Abstract
Therapy of severe atopic dermatitis, which is refractory to consistent treatment with topical steroids and topical calcineurin inhibitors is still a problem in many cases. The use of cyclosporine, which is the only approved systemic drug for the therapy of severe atopic dermatitis, is often limited by contraindications or adverse reactions. In this context, results from controlled and open-label studies with novel therapeutic approaches such as methotrexate, omalizumab or rituximab, which are in part very promising, are of great interest. In this work we would like to provide an overview of established and new therapeutic options for the treatment of severe atopic dermatitis.
Highlights
Severe therapy-resistant atopic dermatitis (AD) defined by a scoring atopic dermatitis (SCORAD) (Scoring Atopic Dermatitis) score of more than 35 – 40 is often associated with severe impairments in the patient’s private and professional life and leads to a significant impairment of their quality of life.In some cases, in severe forms in adult patients, adequate stabilization cannot be achieved by avoidance of typical triggers, consistent basic therapy with lipid-regulating emollients, antiseptic or antibiotic measures or by regular therapy with topic steroids or topic immunomodulators
It has been suggested that the lipophilic yeast Malassezia sympodialis, which belongs to the normal skin flora and can be found mainly in the head and neck area, is a triggering factor for head and neck dermatitis (HND) [30]
For the therapy of severe AD only few alternatives exist when topic therapy does not lead to a stabilization of the clinical picture even after all possibilities, like consistent basic therapy, consistent use of local steroids and topic immunomodulators with a reactive or, latterly, proactive therapy regimen, photo therapy, patient education and so on, have been utilized
Summary
Novak* Klinik und Poliklinik für Dermatologie und Allergologie, Universität Bonn. The use of cyclosporine, which is the only approved systemic drug for the therapy of severe atopic dermatitis, is often limited by contraindications or adverse reactions. In this context, results from controlled and open-label studies with novel therapeutic approaches such as methotrexate, omalizumab or rituximab, which are in part very promising, are of great interest. In this work we would like to provide an overview of established and new therapeutic options for the treatment of severe atopic dermatitis. We would like to provide an overview of established and new therapeutic options for the treatment of severe atopic dermatitis.
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