Japanese guidelines for atopic dermatitis 2020 |
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| Institution: | 1. Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan;2. Allergy Center, National Center for Child Health and Development, Tokyo, Japan;3. Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan;4. Department of Dermatology, Keio University School of Medicine, Tokyo, Japan;5. Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Japan;6. Department of Dermatology, Graduate School of Medicine, Nihon Medical School, Tokyo, Japan;7. Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan;8. Department of Dermatology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan;9. Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;10. Division of Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan;11. Division of Allergy, National Hospital Organization Mie National Hospital, Tsu, Japan;12. Division of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan;13. Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan |
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| Abstract: | 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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| Keywords: | Atopic dermatitis Eczema Clinical practice guidelines Evidence-based medicine Treatment |
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