2+)-mediated cross-linking and the freezing-thawing(F-T)cycle method.Hy@Rm dressing creates a favorable condition to not only serve as extrinsic culture harbors but also as nutrient suppliers to support R.mucosa survival in the harsh microenvi-ronment of AD sites to defeat S.aureus,which predominantly colonizes AD skins as an indigenous pathogen,mainly through the secretion of sphingolipids metabolites by R.mucosa like a therapeutics bio-factory.Mean-while,this elaborately designed skin dressing could accelerate wound healing,normalize aberrant skin char-acters,recover skin barrier functions,alleviate AD-associated immune/inflammation responses,functioning like a combinational therapy.This study offers a promising means for the topical bacteria transplant to realize effective microbe biotherapy toward the skin diseases feature with microbe milieu disorders,including but not limited to AD disease.
基金Capital’s Fund for Health Improvement and Research,Grant/Award Number:CFH2020-2-7121
文摘Importance:Preserving skin health is crucial for atopic dermatitis control as well as for the thriving of children.However,a well-developed and validated tool that measures the knowledge,attitude,and practice of skin care is lacking.Objective:To develop and validate the atopic dermatitis and infant skincare knowledge,attitude,and practice(ADISKAP 1.0)scale that measures parental health literacy on atopic dermatitis and skin care.Methods:We conducted a review of the literature,a focus group(two dermatologists and 12 parents),and a panel discussion in order to generate the ADISKAP prototype.Two samples of parents with knowingly superior(dermatologists,n=59)and inferior(general population,n=395)knowledge traits participated in the validation of ADISKAP.Cronbach’s alpha was reported as a measure of internal consistency,and the intraclass correlation coefficient(ICC)was calculated to assess the test-retest validity.The known-groups technique was used to evaluate construct validity.Results:The ADISKAP scale contained 17 items after content and face validity validation.After removing items that displayed poor test-retest reliability(n=4)and construct validity(n=3),12 items were retained in the ADISKAP 1.0.Interpretation:ADISKAP 1.0 is a reliable and valid tool for assessing parental knowledge,attitude,and practice on infantile atopic dermatitis and skin care.
文摘Atopic dermatitis(AD)is the most common inflammatory skin disease,and it is considered a complex and heterogeneous condition.Different phenotypes of AD,defined according to the patient age at onset,race,and ethnic background;disease duration;and other disease characteristics,have been recently described,underlying the need for a personalized treatment approach.Recent advancements in understanding AD pathogenesis resulted in a real translational revolution and led to the exponential expansion of the therapeutic pipeline.The study of biomarkers in clinical studies of emerging treatments is helping clarify the role of each cytokine and immune pathway in AD and will allow addressing the unique immune fingerprints of each AD subset.Personalized medicine will be the ultimate goal of this targeted translational research.In this review,we discuss the changes in the concepts of both the pathogenesis of and treatment approach to AD,highlight the scientific rationale behind each targeted treatment and report the most recent clinical efficacy data.
