The Treatment of Atopic Dermatitis and Other Dermatoses with Leukotriene Antagonists

Skin Therapy Letter-Family Practice Edition

关键词: atopic dermatitis;    dermatoses;    leukotriene antagonists Atopic DermatitisAtopic dermatitis (AD) is a chronically relapsing eczematous disorder of the skin that occurs in persons of all ages but is more common in children. AD has been reported to affect more than 10% of children in most countries.1 Approximately 60-70% of those with mild to severe dermatitis will continue to experience symptoms into adulthood.2 The condition is characterized by intense pruritus and a course marked by exacerbations and remissions. Patients with AD may have disrupted sleep with consequent daytime fatigue and compromised school and work quality.3 Skin hydration;    avoidance of irritants;    antihistamines;    topical corticosteroids and newer topical immunomodulators are the mainstay of therapy for AD. However;    AD is usually refractory to treatment and the local and systemic side effects of topical steroids are widely recognized. AD is associated with other atopic diseases such as allergic rhinoconjunctivitis or bronchial asthma.4 Nearly 80% of children with AD eventually develop allergic rhinitis or asthma.5 It is estimated that in the U.S;    $364 million is spent annually on the treatment of childhood AD.6;   

DOI  :  

学科分类：医学（综合）

来源: Skin Therapy Letter-Family Practice Edition

【 摘 要 】

Atopic dermatitis (AD) is a chronically relapsing eczematous disorder of the skin that occurs in persons of all ages but is more common in children. AD is associated with other atopic diseases such as allergic rhinoconjunctivitis or bronchial asthma. Nearly 80% of children with AD eventually develop allergic rhinitis or asthma. AD can be classified as “mixed” (cases associated with respiratory allergies) and “pure”. Pure AD has “intrinsic” and “ extrinsic” variants. In the extrinsic type, interleukin-4 is secreted by T-cells isolated from spontaneous lesions and skin-derived T-lymphocytes express more IL-13. Due to the different immunopathogenesis, it has been suggested that antileukotriene agents may be more successful in the treatment of the extrinsic subgroup. Leukotrienes (LTs) are a class of potent biological inflammatory mediators derived from arachidonic acid through the 5-lipoxygenase pathway. There is evidence of enhanced LT production in the pathogenesis of AD. Evidence in the literature provides a pathophysiological rationale for the use of cysLT receptor blockers in the treatment of AD. However, the exact mechanism of action of leukotriene receptor antagonists in AD is not known. In small clinical and case studies, montelukast was found to be a safe and effective alternative or steroid-sparing therapy in the management of patients with atopic dermatitis.

【 授权许可】

Unknown