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Atopic dermatitis (AD) results from the interaction between dysfunction of the skin barrier, dysregulation of the immune system, and alteration of the skin microbiome. As the most common inflammatory skin disease worldwide and still increasing, it is a real health problem. Vitamin D deficiency is also considered a global problem affecting 13 out of 100 people in Europe. Since vitamin D is involved in the formation of the epidermal barrier, by the synthesis of structural proteins and regulation of keratinocyte proliferation and differentiation, there is a rational to evaluate the relation between vitamin D levels and the prevention or treatment of AD. The authors performed a review of the existing scientific literature on the role of vitamin D in AD. Although studies are scarce not very robust with no consensual results, most studies report lower serum levels of vitamin D in patients with AD. In addition, there seems to be an inverse relationship between plasma levels of vitamin D and clinical severity, a hypothesis that is reinforced by studies that demonstrated a statistically significant benefit of vitamin D supplementation for improving clinical symptoms and signs of AD. Some studies also suggest a possible influence of prenatal vitamin D levels on the onset of AD during childhood. Therefore, vitamin D supplementation may play a relevant role as a complement to the treatment of AD or for its prevention, but more and better scientific evidence is needed to confirm this. [ABSTRACT FROM AUTHOR]

Objective: The use of dupilumab in children with atopic dermatitis (AD) demonstrated clinical efficacy in clinical trials. Nevertheless, real-world evidence is still limited. We aim to provide data on this matter regarding a Portuguese pediatric population. Methods: Retrospective analysis of patients with AD below the age of 18 treated with dupilumab in two Portuguese hospitals. Data regarding previous therapies, activity scores, and adverse reactions were collected. Results: Thirty patients were included in the analysis (19 male patients, 63%), with a median age of 14 years (2-17 years). The median follow-up after starting treatment was 80 weeks. The median baseline Eczema Area and Severity Index (EASI) score was 32.3. Sixty percent of patients achieved EASI-90 and 77% EASI-75 at week 16 (n = 30); 79% EASI-90 and 92% EASI-75 at week 52 (n = 24); 64% EASI-90 and 82% EASI-75 at week 104 (n = 11); and 75% EASI-90 and 100% EASI-75 at week 132 (n = 4). Regarding adverse reactions, four patients (12%) presented facial erythema and two patients had eosinophilia above 2000/µL and conjunctivitis. In five patients (17%), there was a need for a dose increase, with treatment failure occurring in two patients (7%). Conclusion: Our data corroborated the evidence from clinical trials, highlighting the maintained efficacy and adequate safety profile of dupilumab in this age group. [ABSTRACT FROM AUTHOR]

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Introdução: As diretrizes clínicas (DC) otimizam os cuidados em saúde dos pacientes. Eles precisam de qualidade para serem bem confiáveis para uso na prática profissional de saúde, principalmente em condições crônicas como a dermatite atópica, que afeta mais prevalentemente crianças e leva a custos de tratamento e taxa de morbidade significativos. Isto é, quanto mais documentos qualificados, melhor a condução das ações em saúde. Objetivos: Avaliar a qualidade metodológica de DC internacionais sobre dermatite atópica. Material e Método: Foi conduzida revisão sistemática através das bases de dados Medline e Embase e, ainda, em repositórios de DC, em 23 de fevereiro de 2023. Foram elegíveis DC sobre dermatite atópica publicadas desde 2017 se elas foram desenvolvidas por um processo de revisão sistemática, pois se pressupôs que fossem as mais bem produzidas metodologicamente. Em seguida, os documentos incluídos tiveram a qualidade avaliada a partir da segunda versão do instrumento Appraisal of Guidelines for Research and Evaluation (AGREE-II). Resultados: Cinco DC foram incluídas: duas do Reino Unido, elaboradas pelo National Institute for Health and Care Excellence, uma em 2017 (atualizada em 2021) e outra em 2021; e outras da Malásia (2018), México (2018) e Espanha (2022). Três delas foram produzidas por organizações governamentais e duas por grupos de pesquisas com financiamento de companhias farmacêuticas (os de México e Espanha). Essas duas últimas DC tinham os menores escores para o domínio 3 (rigor de desenvolvimento), respectivamente, 52% e 54%. As DC inglesas tiveram 77%, enquanto a da Malásia, 75%. Sobre o domínio 6 (independência editorial), quatro DC tiveram valores altos (>65%), enquanto a da Malásia foi avaliada com valor de 50% e uma teve escore abaixo disso. Discussão e Conclusões: Apesar de incluírem DC desenvolvidas a partir de revisões sistemáticas, algumas delas ainda apresentaram problemas nos domínios de rigor de desenvolvimento e de independência editorial, os dois considerados de mais importância pelo AGREE-II. Isso pode representar preocupações para pacientes com dermatite atópica e para especialistas que realizam os cuidados.

Dati generali. La dermatite atopica (DA) è una malattia cronica della pelle che colpisce i bambini in tutto il mondo. I bambini con DA hanno un rischio maggiore di sviluppare asma e altre malattie allergiche. La polmonite acuta è un’infezione respiratoria che può causare morbilità e mortalità significative, specialmente nei bambini sotto i 2 anni. Tuttavia, non è chiaro come il sistema immunitario risponda alla polmonite acuta nei bambini con DA sotto i 2 anni. Obiettivo. Questo studio mira a indagare la risposta immunitaria dei bambini sotto i 2 anni con DA che fanno polmonite acuta e confrontarla con bambini senza DA con la stessa infezione. Materiali e metodi. Lo studio include bambini sotto i 2 anni ricoverati in ospedale con una diagnosi di polmonite acuta. I partecipanti sono stati divisi in due gruppi: il gruppo A comprende bambini con DA che sono andati incontro a polmonite acuta e il gruppo B comprende bambini senza DA con la stessa infezione. Risultati. Lo studio ha incluso 50 bambini, 25 in ciascun gruppo. Il gruppo A con DA ha mostrato livelli significativamente più alti di IL-4, IL-5 e IL-6 al momento del ricovero in ospedale rispetto al gruppo B. I bambini con DA hanno avuto una degenza ospedaliera più lunga e hanno avuto bisogno di ossigenoterapia più frequentemente. Conclusione. I bambini sotto i 2 anni con DA che fanno polmonite acuta hanno una risposta immunitaria diversa rispetto a quelli senza DA. Hanno anche una degenza ospedaliera più lunga e hanno maggiori probabilità di richiedere l’ossigenoterapia. [ABSTRACT FROM AUTHOR]

Introduction and Objective: The present study on atopic dermatitis (AD) in Portugal aims to characterize patient needs and discuss measures to improve health care in dermatology, particularly in cases of moderate to severe disease. Methods: The study was conducted in three phases--(1) data collection on the patient access to healthcare and subsequent analysis; (2) critical evaluation of the data in individual interviews with dermatologists and one pediatrician; and lastly, (3) data discussion in consensus meetings to validate the existing care capacity in dermatology, to identify gaps in care for patients with AD and to define mitigation strategies. Results: In Portugal, it is estimated that AD affects ~ 360,000 patients, 70,000 of whom have moderate to severe disease. Healthcare capacity analysis confirmed that the private system plays an important role in the management of AD. It is estimated that 30% of patients rely solely on the Portuguese public health service. Nevertheless, patients with moderate to severe disease can only access advanced targeted therapies from public healthcare providers. Analysis of public care capacity in dermatology shows relevant gaps in the referral system, the geographical coverage of specialized centers, the number of specialists and high waiting times for first appointments. Considering the negative impact of the disease on patients' quality of life, 86% of patients with AD use private settings to better manage their disease. Conclusion: In conclusion, private setting bridges the gaps in public health care capacity in dermatology, and therefore, it is crucial for patients with AD. However, a major limitation is the lack of reimbursement for advanced targeted therapies recommended for moderate to severe AD when they are prescribed in a private setting, thus compromising patient access to these therapies. A possible strategy could be to extend the prescription of these therapies to a private setting based on a reimbursement model similar to that outlined in Act 48/2016 of 22 March. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disease of multifactorial origin, common in childhood, whose etiopathogenesis encompasses intra and extra-domestic factors. This condition encompasses symptomatology and complex therapy, a fact that has a negative impact both on the life of the individual with atopic eczema and on the family environment. This integrative literature review aims to discuss genetic and environmental aspects in the development of AD, as well as the repercussions of the disease in the social, physical, and psychological spheres in the life of the child and his family. In order to achieve the objective of the article, a qualitative exploratory approach was used in the search for information related to AD, the possible factors that favor the development of the disease and the impact of the pathology, searching dermatological literature and articles published between the year 2008 to 2022. [ABSTRACT FROM AUTHOR]

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Fundamentals: Atopic Dermatitis (AD) and Psoriasis (PS) share clinical and physiopathological similarities. Objective: Determine the prevalence of sensitization to Malassezia spp. in adults with AD and PS and its correlation with disease severity. Methods: A cross-sectional study was carried out from January 2016 to August 2017 with adults. Malassezia spp.-specific IgE dosages were measured, and skin scrapings for fungal culture performed. Parametric or nonparametric tests were used for analysis. Results: Median age of the 20 participants with AD was 29 years old, and the mean SCORAD was 45.35 ± 18.32. Malassezia spp.- specific IgE median dosage was 0.63 kU/l. M. furfur and M. sympodialis were isolated. Spearman’s nonparametric correlation analysis showed no correlation between sensitization to Malassezia spp. and disease severity. The median age of the 36 participants with PS was 61 years old, the median body surface area affected was 22%, and Malassezia spp.-specific IgE median dosage was 0.00 kU/l. M. furfur and Malassezia spp. were identified. Study limitations: Assessing the sensitization to Malassezia spp. was difficult due to the reduced number of participants in the study. Furthermore, there was no uniformity in the location to collect skin scrapings. The use of topical medication was not suspended before collecting skin specimens for mycological examination, therefore interfering with fungal isolation. Conclusion: Sensitization to Malassezia spp. was only detected in the AD sample. Malassezia spp.-specific IgE test did not prove to be a marker for disease severity in our AD sample.

Introduction: Atopic dermatitis is a chronic and recurrent condition, influenced by environmental factors, that requires frequent medical prescriptions. The aim of this study was to investigate if children and adolescents with atopic dermatitis treated at a public clinic reported exacerbation of the disease or self-care problems during the COVID-19 pandemic. Methods: We conducted a retrospective longitudinal study. Data were collected from the medical records of patients aged < 18 years with atopic dermatitis treated at a public outpatient clinic in Rio Grande do Sul, Brazil. The perception of disease exacerbation in children and adolescents was evaluated using the chi-square test or Fisher's exact test. Poisson regression was used to estimate the risk of worsening of skin lesions according to the fear of COVID-19. Results: The study sample included 33 patients, of whom 70% were female and 57.6% lived in the state's capital city. Mean patient age was 9.6 ± 3.9 years, and mean time of clinic follow-up was 4.6 ± 2.9 years. The perception of disease exacerbation during the pandemic was reported by 81.8% of children/adolescents. Children reported increased itching (78.3%) and desquamation (60.9%), whereas adolescents reported increased redness (60%). The fear of contracting COVID-19 was associated with an eight-fold increased risk of worsening of skin lesions. Conclusion: The high percentage of children/adolescents with worsening of skin lesions and the association between disease exacerbation and the fear of COVID-19 reinforce the importance of a multidisciplinary approach that focuses on pathophysiological and psychosocial factors in patients with atopic dermatitis. [ABSTRACT FROM AUTHOR]

Introdução: A dermatite atópica é uma doença crônica e recidivante, influenciada por fatores ambientais, que necessita prescrições médicas frequentes. O objetivo deste estudo foi investigar se crianças e adolescentes com dermatite atópica atendidos em um serviço público tiveram agravamento das lesões ou dificuldades no autocuidado durante a pandemia COVID-19. Métodos: Estudo longitudinal retrospectivo. Os dados foram coletados do prontuário de pacientes com dermatite atópica menores de 18 anos atendidos em um ambulatório público de referência do Rio Grande do Sul. A percepção sobre o agravamento das lesões foi avaliada pelos testes Qui-quadrado ou Exato de Fisher e regressão de Poisson foi utilizada para estimar o risco de agravamento das lesões conforme o medo da COVID-19. Resultados: Foram avaliados 33 pacientes, sendo 70% do sexo feminino e 57,6% residentes na capital. A média de idade foi de 9,6 ± 3,9 anos e o tempo médio de acompanhamento pelo serviço 4,6 ± 2,9 anos. A percepção de agravamento das lesões durante o período de suspensão dos atendimentos esteve presente em 81,8% das crianças/adolescentes. As crianças relataram com frequência o aumento de coceira (78,3%) e descamação (60,9%), enquanto os adolescentes referiram maior aumento da vermelhidão (60%). O medo de contrair o vírus foi associado a um risco oito vezes maior de apresentar agravamento das lesões. Conclusões: O alto percentual de crianças/adolescentes com agravamento das lesões e a associação da piora da doença com o medo relacionado à pandemia reforçam a importância do acompanhamento destes por equipe multidisciplinar que observe fatores fisiopatológicos e psicossociais.

Resumo: O quadro da dermatite atópica (DA) é caracterizado por prurido crônico de evolução flutuante, que pode resultar em distúrbios no padrão de sono e em estigmatização social devido à presença de lesões visíveis e recidivantes, as quais tendem a se tornar progressivamente liquenificadas. Fatores como os já citados e outros associados, como incapacidade laboral, falta de concentração ao longo do dia e isolamento apresentam-se como profundos impactantes para a saúde mental do paciente, podendo resultar em baixa autoestima, depressão e frustração. Além disso, sabe-se que a DA é uma doença essencialmente inflamatória, ao mesmo tempo em que estudos recentes demonstram papel de citocinas no desenvolvimento de síndromes depressivas, podendo haver correlação causal entre os quadros por vias inflamatórias. Objetivos: Essa revisão sistemática de literatura objetivou analisar a relação entre dermatite atópica e sintomas depressivos, identificando possíveis mecanismos responsáveis por essa ligação. Métodos: A busca foi feita entre 17/11/2020 e 18/11/2020 seguindo o modelo PRISMA e utilizando as bases PUBMED, Biblioteca Virtual em Saúde (BVS) - IBECS, LILACS e CUMED - e EMBASE. As palavras-chave “Depression” e “Atopic Eczema”, em conjunto com seus termos MeSh e DECS, foram utilizadas e associadas através do método booleano. Critérios para inclusão foram definidos como artigos que são ensaios clínicos ou observacionais envolvendo grupo de pacientes com dermatite atópica e grupo controle, que pôde ser constituído pelo próprio grupo com dermatite atópica, porém, após intervenção. Os sintomas depressivos precisavam ser medidos por escalas ou terem critérios para diagnóstico de síndrome depressiva estabelecidos. A seleção foi feita por todos os autores de forma independente, sendo discordâncias solucionadas por consenso. Resultados: Ao final, quinze estudos restaram, os quais foram classificados entre aqueles que comparam tratamentos e seus desfechos relacionados à depressão e DA, aqueles que propõem DA como agravante de sintomas depressivos, aqueles que propõem sintomas depressivos como agravantes da DA e aqueles que trazem análises estatísticas sem estabelecer claramente onde reside a relação de causalidade entre os dois quadros. Conclusões: Diversos estudos mostraram a existência de relação entre o quadro de DA e sintomas depressivos em vias distintas, tanto analisando a DA como agravante de sintomas depressivos como vice-versa. A partir dessa perspectiva, é possível que haja uma causalidade bidirecional cíclica, na qual um constante feedback positivo gera piora de ambos os quadros até que a abordagem adequada seja tomada, evidenciando a importância da propedêutica multidisciplinar para esses pacientes.

Introduction: Atopic dermatitis is a chronic and recurrent condition, influenced by environmental factors, that requires frequent medical prescriptions. The aim of this study was to investigate if children and adolescents with atopic dermatitis treated at a public clinic reported exacerbation of the disease or self-care problems during the COVID-19 pandemic. Methods: We conducted a retrospective longitudinal study. Data were collected from the medical records of patients aged < 18 years with atopic dermatitis treated at a public outpatient clinic in Rio Grande do Sul, Brazil. The perception of disease exacerbation in children and adolescents was evaluated using the chi-square test or Fisher’s exact test. Poisson regression was used to estimate the risk of worsening of skin lesions according to the fear of COVID-19. Results: The study sample included 33 patients, of whom 70% were female and 57.6% lived in the state’s capital city. Mean patient age was 9.6 ± 3.9 years, and mean time of clinic follow-up was 4.6 ± 2.9 years. The perception of disease exacerbation during the pandemic was reported by 81.8% of children/adolescents. Children reported increased itching (78.3%) and desquamation (60.9%), whereas adolescents reported increased redness (60%). The fear of contracting COVID-19 was associated with an eight-fold increased risk of worsening of skin lesions. Conclusion: The high percentage of children/adolescents with worsening of skin lesions and the association between disease exacerbation and the fear of COVID-19 reinforce the importance of a multidisciplinary approach that focuses on pathophysiological and psychosocial factors in patients with atopic dermatitis. [ABSTRACT FROM AUTHOR]

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Objetivo: Analisar na literatura o papel do farmacêutico no cuidado a pessoas com dermatite atópica. Metodologia: foi realizada uma revisão sistemática nas bases de dados Medline/ PubMed, LILACS e Web of Science, usando os descritores: dermatitis, eczema, pharmacist. Foram incluídos os artigos escritos em inglês, português e espanhol, que tenham como característica serem estudos sobre o papel do farmacêutico para pessoas com dermatite atópica (DA). Resultados: A pesquisa inicialmente identificou 923 resultados nas bases de dados, que após o processo de seleção apenas quatro artigos foram incluídos na revisão. Os principais serviços identificados foram o aconselhamento e educação em saúde, esses causaram impactos nos resultados clínicos, humanísticos e econômicos. Os resultados clínicos foram informações sobre o tratamento da DA, uso adequado de emolientes e melhoria da compreensão da DA; já o econômico resultou na diminuição dos gastos com assistência médica; e humanístico teve a satisfação dos cuidadores com os vários aspectos do serviço, bem como, estavam mais confiantes sobre o tratamento. Conclusão: Apesar dos poucos estudos analisados pode se observar que o papel do farmacêutico está centralizado no cuidado aos pacientes com DA prestando serviços de aconselhamento, educação em saúde, contribuindo com informações sobre a doença, sintomas, tratamento farmacológico e não farmacológico e na diminuição de problemas quanto ao uso de medicamentos.

Impaired skin barrier is one of the hallmarks of atopic dermatitis (AD), with abnormalities in the cornified envelope, lipid lamellae, tight junctions and cutaneous microbiome. These findings are also present in nonlesional skin of AD individuals, suggesting that epidermal barrier defects may be the initial step towards the development of AD and eventually other atopic diseases (atopic march). It is currently known that pathophysiology of AD involves an interplay between this dysfunctional skin barrier and a predominantly type 2 skewed innate and adaptive immune responses, which further disrupt the skin barrier through type 2 cytokines. In this setting, there is enhanced penetration of environmental and food allergens through a deficient barrier, leading to an increased susceptibility to sensitization. During the sensitization process, thymic stromal lymphopoietin (TSLP) polarizes skin dendritic cells to a T-helper 2 response, and TSLP seems to be a key cytokine in the sensitization of food allergy, allergic asthma and rhinitis. In this review, the authors describe the current knowledge of the pathophysiology of the epidermal barrier, its disruption in AD and how it may be involved in the development of atopic comorbidities and the role of barrier repair therapy on the prevention of the atopic march progression. [ABSTRACT FROM AUTHOR]

Through the theoretical and practical references of ethnography, from a phenomenological perspective, this article presents reflections on the ethical limits of research with chronically ill children. From the presentation of an outpatient narrative of a child affected by atopic dermatitis, the concept of supportive meaning is developed as a requisite for parrhesia in order to establish a genuine exchange between researcher and informant. In this case, in addition to an ethical listening, the researcher must consider that the current state of the ill child requires a different perception and care from those related to the development of ethnographic research in other contexts.

Introdução: A dermatite atópica (DA) é uma doença inflamatória crônica e multifatorial. Casos graves afetam a qualidade de vida. A patogénese é complexa, marcada por resposta imune celular defeituosa, exacerbação da resposta inflamatória Th2 e comprometimento da função de barreira da pele. Evidências sugerem que a vitamina D atua na regulação da resposta imune inata e adaptativa, na redução do processo inflamatório e na melhora da barreira cutânea. O nosso objectivo foi correlacionar os níveis séricos de vitamina D com a gravidade da DA. Material e Métodos: Foram analisados prontuários de 30 pacientes assistidos em um ambulatório de Dermatologia, entre 2015 e 2018. Os pacientes foram divididos em 2 grupos: doença leve (terapia tópica) e doença moderada a grave (usuários de imunossupressores). Resultados: Foram selecionados 10 casos com DA leve e 20 com DA moderada a grave. Entre os pacientes com doença leve, 20% apresentaram deficiência de vitamina D. Quanto aos pacientes com doença moderada a grave, 40% apresentaram vitamina D deficiente. Comparando a média de vitamina D nos dois grupos, não houve diferença estatística entre o valor médio. Conclusão: Estudos sobre associação entre os níveis de vitamina D e gravidade da DA permanecem controversos. Alguns trabalhos reforçam essa associação. Neste estudo, apesar da proporção de pacientes com deficiência de vitamina D ser duas vezes maior entre os pacientes com DA moderada a grave, não houve significância estatística entre os dois grupos, corroborando estudos já publicados. Mais estudos relacionando a dermatite atópica à vitamina D são desejáveis, tendo em vista a sua possível aplicabilidade como terapêutica auxiliar.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory disease that affects both children and adults. The main symptom is pruritus, which has an important impact on quality of life (QoL). The objective of our study was to assess the impact of AD on the quality of life of children through the CDLQI score. Population and Methods: We performed a cross-sectional survey, with descriptive and analytical aims, carried out on the basis of prospective recruitment, carried out over a period of 7 months from December 2017 to June 2018. The study included children (5-16 years) with AD selected during dermatology consultations at the Centre Hospitalier Universitaire of Treichville. Data collected included the socio-demographic characteristics of patients and their AD and the results of a questionnaire on the severity score (SCORAD) and the quality of life index in these children (CDLQI). Results: We included 60 children, mainly within the group from 05 to 09 years (57%). CDLQI average score was 9.9 and mean SCORAD 24. Pruritus, insomnia and sadness had more impact on QoL. We found a strong association between the severity of AD objectified by SCORAD and the CDLQI. Conclusion: The study reveals a high impact of AD on the QoL of children in Abidjan mainly through pruritus, insomnia and sadness. It opens up reflection on the need for education for AD management and the prospect of creating an atopy school in Côte d’Ivoire. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a chronic inflammatory multifactorial disease. Severe cases affect the quality of life. The pathogenesis is complex, marked by defective cellular immune system, exacerbation of Th2-type immune response and impaired skin barrier function. Studies suggest that vitamin D acts in the regulation of the innate and adaptive immune response, reduces the inflammatory process and improves the skin barrier. Our objective was to correlate vitamin D serum levels with the severity of AD. Material and Methods: Between 2015 and 2018 the authors evaluated 30 patients aged between 18 and 90 years old, under treatment at a Dermatology ambulatory clinic. Patients were divided into 2 groups: mild disease (only topical therapy) and moderate to severe disease (under immunosuppressive treatment). Results: Ten cases with mild AD and 20 with moderate to severe AD were selected. Among patients with mild disease, 20% had vitamin D deficiency. As for patients with moderate to severe disease, 40% had a deficient serum level of 25-hydroxyvitamin D. Comparing the average vitamin D in the two groups, there was no statistical difference between them. Conclusion: In the literature, the association between vitamin D levels and the severity of AD remain controversial, although some studies support this association. In this study, despite the proportion of patients with 25-hydroxyvitamin D deficiency being twice as high among patients with moderate to severe AD, there was no statistical significance between the groups, corroborating previous manuscripts. Clinical studies relating atopic dermatitis to vitamin D are warranted, considering its possible use as a concomitant therapy. [ABSTRACT FROM AUTHOR]

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Introdução: A dermatite atópica (DA) é a doença cutânea mais comum na infância, com prevalência mundial estimada em cerca de 15% a 20% das crianças e 1% a 10% dos adultos. Estudos recentes correlacionam-na com prejuízo do sono de pacientes e familiares e pior qualidade de vida pelo caráter estigmatizante das lesões cutâneas. O controle da DA deve envolver uma rotina diária de cuidados com a pele, monitorando os fatores precipitantes e a manutenção da hidratação cutânea. O suporte multiprofissional contínuo e a educação continuada visam melhoria da aderência ao tratamento medicamentoso e não medicamentoso por parte dos pacientes e responsáveis. Objetivo: Demonstrar o funcionamento de um grupo de apoio a pacientes e familiares com DA como forma adjuvante ao tratamento tradicional. Relato de Experiência: Durante os meses de outubro de 2018 e junho de 2019 foram realizadas quatro reuniões multidisciplinares na Faculdade de Medicina da Universidade Federal de Juiz de Fora (UFJF) com pacientes portadores de DA e seus cuidadores, provenientes do ambulatório de dermatologia pediátrica do Hospital Universitário da Universidade Federal de Juiz de Fora (HU-UFJF). Diversos temas foram abordados, incluindo cuidados gerais com a doença, nutrição infantil, psicologia e autoestima de crianças com DA. O encontro envolveu profissionais médicos, não médicos e estudantes de medicina, as dinâmicas realizadas incluíram rodas de conversas com familiares e atividades lúdicas educativas sobre a doença com as crianças. Conclusão: As reuniões podem impactar positivamente no controle da doença ao fortalecer a relação médico-paciente e fornecer educação continuada aos portadores de DA e seus familiares. O compartilhamento de experiências durante os encontros e o suporte multiprofissional trazem ainda mais benefícios para os pacientes com a doença, abordando aspectos psicossociais, nutricionais e educacionais, o que em última análise, aumenta a aderência ao tratamento.

The main objective of this study was to assess the impact of atopic dermatitis (AD) on the quality of life (QOL) of caregivers of children and adolescents under 18, followed up in the municipality of Santo André. They were selected during consultations, being recorded general and disease data, and the questionnaire, The World Health Organization instrument to evaluate quality of life - WHOQOL-BREF, was applied to caregivers. For the statistical analysis, the qualitative variables described by absolute and relative frequencies were used. The data show a compromise in the QoL of caregivers of children and adolescents with AD, when compared to that of caregivers of healthy controls, especially in the physical, psychological and social relations domains. The presence of AD affects the family's QOL leading to a high degree of impairment of family dynamics. [ABSTRACT FROM AUTHOR]

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Copyright of Jornal de Pediatria is the property of Sociedade Brasileira de Pediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: O uso de hidratantes melhora a função de barreira cutânea e pode ser útil na dermatite atópica. Objetivos: Avaliar eficácia e segurança de hidratante ativo reparador de barreira à base de glicerina, erythritol, Imperata cilindrica e homarine como tratamento auxiliar da dermatite atópica. Métodos: Aplicação de hidratante em crianças com dermatite atópica de leve a moderada durante um mês, com avaliações subjetivas e objetivas após 15 e 30 dias. Resultados: Foram analisados os dados de 35 crianças, de um a dez anos, quanto a: alterações do sono, ressecamento, descamação, prurido e maciez da pele, que tiveram redução significativa da visita inicial em relação à final. A avaliação objetiva do índice de gravidade Scorad (score on atopic dermatitis) revelou redução de 25.27 para 9.30 (p < 0.0001). Houve redução no uso de dexclorfeniramina de 25.71% no 15o dia para 5.72% no 30o dia (p = 0.0233) e de 34.29% no 15o dia para 5.72% no 30o dia com hidrocortisona (p = 0.0075). Conclusões: O uso do hidratante durante 30 dias melhorou os sintomas analisados, com significativa diminuição do índice de gravidade e menor necessidade de anti-histamínicos e corticosteroides tópicos. A utilização de hidratante adequado foi eficaz e segura como auxiliar para crianças com dermatite atópica.

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of JBES: Brazilian Journal of Health Economics / Jornal Brasileiro de Economia da Saúde is the property of JBES: Brazilian Journal of Health Economics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

As perturbações do sono são frequentes em crianças com dermatite atópica, com impacto negativo significativo na sua qualidade de vida e com consequências no seu comportamento e desempenho cognitivo. Porém, a fisiopatologia das perturbações do sono associadas à dermatite atópica é ainda pouco compreendida. Inicialmente consideradas consequência direta do prurido e do ato de escoriar associado durante o período noturno, hoje sabe-se que as perturbações do sono resultam de uma complexa interligação entre diversos fatores. Estudos recentes têm sugerido que a melatonina possa estar envolvida, não só pela função primordial de controlo do ciclo circadiano, mas também pelas características anti-inflamatória e antioxidante. Nesta revisão, os autores abordam os novos conhecimentos fisiopatológicos sobre os distúrbios do sono em crianças com dermatite atópica, focando o papel da melatonina e sua possível aplicação terapêutica.

Sleep disturbance is common in children with atopic dermatitis, with a significant impact in their quality of life and negative effects on behavior and neurocognitive function. However, the pathophysiology of sleep disturbance in patients with atopic dermatitis is not well understood. It was thought to be consequence of pruritus and scratching, but nowadays we know to a consequence of multiple factors. Recent studies have suggested that melatonin could be involved, not only because of its primordial effect on sleep induction, but also its effects on immunomodulation and as anti-oxidant. In this review, the authors summarize the new insights about the sleep disturbances in children with atopic dermatitis, emphasizing the role of melatonin and its possible therapeutic implication. [ABSTRACT FROM AUTHOR]

Introduction: Important dimensions such as personal experiences, attitudes toward disease, its causes and treatments, are not fully addressed in clinical trials. Focus group (FG) has emerged as an interesting and valuable tool in clinical research complementing this gap. The aim of this qualitative research was to assess in both caregivers and patients dealing with atopic dermatitis (AD) their attitudes, personal experiences and perspectives toward the disease and its topical treatment as well as the impact in quality of life (QoL). Material and Methods: For discussion sessions, 10 caregivers of children and 10 adult patients were recruited. Two sessions of FG took place with 3 main themes discussed: perspectives toward AD, topical treatments and the impact in QoL. All activities were recorded in video and the discussions and notes were then transcribed to a document, followed by transcripts analysis. Results: The best descriptive feelings in the moment of diagnosis where “concern” (30%) and “quality of life” (30%) for caregivers and patients, respectively. The actual “positive” emotion or state of mind toward the disease was “overcoming” for caregivers (21%) and “control” for patients (17%). The main “negative or neutral” emotion was “fear” for caregivers (13%) and “resignation” for patients (18%), but when projecting to their child, “frustration” (19%) was the most mentioned. In relation to topical treatments, the mean global satisfaction of caregivers was high for tacrolimus (8.5/10), except in the item “price”. In the case of patients, corticosteroids received a better score (8.0/10), with exception for “tolerability/adverse effects”. Features like “preventive treatment with reduction of flares” and “free of cortisone” were important for both participants in an “ideal topical medicine” setting. All participants showed high levels of negative impact in their QoL due to AD, with 47% and 64.6% considering scores of “very much” and “a lot” of interference, respectively. Conclusion: Qualitative studies in AD by FG are scarce and to our knowledge this is the first one gathering both adult patients and caregivers. The dimensions yielded by this approach are useful to complement data retrieved from clinical trials and to drive decisions from researchers and health authorities. [ABSTRACT FROM AUTHOR]

Copyright of Pesquisa Veterinaria Brasileira is the property of Colegio Brasileiro de Patologia Animal - CBPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)