Consensus on the therapeutic management of atopic dermatitis Brazilian Society of Dermatology

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art_AOKI_Consensus_on_the_therapeutic_management_of_atopic_dermatitis_2019.PDF (344.49 KB)
Citações na Scopus
24
Tipo de produção
article
Data de publicação
2019
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SOC BRASILEIRA DERMATOLOGIA
Autores
LORENZINI, Daniel
WEBER, Magda Blessmann
CESTARI, Tania
GONTIJOS, Bernardo
Citação
ANAIS BRASILEIROS DE DERMATOLOGIA, v.94, n.2, suppl.1, p.S67-S75, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BACKGROUND: Atopic dermatitis is a highly prevalent inflammatory and pruritic dermatosis with a multifactorial etiology, which includes skin barrier defects, immune dysfunction, and microbiome alterations. Atopic dermatitis is mediated by genetic, environmental, and psychological factors and requires therapeutic management that covers all the aspects of its complex pathogenesis. OBJECTIVES: The aim of this article is to present the experience, opinions, and recommendations of Brazilian dermatology experts regarding the therapeutic management of atopic dermatitis. METHODS: Eighteen experts from 10 university hospitals with experience in atopic dermatitis were appointed by the Brazilian Society of Dermatology to organize a consensus on the therapeutic management of atopic dermatitis. The 18 experts answered an online questionnaire with 14 questions related to the treatment of atopic dermatitis. Afterwards, they analyzed the recent international guidelines on atopic dermatitis of the American Academy of Dermatology, published in 2014, and of the European Academy of Dermatology and Venereology, published in 2018. Consensus was defined as approval by at least 70% of the panel. RESULTS/CONCLUSION: The experts stated that the therapeutic management of atopic dermatitis is based on skin hydration, topical anti-inflammatory agents, avoidance of triggering factors, and educational programs. Systemic therapy, based on immunosuppressive agents, is only indicated for severe refractory disease and after failure of topical therapy. Early detection and treatment of secondary bacterial and viral infections is mandatory, and hospitalization may be needed to control atopic dermatitis flares. Novel target-oriented drugs such as immunobiologicals are invaluable therapeutic agents for atopic dermatitis.
Palavras-chave
Atopic dermatitis, Interleukins, Inflammation, Keratinocytes, Skin barrier
URI
https://observatorio.fm.usp.br/handle/OPI/32465
Referências
  1. Akerstrom U, 2015, ACTA DERM-VENEREOL, V95, P587, DOI 10.2340/00015555-2051
  2. Alomar A, 2004, BRIT J DERMATOL, V151, P3, DOI 10.1111/j.1365-2133.2004.06269.x
  3. Arellano FM, 2007, J INVEST DERMATOL, V127, P808, DOI 10.1038/sj.jid.5700622
  4. Arkwright PD, 2013, J ALLER CL IMM-PRACT, V1, P142, DOI 10.1016/j.jaip.2012.09.002
  5. Barbarot S, 2018, ALLERGY, V73, P1284, DOI 10.1111/all.13401
  6. Bath-Hextall F, 2009, ALLERGY, V64, P258, DOI 10.1111/j.1398-9995.2008.01917.x
  7. Batista DIS, 2015, J EUR ACAD DERMATOL, V29, P1091, DOI 10.1111/jdv.12753
  8. Blauvelt A, 2017, LANCET, V389, P2287, DOI 10.1016/S0140-6736(17)31191-1
  9. Blume-Peytavi U, 2009, J EUR ACAD DERMATOL, V23, P751, DOI 10.1111/j.1468-3083.2009.03140.x
  10. Blume-Peytavi U, 2016, PEDIATR DERMATOL, V33, P311, DOI 10.1111/pde.12819
  11. Borok J, 2018, CLIN REV ALLERGY IMM
  12. Brasch J, 2014, ALLERGO J INT, V23, P126
  13. Breuer K, 2005, CLIN EXP ALLERGY, V35, P1088, DOI 10.1111/j.1365-2222.2005.02295.x
  14. Brunner PM, 2017, J ALLERGY CLIN IMMUN, V139, pS65, DOI 10.1016/j.jaci.2017.01.011
  15. Cuomo B, 2017, ITAL J PEDIATR, V43, DOI 10.1186/s13052-017-0410-8
  16. Czarnowicki T, 2015, J ALLERGY CLIN IMMUN, V136, P104, DOI 10.1016/j.jaci.2015.01.020
  17. Diepgen TL, 2002, PEDIAT ALLERG IMM-UK, V13, P278, DOI 10.1034/j.1399-3038.2002.01047.x
  18. Eichenfield LF, 2014, J AM ACAD DERMATOL, V71, P116, DOI 10.1016/j.jaad.2014.03.023
  19. Eichenfield LF, 2014, J AM ACAD DERMATOL, V70, P338, DOI 10.1016/j.jaad.2013.10.010
  20. Eichenfield LF, 2012, SEMIN CUTAN MED SURG, V31, pS3, DOI 10.1016/j.sder.2012.07.002
  21. Eigenmann PA, 1998, PEDIATRICS, V101, DOI 10.1542/peds.101.3.e8
  22. Elias PM, 2008, J ALLERGY CLIN IMMUN, V121, P1337, DOI 10.1016/j.jaci.2008.01.022
  23. Fogg MI, 2003, J ALLERGY CLIN IMMUN, V112, P796, DOI 10.1016/S0091-6749(03)01715-9
  24. Garritsen FM, 2014, BRIT J DERMATOL, V170, P501, DOI 10.1111/bjd.12645
  25. Garritsen FM, 2013, BRIT J DERMATOL, V168, P688, DOI 10.1111/bjd.12283
  26. Gieler U, 1992, HAUTARZT S11, V43, pS37
  27. Gittler JK, 2012, J ALLERGY CLIN IMMUN, V130, P1344, DOI 10.1016/j.jaci.2012.07.012
  28. Glatz M, 2017, IMMUNOL ALLERGY CLIN, V37, P63, DOI 10.1016/j.iac.2016.08.012
  29. Goujon C, 2018, J ALLER CL IMM-PRACT, V6, P562, DOI 10.1016/j.jaip.2017.07.007
  30. Grice EA, 2009, SCIENCE, V324, P1190, DOI 10.1126/science.1171700
  31. Herro Elise M, 2011, J Clin Aesthet Dermatol, V4, P39
  32. Hon KL, 2016, J DERMATOL TREAT, V27, P156, DOI 10.3109/09546634.2015.1067669
  33. Huang JT, 2009, PEDIATRICS, V123, pE808, DOI 10.1542/peds.2008-2217
  34. Khan N, 2013, GASTROENTEROLOGY, V145, P1007, DOI 10.1053/j.gastro.2013.07.035
  35. Kong HDH, 2012, GENOME RES, V22, P850, DOI 10.1101/gr.131029.111
  36. Koutroulis I, 2016, CLIN PEDIATR, V55, P176, DOI 10.1177/0009922815594346
  37. Kupfer J, 2010, J PSYCHOSOM RES, V68, P353, DOI 10.1016/j.jpsychores.2009.04.014
  38. Lee DE, 2018, J DERMATOL TREAT, V29, P364, DOI 10.1080/09546634.2017.1373736
  39. Leung DYM, 2013, ALLERGOL INT, V62, P151, DOI 10.2332/allergolint.13-RAI-0564
  40. Leung DYM, 2011, J ALLERGY CLIN IMMUN, V127, P965, DOI 10.1016/j.jaci.2011.02.010
  41. Lorenzini D, 2015, J EUR ACAD DERMATOL, V29, P38, DOI 10.1111/jdv.12429
  42. Luger TA, 2011, J EUR ACAD DERMATOL, V25, P251, DOI 10.1111/j.1468-3083.2010.03789.x
  43. Mancini AJ, 2012, SEMIN CUTAN MED SURG, V31, pS23, DOI 10.1016/j.sder.2012.07.003
  44. Meggitt SJ, 2006, LANCET, V367, P839, DOI 10.1016/S0140-6736(06)68340-2
  45. Mohan GC, 2015, JAMA DERMATOL, V151, P1009, DOI 10.1001/jamadermatol.2015.0250
  46. Myles IA, 2018, JCI INSIGHT, V3, DOI 10.1172/jci.insight.120608
  47. Ong PY, 2016, CLIN REV ALLERG IMMU, V51, P329, DOI 10.1007/s12016-016-8548-5
  48. Orfali RL, 2017, GIORN ITAL DERMAT V, V152, P140, DOI 10.23736/S0392-0488.16.05533-4
  49. Orfali RL, 2012, J AM ACAD DERMATOL, V66, pAB68
  50. Ozkaya E, 2005, J AM ACAD DERMATOL, V52, P579, DOI 10.1016/j.jaad.2004.11.037
  51. Paller AS, 2016, J AM ACAD DERMATOL, V75, P494, DOI 10.1016/j.jaad.2016.05.046
  52. Park HY, 2013, ANN DERMATOL, V25, P410, DOI 10.5021/ad.2013.25.4.410
  53. Peyrin-Biroulet L, 2011, GASTROENTEROLOGY, V141, P1621, DOI 10.1053/j.gastro.2011.06.050
  54. Reitamo S, 1998, J INVEST DERMATOL, V111, P396, DOI 10.1046/j.1523-1747.1998.00323.x
  55. Ring J, 2012, J EUR ACAD DERMATOL, V26, P1176, DOI 10.1111/j.1468-3083.2012.04636.x
  56. Ring J, 2012, J EUR ACAD DERMATOL, V26, P1045, DOI 10.1111/j.1468-3083.2012.04635.x
  57. Rosen T, 2013, J AM ACAD DERMATOL, V68, pS2, DOI 10.1016/j.jaad.2012.09.052
  58. Schmitt J, 2010, BRIT J DERMATOL, V162, P661, DOI 10.1111/j.1365-2133.2009.09561.x
  59. Schneider L, 2013, J ALLERGY CLIN IMMUN, V131, P295, DOI 10.1016/j.jaci.2012.12.672
  60. Shi BC, 2016, J ALLERGY CLIN IMMUN, V138, P1233, DOI 10.1016/j.jaci.2016.04.053
  61. Sidbury R, 2014, J AM ACAD DERMATOL, V71, P1218, DOI 10.1016/j.jaad.2014.08.038
  62. Sidbury R, 2014, J AM ACAD DERMATOL, V71, P327, DOI 10.1016/j.jaad.2014.03.030
  63. Simpson EL, 2016, NEW ENGL J MED, V375, P2335, DOI 10.1056/NEJMoa1610020
  64. Simpson EL, 2017, J AM ACAD DERMATOL, V77, P623, DOI 10.1016/j.jaad.2017.06.042
  65. Simpson EL, 2016, J AM ACAD DERMATOL, V75, P506, DOI 10.1016/j.jaad.2016.04.054
  66. Simpson EL, 2014, J ALLERGY CLIN IMMUN, V134, P818, DOI 10.1016/j.jaci.2014.08.005
  67. Sole D, 2006, J INVEST ALLERG CLIN, V16, P367
  68. Staab D, 2002, PEDIAT ALLERG IMM-UK, V13, P84, DOI 10.1034/j.1399-3038.2002.01005.x
  69. Stalder JF, 2017, ALLERGY, V72, P1713, DOI 10.1111/all.13189
  70. Sun D, 2017, IMMUNOL ALLERGY CLIN, V37, P75, DOI 10.1016/j.iac.2016.08.015
  71. Takaoka R, 2016, PEDIAT ALLER IMM PUL, V29, P160, DOI 10.1089/ped.2016.0702
  72. Thaci D, 2008, BRIT J DERMATOL, V159, P1348, DOI 10.1111/j.1365-2133.2008.08813.x
  73. Thaci D, 2016, LANCET, V387, P40, DOI 10.1016/S0140-6736(15)00388-8
  74. Thompson MM, 2006, DERMATOL THER, V19, P91, DOI 10.1111/j.1529-8019.2006.00062.x
  75. Van der Meer JB, 1999, BRIT J DERMATOL, V140, P1114
  76. van der Schaft J, 2015, BRIT J DERMATOL, V172, P1621, DOI 10.1111/bjd.13730
  77. Van der Schaft J, 2015, ACTA DERM-VENEREOL, V95, P963, DOI 10.2340/00015555-2125
  78. WALSH P, 1993, J AM ACAD DERMATOL, V29, P501, DOI 10.1016/S0190-9622(08)82011-7
  79. Wang DA, 2016, AM J CLIN DERMATOL, V17, P425, DOI 10.1007/s40257-016-0205-5
  80. Watson Wade, 2011, Allergy Asthma Clin Immunol, V7 Suppl 1, pS4, DOI 10.1186/1710-1492-7-S1-S4
  81. Waxweiler WT, 2011, PEDIATR DERMATOL, V28, P689, DOI 10.1111/j.1525-1470.2011.01488.x
  82. Weber MB, 2012, AN BRAS DERMATOL, V87, P697, DOI 10.1590/S0365-05962012000500004
  83. Werfel T, 2015, J ALLERGY CLIN IMMUN, V136, P96, DOI 10.1016/j.jaci.2015.04.015
  84. Wollenberg A, 2008, ALLERGY, V63, P742, DOI 10.1111/j.1398-9995.2008.01683.x
  85. Wollenberg A, 2018, J EUR ACAD DERMATOL, V32, P850, DOI 10.1111/jdv.14888
  86. Wollenberg A, 2018, J EUR ACAD DERMATOL, V32, P657, DOI 10.1111/jdv.14891
  87. Wollenberg A, 2016, J EUR ACAD DERMATOL, V30, P729, DOI 10.1111/jdv.13599
  88. Wollenberg A, 2018, J ALLER CL IMM-PRACT, V6, P1778, DOI 10.1016/j.jaip.2018.01.034

Coleções
Artigos e Materiais de Revistas Científicas - FM/MDT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/56