• Carbohydrates
• Eczema
• Polymer
• Skin disease
• Topical

• Hydrogels/chemistry
• Dermatitis, Atopic/drug therapy
• Humans
• Polysaccharides/chemistry
• Polysaccharides/therapeutic use
• Animals
• Emollients/chemistry
• Emollients/therapeutic use
• Skin/drug effects
• Skin/pathology
• Hyaluronic Acid/chemistry
• Chitosan/chemistry
• Alginates/chemistry
• Alginates/therapeutic use
• Cellulose/chemistry

• Atopic dermatitis
• Bioengineered materials
• Hydrogel
• Nanotechnology
• Stem cell

• Dermatitis, Atopic/therapy
• Humans
• Biocompatible Materials/chemistry
• Bioengineering/methods
• Animals
• Drug Delivery Systems/methods
• Phototherapy/methods

• antibacterial
• atopic dermatitis
• core−shell electrospun nanofibers
• moisturizing patch
• mucoadhesive

• Dermatitis, Atopic/drug therapy
• Dermatitis, Atopic/pathology
• Anti-Bacterial Agents/chemistry
• Anti-Bacterial Agents/pharmacology
• Humans
• Staphylococcus aureus/drug effects
• Nanofibers/chemistry
• Transdermal Patch
• Adhesives/chemistry
• Adhesives/pharmacology
• Nanostructures/chemistry
• Animals
• Skin/drug effects
• Skin/pathology

• Contact-mediated controlled release
• GAG-binding enhanced transduction (GET)
• Gene transfer
• Pluronic F-127 (PF127)
• Transfection

• Hydrogels/chemistry
• Poloxamer/chemistry
• Cell-Penetrating Peptides
• Bandages
• Genetic Therapy

• MR/K026682/1 Medical Research Council

• Cortisol
• Heart rate variability
• Physiological parameters
• Relaxing
• Therapeutic body wraps
• Therapy

• PVB
• electrospinning
• electrospray
• fibers
• urea

• POIR.04.04.00-00-4571/17-00 Foundation for Polish Science

• Atopic skin
• Controlled oil spreading
• Electrospun fibers
• Keratinocytes
• Oil flow numerical modeling
• fiber elongation

• Administration, Cutaneous
• Humans
• Linoleic Acids
• Oenothera biennis
• Plant Oils
• gamma-Linolenic Acid

This article has been co-authored by a patient with atopic dermatitis (AD) and her consulting dermatologist who is based at the University Hospital in Angers, France. Here they discuss the patient’s experiences and difficulties with AD, as well as strategies that can help a patient in this situation. The patient describes the history of her illness and the difficulties encountered, particularly in terms of quality of life. She describes the various treatments she has received, mainly based on topical corticosteroids, and tells of her satisfaction at being treated today at the University Hospital. The healthcare team there is supportive and reassuring and she is receiving a systemic medication that has successfully reduced and controlled her AD symptoms. The physician describes the main characteristics of AD, and then reviews this case of chronic eczema with topographical localisations on the hands, head and neck and diffuse flares. Rapid resolution of the flares on the patient’s hands and face, which were having a strong impact on mood, was achieved by treatment with systemic ciclosporin and topical corticosteroids. In 6 months, treatment with dupilumab will be planned to avoid ciclosporin-induced adverse effects on kidney function. The pivotal roles of therapeutic education as an adjunct to conventional therapy, a good patient–physician relationship with consideration of the patient’s personal preferences, and treatment objectives are highlighted in this perspective piece.

This article has been co-authored by a French patient who has had atopic dermatitis (eczema, AD) since childhood and her dermatologist, a French healthcare professional based in a university hospital in Angers. AD is caused by a genetic variation that affects the skin’s ability to protect against bacteria, irritants and allergens. In people with AD, environmental factors make the skin red and itchy. AD can occur at any age; it most often begins before 5 years of age and may persist into adolescence and adulthood. AD signs and symptoms vary widely, and the disease may be accompanied by asthma and allergies. AD is long lasting (chronic) and, even if treatment is successful, signs and symptoms may return (flare) periodically. The patient describes her personal experience, including how the discomfort from the AD on her face and hands affected her daily activities and sleep. She talks about having to try various treatments, including home remedies, over the years to control AD and relates her frustration when experiencing symptoms. Now she is being monitored by a healthcare team in a French university hospital that gives her full care and support. As a result, she is now receiving a systemic medication that reduces and controls the AD symptoms and she is very satisfied with her care. The dermatologist notes that this patient’s experience is a common clinical picture of AD in adults, and discusses how the patient was treated and how the treatment will evolve over time. The dermatologist emphasises the importance of a good patient–physician relationship for successful AD management. This should be based on confidence and empathy, and consider the patient’s expectations, personal preferences and treatment objectives. Therapeutic education (educational programs, video training and workshops) is pivotal as an adjunct to conventional therapy.

• Atopic dermatitis
• Dermatology
• Eczema
• Patient’s perspective

Atopic dermatitis is a heterogeneous disease, in which the pathogenesis is associated with mutations in genes encoding epidermal structural proteins, barrier enzymes, and their inhibitors; the role of genes regulating innate and adaptive immune responses and environmental factors inducing the disease is also noted. Recent studies point to the key role of epigenetic changes in the development of the disease. Epigenetic modifications are mainly mediated by DNA methylation, histone acetylation, and the action of specific non-coding RNAs. It has been documented that the profile of epigenetic changes in patients with atopic dermatitis (AD) differs from that observed in healthy people. This applies to the genes affecting the regulation of immune response and inflammatory processes, e.g., both affecting Th1 bias and promoting Th2 responses and the genes of innate immunity, as well as those encoding the structural proteins of the epidermis. Understanding of the epigenetic alterations is therefore pivotal to both create new molecular classifications of atopic dermatitis and to enable the development of personalized treatment strategies.

• DNA methylation
• FLG
• SPINK genes
• atopic dermatitis
• epigenome
• genetics
• histone modifications
• micro-RNA
• skin barrier dysfunction

• allergic march
• atopic dermatitis
• elimination diet
• emollients
• proactive therapy
• topical calcineurin inhibitors
• topical glucocorticoids
• wet dressings
• wet dressings therapy

• atopic dermatitis
• wet wrap therapy

The use of therapeutic body wraps (TBW) has been reported in small series or case reports, but has become controversial.

This is a feasibility, multicentre, randomized, controlled, open-label trial with blinded outcome assessment (PROBE design).

Children with autism and severe-injurious behaviours (SIB) were enrolled from 13 specialized clinics.

Dry-sheet TBW (DRY group) vs. wet-sheet TBW (WET group).

3-month change in the Aberrant Behaviour Checklist irritability score (ABC-irritability) within per-protocol (PP) sample.

From January 2008 to January 2015, we recruited 48 children (age range: 5.9 to 9.9 years, 78.1% male). Seven patients (4 in the DRY group, 3 in the WET group) were dropped from the study early and were excluded from PP analysis. At endpoint, ABC-irritability significantly improved in both groups (means (standard deviation) = -11.15 (8.05) in the DRY group and -10.57 (9.29) in the WET group), as did the other ABC scores and the Children Autism Rating scale score. However, there was no significant difference between groups. All but 5 patients were rated as much or very much improved. A repeated-measures analysis confirmed the significant improvement in ABC-irritability scores according to time (p < .0001), with no significant difference between the two groups (group effect: p = .55; interaction time x group: p = .27). Pooling both groups together, the mean 3-month change from baseline in ABC-irritability score was -10.90 (effect size = 1.59, p < .0001).

We found that feasibility was overall satisfactory with a slow recruitment rate and a rather good attrition rate. TBW was a safe complementary therapy in this population. There was no difference between wet and dry TBW at 3 months, and ABC-irritability significantly decreased with both wet and dry sheet TBW. To assess whether TBW may constitute an alternative to medication or behavioural intervention for treating SIB in ASD patients, a larger randomized comparative trial (e.g. TBW vs. antipsychotics) is warranted.

ClinicalTrials.gov NCT03164746.

• Attention Deficit and Disruptive Behavior Disorders/physiopathology
• Attention Deficit and Disruptive Behavior Disorders/psychology
• Attention Deficit and Disruptive Behavior Disorders/therapy
• Autistic Disorder/physiopathology
• Autistic Disorder/psychology
• Autistic Disorder/therapy
• Child
• Child, Preschool
• Clothing
• Female
• Humans
• Male
• Time Factors

• French Ministry of Health, Programme Hospitalier de Recherche Clinique

• Atopic dermatitis
• effectiveness
• halometasone cream
• serum cortisol
• wet-wrap therapy

• AGREE-II
• Atopic dermatitis
• Guidelines
• Treatment

• atopic dermatitis
• azathioprine
• biologic
• consensus statement
• cyclosporine
• eczema
• methotrexate
• quality of life
• systemic therapy

• Administration, Cutaneous
• Administration, Oral
• Biological Products/therapeutic use
• Clinical Decision-Making
• Dermatitis, Atopic/diagnosis
• Dermatitis, Atopic/drug therapy
• Dermatitis, Atopic/therapy
• Dermatologic Agents/administration & dosage
• Humans
• Immunosuppressive Agents/administration & dosage
• Immunosuppressive Agents/therapeutic use
• Injections
• Patient Education as Topic
• Phototherapy
• Quality of Life
• Severity of Illness Index

The skin facilitates a number of key roles but its functioning can be impaired by disease. Atopic eczema is a chronic inflammatory disease where the skin barrier has become leaky, and inflammation occurs. It affects up to 20% of children and 3% of adults worldwide, manifesting as red itchy patches of skin with varying severity. This review aims to investigate the leaky skin barrier and immune mechanisms from the perspective of potential novel treatments. The complexity of atopic eczema as a disease is what makes it difficult to treat. Genome-wide association studies have highlighted possible genetic variations associated with atopic eczema, however in some cases, individuals develop the disease without these genetic risk factors. Loss of function mutations in the filaggrin gene are one of these associations and this is plausible due to its key role in barrier function. The Th2 immune response is the link with regards to the immune mechanisms as atopic inflammation often occurs through increased levels of interleukin (IL)-4 and IL-13. Eczematous inflammation also creates susceptibility to colonisation and damage by bacteria such as Staphylococcus aureus. Potential novel treatments are becoming ever more specific, offering the hope of fewer side effects and better disease control. The best new treatments highlighted in this review target the immune response with human beta defensin 2, phosphodiesterase-4 inhibitors and monoclonal antibodies all showing promise.

• Atopic eczema
• Novel treatment
• Filaggrin
• Skin barrier
• Immune dysfunction

• Baths/methods
• Dermatitis, Atopic/pathology
• Dermatitis, Atopic/therapy
• Dermatologic Agents/administration & dosage
• Emollients/administration & dosage
• Humans
• Practice Guidelines as Topic
• Randomized Controlled Trials as Topic
• Skin Care/methods
• Time Factors

• atopic dermatitis
• children
• proactive therapy
• therapeutic patient education
• wet wrap

• Administration, Cutaneous
• Dermatitis, Atopic/drug therapy
• Dermatitis, Atopic/pathology
• Drug Delivery Systems
• Drug Liberation
• Humans
• Hydrogel, Polyethylene Glycol Dimethacrylate/administration & dosage
• Hydrogel, Polyethylene Glycol Dimethacrylate/chemistry
• Poloxamer/administration & dosage
• Poloxamer/chemistry
• Rheology
• Skin/drug effects
• Skin/pathology
• Temperature

• atopic dermatitis
• childhood
• consensus
• management

• Child
• Dermatitis, Atopic/therapy
• Evidence-Based Medicine
• Humans
• Italy
• Pediatrics/standards

• TL1 TR001443 NCATS NIH HHS

Since the treatment guidelines for atopic dermatitis (AD) were released by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been several advances in AD management.

We aimed to establish updated evidence- and experience-based treatment guidelines for Korean AD.

We collected a database of references from relevant systematic AD reviews and guidelines regarding general AD management such as bathing and skin care, avoidance of exacerbating factors, education and psychosocial support, and the use of moisturizers and topical anti-inflammatory and antipruritic drugs. Evidence for each statement was graded and the strength of the recommendation for each statement classified. Thirty-nine KADA council members participated in three rounds of voting to establish an expert consensus of recommendations.

Basic AD treatment includes proper bathing and skin care, avoidance of exacerbating factors, proper education and psychosocial support, and use of moisturizers. The regular use of moisturizer has a steroid-sparing effect and reduces relapse episodes. The short- and long-term use of topical corticosteroids and calcineurin inhibitors improves AD symptoms and should be encouraged to use in an active and proactive treatment. Wet-wrap therapy can be used for rapid recovery of acute exacerbation. Topical antipruritic drugs cannot be recommended for the treatment of AD.

This report provides up-to-date evidence- and experience-based treatment guidelines for AD regarding general management and topical treatment. In addition, the average agreement scores obtained by a panel of experts based on the Korean healthcare system and patient adherence are presented.

• Administration
• Guideline
• Therapeutics
• topical

Atopic dermatitis (AD) is a condition frequently encountered in medical practices across the country. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). Patients with AD have a unique predisposition to colonization or infection by Staphylococcus aureus. Treatments for AD need to rapidly control symptoms of the disease, improve quality of life and prevent exacerbations. Given the chronic and relapsing nature of the disease, therapies need to encourage good compliance and be well tolerated.

• antihistamines
• atopic dermatitis
• cosmeceuticals
• emollients
• topical calcineurin inhibitors
• topical corticosteroids
• treatment

• Atopic dermatitis
• Management
• Outcomes
• Wet wrap therapy

• atopic dermatitis
• behaviour
• declarative knowledge
• eczema
• education
• framework
• procedural knowledge

• Behavior
• Cognitive Behavioral Therapy
• Eczema/nursing
• Eczema/therapy
• Humans
• Patient Education as Topic/methods
• Self Care

• atopic dermatitis
• diluted corticosteroids
• eczema
• emollients
• long-term-intervention
• wet-wrap treatment

• Administration, Topical
• Adrenal Cortex Hormones/administration & dosage
• Bandages
• Child
• Child, Preschool
• Dermatitis, Atopic/diagnosis
• Dermatitis, Atopic/drug therapy
• Dermatitis, Atopic/therapy
• Double-Blind Method
• Emollients/administration & dosage
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Mometasone Furoate
• Petrolatum/administration & dosage
• Pregnadienediols/administration & dosage
• Prospective Studies
• Reference Values
• Risk Assessment
• Treatment Outcome

• Atopic dermatitis
• Complications
• Diagnosis
• Eczema
• Management recommendations
• Pruritus