背景特应性皮炎（AD）是一种慢性炎症性皮肤病，其特征是剧烈瘙痒和复发性湿疹性病变。AD发病的重要因素包括遗传易感性,表皮屏障功能障碍，免疫失调，肠道和皮肤失调。益生菌可能是通过免疫系统调节以及增强上皮屏障完整性的包括AD在内的过敏的潜在预防策略。为进一步了解益生菌在AD管理中的作用,知识，态度,并进行了实践（KAP）调查。材料和方法由九名专家组成的指导委员会就益生菌在AD和相关突发疾病管理中的作用提出了共识建议，态度,和实践问卷，同时分析由175名成员组成的国家小组的文献综述和答复。根据医疗保健研究和质量机构（AHRQ）标准评估证据强度和质量。在获得≥70％的小组成员的认可后，考虑接受专家意见作为建议，如李克特量表所示。结果国家小组强调，营养状况的改善，免疫调节特性，对胃肠道（GI）和皮肤的有益作用支持益生菌在AD中的使用。专家组一致认为，益生菌应该是AD和相关突发疾病管理中补充治疗的一部分。大多数情况下,8至12周的益生菌补充持续时间是皮肤科医生的首选。益生菌,当用作辅助治疗时，可作为一种策略，以减少类固醇的使用或维持治疗的高风险病例与耀斑。结论Delphi介导的KAP反应为益生菌在AD管理中的使用提供了一种现实的方法。这表明当与传统治疗一起使用时，益生菌可用作AD和相关发作的辅助治疗。
Background Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itching and recurrent eczematous lesions. Important factors in the etiopathogenesis of AD include genetic predisposition, epidermal barrier dysfunction, immune dysregulation, and gut and skin dysbiosis. Probiotics could be a potential preventive strategy for allergies including AD through immune system modulation as well as enhancement of the epithelial barrier integrity. To further understand the role of probiotics in the management of AD, a Knowledge, Attitude, and Practices (KAP) survey was conducted. Materials and methods A steering committee comprising nine experts formulated
consensus recommendations on the role of probiotics in the management of AD and associated flare-ups through the use of the Knowledge, Attitude, and Practices questionnaire while analyzing literature reviews and responses from a national panel consisting of 175 members. The evidence strength and quality were evaluated based on the Agency for Healthcare Research and Quality (AHRQ) criteria. The acceptance of expert opinions as recommendations was considered upon receiving an endorsement from ≥70% of the panelists, as indicated by a Likert scale. Results The national panel emphasized that the improvement in nutritional status, immunomodulatory properties, and beneficial effects on the gastrointestinal (GI) tract and skin support the use of probiotics in AD. The panel agreed that probiotics should be a part of the complementary therapy in the management of AD and associated flare-ups. Mostly, a probiotics supplementation duration of eight to 12 weeks is preferred by dermatologists. Probiotics, when used as an adjuvant therapy, may serve as a strategy to reduce steroid usage or maintenance therapy in high-risk cases with flares. Conclusion A Delphi-mediated KAP response provides a real-life approach to the use of probiotics in the management of AD. It suggests that probiotics could be useful as an adjuvant therapy in the management of AD and associated flare-ups when used along with traditional treatment.
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