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What's new in atopic eczema? An analysis of systematic reviews published in 2016. Part 1: treatment and prevention.
- Source :
-
Clinical and experimental dermatology [Clin Exp Dermatol] 2019 Jun; Vol. 44 (4), pp. 363-369. Date of Electronic Publication: 2019 Jan 31. - Publication Year :
- 2019
-
Abstract
- This review is part of a series of annual updates summarizing the evidence base for atopic eczema (AE). It provides a summary of key findings from 28 systematic reviews that were published or indexed during 2016 with a focus on treatment and prevention of AE. There is reasonable evidence of benefit for topical corticosteroids, calcineurin inhibitors, a glycyrrhetinic acid-containing preparation (Atopiclair <superscript>®</superscript> ), oral ciclosporin, oral azathioprine, narrowband ultraviolet B radiation and education programmes. Overall, there is evidence that topical corticosteroids and calcineurin inhibitors have similar efficacy and that both can prevent AE flares when used twice weekly as maintenance therapy. However, topical calcineurin inhibitors are costlier and have more adverse reactions, thus topical corticosteroids should remain the standard of care for patients with AE. There is no evidence that multiple applications are better than once-daily application of topical corticosteroid. There is inconsistent evidence to support omalizumab and specific allergen immunotherapy use in AE. There is some evidence that vitamin D supplementation and synbiotics reduce AE severity, although the margin of improvement may not be clinically meaningful. There is little evidence to support the use of wet wraps or of complementary/alternative medicine (including Chinese herbal medicine). There is some evidence to suggest that a diet high in fish in infancy may be preventative for AE, but other dietary interventions for the prevention of AE show little promise. This review provides a succinct guide for clinicians and patients wishing to remain up to date with the latest evidence for the treatment and prevention of AE.<br /> (© 2019 British Association of Dermatologists.)
- Subjects :
- Administration, Oral
Administration, Topical
Adrenal Cortex Hormones administration & dosage
Anti-Allergic Agents therapeutic use
Azathioprine administration & dosage
Azathioprine therapeutic use
Calcineurin Inhibitors administration & dosage
Child, Preschool
Complementary Therapies
Cyclosporine administration & dosage
Cyclosporine therapeutic use
Dermatitis, Atopic radiotherapy
Dietary Fats administration & dosage
Dietary Fats therapeutic use
Glycyrrhetinic Acid administration & dosage
Glycyrrhetinic Acid therapeutic use
Humans
Immunosuppressive Agents therapeutic use
Infant
Infant, Newborn
Omalizumab administration & dosage
Omalizumab therapeutic use
Plant Extracts administration & dosage
Plant Extracts therapeutic use
Ultraviolet Therapy methods
Vitamin D therapeutic use
Adrenal Cortex Hormones therapeutic use
Calcineurin Inhibitors therapeutic use
Dermatitis, Atopic drug therapy
Dermatitis, Atopic prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2230
- Volume :
- 44
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Clinical and experimental dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 30706549
- Full Text :
- https://doi.org/10.1111/ced.13885