Atopisches Ekzem

Zusammenfassung

Das atopische Ekzem ist eine häufig bei Kindern vorkommende, oftmals chronisch-rezidivierend verlaufende, teilweise stark juckende Hauterkrankung, die im Arbeitsalltag eines Facharztes für Kinder- und Jugendmedizin oder eines Dermatologen eine wichtige Rolle spielt. Bis heute ist die Ätiopathogenese nicht vollständig geklärt. Im akuten Schub stehen eine Vielzahl von topischen und systemischen immunsuppressiven oder immunmodulatorischen Substanzen zur Verfügung, die eine kontinuierlich durchzuführende regelmäßige Hautpflege ergänzen. Des Weiteren gilt es, mögliche Triggerfaktoren zu erkennen und zu meiden.

Summary

Atopic dermatitis, frequently occuring in children, is known for its chronic recurrent and prominently pruritic character. In general, it plays an important role in the daily routine of pediatricians and dermatologists. As of today, the etiology remains partly unknown. In the acute phase several immunosuppressive and immunomodulatory drugs are available which may complement basic skin care. Furthermore, known trigger factors are to be identified and where possible eliminated.

Schlüsselwörter

Atopisches Ekzem - Basistherapie - antientzündliche Therapie

Keywords

Atopic dermatitis - basic skin care - immunosuppressive drugs

• Literatur

• 1 Barnetson RSC, Rogers M. Childhood atopic eczema. BMJ 2002; 324: 1376-1379.
• 2 Bønnelykke K, Pipper CB, Tavendale R. et al Filaggrin gene variants and atopic diseases in early childhood assessed longitudinally from birth. Pediatr Allergy Immunol 2010; 21: 954-961.
• 3 Braun-Falco O, Plewig G, Wolff HH. et al (Hrsg). Dermatologie und Venerologie.. Heidelberg: Springer; 2005
• 4 Diepgen TL, Fartasch M, Hornstein OP. Evaluation and Relevance of Atopic Basic and Minor features in Patients with Atopic Dermatitis and in the General Population. Acta Derm Venerol 1998; 144: 50-54.
• 5 Esparza-Gordillo J, Weidinger S, Fölster-Holst R. et al A common variant on chromosome 11q13 is associated with atopic dermatitis. Nat Genet 2009; 41: 596-601.
• 6 Fölster-Holst R, Müller F, Schnopp N. et al Prospective, randomized controlled trial on Lactobacillus rhamnosus in infants with moderate to severe atopic dermatitis. Paediatr Dermatol 2006; 155: 1256-1261.
• 7 Gauger A, Mempel M, Schekatz A. et al Silvercoated textiles reduce Staphylococcus aureus colonization in patients with atopic eczema. Dermatology 2003; 207: 1064-1068.
• 8 Grimalt R, Mengeaud V, Cambazard F. et al The steroidsparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology 2007; 214: 61-67.
• 9 Hanifin JM, Thurston M, Omoto M. et al The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group. Exp Dermatol 2001; 10: 11-18.
• 10 Heratizadeh A, Breuer K, Kapp A, Werfel T. Symptomatische Therapie der atopischen Dermatitis. Hautarzt 2003; 54: 937-945.
• 11 Kalliomäki M, Salminen S, Arvilommi H. et al Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 2001; 357: 1076-1079.
• 12 Luger T, Loske KD, Elsner P. et al Topische Dermatotherapie mit Glukokortikoiden - Therapeutischer Index. JDDG JDDG: Journal der Deutschen Dermatologischen Gesellschaft 2004; 2: 629-634.
• 13 Lukas A, Wolf G, Fölster-Holst R. Besonderheiten der topischen und systemischen Dermatotherapie im Kindesalter. JDDG: Journal der Deutschen Dermatologischen Gesellschaft 2006; 8: 658-678.
• 14 Muche-Borowski C, Kopp M, Reese I. et al Allergieprävention. JDDG: Journal der Deutschen Dermatologischen Gesellschaft 2010; 8: 718-725.
• 15 Niedner R. Glukokortikosteroide in der Dermatologie. Dtsch Arztebl 1996; 44: 2868-2872.
• 16 Palmer CN, Irvine AD, Terron-Kwiatkowski A. et al Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet 2006; 38: 441-446.
• 17 Pavlovsky M, Baum S, Shpiro D. et al Narrow band UVB: is it effective and safe for paediatric psoriasis and atopic dermatitis?. JEADV 2011; 25: 727-729.
• 18 Schäfer T, Borowski C, Diepgen TL. et al Allergieprävention: Evidenzbasierte und konsentierte Leitlinie des Aktionsbündnisses Allergieprävention (abap) - Kurzfassung. Allergo J 2004; 13: 252-260.
• 19 Schmitt J, von Kobyletzki L, Svensson Å, Apfelbacher C. Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials. Br J Dermatol 2010; 164: 415-428.
• 20 Schneeweiss S, Doherty M, Zhu S. et al Topical Treatments with Pimecrolimus, Tacrolimus and Medium to High-Potency Corticosteroids, and Risk of Lymphoma. Dermatology 2009; 219: 7-21.
• 21 Schultz-Larsen F, Hanifin JM. Epidemiology of atopic dermatitis. Immunol Allergy Clin North Am 2002; 22: 1-24.
• 22 Simpson IL. Atopic dermatitis: a review of topical treatment options. Current Medical Research and Opinion 2010; 26: 633-640.
• 23 Staab D, Diepgen TL, Fartasch M. et al Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial. BMJ 2006; 332: 933-938.
• 24 Stalder JFTaïeb. et al Severity Scoring of Atopic Dermatitis: The SCORAD Index. Dermatology 1993; 186: 23-31.
• 25 Stamatas GN, Nikolovski J, Luedtke MA. et al Infant Skin Microstructure Assessed In Vivo Differs from Adult Skin in Organization and at the Cellular Level. Ped Dermatol 2010; 27: 125-131.
• 26 Von Berg A, Koletzko S, Grubl A. et al The effect of hydrolyzed cow`s milk formula for allergy prevention in the first year of life: the German Infant Nutritional Intervention Study, a randomised doubleblind trial. J Allergy Clin Immunol 2003; 111: 533-540.
• 27 Wahn U, Bos JD, Goodfield M. et al Efficacy and Safety of Pimecrolimus Cream in the Long-Term Management of Atopic Dermatitis in Children. Pediatrics 2002; 110: 1-8.
• 28 Weidinger S, O`Sullivan M, Illig T. et al Filaggrin mutations, atopic eczema, hay fever, and asthma in children. J Allergy Clin Immunol 2008; 121: 1203-1209.
• 29 Werfel T, Aberer W, Augustin M. et al Neurodermitis S2-Leitlinie. JDDG 2009; 7: 1-46.
• 30 Wollenberg A, Reitamo S, Atzori F. et al Proactive treatment of atopic dermatitis in adults with 0.1 % tacrolimus ointment. Allergy 2008; 63: 742-750.