Emollients

润肤剂
  • 文章类型: Journal Article
    SIDeMaST(意大利皮肤病学会,Chirurgica,EsteticaedelleMalattieSessualmenteTrasmesse)促进了本指南关于慢性斑块状银屑病的全身治疗的发展。在EuroGuiderm的许可下,SIDeMaST根据意大利的医疗保健环境调整了该指南,为照顾特应性皮炎患者的意大利医生提供了可靠且负担得起的工具。根据EuroGuiDerm指南和共识声明开发手册制定了基于证据和共识的过敏性湿疹指南。在2020年12月至2021年7月期间举行了四次共识会议。来自12个欧洲国家的29名专家(包括临床医生和患者代表)参加了会议。指南的第二部分包括有关润肤剂和保湿剂的基本治疗的建议和详细信息,局部抗炎治疗,抗菌和止痒治疗和紫外线光疗。此外,指南的这一部分涵盖了避免挑衅因素的技术,以及饮食干预,免疫疗法,特应性湿疹患者的补充医学和教育干预措施,并处理该疾病的职业和心理皮肤病学方面。它还包含有关儿童和青少年患者以及孕妇或哺乳期妇女的治疗指南,以及对想要孩子的患者的考虑。还提供了关于患者观点的一章。fi指南的第一部分,单独发布,包含常规免疫抑制药物全身治疗的建议和指导,生物制剂和Janus激酶(JAK)抑制剂,以及有关指南范围和目的的信息,以及关于指导方法的一节。
    SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by atopic dermatitis. The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This second part of the guideline includes recommendations and detailed information on basic therapy with emollients and moisturizers, topical anti-inflammatory treatment, antimicrobial and antipruritic treatment and UV phototherapy. Furthermore, this part of the guideline covers techniques for avoiding provocation factors, as well as dietary interventions, immunotherapy, complementary medicine and educational interventions for patients with atopic eczema and deals with occupational and psychodermatological aspects of the disease. It also contains guidance on treatment for pediatric and adolescent patients and pregnant or breastfeeding women, as well as considerations for patients who want to have a child. A chapter on the patient perspective is also provided. The first part of the guideline, published separately, contains recommendations and guidance on systemic treatment with conventional immunosuppressive drugs, biologics and janus kinase (JAK) inhibitors, as well as information on the scope and purpose of the guideline, and a section on guideline methodology.
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  • 文章类型: Journal Article
    美国皮肤病学会于2014年首次发布了一系列诊断和治疗特应性皮炎的指南。选择了12名临床医生进行审查,grade,并提供有关临床特征的可用数据的临床见解,症状学,病理生理学,教育,治疗,以及特应性皮炎(AD)的新兴临床研究。基于这些发现,AAD发布了一份指南,为医生简化特应性皮炎的信息,建议使用临床证据进行诊断,并首先用非药物疗法治疗以恢复天然皮肤屏障。建议采用局部药物治疗以改善瘙痒和炎症,并在临床相关的中度至重度病例中使用较新的全身性药物。与缺乏治疗数据的实践相比,强调了循证实践。为了突出特应性皮炎的新证据和药理学突破,AAD制定了一套更新的指南,对医生进行新药及其在治疗中的作用的教育.本章回顾了AAD指南作为管理特应性皮炎和保持最新疾病进展的工具。
    The American Academy of Dermatology first published a series of guidelines for diagnosing and managing atopic dermatitis in 2014. Twelve clinicians were selected to review, grade, and offer clinical insight on available data regarding the clinical features, symptomology, pathophysiology, education, treatment, and emerging clinical studies on atopic dermatitis (AD). Based on these findings, the AAD released a guideline to streamline information on atopic dermatitis for physicians, recommending using clinical evidence to diagnose and first treating with nonpharmacologic therapies to restore the natural skin barrier. Topical pharmacologic therapies were recommended for improving pruritus and inflammation and newer systemic agents for clinically relevant moderate-to-severe cases. Evidence-based practices were emphasized in comparison to those that lacked therapeutic data. To highlight the emerging evidence and pharmacologic breakthroughs in atopic dermatitis, the AAD produced an updated set of guidelines educating physicians on new agents and their role in treatment. This chapter reviews the AAD guidelines as a tool for managing atopic dermatitis and staying up to date on disease advancements.
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  • 文章类型: Systematic Review
    背景:自2014年指南以来,出现了新的证据,进一步告知了局部治疗AD的管理。这些指南更新了2014年通过局部疗法治疗特应性皮炎(AD)的建议。
    目的:提供与成人局部治疗AD相关的循证建议。
    方法:一个多学科工作组进行了系统审查,并应用GRADE方法来评估证据的确定性以及制定和分级建议。
    结果:工作组就局部治疗成人AD的管理提出了11项建议,包括非处方药和处方外用皮质类固醇(TCS),钙调磷酸酶抑制剂(TCI),Janus激酶(JAK)抑制剂,磷酸二酯酶-4抑制剂(PDE-4),抗菌药物,和抗组胺药.
    结论:将文献综述限制为英语随机试验的务实决定可能排除了以其他语言发表的数据和相关的长期随访数据。
    结论:对使用保湿剂提出了强有力的建议,TCI,TCS,和局部PDE-4和JAK抑制剂。有条件地建议使用沐浴和湿巾疗法,并反对使用局部抗菌剂,防腐剂,和抗组胺药.
    New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014 recommendations for management of AD with topical therapies.
    To provide evidence-based recommendations related to management of AD in adults using topical treatments.
    A multidisciplinary workgroup conducted a systematic review and applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach for assessing the certainty of evidence and formulating and grading recommendations.
    The workgroup developed 12 recommendations on the management of AD in adults with topical therapies, including nonprescription agents and prescription topical corticosteroids (TCS), calcineurin inhibitors (TCIs), Janus kinase (JAK) inhibitors, phosphodiesterase-4 inhibitors (PDE-4), antimicrobials, and antihistamines.
    The pragmatic decision to limit the literature review to English-language randomized trials may have excluded data published in other languages and relevant long-term follow-up data.
    Strong recommendations are made for the use of moisturizers, TCIs, TCS, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.
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  • 文章类型: Systematic Review
    这些指南更新了2014年对局部治疗成人特应性皮炎的管理建议。一个多学科工作组采用最佳实践来制定指南,包括对建议分级的证据和应用进行系统审查,评估,发展,和评估方法,用于评估证据的确定性并制定和分级建议。特应性皮炎治疗的证据支持使用非处方保湿剂的强烈建议,局部钙调磷酸酶抑制剂,外用皮质类固醇,和局部PDE-4和JAK抑制剂。有条件地建议使用沐浴和湿巾疗法,并反对使用局部抗菌剂,防腐剂,和抗组胺药.
    These guidelines update the 2014 recommendations for management of atopic dermatitis in adults with topical therapies. A multidisciplinary workgroup employed best practices for guideline development, including a systematic review of the evidence and application of the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading recommendations. The evidence on atopic dermatitis treatment supported strong recommendations for the use of nonprescription moisturizers, topical calcineurin inhibitors, topical corticosteroids, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.
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  • 文章类型: Journal Article
    这是2021年异位性皮炎管理临床实践指南的英文版的节略版。特应性皮炎(AD)是一种以复发性湿疹为特征的疾病,以瘙痒为主要病变。在日本,从循证医学的角度来看,目前治疗AD的策略包括三个主要措施:(i)使用局部皮质类固醇,他克莫司软膏,和德戈西替尼软膏作为炎症的主要治疗方法;(ii)局部应用润肤剂治疗皮肤屏障功能障碍;(iii)避免明显的恶化因素,心理咨询,关于日常生活的建议。在本修订准则中,关于三种新药的描述,即,dupilumab,delgocitinib,和Baricitinib,已添加。该指南提出了审查临床研究文章的建议,评估医疗活动的利弊之间的平衡,并在临床实践中需要决策的几个重要方面优化与医疗活动相关的患者结果。
    This is an abridged edition of English version of the Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021. Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. In Japan, from the perspective of evidence-based medicine, the current strategies for the treatment of AD consist of three primary measures: (i) use of topical corticosteroids, tacrolimus ointment, and delgocitinib ointment as the main treatment of the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling, and advice about daily life. In the present revised guidelines, the description about three new drugs, namely, dupilumab, delgocitinib, and baricitinib, has been added. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.
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  • 文章类型: Journal Article
    背景:润肤剂是治疗皮肤干燥状况的主要方法。在英国,处方者通常应遵循当地国家卫生服务(NHS)的处方.2018年的一项研究表明,英格兰和威尔士的推荐润肤剂差异很大。此后,有证据表明,沐浴添加剂对湿疹没有额外的临床益处。
    目的:比较英国的润肤制剂和指南。
    方法:在2021年4月至5月确定了临床调试小组(CCG)的处方和指南,然后进行了描述性分析。
    结果:总计,105个CCG,确定了72种润肤剂处方和47种润肤剂处方指南。在19%的案例中,处方集与其随附的指南之间存在内部不一致。大多数(68%)的处方/指南是使用排名系统进行组织的。总的来说,命名了126种不同的免洗润肤剂。乳膏和软膏是普遍可用的,是最推荐的一线类型。成本比患者选择更有可能被推荐作为选择处方哪种润肤剂的标准。水性奶油是最常见的不推荐的免洗润肤剂。近四分之三(74%)的配方表示,不应规定浴用添加剂。
    结论:英格兰的所有CCG都有润肤的处方/指南,但是他们的建议之间仍然存在很大的差异。尽管自2017年以来,处方集/指南的数量有所减少,但唯一推荐的免洗润肤剂的总数却有所增加。大多数CCG不再推荐用于湿疹的沐浴润肤剂。
    BACKGROUND: Emollients are a mainstay of treatment for dry skin conditions. In the UK, prescribers are usually expected to follow local National Health Service (NHS) formularies. A previous study in 2018 showed that the recommended emollients across England and Wales varied widely. Evidence has since emerged that bath additives provide no additional clinical benefit in eczema.
    OBJECTIVE: To compare emollient formularies and guidelines in England.
    METHODS: Clinical Commissioning Group (CCG) formularies and guidelines were identified in April-May 2021, compiled and then analysed descriptively.
    RESULTS: In total, 105 CCGs, 72 emollient formularies and 47 emollient prescribing guidelines were identified. There were internal inconsistencies between formularies and their accompanying guidelines in 19% of cases. The majority (68%) of formularies/guidelines were organized using a ranking system. In total, 126 different leave-on emollients were named. Creams and ointments were universally available and were the most recommended first-line types. Cost was more likely than patient choice to be recommended as a criterion for selecting which emollient to prescribe. Aqueous cream was the leave-on emollient most commonly not recommended. Nearly three-quarters (74%) of formularies stated that bath additives should not be prescribed.
    CONCLUSIONS: All CCGs in England have an emollient formulary/guideline, but there is still great variability between them in their recommendations. Although the number of formularies/guidelines has reduced since 2017, there has been an increase in the total number of unique recommended leave-on emollients. Most CCGs are no longer recommending bath emollients for eczema.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    背景:特应性皮炎(AD)是一种复发性慢性炎症性皮肤病,具有重大的公共卫生负担。
    目的:进行一项调查,以便从广泛的护理提供者那里获得有关当前AD患者护理和治疗问题的信息,以及有关改进AD指南的方法的信息。
    方法:通过专业协会进行了一项在线调查,根据德国指南(GL),重点关注AD医疗保健专业人员在AD管理知识和经验方面的当前差距。
    结果:总计,542名受访者每年平均治疗200名AD患者。AD管理中最常见的问题涉及润肤剂(50%),主要是由于患者的费用和不能开润肤剂/保湿剂。开处方生物制剂的障碍包括成本。受访者表示,GL缺乏有关患者教育(27%)和使用基本润肤剂(27%)的信息。应考虑可行性问题(32%)和增加护理途径(41%)以改善GL。
    结论:在这项调查中,我们将主要由于患者费用和缺乏咨询时间而导致的基础AD护理不足确定为现实挑战.这些问题仍有待在今后的准则中解决。
    BACKGROUND: Atopic dermatitis (AD) is a relapsing chronic inflammatory skin disease with a significant public health burden.
    OBJECTIVE: To conduct a survey in order to gain information on current problems on the care and treatment of AD patients from a wide range of care providers, as well as information on ways of improving AD guidelines.
    METHODS: An online survey was conducted via professional associations, focussing on AD health care professionals with regards to current gaps in knowledge of AD management and experience based on the German guidelines (GL).
    RESULTS: In total, 542 respondents treated a median of 200 AD patients yearly. The most frequent problems in the management of AD concerned emollients (50%), largely due to patient costs and the inability to prescribe emollients/moisturizers. Barriers to prescribing biologics included cost. Respondents stated that the GL lacks information regarding patient education (27%) and use of basic emollients (27%). Consideration should be given to feasibility issues (32%) and the addition of care pathways (41%) to improve the GL.
    CONCLUSIONS: In this survey, we identified inadequate basic AD care mainly due to patient costs and lack of time for counselling as real-life challenges. These issues remain to be addressed in future guidelines.
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  • 文章类型: Journal Article
    This is the English version of guidelines for the management of asteatosis 2021 in Japan. Asteatosis is a synonym of xerosis found in a wide range of diseases that induce dry skin through impaired functions of either water retention of the stratum corneum or skin covering with acid mantle. Patients with asteatosis may be accompanied by pruritus. Moisturizers are the first-line treatment for asteatosis and their adequate use must be recommended. The main purpose of the present guidelines is to define skin symptoms requiring treatment with moisturizers for medical use in patients with asteatosis. If the deterioration of marked scaling or scratch marks is predicted, therapeutic intervention with moisturizers for medical use should be considered even in the absence of pruritus. Regarding six important points requiring decision-making in clinical practice (clinical questions), we evaluated the balance between the benefits and harm of medical interventions in reference to previous reports of clinical research, and presented the recommendation grades and evidence levels to optimize the patient outcome by medical interventions.
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  • 文章类型: Journal Article
    Background: Neonates and infants are susceptible to skin barrier disruption as their skin anatomically and functionally is still developing. The process of skin acidification plays a vital role in barrier maturation and the activation of enzymes involved in the extracellular processing of stratum corneum lipids. The current consensus paper explores challenges, and current treatment approaches in neonatal and infant normal and sensitive skin and the role of ceramides containing moisturizers. Methods: For this purpose, an expert panel of pediatric dermatologists and dermatologists discussed information from systematic literature searches, coupled with expert opinion and experience of the panel, to adopt eight statements. The consensus process consisted of a modified Delphi technique. Results: During the first years after birth, the neonatal and infant skin is more permeable to topical agents and, therefore, requires particular caution with topical skincare regimens. Mildly acidic or pH-neutral cleansers have benefits for neonates and infants. Skincare for neonates and infants should be safe, effective, and fragrance free as well as sensitizing agent-free. Additionally, the skincare should be pleasant to use, containing ingredients that benefit the lipid and water content of the SC, such as those products containing ceramides. Conclusion: Taking into consideration the maturation process of neonatal and infant skin, the application of moisturizers and cleansers containing barrier lipids may help maintain the protective skin barrier and soothe with long-term moisturizing benefits. J Drugs Dermatol. 2020;19(8) 769-776: doi:10.36849/JDD.2020.5252 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.
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