Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease characterized by pruritus and inflammation and is accompanied by cutaneous physiological dysfunction (Saeki et al. J Dermatol 36: 563–577, 2009).
A wide variety of etiological and exacerbating factors has been proposed, with the importance level of each varying among individual patients. In addition, inflammation associated with this disease will be elucidated by both allergic and nonallergic mechanisms. Etiological and exacerbating factors vary among age groups. While the dominant factors in the first half of childhood include foods, sweating, physical irritation (including scratching), environmental factors, and microbes/fungi, the dominant factors in the second half of childhood to adulthood include environmental factors, sweating, physical irritation (including scratching), microbes/fungi, contact allergens, stress, and foods (Fig. 24.1) (Katayama et al. Allergology International 63: 377–398, 2014).
The detection of both atopic dermatitis (AD) aggravating factors and countermeasures is crucial. Additionally, the method of patient instruction relating to these countermeasures is an important aspect of AD management. We conducted a questionnaire-based survey (Kaneko et al. Nishinihon J Dermatol 73, 614–618, 2011; Kaneko et al. Japanese J Dermatol 123, 2091–2097, 2013; Kaneko et al. Arerugi 63, 1250–1257, 2014) on physicians, patients, and pharmacists, on the topic of instruction given to patients with AD on an outpatient basis, and our findings are summarized below.
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