Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report

University of Zagreb, Zagrabia, Grad Zagreb, Croatia
Journal of Allergy and Clinical Immunology (Impact Factor: 11.48). 08/2006; 118(1):152-69. DOI: 10.1016/j.jaci.2006.03.045
Source: PubMed


There are remarkable differences in the diagnostic and therapeutic management of atopic dermatitis practiced by dermatologists and pediatricians in different countries. Therefore, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology nominated expert teams who were given the task of finding a consensus to serve as a guideline for clinical practice in Europe as well as in North America. The consensus report is part of the PRACTALL initiative, which is endorsed by both academies.

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    • "c o m / l o c a t e / i n t i m p cells [4]. When the patient encounters the same hapten again, the hapten diffuses through the skin and is taken up by LCs or dermal DCs, which in turn present the hapten to specific T cells [13]. These specific T cells are then activated and induce cytokine production that further activates the inflammatory response to elicit the typical clinical symptoms of ACD; redness, papules and vesicles. "
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    ABSTRACT: Allergic contact dermatitis (ACD) is a hapten-specific CD4(+) T-cells mediated inflammatory response of the skin. Its pathomechanism involves 2 phases, an induction phase and an elicitation phase. Langerhans cells (LCs) and dendritic cells (DCs) in the skin play key roles in presenting low molecular weight chemicals (haptens) to the lymph nodes. Therefore, inhibition of the migration of LCs or DCs and T-cell proliferation is each expected to control ACD disease. To explore the effectiveness of paeoniflorin (PF) on the migration of LCs and T-cell proliferation in vivo, we establish a murine model of ACD, promoted by repeated exposure to an allergen (specifically 1-Chloro-2,4-dinitrobenzene (DNCB)). Administration of PF inhibits DC migration in this DNCB-induced model in the induction phase. As a result, epidermal LC density in the elicitation phase increased in PF-treated mice when compared to PF-untreated mice. At the same time, PF reduced IFN-γ(+)CD4(+) and IL-17(+)CD4(+) T cells proliferation (but not IL-4(+)CD4(+) T cells proliferation), leading to an attenuated cutaneous inflammatory response. Consistent with this T-cell proliferation profile, secretions of IFN-γ and IL-17 were reduced and IL-10 secretion increased in PF-treated mice, but production of IL-4 and IL-5 remained unchanged in the skin and blood samples. These results suggest that oral administration of PF can treat and prevent ACD effectively through inhibition of DC migration, and thus decrease the capacity of DCs to stimulate Th1 and Th17 cell differentiation and cytokine production. Copyright © 2015. Published by Elsevier B.V.
    Full-text · Article · Mar 2015 · International Immunopharmacology
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    • "resulting in a skin barrier that is insufficient at protecting against environmental irritants and allergens [8]. Typically, such conditions are treated with humectants and occlusive agents that smooth the rough surface of the Stratum Corneum (SC) and normalize its moisture levels [1] [8]. However, moisturising agents only aim to reduce trigger factors and maintain skin hydration, and the need to apply them several times a day can be a tedious task. "
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    ABSTRACT: Eczema, is a common skin inflammatory disorder particularly among children. The treatment of which usually consists of the application of emollients and moisturisers to maintain skin moisture and to reduce the risk of inflammation, infection and exacerbative factors. Recently, DreamSkin® Health Limited has developed a unique polymer treatment for eczema. The polymer has been applied to medical grade silk clothing as a means of delivering the therapeutic benefits to the sufferers' skin. They claim that the polymer reduces the loss of moisture caused by evaporation from damaged skin; acts as a barrier against external irritants and helps to restore the skin's natural temperature management process. The aim of this study was to assess the products effectiveness at providing symptomatic relief for a volunteer with confirmed Eczema and Atopic Dermatitis over a period of 14 days. Both skin capacitance and NIR spectra were collected during the course of the study, using the Corneometer® CM 825 and a spectrophotometer equipped with a customized reflectance probe for measurements in the Near Infrared region. The treated area showed visibly improved skin and overall results from both techniques showed a noticeable increase in skin water content after 14 days, peaking on the 7(th) day. However, slight differences were observed in the 7 magnitude of increase between the two instruments. Future work will focus on expanding this study to include more cases as well as performing statistical analysis to build upon our previous work in the area of skin hydration determinations using Near Infrared Spectroscopy.
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    • "Houttuynia cordata Thunb has long been used in traditional oriental medicine for the treatment of inflammatory diseases. Also, several studies demonstrated that Houttuynia cordata Thunb has been associated with a broad range of pharmacological activities, including antiinflammatory [1], antiviral [11], and anticancer effects [12]. "
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    ABSTRACT: CP001 is four traditional herbal medicine mixtures with anti-inflammatory properties. In this study, we investigated the effect of oral administration of CP001 ethanol extract on the 2,4-dinitrochlorobenzene- (DNCB-) induced AD mouse models. For that purpose, we observed the effects of oral administration of CP001 on skin inflammatory cell infiltration, skin mast cells, production of serum IgE, and expression of Th2 cytokine mRNA in the AD skin lesions of DNCB treated BALB/c mice. Histological analyses demonstrated that CP001 decreased dermis and epidermis thickening as well as dermal infiltration induced by inflammatory cells. In addition, CP001 decreased mast cell infiltration in count as well as dermal infiltration induced by inflammatory cells. In the skin lesions, mRNA expression of interleukin- (IL-) 4 and IL-13 was inhibited by CP001. CP001 also reduced the production of IgE level in mouse plasma. In addition, we investigated the effect of CP001 on the inflammatory allergic reaction using human mast cells (HMC-1). In HMC-1, cytokine production and mRNA levels of IL-4, IL-13, IL-6, and IL-8 were suppressed by CP001. Taken together, our results showed that oral administration of CP001 exerts beneficial effects in AD symptoms, suggesting that CP001 might be a useful candidate for the treatment of AD.
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