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Management and treatment of atopic dermatitis with modern therapies, complementary and alternative medicines: a review

Abstract

Atopic dermatitis (AD) is a common dermatological disease characterized by relapsing pruritus and rash accompanied by cutaneous physiological dysfunction. This disease could affect certain population worldwide, including infants, children and adults. The prevalence of AD has been increased rapidly over the past few decades and the severity of the disease, symptoms, and effects on patients’ quality of life may vary among individuals. AD could be caused or triggered by several factors, such as genotypic, climatic, food allergens and environmental. Many treatments are available to alleviate the symptoms and severity of AD, including topical therapy, immunosuppressant and systemic therapy, phytotherapeutic approach, traditional Chinese medicine (TCM), as well as complementary and adjunct therapies. Topical therapies involve moisturizers, emollients, topical corticosteroids, topical pimecrolimus and tacrolimus and antipruitic/antihistamine therapy. Whereas, systemic therapies and immunosuppressant prescribed for AD treatment include cyclosporine A, azathioprine and methotrexate. Nowadays, not only the modern medicines are used for treatment of AD but also the phytotherapy using herbs and TCM are commonly incorporated into the therapy. In addition some studies have been showed that complementary/adjunct therapies are effective as preventive approaches for managing AD. In this review some examples of these therapies and approaches will be discussed with relevant supporting literatures.

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Abbreviations

AD:

Atopic dermatitis

AZA:

Azathioprine

BBUVB:

Broadband ultraviolet light B

CsA:

Cyclosporine A

DLQI:

Dermatology Life Quality Index

EASI:

Eczema Area and Severity Index

EPP:

Ethyl phenylpropiolate

FLG:

filaggrin

IFN-γ:

Interferon gamma

IGA:

Investigator’s Global Assessment

IgE:

Immunoglobulin E

IL-1:

Interleukin-1

IL-10:

Interleukin-10

IL-13:

Interleukin-13

IL-4:

Interleukin-4

IL-4:

Interleukin-4

IL-5:

Interleukin-5

IL-6:

Interleukin-6

IL-8:

Interleukin-8

MTX:

Methotrexate

NO2 :

Nitrogen dioxide

PHF:

PentaHerb formula

PUFA:

Polyunsaturared fatty acids

SCORAD:

Severity scoring of atopic dermatitis

TARC:

Thymus and activation-regulated chemokine

TCM:

Traditional Chinese medicines

TEWL:

Transdermal water loss

Th-1:

T-helper-1

Th-2:

T-helper-2

Th22:

T-helper 22

TNF-α:

Tumor necrosis factor alpha

TSLP:

Thymic stromal lymphopoietin

UV:

Ultra-violet

UVA:

Ultraviolet A

UVB:

Ultraviolet B

VAS:

Visual analogue scale

VCO:

Virgin coconut oil

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Acknowledgements

The authors would like to thank Elsevier for the license for the figures. The authors would like to thank UCSI University for scientific databases access for the literatures used in the review paper.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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YLC, MAN and VWMO wrote the manuscript. MAN and VWMO contributed equally to the manuscript. YLC critically revised the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Yik-Ling Chew.

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Chew, YL., Al-Nema, M. & Ong, V.WM. Management and treatment of atopic dermatitis with modern therapies, complementary and alternative medicines: a review. Orient Pharm Exp Med 18, 67–76 (2018). https://doi.org/10.1007/s13596-018-0300-7

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Keywords

  • Atopic dermatitis
  • Herbal therapies
  • Anti-inflammatory
  • Topical corticosteroids
  • Traditional Chinese medicine