Journal of Clinical Medicine

Editorial

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4 pages, 174 KiB

Open AccessEditorial

Atopic Dermatitis: Sailing beyond the Sunset with a Multitude of Novel Treatments

by Stamatios Gregoriou and Jacek C. Szepietowski

J. Clin. Med. 2022, 11(12), 3475; https://doi.org/10.3390/jcm11123475 - 16 Jun 2022

Cited by 1 | Viewed by 1348

Abstract

Atopic eczema or dermatitis (AD) is a chronic pruritic inflammatory cutaneous disorder with an incidence up to 20% in children and 10% in adults depending on region and ethnicity [...] Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

Research

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10 pages, 710 KiB

Open AccessArticle

Definition of the Clinical Characteristics of Patients with Moderate and Severe Atopic Dermatitis for Whom Narrow-Band UVB (NB-UVB) and Medium-Dose UVA1 Phototherapies Are Still Valuable Treatment Options at the Age of Biologics

by Mariateresa Rossi, Caterina Damiani, Mariachiara Arisi, Cesare Tomasi, Francesco Tonon, Marina Venturini and Piergiacomo Calzavara-Pinton

J. Clin. Med. 2023, 12(9), 3303; https://doi.org/10.3390/jcm12093303 - 05 May 2023

Cited by 6 | Viewed by 1115

Abstract

Narrow-band (NB) UVB and UVA1 have been successfully used for the treatment of atopic dermatitis (AD) since the 1980s, but the clinical indications for their use “at the age of biologics” remain to be assessed. From 2013 to 2017, 145 patients underwent a [...] Read more.

Narrow-band (NB) UVB and UVA1 have been successfully used for the treatment of atopic dermatitis (AD) since the 1980s, but the clinical indications for their use “at the age of biologics” remain to be assessed. From 2013 to 2017, 145 patients underwent a first treatment cycle with phototherapy. They achieved a median final EASI score of 9.90 with UVA1 and 13.70 with NB-UVB. The rates of patients achieving an IGA score of 0/1 persistent for at least 6 months were 33% with UVA1 and 28% with NB-UVB, and the rates with an EASI90 improvement were 10.9% with UVA1 and 11.0% with NB-UVB. The cut-off baseline EASI values for a good probability to achieve a 0/1 IGA were 24.4 with UVA1 and 24.7 with NB-UVB. A 0/1 IGA persistent for at least 6 months was more likely to be achieved by patients with a history of flares interspersed with periods of mild or no disease. From 2018, we only enrolled patients with the above-mentioned characteristics. The number of treated patients was lower, but the final EASI score, the rate of patients achieving IGA 0/1 persistent for at least 6 months, and EASI90 were significantly higher. Medium-dose UVA1 and NB-UVB phototherapies remain useful for the treatment of AD patients with a baseline EASI score lower than 24.4 and 24.7, respectively, and a medical history of flares followed by prolonged periods of complete or near-complete remission. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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12 pages, 2788 KiB

Open AccessArticle

Impact of the Family and Household Environment on Pediatric Atopic Dermatitis in Japan

by Hidehisa Saeki, Yukihiro Ohya, Hisakatsu Nawata, Kazuhiko Arima, Miho Inukai, Ana B. Rossi and Gaelle Bego-Le-Bagousse

J. Clin. Med. 2023, 12(8), 2988; https://doi.org/10.3390/jcm12082988 - 20 Apr 2023

Cited by 1 | Viewed by 2018

Abstract

Pediatric atopic dermatitis (AD) can negatively impact the family quality of life (QoL). We report data from the real-world Epidemiology of Children with Atopic Dermatitis Reporting on their Experience (EPI-CARE) study in Japanese pediatric patients, focusing on disease impact on family QoL. Children [...] Read more.

Pediatric atopic dermatitis (AD) can negatively impact the family quality of life (QoL). We report data from the real-world Epidemiology of Children with Atopic Dermatitis Reporting on their Experience (EPI-CARE) study in Japanese pediatric patients, focusing on disease impact on family QoL. Children and adolescents aged 6 months to <18 years completed an online survey between September 2018–December 2019. The impact of disease severity on family QoL and its effect on parents’ time were assessed using the dermatitis family impact (DFI) questionnaire. The impact of a family history of allergic conditions, current residency, second-hand smoke exposure, and household pets on AD prevalence and severity was also assessed. Family QoL decreased as AD severity increased, particularly in families with children aged <6 years; but had the greatest impact on sleep and tiredness in families with children aged <12 years. Parents spent at least 4.6 h/week caring for children <6 years, including those with mild symptoms. Most children (>80%) had a family history of allergic conditions; AD prevalence was increased in those exposed to second-hand smoke or household pets. This study demonstrated that pediatric AD in Japanese individuals has negative impacts on family QoL and that family and household environments can influence pediatric AD prevalence. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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8 pages, 1519 KiB

Open AccessArticle

Is Dupilumab as Effective in Intrinsic Atopic Dermatitis as It Is in Extrinsic Atopic Dermatitis?

by Federica Gelato, Luca Mastorino, Ekaterina Stepkina, Giovanni Cavaliere, Simone Ribero, Pietro Quaglino and Michela Ortoncelli

J. Clin. Med. 2023, 12(6), 2189; https://doi.org/10.3390/jcm12062189 - 11 Mar 2023

Cited by 2 | Viewed by 2306

Abstract

Atopic dermatitis (AD) can be subclassified into the more frequent extrinsic type (EAD), with elevated serum IgE levels and frequent association with other atopic conditions, and the less frequent intrinsic type (IAD), with normal IgE levels and no history of atopy. This retrospective [...] Read more.

Atopic dermatitis (AD) can be subclassified into the more frequent extrinsic type (EAD), with elevated serum IgE levels and frequent association with other atopic conditions, and the less frequent intrinsic type (IAD), with normal IgE levels and no history of atopy. This retrospective study has the objective to compare the efficacy of dupilumab therapy in patients with IAD versus EAD in a real-life setting. We studied a group of 360 patients treated with dupilumab for moderate-to-severe AD of whom 49 had IAD (IgE < 200 kU/L and no history of other atopic conditions) and 311 had EAD (IgE ≥ 200 kU/L and/or history of atopy). There were no statistically significant differences in the achievement of EASI75 between IAD and EAD patients either at 16, 32, or 48 weeks (61% vs. 50%; 66% vs. 60%; and 53% vs. 65%, respectively). Similarly, there were no statistically significant differences in the achievement of EASI90 or the reduction in NRSpp, NRSsd, and DLQI at each timepoint. Additionally, mean absolute eosinophils and IgE values were significantly higher in the EAD group at all timepoints. This study confirms that dupilumab, targeting the Th2 pathway, which is known to be overexpressed in all AD phenotypes, appears to be equally effective in the two populations regardless of IgE levels. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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19 pages, 9725 KiB

Open AccessArticle

Th2 Cytokines Affect the Innate Immune Barrier without Impairing the Physical Barrier in a 3D Model of Normal Human Skin

by Elena Donetti, Federica Riva, Serena Indino, Giulia Lombardo, Franz Baruffaldi Preis, Elia Rosi and Francesca Prignano

J. Clin. Med. 2023, 12(5), 1941; https://doi.org/10.3390/jcm12051941 - 01 Mar 2023

Cited by 2 | Viewed by 1880

Abstract

(1) Background: Atopic dermatitis is one of the most common inflammatory skin diseases characterized by T helper (Th) 2 and Th22 cells producing interleukin (IL)-4/IL-13 and IL-22, respectively. The specific contribution of each cytokine to the impairment of the physical and the immune [...] Read more.

(1) Background: Atopic dermatitis is one of the most common inflammatory skin diseases characterized by T helper (Th) 2 and Th22 cells producing interleukin (IL)-4/IL-13 and IL-22, respectively. The specific contribution of each cytokine to the impairment of the physical and the immune barrier via Toll-like receptors (TLRs) is poorly addressed concerning the epidermal compartment of the skin. (2) Methods: The effect of IL-4, IL-13, IL-22, and the master cytokine IL-23 is evaluated in a 3D model of normal human skin biopsies (n = 7) at the air–liquid interface for 24 and 48 h. We investigated by immunofluorescence the expressions of (i) claudin-1, zonula occludens (ZO)-1 filaggrin, involucrin for the physical barrier and (ii) TLR2, 4, 7, 9, human beta-defensin 2 (hBD-2) for the immune barrier. (3) Results: Th2 cytokines induce spongiosis and fail in impairing tight junction composition, while IL-22 reduces and IL-23 induces claudin-1 expression. IL-4 and IL-13 affect the TLR-mediated barrier largely than IL-22 and IL-23. IL-4 early inhibits hBD-2 expression, while IL-22 and IL-23 induce its distribution. (4) Conclusions: This experimental approach looks to the pathogenesis of AD through molecular epidermal proteins rather than cytokines only and paves the way for tailored patient therapy. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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10 pages, 3819 KiB

Open AccessArticle

Comorbidity Patterns in Patients with Atopic Dermatitis Using Network Analysis in the EpiChron Study

by Manuel Almenara-Blasco, Jonás Carmona-Pírez, Tamara Gracia-Cazaña, Beatriz Poblador-Plou, Juan Blas Pérez-Gilaberte, Alba Navarro-Bielsa, Antonio Gimeno-Miguel, Alexandra Prados-Torres and Yolanda Gilaberte

J. Clin. Med. 2022, 11(21), 6413; https://doi.org/10.3390/jcm11216413 - 29 Oct 2022

Viewed by 1420

Abstract

Background: Atopic dermatitis (AD) is associated with different comorbidities. Methods: Retrospective, observational study based on clinical information from the individuals of the EpiChron Cohort Study (Aragon, Spain) with a diagnosis of AD between 1 January 2010 and 31 December 2018. We calculated the [...] Read more.

Background: Atopic dermatitis (AD) is associated with different comorbidities. Methods: Retrospective, observational study based on clinical information from the individuals of the EpiChron Cohort Study (Aragon, Spain) with a diagnosis of AD between 1 January 2010 and 31 December 2018. We calculated the tetrachoric correlations of each pair of comorbidities to analyze the weight of the association between them. We used a cut-off point for statistical significance of p-value < 0.01. Results: The prevalence of AD in the EpiChron Cohort was 3.83%. The most frequently found comorbidities were respiratory, cardio-metabolic, cardiovascular, and mental health disorders. Comorbidities were combined into 17 disease patterns (15 in men and 11 in women), with some sex and age specificities. An infectious respiratory pattern was the most consistently described pattern across all ages and sexes, followed by a cardiometabolic pattern that appeared in patients over 18 years of age. Conclusions: Our study revealed the presence of different clinically meaningful comorbidity patterns in patients with AD. Our results can help to identify which comorbidities deserve special attention in these types of patients and to better understand the physio-pathological mechanisms underlying the disease associations identified. Further studies are encouraged to validate the results obtained in different clinical settings and populations. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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9 pages, 263 KiB

Open AccessArticle

National Information Campaign Revealed Disease Characteristic and Burden in Adult Patients Suffering from Atopic Dermatitis

by Niccolò Gori, Andrea Chiricozzi, Franco Marsili, Silvia Mariel Ferrucci, Paolo Amerio, Vincenzo Battarra, Salvatore Campitiello, Antonio Castelli, Maurizio Congedo, Monica Corazza, Antonio Cristaudo, Gabriella Fabbrocini, Giampiero Girolomoni, Giovanna Malara, Giuseppe Micali, Giovanni Palazzo, Aurora Parodi, Annalisa Patrizi, Giovanni Pellacani, Paolo Pigatto, Eugenio Provenzano, Pietro Quaglino, Marco Romanelli, Mariateresa Rossi, Paola Savoia and Ketty Peris Show full author list Hide full author list

J. Clin. Med. 2022, 11(17), 5204; https://doi.org/10.3390/jcm11175204 - 02 Sep 2022

Cited by 5 | Viewed by 1838

Abstract

Atopic dermatitis (AD) is a common inflammatory skin disease often associated with a significant impairment in the quality of life of affected patients. The Italian Society of Dermatology and Venereology (SIDeMaST) planned a national information campaign, providing direct access to 27 dermatologic centers [...] Read more.

Atopic dermatitis (AD) is a common inflammatory skin disease often associated with a significant impairment in the quality of life of affected patients. The Italian Society of Dermatology and Venereology (SIDeMaST) planned a national information campaign, providing direct access to 27 dermatologic centers dedicated to the management of AD. The aim of this study aimed was to outline critical aspects related to AD in the general population. Overall, 643 adult subjects were included in this study, and in 44.2% (284/643) of cases, a diagnosis of AD was confirmed, whereas about 55% of subjects were affected by other pruritic cutaneous diseases. Higher intensity of pruritus and sleep disturbance, as well as an increased interference in sport, work, and social confidence was reported in the AD group compared to the non-AD group. In the AD subgroup, the mean duration of disease was of 15.3 years, with a mean eczema area and severity index (EASI) score of 11.2, and investigator global assessment (IGA) score of 1.9 and an itch numeric rating scale (NRS) of 6.9. Almost 32% of patients were untreated, either with topical or systemic agents, whereas 44.3% used routine topical compounds (topical corticosteroids and calcineurin inhibitors), and only 7.0% of patients were systemically treated. Only 2.8% of patients reported complete satisfaction with the treatment received for AD to date. This study reveals a profound unmet need in AD, showing a poorly managed and undertreated patient population despite a high reported burden of disease. This suggests the usefulness of information campaigns with the goal of improving patient awareness regarding AD and facilitating early diagnosis and access to dedicated healthcare institutions. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

15 pages, 3076 KiB

Open AccessArticle

Mesenchymal Stem Cells Profile in Adult Atopic Dermatitis and Effect of IL4-IL13 Inflammatory Pathway Inhibition In Vivo: Prospective Case-Control Study

by Anna Campanati, Monia Orciani, Andrea Marani, Mariangela Di Vincenzo, Simona Magi, Stamatios Gregoriou, Federico Diotallevi, Emanuela Martina, Giulia Radi and Annamaria Offidani

J. Clin. Med. 2022, 11(16), 4759; https://doi.org/10.3390/jcm11164759 - 15 Aug 2022

Cited by 4 | Viewed by 2218

Abstract

Atopic dermatitis (AD) is an inflammatory disease that typically begins in childhood and may persist into adulthood, becoming a lifelong condition. The major inflammatory mediators of AD are known to be interleukin IL4 and IL13, so Dupilumab, which is able to inhibit both [...] Read more.

Atopic dermatitis (AD) is an inflammatory disease that typically begins in childhood and may persist into adulthood, becoming a lifelong condition. The major inflammatory mediators of AD are known to be interleukin IL4 and IL13, so Dupilumab, which is able to inhibit both interleukins by blocking the shared IL4Rα subunit, has become an attractive option for treating AD. Mesenchymal stem cells (MSCs) are involved in the onset and development of AD by secreting specific interleukins. The aim of this study was to isolate MSCs from healthy controls (C-MSCs) and patients with AD before (AD-MSCs T0) and after 16 weeks of treatment with Dupilumab (AD-MSCs T16); to evaluate the expression mainly of IL4 and IL13 and of other inflammatory cytokines in C-MSCs, AD-MSCs at T0 and at T16; and to evaluate the efficacy of Dupilumab on MSCs immunobiology. C- and AD-MSCs (T0, T16) were isolated from skin specimens and characterized; the expression/secretion of IL4 and IL13 was evaluated using immuno-cytochemistry (ICC), indirect immune-fluorescence (IIF) and an ELISA test; secretion of IL2, IL4, IL5, IL6, IL10, IL12, IL13, IL17A, Interferon gamma (IFNγ), Tumor necrosis factor alpha (TNFα), Granulocyte Colony-Stimulating Factor (G-CSF), and Transforming Growth Factor beta1 (TGFβ1) were measured with ELISA. IL13 and IL6 were over-expressed, while IL4 was down-regulated in AD-MSCs at T0 compared to C-MSCs. IL6 and IL13 expression was restored after 16 weeks of Dupilumab treatment, while no significant effects on IL4 expression were noted. Finally, IL2, IL5, IL10, IL12, IL17A, INFγ, TNFα, G-CSF, and TGFβ1 were similarly secreted by C- and AD-MSCs. Although Dupilumab blocks the IL4Rα subunit shared by IL4 and IL13, it is evident that its real target is IL13, and its ability to target IL13 in MSCs reinforces the evidence, already known in differentiated cells, of the central role IL13 rather than IL4 in the development of AD. The inflammatory cascade in AD begins at the mesenchymal level, so an upstream therapeutic intervention, able to modify the immunobiology of atopic MSCs, could potentially change the natural history of the disease. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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11 pages, 3544 KiB

Open AccessArticle

Dupilumab Improves Skin Barrier Function in Adults with Atopic Dermatitis: A Prospective Observational Study

by Trinidad Montero-Vilchez, Juan-Angel Rodriguez-Pozo, Pablo Diaz-Calvillo, Maria Salazar-Nievas, Jesús Tercedor-Sanchez, Alejandro Molina-Leyva and Salvador Arias-Santiago

J. Clin. Med. 2022, 11(12), 3341; https://doi.org/10.3390/jcm11123341 - 10 Jun 2022

Cited by 10 | Viewed by 2926

Abstract

Epidermal barrier dysfunction plays an important role in atopic dermatitis (AD). The difficulty of objectively assessing AD severity and the introduction of new biologicals into clinical practice highlight the need to find parameters to monitor clinical outcomes. The aim of this study is [...] Read more.

Epidermal barrier dysfunction plays an important role in atopic dermatitis (AD). The difficulty of objectively assessing AD severity and the introduction of new biologicals into clinical practice highlight the need to find parameters to monitor clinical outcomes. The aim of this study is to evaluate the impact of dupilumab on skin barrier function and compare it with other treatments in patients with AD. A prospective observational study was conducted in adults with AD treated with topical corticosteroids (TCS), cyclosporine, or dupilumab. The main outcome measures after 16 weeks of treatment were Eczema Area and Severity (EASI)-50 (50% improvement in EASI), and transepidermal water loss (TEWL)-50 (50% improvement in TEWL). Forty-six patients with AD were included in the study. The proportion of patients who achieved EASI-50 at week 16 was significantly higher in patients receiving dupilumab (81.8% vs. 28.6% vs. 40%, p = 0.004). In eczematous lesions, TEWL decreased in patients receiving dupilumab (31.02 vs. 12.10 g·h⁻¹·m⁻², p < 0.001) and TCS (25.30 vs. 14.88 g·h⁻¹·m⁻², p = 0.047). The proportion of patients who achieved TEWL-50 at week 16 was higher for dupilumab than for cyclosporine or TCS. Temperature only decreased in the dupilumab group. Stratum corneum hydration increased in eczematous lesions and non-involved skin only in patients with dupilumab. In conclusion, dupilumab improves skin barrier function in patients with AD better than TCS or cyclosporine, both in eczematous lesions and in non-lesioned skin. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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Review

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16 pages, 716 KiB

Open AccessReview

The Imprint of Exposome on the Development of Atopic Dermatitis across the Lifespan: A Narrative Review

by Katerina Grafanaki, Angelina Bania, Eleni G. Kaliatsi, Eleftheria Vryzaki, Yiannis Vasilopoulos and Sophia Georgiou

J. Clin. Med. 2023, 12(6), 2180; https://doi.org/10.3390/jcm12062180 - 11 Mar 2023

Cited by 9 | Viewed by 2881

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects more than 200 million people worldwide, including up to 20% of children and 10% of the adult population. Although AD appears frequently in childhood and often continues into adulthood, about 1 in [...] Read more.

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects more than 200 million people worldwide, including up to 20% of children and 10% of the adult population. Although AD appears frequently in childhood and often continues into adulthood, about 1 in 4 adults develop the adult-onset disease. The prenatal period, early childhood, and adolescence are considered critical timepoints for the development of AD when the exposome results in long-lasting effects on the immune system. The exposome can be defined as the measure of all the exposures of an individual during their lifetime and how these exposures relate to well-being. While genetic factors could partially explain AD onset, multiple external environmental exposures (external exposome) in early life are implicated and are equally important for understanding AD manifestation. In this review, we describe the conceptual framework of the exposome and its relevance to AD from conception and across the lifespan. Through a spatiotemporal lens that focuses on the multi-level phenotyping of the environment, we highlight a framework that embraces the dynamic complex nature of exposome and recognizes the influence of additive and interactive environmental exposures. Moreover, we highlight the need to understand the developmental origins of AD from an age-related perspective when studying the effects of the exposome on AD, shifting the research paradigm away from the per se categorized exposome factors and beyond clinical contexts to explore the trajectory of age-related exposome risks and hence future preventive interventions. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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20 pages, 342 KiB

Open AccessReview

New and Upcoming Topical Treatments for Atopic Dermatitis: A Review of the Literature

by Nikolaos Sideris, Eleni Paschou, Katerina Bakirtzi, Dimitra Kiritsi, Ilias Papadimitriou, Aikaterini Tsentemeidou, Elena Sotiriou and Efstratios Vakirlis

J. Clin. Med. 2022, 11(17), 4974; https://doi.org/10.3390/jcm11174974 - 24 Aug 2022

Cited by 17 | Viewed by 4084

Abstract

Atopic dermatitis (AD) is a chronic inflammatory dermatosis with periods of exacerbation and remissions. AD is characterized by intense, persistent pruritus and heterogeneity in clinical symptomatology and severity. Therapeutic goals include the amelioration of cutaneous eruptions, diminishing relapses and eventually the disease burden. [...] Read more.

Atopic dermatitis (AD) is a chronic inflammatory dermatosis with periods of exacerbation and remissions. AD is characterized by intense, persistent pruritus and heterogeneity in clinical symptomatology and severity. Therapeutic goals include the amelioration of cutaneous eruptions, diminishing relapses and eventually the disease burden. To date, topical corticosteroids (TCS) and calcineurin inhibitors (TCI) have yet been deemed the mainstay of topical treatments in AD management. Nevertheless, despite their indisputable efficiency, TCS and TCI are not indicated for continuous long-term use given their safety profile. While research in AD has concentrated predominantly on systemic therapies, more than 30 novel topical compounds are under development. The existing data appear encouraging, with some regimens that are already FDA-approved (ruxolitinib was the most recent in September 2021) and several pharmaceutical pipeline products for mild-to-moderate AD that are in an advanced stage of development, such as tapinarof, difamilast and roflumilast. Larger, long-term studies are still required to evaluate the efficacy and safety of these novel compounds in the long run and weigh their advantages over present treatments. In this review, we aim to provide an overview of the latest knowledge about AD topical treatments, echoing upcoming research trends. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

11 pages, 298 KiB

Open AccessReview

Use of Dexpanthenol for Atopic Dermatitis—Benefits and Recommendations Based on Current Evidence

by Yoon Sun Cho, Hye One Kim, Seung Man Woo and Dong Hun Lee

J. Clin. Med. 2022, 11(14), 3943; https://doi.org/10.3390/jcm11143943 - 06 Jul 2022

Cited by 5 | Viewed by 3697

Abstract

Background: Atopic dermatitis (AD) is an inflammatory skin disease of multiple phenotypes and endotypes, and is highly prevalent in children. Many people of all ages, including active adolescents, pregnant women, and the elderly, suffer from AD, experiencing chronicity, flares, and unexpected relapse. Dexpanthenol [...] Read more.

Background: Atopic dermatitis (AD) is an inflammatory skin disease of multiple phenotypes and endotypes, and is highly prevalent in children. Many people of all ages, including active adolescents, pregnant women, and the elderly, suffer from AD, experiencing chronicity, flares, and unexpected relapse. Dexpanthenol has multiple pharmacological effects and has been employed to treat various skin disorders such as AD. We aimed to summarize the up-to-date evidence relating to dexpanthenol and to provide a consensus on how to use dexpanthenol effectively for the treatment of AD. Methods: The evidence to date on the application and efficacy of dexpanthenol in AD was reviewed. The literature search focused on dexpanthenol use and the improvement of skin barrier function, the prevention of acute flares, and its topical corticosteroid (TCS) sparing effects. Evidence and recommendations for special groups such as pregnant women, and the effects of dexpanthenol and emollient plus in maintenance therapy, were also summarized. Results: Dexpanthenol is effective and well-tolerated for the treatment of AD. Dexpanthenol improves skin barrier function, reduces acute and frequent flares, has a significant TCS sparing effect, and enhances wound healing for skin lesions. Conclusion: This review article provides helpful advice for clinicians and patients on the proper maintenance treatment of AD. Dexpanthenol, as an active ingredient in ointments or emollients, is suitable for the treatment and maintenance of AD. This paper will guide dermatologists and clinicians to consider dexpanthenol as a treatment option for mild to moderate AD. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

Other

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9 pages, 1423 KiB

Open AccessCase Report

Treatment of Severe Atopic Dermatitis with Dupilumab in Patients with Advanced Cancer

by Milena Tanczosova, Jan Hugo and Spyridon Gkalpakiotis

J. Clin. Med. 2023, 12(3), 1191; https://doi.org/10.3390/jcm12031191 - 02 Feb 2023

Cited by 2 | Viewed by 2671

Abstract

Atopic dermatitis is a chronic inflammatory intensively pruritic skin disease. Patients with moderate-to-severe atopic dermatitis or with difficult-to-treat areas are candidates for systemic therapy, especially when topical therapy is inadequate. Currently, we have available not only conventional immunosuppressive systemic therapy, but also targeted [...] Read more.

Atopic dermatitis is a chronic inflammatory intensively pruritic skin disease. Patients with moderate-to-severe atopic dermatitis or with difficult-to-treat areas are candidates for systemic therapy, especially when topical therapy is inadequate. Currently, we have available not only conventional immunosuppressive systemic therapy, but also targeted biological therapy, which has shown a remarkable reduction in clinical severity with a good safety profile. Dupilumab has been approved to treat moderate-to-severe atopic dermatitis. Even though the therapy has been available for more than 3 years, there are still limited data regarding the treatment of patients with concomitant cancer. Previous immunosuppressive treatment for atopic dermatitis, such as cyclosporine or azathioprine, poses a safety risk for patients with malignant disease. We present a case series of three patients with advanced cancer and severe atopic dermatitis treated with dupilumab for an average of 17 months with a great response toward atopic dermatitis without cancer recurrence. One patient had colorectal cancer’ the second and the third both had cancer duplicity—colorectal and kidney cancer and penile squamous cell carcinoma with prostate cancer. Our cases suggest that dupilumab can safely control atopic dermatitis in patients with advanced cancer. Full article

(This article belongs to the Special Issue Atopic Dermatitis: Research and Clinical Updates and Perspectives)

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