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What's new in the topical treatment of allergic skin diseases
Imran Aslam1, Laura F Sandoval, Steven R Feldman
1aCenter for Dermatology Research, Departments of Dermatology bPathology cPublic Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Purpose Of Review:
To review recent literature on the topical treatment of allergic skin diseases to help clinicians make informed evidence-based decisions.
Recent Findings:
Twenty-four publications were identified from a PubMed search of randomized controlled trials and systematic reviews of topical treatment of atopic dermatitis and allergic contact dermatitis published from 1 January 2013 to 31 January 2014. Studies on the topical treatment of atopic dermatitis largely supported the recommended use of topical corticosteroids and topical calcineurin inhibitors. Barrier therapy continues to play an important role without evidence supporting use of one emollient over another. Lipoxin A4, an eicosanoid with anti-inflammatory properties, and a 5% cis-urocanic acid emulsion cream were effective in the treatment of atopic dermatitis, although studies were small. Adjunct therapy with bleach baths, natural oils, and textiles all showed some benefit; however, studies are limited. Literature on topical treatment of allergic contact dermatitis was limited to one publication, providing evidence for a natural multicomponent cream as maintenance therapy after control of disease with a topical corticosteroid.
Summary:
There is strong evidence for the use of topical anti-inflammatory therapies in the treatment of atopic dermatitis. There is little evidence to suggest that one emollient is better than others.
Insights
Topical anti-inflammatory therapies are strongly supported for atopic dermatitis treatment. For allergic contact dermatitis, limited evidence suggests multicomponent creams may aid maintenance after corticosteroid use.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Allergic skin diseases, including atopic dermatitis and allergic contact dermatitis, significantly impact patient quality of life.
- Effective topical treatments are crucial for managing these conditions, necessitating up-to-date evidence-based guidance for clinicians.
Purpose of the Study:
- To review recent literature on topical treatments for atopic dermatitis and allergic contact dermatitis.
- To provide clinicians with evidence-based information for informed decision-making in managing allergic skin diseases.
Main Methods:
- A PubMed search identified 24 randomized controlled trials and systematic reviews published between January 2013 and January 2014.
- Literature focused on topical treatments for atopic dermatitis and allergic contact dermatitis.
Main Results:
- Topical corticosteroids and calcineurin inhibitors are supported for atopic dermatitis. Barrier therapy is important, with no emollient superiority found.
- Emerging treatments like Lipoxin A4 and cis-urocanic acid showed promise in small studies for atopic dermatitis.
- Adjunct therapies (bleach baths, natural oils, textiles) showed some benefit but require further study. Limited data exists for allergic contact dermatitis topical treatments.
Conclusions:
- Strong evidence supports topical anti-inflammatory therapies for atopic dermatitis management.
- Current evidence does not favor one emollient over another for atopic dermatitis treatment.
- Further research is needed to solidify evidence for adjunct therapies and topical treatments in allergic contact dermatitis.
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