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Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy...
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Transcript of Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy...
![Page 1: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/1.jpg)
Causes and Treatment of Atopic Dermatitis
Dong Seok Cha, Ph.D.
Department of Oriental PharmacyCollege of Pharmacy Woosuk University
14 September 2010
![Page 2: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/2.jpg)
- Characteristic of Atopic Dermatitis (AD)
- Causes of AD
- Treatment of AD
- Prevention of AD
• Definition• Symptom
Contents
• Avoiding allergens• Drug treatment• Phototherapy• Alternative Treatment
• Genetic factor• Environmental factor• Immune system imbalance• Dysfunction of skin barrier
![Page 3: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/3.jpg)
Characteristic of Atopic Dermatitis
![Page 4: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/4.jpg)
What is Atopic Dermatitis?
• Atopy or atopic syndrome= allergic hypersensitivity
• Dermatitis= inflammation of the skin • Atopic Dermatitis (AD)
- A type of eczema- Non-contagious- Often begins in childhood and may persist into adulthood.- Occurs together with other atopic diseases
![Page 5: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/5.jpg)
Prevalence Rate of Atopic Dermatitis
1995 20050
5
10
15
20
25
30
35
AD
pre
vale
nce
rate
(%
)
AD25%
non AD75%
AD prevalence rate of elementary school student
AD13%
non AD87%
AD prevalence rate of middle school student
1~5세
6~11
세
12~18
세
19~29
세
30~39
세
40~49
세
50~59
세
60~69
세
70
세이상
0
4
8
12
16
20
AD
pre
va
len
ce
ra
te (
%)
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Symptoms of Atopic Dermatitis
Atopic Dermati-
tis
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Causes of Atopic Dermatitis
![Page 8: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/8.jpg)
Dysfunction of skin
barrier
Environmental fac-
tor
Causes of Atopic Dermatitis
Immune system im-
balance
Genetic factor
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Causes of AD – Genetic Factor
• Family history is very important
• The inheritance pattern is complex
• AD genetics involve several genes, each with a different func-tion
- IgE response related gene- skin barrier function related gene- skin inflammation related gene
• Genetic mutation of the epidermal barrier protein, filaggrin is one predisposing factor for atopic dermatitis
![Page 10: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/10.jpg)
Causes of AD – Genetic Factor
![Page 11: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/11.jpg)
Causes of AD – Environmental Factor
1995 2000 20050
5
10
15
20
25
30
35
AD
pre
vale
nce
rate
(%
)
• IndustrializationHygiene hypothesis
• Dietary lifeFood allergyTrans fat
• Residential EnvironmentAeroallergens eg. dust mites, pollens, animal dandersVOCs eg. formaldehyde, benzene
Sick building syndrome
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Causes of AD - Immune System Imbalance
Th1
Th2
[Homeostatic state]
Th1
Th2
Th1
Th2
[Cell-mediated Immunity] [Allergy / Atopy]
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Causes of AD - Immune System Imbalance
![Page 14: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/14.jpg)
Causes of AD – Dysfunction of Skin Barrier
Ceramide
TEWL Skin Bar-rier Func-
tion
AllergenIrritant
Chronic Stage of
AD
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Treatment of Atopic Dermatitis
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Treatment of Atopic Dermatitis
• Treatment for Atopic Dermatitis has multidimensional aims- Improving the skin barrier function- Reducing the inflammation- Identifying the responsible triggers - Preventing any secondary infection
• Common treatment options for AD- Avoiding allergens
- Drug treatment- Phototherapy- Alternative therapy
![Page 17: Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University 14 September 2010.](https://reader030.fdocuments.us/reader030/viewer/2022032802/56649e0e5503460f94af8eef/html5/thumbnails/17.jpg)
Treatment of AD – Avoiding Allergens
• Discovering the triggers of allergic reactions • Learning to avoid them.
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Treatment of AD – Drug Treatment
• Topical Treatment - Emollient (moisturizer) - Topical corticosteroids - Topical calcineurin inhibitors
eg. Pimecrolimus and Tacrolimus - Topical antimicrobial therapy - Coal tar
• Systemic Treatment - Antihistamines - Corticoteroids - Immunomodulators
eg. Azathioprine - Antimicrobials
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Treatment of AD – Recent Drugs Being Tested for AD
• Corticosteroids, immunosuppressants have serious side ef-fects
• AD imposes tremendous social and financial costs on patientsImproved drugs are necessary
Leukotriene antagonist
Monoclonal antibodies
Leflunomide
Recombinant interferon-gamma
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Treatment of AD – Phototherapy• Ultraviolet (UV) light therapy
• Works as an anti-inflammatory agent
• Various type of UV - Psoralen plus UVA (PUVA) - A combination of broadband UVB/UVA light treatment - Broadband UVA exposure - Broad-band UVB exposure - Narrowband UVB (280-320 nm) - UVA-1 (340-400 nm)
• Side effects - stinging, burning, ageing of the skin, pigmentation - risk of squamous cell carcinoma and melanoma.
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Treatment of AD – Alternative Therapy
• Currently, the level of interest in alternative treatments contin-ues to increase
• Traditional herbal medicine formulation
• External application
• Combined internal and external treatment
Merit Demerit
Reducing corticosteroid usage Prescribed differently for each patient
Less side effect Unique flavor
Regulation of immune responses Herbal allergens
Synergic effect Expensive
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Prevention of Atopic Dermatitis
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Prevention of Atopic Dermatitis
Lifestyle
Mental healthcare
Diet
Skin care
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Thank you for your attention