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14 September 2010. Causes and Treatment of Atopic Dermatitis. Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University. Contents. Characteristic of Atopic Dermatitis (AD) Causes of AD Treatment of AD Prevention of AD. Definition Symptom.

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slide1

14 September 2010

Causes and Treatment of Atopic Dermatitis

Dong Seok Cha, Ph.D.

Department of Oriental Pharmacy

College of Pharmacy

Woosuk University

slide2

Contents

  • Characteristic of Atopic Dermatitis (AD)
  • Causes of AD
  • Treatment of AD
  • Prevention of AD
  • Definition
  • Symptom
  • Genetic factor
  • Environmental factor
  • Immune system imbalance
  • Dysfunction of skin barrier
  • Avoiding allergens
  • Drug treatment
  • Phototherapy
  • Alternative Treatment
slide4

What is Atopic Dermatitis?

  • Atopy or atopic syndrome
  • = allergic hypersensitivity
  • Dermatitis
      • = inflammation of the skin
  • Atopic Dermatitis (AD)
    • A type of eczema
    • Non-contagious
    • Often begins in childhood and may persist into adulthood.
    • Occurs together with other atopic diseases
slide8

Causes of Atopic Dermatitis

Genetic factor

Environmental factor

Immune system imbalance

Dysfunction of skin barrier

slide9

Causes of AD – Genetic Factor

  • Family history is very important
  • The inheritance pattern is complex
  • AD genetics involve several genes, each with a different function
  • - IgE response related gene
  • - skin barrier function related gene
  • - skin inflammation related gene
  • Genetic mutation of the epidermal barrier protein, filaggrin is one predisposing factor for atopic dermatitis
slide11

Causes of AD – Environmental Factor

  • Industrialization
      • Hygiene hypothesis
  • Dietary life
      • Food allergy
      • Trans fat
  • Residential Environment
      • Aeroallergens
      • eg. dust mites, pollens, animal danders
      • VOCs
      • eg. formaldehyde, benzene

Sick building syndrome

slide12

Causes of AD - Immune System Imbalance

Th2

Th1

[Homeostatic state]

Th2

Th1

Th1

Th2

[Cell-mediated Immunity]

[Allergy / Atopy]

slide14

Causes of AD – Dysfunction of Skin Barrier

TEWL

Allergen

Irritant

Chronic Stage of AD

Skin Barrier Function

Ceramide

slide16

Treatment of Atopic Dermatitis

  • Treatment for Atopic Dermatitis has multidimensional aims
    • Improving the skin barrier function
    • Reducing the inflammation
    • Identifying the responsible triggers
    • Preventing any secondary infection
  • Common treatment options for AD
    • - Avoiding allergens
    • Drug treatment
    • Phototherapy
    • Alternative therapy
slide17

Treatment of AD – Avoiding Allergens

  • Discovering the triggers of allergic reactions
  • Learning to avoid them.
slide18

Treatment of AD – Drug Treatment

  • Topical Treatment
  • - Emollient (moisturizer)
  • - Topical corticosteroids
  • - Topical calcineurin inhibitors
  • eg. Pimecrolimus and Tacrolimus
  • - Topical antimicrobial therapy
  • - Coal tar
  • Systemic Treatment
  • - Antihistamines
  • - Corticoteroids
  • - Immunomodulators
  • eg. Azathioprine
  • - Antimicrobials
slide19

Treatment of AD – Recent Drugs Being Tested for AD

  • Corticosteroids, immunosuppressants have serious side effects
  • AD imposes tremendous social and financial costs on patients

Improved drugs are necessary

Leukotriene antagonist

Monoclonal antibodies

Leflunomide

Recombinant interferon-gamma

slide20

Treatment of AD – Phototherapy

  • Ultraviolet (UV) light therapy
  • Works as an anti-inflammatory agent
  • Various type of UV
  • - Psoralen plus UVA (PUVA)
  • - A combination of broadband UVB/UVA light treatment
  • - Broadband UVA exposure
  • - Broad-band UVB exposure
  • - Narrowband UVB (280-320 nm)
  • - UVA-1 (340-400 nm)
  • Side effects
  • - stinging, burning, ageing of the skin, pigmentation
  • - risk of squamous cell carcinoma and melanoma.
slide21

Treatment of AD – Alternative Therapy

  • Currently, the level of interest in alternative treatments continues to increase
  • Traditional herbal medicine formulation
  • External application
  • Combined internal and external treatment
slide23

Prevention of Atopic Dermatitis

Diet

Mental health

care

Skin care

Lifestyle