2022+意大利共识:湿疹的局部非药物治疗.pdf
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1、402 ItalIan Journal of Dermatology anD Venereology october 2022 GU I D ELI N EStopical non-pharmacological treatment of eczema:an Italian consensusfabrizio guarnerI 1*,anna BellonI fortIna 2,monica CoraZZa 3,antonio CrIStauDo 4,Caterina fotI 5,aurora ParoDI 6,Paolo PIgatto 7,luca StIngenI 8,ornella
2、De PIt 91unit of Dermatology,Department of Clinical and experimental medicine,university of messina,messina,Italy;2unit of Dermatology,Department of medicine DImeD,university of Padua,Padua,Italy;3Section of Dermatology and Infectious Diseases,Department of medical Sciences,university of ferrara,fer
3、rara,Italy;4San gallicano Dermatological Institute IrCCS,roma,Italy;5Department of Biomedical Sciences and Human oncology,aldo moro university of Bari,Bari,Italy;6Section of Dermatology,Department of Health Sciences,university of genoa,genoa,Italy;7unit of Dermatology,Department of Surgical and odon
4、toiatric Biomedical Sciences,galeazzi IrCCS orthopedic Institute,milan,Italy;8Section of Dermatology,Department of medicine and Surgery,university of Perugia,Perugia,Italy;9Unit of Clinical Pathology,Inflammatory and Autoimmune Skin Diseases,Cristo Re Hospital,Rome,Italy*Corresponding author:fabrizi
5、o guarneri,unit of Dermatology,Department of Clinical and experimental medicine,university of messina,viale annun-ziata residence dei fiori villa 7,98168 messina,Italy.e-mail:f.guarneritiscali.ita BStraCtEczematous diseases(contact dermatitis,atopic dermatitis,hand eczema)are among the most frequent
6、 findings in dermatological clinical practice.A large body of evidence exists on structural and functional skin barrier damage in eczematous diseases,and on the importance of interventions aimed to repair such damage.While there is substantial agreement on pharmacological treatment,more sparse data
7、are available on role,indications and usefulness of topical non-pharmacological treatments,despite significant research and progress in the composition and technology of emollients,cleansers and barrier creams significantly changed and expanded the functional activities of these products.This often
8、leads to inadequate prescription and/or use,which increase individual and social costs of the disease and make the products useless or,in some cases,even counterproductive.this consensus document,discussed and compiled in a series of meetings by a group of Italian dermatologists experienced in the f
9、ield of eczematous diseases,summarizes epidemiology and clinical features of the nosological entities of the“eczema fam-ily”,illustrates the chemical/biochemical structure of emollients,cleansers and barrier creams,and aims to help physicians to exploit the full potential of available products,by pr
10、oviding a detailed but practical guide on characteristics,indications and correct use of non-pharmacological treatments currently available for eczematous diseases.(Cite this article as:guarneri f,Belloni fortina a,Corazza m,Cristaudo a,foti C,Parodi a,et al.topical non-pharmacological treatment of
11、eczema:an Italian consensus.Ital J Dermatol Venereol 2022;157:402-13.DoI:10.23736/S2784-8671.22.07283-8)Key words:eczema;Dermatitis,irritant;Dermatitis,allergic contact;Dermatitis,atopic;Hand;emollients.Italian Journal of Dermatology and Venereology 2022 october;157(5):402-13DoI:10.23736/S2784-8671.
12、22.07283-8 2022 eDIZIonI mInerVa meDICaonline version at https:/www.minervamedica.itthe“eczema family”includes some very common,non-infectious inflammatory diseases,namely contact dermatitis(CD),atopic dermatitis(aD)and hand eczema(He).the acute phase of these diseases is mainly charac-terized by er
13、ythema,edema,vesicles,exudation and crusts,while chronic lesions show reactive epidermal changes such as lichenification and desquamation.1-5 alterations of the skin barrier function,acquired and/or constitutional,are always present.2multiple mechanisms may concur in the pathogenesis of eczema,and t
14、herefore mixed clinical pictures,with characteristics of different eczematous diseases,are fre-quent in real life conditions.5 Particularly when chronic and/or localized to sensitive areas,these diseases have high individual and social costs,direct and indirect,may significantly impair the quality o
15、f life and,when hands are involved,negatively affect the ability to work and/or per-form daily activities.4,6,7avoidance of irritants and/or contact allergens is obvi-ously the best option to obtain complete and durable reso-lution of eczema in the case of CD and is helpful also in the case of aD,bu
16、t it is often neither easy nor immediate COPYRIGHT 2022 EDIZIONI MINERVA MEDICAThis document is protected by international copyright laws.No additional reproduction is authorized.It is permitted for personal use to download and save only one file and print only one copy of this Article.It is not per
17、mitted to make additional copies(either sporadically or systematically,either printed or electronic)of the Article for any purpose.It is not permitted to distribute the electronic copy of the article through online internet and/or intranet file sharing systems,electronic mailing or any other means w
18、hich may allow access to the Article.The use of all or any part of the Article for any Commercial Use is not permitted.The creation of derivative works from the Article is not permitted.The production of reprints for personal or commercial use is not permitted.It is not permitted to remove,cover,ove
19、rlay,obscure,block,or change any copyright notices or terms of use which the Publisher may post on the Article.It is not permitted to frame or use framing techniques to enclose any trademark,logo,or other proprietary information of the Publisher.non-PHarmaCologICal treatment of eCZema guarnerIVol.15
20、7-no.5 ItalIan Journal of Dermatology anD Venereology 403general population was affected;the prevalence was high-er in adults than in children(21.4%vs.16.5%),in women than in men(27.9%vs.13.2%),and in girls than in boys(19.0%vs.12.4%).14the trend of increasing prevalence from childhood to adulthood
21、is consistent with the increase of cumulative allergenic stimulation and reactivity of the immune sys-tem.5 Similarly to allergies and autoimmune diseases,15-17 aCD is more frequent among females.no geographic dif-ferences were found between europe and america,while no studies were conducted in afri
22、ca.14 for which concerns asia,epidemiological studies were carried out only in China,and showed a prevalence similar to the european one.14,18,19 Interestingly,data are not consistent with the global Burden of Diseases data on atopic dermatitis,20-22 a pathological condition in which the skin barrie
23、r is im-paired and the immune system may over-react to environ-mental allergens.a new element in the epidemiology of CD has arisen during the CoVID-19 pandemics.In this period,the pro-longed and large-scale use of masks and gloves has caused a significant increase of ACD and ICD,because of skin barr
24、ier alterations and allergic sensitization caused by the components of such personal protective equipment.23-28moreover,use of hand sanitizers(alcohol-or not alco-hol-based)and frequent handwashing,recommended for the prevention of CoVID-19,have dramatically increased hand ICD.No extensive estimates
25、 of the modification of the frequency of ICD in the general population are current-ly available,but dermatological societies produced alerts and position papers suggesting to limit hand exposure.29Atopic dermatitisepidemiological data are widely variable between studies,depending not only on the pop
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- 关 键 词:
- 意大利 共识 共鸣 湿疹 局部 药物 治疗 医治
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