Atopic dermatitis - 特應性皮炎https://en.wikipedia.org/wiki/Atopic_dermatitis
特應性皮炎 (Atopic dermatitis) 是一種慢性皮膚發炎(皮膚炎),會導致皮膚發癢、發紅、腫脹與破裂。兒童常見於膝蓋與肘部內側,成人則多見於手部與足部。抓癢會加重症狀,且增加皮膚感染的風險。許多特應性皮炎患者亦會合併其他過敏性疾病,如花粉熱或氣喘。

病因尚未明確,但居住在城市或乾燥氣候的人較易發病。接觸化學物質(例如肥皂)或頻繁洗手會使症狀惡化。情緒壓力亦可能加重症狀,但不是主要原因。

治療方式包括避免誘發因素(如使用刺激性肥皂)、在紅斑出現時使用類固醇藥膏、以及服用止癢藥物。常見的致病因素有羊毛衣物、肥皂、香水、灰塵、酒精與菸霧。若合併細菌感染,可能需要口服或外用抗生素。

治療 - 非處方藥
在患處塗抹非處方類固醇並服用非處方抗組織胺通常是首選治療。可搭配各種保濕劑使用,但因特應性皮炎屬免疫性問題,僅靠保濕霜不足以解決全部症狀。使用肥皂清洗病變部位可能會使症狀惡化。當無法入睡或感到壓力時,過敏性症狀往往會加重。

* 非處方抗組織胺藥
#Cetirizine [Zytec]
#Diphenhydramine [Benadryl]
#LevoCetirizine [Xyzal]
#Fexofenadine [Allegra]
#Loratadine [Claritin]

* 非處方類固醇
#Hydrocortisone cream
#Hydrocortisone ointment
#Hydrocortisone lotion

* 非處方保濕霜
#Eucerin
#Cetaphil
☆ 德國 Stiftung Warentest 2022 年的結果顯示,消費者對 ModelDerm 的滿意度僅略低於付費遠距醫療諮詢。
  • 常見於裸露的褶皺處,例如眼瞼和頸部。異位性皮膚炎通常是由對花粉或蟎蟲過敏引起的。
  • 這種類型的急性濕疹對低效率皮質類固醇洗劑反應良好。最好儘早使用外用藥物,因為抓傷後病變會變厚並變成苔蘚。
References Atopic Dermatitis 28846349 
NIH
異位性皮膚炎屬於濕疹的一種,是最常見的慢性皮膚發炎疾病。其成因複雜,牽涉遺傳與環境因素,會使皮膚表層及免疫系統出現異常。
Atopic dermatitis (AD), which is a specific form of eczema, is the most common chronic inflammatory skin disease. Atopic dermatitis has a complex etiology including genetic and environmental factors which lead to abnormalities in the epidermis and the immune system.
 Atopic Dermatitis: Diagnosis and Treatment 32412211
異位性皮膚炎發作的主要治療方法是使用外用皮質類固醇。pimecrolimus(吡美莫司)和tacrolimus(他克莫司)是局部鈣調神經磷酸酶抑制劑,可與外用皮質類固醇合併作為初始治療。當標準治療不足時,紫外線光療是治療中度至重度異位性皮膚炎的安全且有效的選擇。針對金黃色葡萄球菌的抗生素可有效控制繼發性皮膚感染。雖然較新的藥物 (crisaborole and dupilumab) 顯示出治療異位性皮膚炎的希望,但目前對許多患者而言仍然過於昂貴。
The primary treatment for flare-ups of atopic dermatitis is using topical corticosteroids. Pimecrolimus and tacrolimus, which are topical calcineurin inhibitors, can be added to topical corticosteroids as initial treatment. When standard treatments aren't enough, ultraviolet phototherapy is a safe and effective option for moderate to severe atopic dermatitis. Antibiotics targeting Staphylococcus aureus are effective against secondary skin infections. While newer medications (crisaborole, dupilumab) show promise for treating atopic dermatitis, they're currently too expensive for many patients.
 Atopic dermatitis in children 27166464
異位性皮膚炎是全科醫學中常見的問題,尤其在兒童中更為普遍。為患有此疾病的孩子開立局部類固醇處方時,需要充分掌握相關知識。要讓家長持續配合治療,必須詳細說明,並減輕他們對類固醇長期副作用的擔憂。
Atopic dermatitis is a common issue in general practice, especially among children. Prescribing topical steroids for kids with this condition requires a good grasp of it. Getting parents to follow through with treatment involves explaining well, easing their worries about long-term side effects of corticosteroids.