Atopic dermatitis secondary prevention: Difference between revisions
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* Epidermal barrier | * Epidermal barrier | ||
** Positive association between damage of the epidermis and severity of atopic dermatitis.<ref name="pmid19494826">{{cite journal |vauthors=Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, Guy RH, Macgowan AL, Tazi-Ahnini R, Ward SJ |title=Epidermal barrier dysfunction in atopic dermatitis |journal=J. Invest. Dermatol. |volume=129 |issue=8 |pages=1892–908 |date=August 2009 |pmid=19494826 |doi=10.1038/jid.2009.133 |url=}}</ref> | ** Positive association between damage of the epidermis and severity of atopic dermatitis.<ref name="pmid19494826">{{cite journal |vauthors=Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, Guy RH, Macgowan AL, Tazi-Ahnini R, Ward SJ |title=Epidermal barrier dysfunction in atopic dermatitis |journal=J. Invest. Dermatol. |volume=129 |issue=8 |pages=1892–908 |date=August 2009 |pmid=19494826 |doi=10.1038/jid.2009.133 |url=}}</ref> | ||
** Increased skin permeability and skin pH due to defective barrier function can lead to colonization by ''Staphylococcus aureus.'' Restoration of skin barrier function is an important factor for protection from colonization by this pathogen.<ref name="pmid21068735">{{cite journal |vauthors=Cho JS, Xuan C, Miller LS |title=Lucky number seven: RNase 7 can prevent Staphylococcus aureus skin colonization |journal=J. Invest. Dermatol. |volume=130 |issue=12 |pages=2703–6 |date=December 2010 |pmid=21068735 |doi=10.1038/jid.2010.294 |url=}}</ref> | ** Increased skin permeability and skin pH due to defective barrier function can lead to colonization by ''[[Staphylococcus aureus]].'' Restoration of skin barrier function is an important factor for protection from colonization by this pathogen.<ref name="pmid21068735">{{cite journal |vauthors=Cho JS, Xuan C, Miller LS |title=Lucky number seven: RNase 7 can prevent Staphylococcus aureus skin colonization |journal=J. Invest. Dermatol. |volume=130 |issue=12 |pages=2703–6 |date=December 2010 |pmid=21068735 |doi=10.1038/jid.2010.294 |url=}}</ref> | ||
** Itching cause scratching which leads to dysfunction of the epidermal skin barrier. | ** Itching cause scratching which leads to dysfunction of the epidermal skin barrier. | ||
*** Risk factors which aggravate itching include sweating, dry skin, emotional stress, hot water, and certain foods. | *** Risk factors which aggravate itching include sweating, dry skin, emotional stress, hot water, and certain foods. | ||
** Stress can result into increased levels of glucocorticosteroids in blood, which further leads to dysfunction of skin barrier by affecting the integrity and adhesion of the stratum corneum.<ref name="pmid18606083">{{cite journal |vauthors=Arndt J, Smith N, Tausk F |title=Stress and atopic dermatitis |journal=Curr Allergy Asthma Rep |volume=8 |issue=4 |pages=312–7 |date=July 2008 |pmid=18606083 |doi= |url=}}</ref> | ** Stress can result into increased levels of [[Cortisol|glucocorticosteroids]] in blood, which further leads to dysfunction of skin barrier by affecting the integrity and adhesion of the [[stratum corneum]].<ref name="pmid18606083">{{cite journal |vauthors=Arndt J, Smith N, Tausk F |title=Stress and atopic dermatitis |journal=Curr Allergy Asthma Rep |volume=8 |issue=4 |pages=312–7 |date=July 2008 |pmid=18606083 |doi= |url=}}</ref> | ||
** To protect and restore the epidermal skin barrier function<ref name="pmid26755903">{{cite journal |vauthors=Oszukowska M, Michalak I, Gutfreund K, Bienias W, Matych M, Szewczyk A, Kaszuba A |title=Role of primary and secondary prevention in atopic dermatitis |journal=Postepy Dermatol Alergol |volume=32 |issue=6 |pages=409–20 |date=December 2015 |pmid=26755903 |pmc=4697018 |doi=10.5114/pdia.2014.44017 |url=}}</ref> | ** To protect and restore the epidermal skin barrier function<ref name="pmid26755903">{{cite journal |vauthors=Oszukowska M, Michalak I, Gutfreund K, Bienias W, Matych M, Szewczyk A, Kaszuba A |title=Role of primary and secondary prevention in atopic dermatitis |journal=Postepy Dermatol Alergol |volume=32 |issue=6 |pages=409–20 |date=December 2015 |pmid=26755903 |pmc=4697018 |doi=10.5114/pdia.2014.44017 |url=}}</ref> | ||
*** Patients should abstain from using soap, cosmetics, dyes, fragrances and detergents | *** Patients should abstain from using soap, cosmetics, dyes, fragrances and detergents | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shalinder Singh, M.B.B.S.[2]
Overview
Primary prevention applies to the patients with diagnosed atopic dermatits. Its main goal is to reducing the severity of presentation of skin lesions as well as the use of medical therapy.
=Secondary Prevention
- Epidermal barrier
- Positive association between damage of the epidermis and severity of atopic dermatitis.[1]
- Increased skin permeability and skin pH due to defective barrier function can lead to colonization by Staphylococcus aureus. Restoration of skin barrier function is an important factor for protection from colonization by this pathogen.[2]
- Itching cause scratching which leads to dysfunction of the epidermal skin barrier.
- Risk factors which aggravate itching include sweating, dry skin, emotional stress, hot water, and certain foods.
- Stress can result into increased levels of glucocorticosteroids in blood, which further leads to dysfunction of skin barrier by affecting the integrity and adhesion of the stratum corneum.[3]
- To protect and restore the epidermal skin barrier function[4]
- Patients should abstain from using soap, cosmetics, dyes, fragrances and detergents
- Wash new clothes before wearing them.
- Keep air temperature around 18–22°C.
- Avoid frequent and sudden climate changes.
- Use air humidifiers in winters
- Avoid excessive exposure to UV radiations and use SPF sunscreens.
- Application of emollients every 6 h
- Stress-reducing therapy
References
- ↑ Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, Guy RH, Macgowan AL, Tazi-Ahnini R, Ward SJ (August 2009). "Epidermal barrier dysfunction in atopic dermatitis". J. Invest. Dermatol. 129 (8): 1892–908. doi:10.1038/jid.2009.133. PMID 19494826.
- ↑ Cho JS, Xuan C, Miller LS (December 2010). "Lucky number seven: RNase 7 can prevent Staphylococcus aureus skin colonization". J. Invest. Dermatol. 130 (12): 2703–6. doi:10.1038/jid.2010.294. PMID 21068735.
- ↑ Arndt J, Smith N, Tausk F (July 2008). "Stress and atopic dermatitis". Curr Allergy Asthma Rep. 8 (4): 312–7. PMID 18606083.
- ↑ Oszukowska M, Michalak I, Gutfreund K, Bienias W, Matych M, Szewczyk A, Kaszuba A (December 2015). "Role of primary and secondary prevention in atopic dermatitis". Postepy Dermatol Alergol. 32 (6): 409–20. doi:10.5114/pdia.2014.44017. PMC 4697018. PMID 26755903.