背景:特应性皮炎(AD)是一种非常普遍的慢性炎症性皮肤病。在马来西亚,据报道,1至6岁儿童的患病率为13.4%,亚洲AD患病率最高的地区之一。许多指南推荐保湿剂作为AD治疗策略的主要部分。为AD患者选择有效且合适的保湿剂对于避免AD急性加重和实现缓解起着至关重要的作用。
方法:鉴于市场上有一系列活性成分和保湿剂外用载体,这篇综述总结了神经酰胺和多囊乳剂(MVE)技术在管理AD中的作用,以帮助指导治疗决策。
结果:神经酰胺对维持皮肤通透性屏障和水合作用至关重要,通过抗炎和抗菌防御系统调节皮肤免疫力,和调节细胞功能。低水平和改变的结构和组成的神经酰胺,在AD患者中通常观察到受损的皮肤渗透性屏障和增加的经表皮水分流失。大多数临床研究表明,以陶瓷为主的保湿剂对患有AD的成人和儿童是安全有效的。MVE技术提供了一个有吸引力的输送系统,以补充SC中的神经酰胺,修复受损的皮肤渗透屏障,并可能提高患者的依从性。
结论:推荐具有正确成分(水平,比率,结构和组成),除了有效的持续释放系统,AD患者是成功控制疾病和预防耀斑的关键策略,减轻患者的疾病负担,家庭和社会。
BACKGROUND: Atopic dermatitis (AD) is a highly prevalent chronic inflammatory skin condition. In Malaysia, a prevalence of 13.4% was reported for children between one and six years of age, one of the highest prevalence rates of AD in Asia. Many guidelines recommended moisturisers as the mainstay of treatment strategy for AD. Selecting an effective and suitable moisturiser for people with AD plays a crucial role in avoiding acute exacerbation of AD and achieving remission.
METHODS: Given that an array of active ingredients and topical vehicles for moisturisers are available in the market, this
review summarised the roles of
ceramides and multivesicular emulsion (MVE) technology in managing AD to help guide treatment decisions.
RESULTS: Ceramides are essential in maintaining the skin permeability barrier and hydration, modulating skin immunity through anti-inflammatory and antimicrobial defence system, and regulating cellular functions. Low levels and altered structures and composition of
ceramides, compromised skin permeability barrier and increased transepidermal water loss were commonly observed in AD patients. Most clinical studies have shown that ceramidedominant moisturisers are safe and effective in adults and children with AD. MVE technology offers an attractive delivery system to replenish
ceramides in the SC, repairing the compromised skin permeability barrier and potentially improving patient compliance.
CONCLUSIONS: Recommending clinically proven therapeutic moisturisers with the right ingredients (level, ratio, structure and composition), alongside an effective sustained release delivery system, to AD patients is one key strategy to successful disease control and flare prevention, subsequently reducing the disease burden to patients, families and societies.