Non-Pharmacologic Therapies for Atopic Dermatitis.

Clinical Dermatology & Pediatrics, Northwestern University Feinberg School of Medicine, 1455 N. Milwaukee Ave, 2nd Floor, Chicago, IL, 60622, USA, .
Current Allergy and Asthma Reports (Impact Factor: 2.77). 07/2013; 13(5). DOI: 10.1007/s11882-013-0371-y
Source: PubMed


Atopic dermatitis (AD) continues to present significant therapeutic challenges, especially in severe cases. Navigating the line between risk and benefit can be difficult for more powerful medications such as immunosuppressants, but non-pharmacologic treatments are often overlooked and underutilized. Creative application of these more physical therapies can serve to minimize the pharmacologic treatments and their side effects, and possibly even create synergy between modalities, to maximize benefit to the patient.

25 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: 44 children (aged 5–15 yrs) with atopic eczema took part in a controlled trial in which they were treated with hypnotherapy or encouraged to use a biofeedback device based on galvanic skin resistance (as relaxation techniques) to control their symptoms. A 3rd group discussed the problems of having eczema without being given specific suggestions to help reduce the symptoms. Complete data were available for 31 Ss. The total amount of body surface affected by eczema was not altered in any of the groups. 20 wks after entry to the trial, Ss in the 2 relaxation groups showed a significant reduction in the severity of surface damage and lichenification compared with the control group. Girls in the hypnotherapy group showed greater improvement than the girls in other groups and showed greater improvement than the boys in the hypnotherapy group. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Contemporary Hypnosis 01/1993; 10:145-154.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Atopic eczema is most commonly diagnosed in children under the age of 5 yr. Environmental factors during pregnancy or in early life may confer risk for childhood atopic eczema. The present prospective study examined the relationship of the perinatal home environment and the risk of suspected atopic eczema among Japanese infants under the age of 1. Study subjects were 865 parent–child pairs. The term ‘suspected atopic eczema’ was used to define an outcome based on our questionnaire at 2–9 months postpartum. Adjustment was made for maternal age, gestation, family income, maternal and paternal education, maternal and paternal history of asthma, atopic eczema, and allergic rhinitis, time of delivery before the second survey, baby's older siblings, baby's sex, and baby's birth weight. A high mite allergen level from maternal bedclothes and mold in the kitchen during pregnancy were significantly associated with an increased risk of suspected atopic eczema. Frequent vacuuming practices during pregnancy and giving the infant a bath or shower at least once a day were significantly inversely related to the risk of suspected atopic eczema. Maternal smoking, maternal use of a synthetic duvet and pillow, carpet use in the living room and maternal bedroom, indoor domestic pets, no ducted heating appliance, and gas use for cooking during pregnancy and household smoking in the same room as the infant, infant's synthetic duvet, carpet use in the infant's room, or vacuuming the infant's room were not related to the risk of suspected atopic eczema. High house dust mite allergen levels and mold in the kitchen during pregnancy may increase the risk of infantile atopic eczema, whereas frequent vacuuming practices during pregnancy and giving the infant a bath or shower at least once a day may protect against infantile atopic eczema.
    Pediatric Allergy and Immunology 07/2007; 18(5):425 - 432. DOI:10.1111/j.1399-3038.2007.00545.x · 3.40 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Climate and sunlight (ultraviolet radiation) influence activity of atopic eczema. To evaluate the effect of moving from a subarctic/temperate climate to a sunny subtropical climate on children's atopic eczema. Children, 4-13 years, with severe atopic eczema were randomized to stay 4 weeks in Gran Canary (index patients = 30) and home in Norway (controls = 26), with a follow up of 3 months. SCORing of Atopic Dermatitis (SCORAD) was primary variable, and secondary were Children's Dermatology Life Quality Index (CDLQI), Staphylococcus aureus skin colonization and pharmacological skin treatment. SCORing of Atopic Dermatitis decreased from 37.2 (29.4-44.9) to 12.2 (9.0-15.4) [mean (95% confidence intervals)] after 4 weeks and 21.2 (17.2-25.1) 3 months thereafter in index patients (P < 0.0005), much less in controls.Children's Dermatology Life Quality Index in the index group improved from 8.7 to 2.2 and 4.5 after 4 weeks and 3 months (P < 0.0005), not in controls. Bacterial skin colonization with S. aureus decreased in the index group from 23/30 (77%) to 12/30 (40%; P = 0.001) and 12/30 (40%; P = 0.005) after 1 month and 3 months, and the use of local steroids decreased in index patients but not in controls. The change from a subartic/temperate to a subtropical climate for 4 weeks improved significantly skin symptoms (SCORAD) and quality of life, even for 3 months after return.
    Allergy 12/2006; 61(12):1403-10. DOI:10.1111/j.1398-9995.2006.01209.x · 6.03 Impact Factor
Show more