最新皮肤科教授西安讲课内容特应性皮炎治疗的理念.ppt

* * * Treatment with 0.1% tacrolimus ointment twice daily is effective for up to 4 years in adults with moderate to severe atopic dermatitis. An open-label, non-comparative extension study for up to 4 years in which 799 patients with moderate to severe atopic dermatitis received tacrolimus 0.1% ointment twice daily: 185 children aged 2–6 years 206 children aged 7–15 years 408 adults aged 16 years and over. The median study duration was 902 days (ranging from 1 to 1,186 days); combined with the previous study, this was 982 days (1–1,479 days). In total, 37.5% of patients were evaluated for at least 3 years, and 59.4% for at least 2 years. The slide shows that the mean Eczema Area and Severity Index score, was significantly decreased by week 1, and continued to decrease throughout the study (P 0.001 for all time points). Reference Hanifin JM, et al. J Am Acad Dermatol 2005; 53:S186–194. * * * * Emollients can help to maintain skin hydration and repair defective barrier function. For maximum effect, patients with atopic eczema should be treated prophylactically and frequently with complete emollient therapy, consisting of: an emollient/moisturising soap substitute an emollient therapeutic bath oil an emollient/moisturising cream/ointment. Reference 1. Cork MJ, et al. Dermatology Update. Montreal, Canada; 6–7 Nov 2003. Deficiency in lamellar bodies formation, lipid structure of corneocytes * * * * Topical cortisteroid application can lead to marked thinning of the horny layer. Skin of the face that had been treated over the long term with topical corticosteroids (flumethasone, betamethasone, fluocinolone, amcinonide; for between 6 months and 4 years) was compared with untreated facial skin in 10 patients by transmission electron microscopy examination using appropriate staining for the multilaminar lipid sheets of the stratum corneum. Light microscopic observations of the steroid-induced atrophic skin showed obvious thinning of the epidermis, of approximately 50