Atopic Dermatitis Host and Environment Model: Revisiting Therapeutic Options
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Authors Information
1Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal
2Immunoallergology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
3Immunoallergology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
4Allergy Unit, Pedro Hispano Hospital, Matosinhos, Portugal
5Basic and Clinical Immunology Laboratory, Medical School, Porto University, Portugal
History
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Published online: 2 December 2019
Accepted: 2 December 2019
Received: 17 May 2019
SUMMARY
Atopic Dermatitis (AD) affects both children and adults and is a serious health concern in many countries. AD is a complex disease with host and environmental factors underlying its pathology. Its treatment is multidimensional reflecting the diverse nature of its triggers and includes emollients, topical steroids and calcineurin inhibitors among others. Immunological dysfunction can be addressed broadly with systemic immunosupressors and specifically with monoclonal antibodies. Dupilumab, which targets IL-4 and IL-13 was granted approval for treatment of moderate-to-severe AD. Biologics targeting IgE/Th2 pathways may have its role in patients with overlapping AD and asthma. Psychological distress can exacerbate symptoms and is associated with increased severity of AD. Environmental triggers, such as, allergens can be addressed in selected cases with allergic immunotherapy. In this paper, we discuss AD treatment and propose a new step-by-step approach aiming at maintaining disease control and improving quality of life
