Atopic dermatitis: skin care and topical therapies.
Authors: Fleischer DM, Udkoff J, Borok J, Friedman A, Nicol N, Bienstock J, Lio P, Tollefson MM, Eichenfield LF Abstract Atopic dermatitis (AD) pathogenesis is strongly influenced by Type 2 innate lymphoid cell and T-helper cell type 2 lymphocyte-driven inflammation and skin barrier dysfunction. AD therapies attempt to correct this pathology, and guidelines suggest suggest basics of AD therapy, which include repair of the skin barrier through bathing practices and moisturizers, infection control, and further lifestyle modifications to avoid and reduce AD triggers.While some patients' AD may be controlled u...
Source: Seminars in Cutaneous Medicine and Surgery - September 13, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Atopic dermatitis: addressing allergy, infection, itch and complementary therapies.
Authors: Ahluwalia J, Davis DM, Jacob S, Waldman A, Ong PY, Cohen S, Friedman A, Lio P, Jetter N, Bienstock J, LeBovidge J, Spergel J, Fonacier L Abstract Atopic dermatitis (AD) is a complex condition that results from the dynamic interplay between genetic predisposition, skin barrier defects, environmental factors, and a dysfunctional immune system. As a result, AD can be complicated by irritant and allergic contact dermatitis and imbalances in the skin microbiome, which can subsequently exacerbate the severity and complicate the course of preexisting atopic disease. Itch is an important symptom of AD, as...
Source: Seminars in Cutaneous Medicine and Surgery - September 13, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Atopic dermatitis: phototherapy and systemic therapy.
Authors: Davis DM, Borok J, Udkoff J, Lio P, Spergel J Abstract The majority of atopic dermatitis (AD) patients respond satisfactorily to gentle bathing, frequent moisturizing, and topical medications. Second-line therapies for AD should be used in recalcitrant cases or in patients with uncontrolled disease despite compliance with first-line measures and avoidance of allergens. Recommended advanced therapies include phototherapy, especially narrowband ultraviolet B, systemic immunosuppressants, and a new biologic agent. Few studies have compared head-to-head efficacy of the different immunosuppressant ther...
Source: Seminars in Cutaneous Medicine and Surgery - September 13, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Atopic dermatitis: emerging therapies.
Authors: Simpson E, Udkoff J, Borok J, Tom W, Beck L, Eichenfield LF Abstract Crisaborole and dupilumab represent the first 2 Food and Drug Administration (FDA)-approved therapies for atopic dermatitis (AD) in more than 15 years, and there are many promising drugs currently in development. This new wave of therapeutics capitalizes on the large body of work clarifying the pathogenesis of AD over the last several decades. In particular, type 2 cytokine-driven inflammation and skin barrier dysfunction are key processes underlying AD pathogenesis. PMID: 28895959 [PubMed - in process] (Source: Seminars ...
Source: Seminars in Cutaneous Medicine and Surgery - September 13, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Atopic dermatitis: therapeutic care delivery: therapeutic education, shared decision-making, and access to care.
Authors: LeBovidge J, Borok J, Udkoff J, Yosipovitch G, Eichenfield LF Abstract Atopic dermatitis (AD) is a chronic skin condition affecting children and adults, with a significant negative impact on patient and caregiver quality of life (QOL). Although effective treatments for AD are available, outcomes are often limited by poor adherence to treatment plans. Effective patient and caregiver education about the disease and its management is a necessary and important component of AD care. Therapeutic patient education (TPE) is a patient-centered process that aims to transfer information and skills necessary ...
Source: Seminars in Cutaneous Medicine and Surgery - September 13, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Highlights of Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar ™.
Highlights of Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. Semin Cutan Med Surg. 2017 Jun;36(3S):S52-S59 Authors: Gordon KB, Leonardi CL, Furst DE, Bhatia N, Eichenfield LF, Beleznay K Abstract New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology ...
Source: Seminars in Cutaneous Medicine and Surgery - July 28, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Meeting the challenge of atopic dermatitis from infancy to adulthood, introduction.
Authors: Eichenfield LF PMID: 28654707 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - June 29, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Practical strategies for the diagnosis and assessment of atopic dermatitis.
Authors: Eichenfield LF, Stein Gold LF Abstract Atopic dermatitis (AD) has a significant, lifelong clinical impact on affected individuals and has profound effects on quality of life both for patients and their families. The diagnosis usually can be reliably established on the basis of the history and physical examination. In patients with skin of color, blanching of the skin may be helpful to detect erythema, lichenification, follicular accentuation, and hypopigmentation (all of which are more common than in lighter-skinned patients). Once the diagnosis of AD is established, an assessment of severity, per...
Source: Seminars in Cutaneous Medicine and Surgery - June 29, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Atopic dermatitis progression: evaluating intervention strategies.
Authors: Stein Gold LF, Eichenfield LF Abstract Several risk factors have been identified that appear to be consistently and strongly associated with the development of atopic dermatitis (AD): a family history of atopy, an inherited genetic predisposition, and active and passive exposure to tobacco smoke. Recent studies also have demonstrated that a simple intervention from birth-the daily application of an emollient moisturizer-seems to protect susceptible infants from the development of AD. PMID: 28654709 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - June 29, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Nonpharmacologic strategies and topical agents for treating atopic dermatitis: an update.
Authors: Stein Gold LF, Eichenfield LF Abstract The signs and symptoms of atopic dermatitis can be safely and effectively controlled in most patients; in many cases, the disease can be improved to the point that signs and symptoms are absent or minimal. In addition, flares can be effectively controlled and, in some cases, prevented. New topical medications, improved strategies for the use of topical corticosteroids and topical calcineurin inhibitors, and judicious use of nonpharmacologic regimens-including bathing, bleach baths, and early use of emollients-have led to better disease management and improved...
Source: Seminars in Cutaneous Medicine and Surgery - June 29, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Addressing the immunopathogenesis of atopic dermatitis: advances in topical and systemic treatment.
Authors: Eichenfield LF, Stein Gold LF Abstract Several immunologic mediators-phosphodiesterase (PDE), interleukin (IL), small molecules, and Janus kinase-have been implicated in the pathogenesis of atopic dermatitis, and evidence has shown that blocking these mediators can help modify the disease process. Several new topical medications have been developed that target the enzyme PDE; crisaborole was recently approved by the US Food and Drug Administration (FDA) for the treatment of atopic dermatitis, and phase II studies have been completed on OPA-15406. The phase III clinical trial results of the systemi...
Source: Seminars in Cutaneous Medicine and Surgery - June 29, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Hidradenitis suppurativa, introduction.
Authors: Naik HB Abstract Hidradenitis suppurativa (HS) is a prevalent and devastating inflammatory skin disease predominating in women and minorities. HS is characterized by painful recurrent abscesses, foul-smelling purulent drainage, sinus tract and fistula formation, and disfiguring scarring involving intertriginous body sites including the axillae, breasts, groin, and buttocks. Disease onset typically occurs in the second to fourth decades of life and is associated with significant impacts on physical and psychological well-being due to pain, shame, and isolation, leading to profound suffering and des...
Source: Seminars in Cutaneous Medicine and Surgery - May 26, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Epidemiologic and clinical features of hidradenitis suppurativa.
This article reviews current epidemiologic data on HS in diverse populations, including prevalence based on geography, age, gender, ethnicity, and details the spectrum of clinical features of hidradenitis suppurativa with discussion of disease severity and risk factors. Recently proposed HS diagnostic criteria are also presented. PMID: 28538742 [PubMed - in process] (Source: Seminars in Cutaneous Medicine and Surgery)
Source: Seminars in Cutaneous Medicine and Surgery - May 26, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Pathophysiology of hidradenitis suppurativa.
Authors: Hoffman LK, Ghias MH, Lowes MA Abstract The pathophysiology of hidradenitis suppurativa (HS) is not well understood. Some of our knowledge comes from clinical and epidemiological observations, along with studies of the histopathology and immunohistochemistry of affected skin. More recently, cutaneous molecular studies and transcriptomic analyses have provided additional information regarding inflammatory processes. The chronic cutaneous inflammation, systemic symptoms, and associated comorbidities suggest that HS should be classified as an immune-mediated disease, rather than a primary infectious ...
Source: Seminars in Cutaneous Medicine and Surgery - May 26, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research

Comorbidities of hidradenitis suppurativa.
Authors: Porter ML, Kimball AB Abstract Hidradenitis suppurativa (HS) is an inflammatory skin disorder with many associated comorbidities, including obesity, metabolic syndrome, smoking, depression, arthritis, autoinflammatory syndromes, inflammatory bowel disease, and genetic syndromes. In addition, HS patients can suffer from a variety of diseases related to the chronic inflammatory nature of their HS such as cardiovascular disease and anemia. An understanding of these comorbidities and associations is essential for the management of HS, and routine screening for these entities should be considered in al...
Source: Seminars in Cutaneous Medicine and Surgery - May 26, 2017 Category: Dermatology Tags: Semin Cutan Med Surg Source Type: research