Systemic treatment of pediatric atopic dermatitis with azathioprine and mycophenolate mofetil (original) (raw)
Pediatric dermatology
Severe forms of atopic dermatitis (AD) cause significant morbidity in vulnerable pediatric populations and necessitate treatment with systemic therapy. The existing literature concerning the treatment of severe pediatric AD with azathioprine (AZ) and mycophenolate mofetil (MM) is sparse. The purpose of this case series is to examine the use of these two drugs in the treatment of severe pediatric AD. Medical records of 28 pediatric patients with AD from the University of North Carolina at Chapel Hill pediatric dermatology clinic treated using these two drugs were analyzed for laboratory values, thiopurine methyltransferase (TPMT) levels, symptoms, infections, and other relevant data. Patients were also contacted via the telephone to ascertain outcomes and any missing data. Treatment outcomes were scored into three categories: significant improvement, some improvement, and no improvement. AZ dosing was correlated to TPMT levels successfully, with comparable levels of improvement in th...
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Atopic dermatitis is an inflammatory process responsible for itching, being a relapsing multifactorial chronic disease, extremely relevant in the context of population health, especially due to its high prevalence in pediatric patients. The impact on the quality of life of patients and families is notable, therefore appropriate treatment is essential. The objective of this study was to analyze the available drug and non-drug treatments regarding their indications and effectiveness. As a study method for this narrative literature review, a selection of articles was made within pre-established delimitations: Database: PUBMED and SciELO; Period: 2017 to 2021; Keywords: Atopic Dermatitis; Therapeutic approach; Skin barrier; Allergy and immunology. Inclusion Criteria: original studies; title with the uniterms; clinical cases; therapeutic intervention; Exclusion Criteria: other narrative review studies. The results found show that to control atopic dermatitis, the following measures are necessary: restoration of the damaged skin barrier; anti-inflammatory therapy, in cases of active eczema, in which topical corticosteroids and immunosuppressants may be used in severe cases (with considerable side effects in prolonged use); and control of itching (preventing further damage to the skin barrier). Wet bandages and wet skin hydration techniques optimize hydration with clinical effectiveness and serve as an alternative to medication side effects. Clothing care, nutrition, use of mild liquid soaps and guided by professionals also showed high clinical effectiveness. Another promising treatment option is monoclonal antibodies, acting against inflammatory cytokines. Therefore, it is concluded that for the treatment of atopic dermatitis in children, it is important to correctly use available non-pharmacological and medicinal methods. The long-term use of medications requires special attention, given the possibility of side effects on the body, especially in childhood. Non-drug techniques for skin restoration and control of contact with allergens result in considerable benefits for the patient's quality of life and must be widely explored.
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