Allergology International (Jul 2020)

Japanese guidelines for atopic dermatitis 2020

  • Norito Katoh,
  • Yukihiro Ohya,
  • Masanori Ikeda,
  • Tamotsu Ebihara,
  • Ichiro Katayama,
  • Hidehisa Saeki,
  • Naoki Shimojo,
  • Akio Tanaka,
  • Takeshi Nakahara,
  • Mizuho Nagao,
  • Michihiro Hide,
  • Yuji Fujita,
  • Takao Fujisawa,
  • Masaki Futamura,
  • Koji Masuda,
  • Hiroyuki Murota,
  • Kiwako Yamamoto-Hanada

Journal volume & issue
Vol. 69, no. 3
pp. 356 – 369

Abstract

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Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion, which is frequently encountered in clinical practice. Skin barrier dysfunction leads to enhanced skin irritability to non-specific stimuli and epicutaneous sensitization. In the lesion site, a further inflammation-related reduction in skin barrier function, enhanced irritability and scratching-related stimuli deteriorate eczema, leading to vicious cycle of inflammation. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.

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