Fernández VJM, Armario HJC

Idioma: Español
Referencias bibliográficas: 34
Paginas: 30-36
Archivo PDF: 1808.71 Kb.

RESUMEN

En el momento actual, la meta del tratamiento de la dermatitis atópica es el control de los síntomas. Las nuevas alternativas terapéuticas para esta enfermedad están relacionadas con la aplicación de los nuevos fármacos biológicos que en la actualidad se están ensayando en otros procesos dermatológicos y el desarrollo de nuevas moléculas específicas para el tratamiento de la dermatitis atópica, el eczema de manos u otros tipos de eczema. En este artículo realizamos una revisión sobre las principales novedades en cada uno de los grupos terapéuticos de la dermatitis atópica, con especial interés sobre los datos de eficacia y seguridad. Trataremos de los nuevos hidratantes y emolientes (Atopiclair^® y N-palmitoiletanolamina), tratamientos tópicos (corticoides, antibióticos, antifúngicos, antagonistas de los receptores opiáceos y derivados de la vitamina D), tratamientos físicos (láser de colorante pulsado y láser de excímeros), tratamientos sistémicos (probióticos, ácido docosahexanoico (DHA), montelukast, rosiglitazona y micofenolato de mofetilo) y tratamientos biológicos (omalizumab, rituximab, alefacept, infliximab, etanercept, efalizumab y ustekinumab).

REFERENCIAS (EN ESTE ARTÍCULO)

1. Hoare C, Li Wan Po A, Williams H. Systematic review of treatments for atopic eczema. Technol Assess 2000; 4: 1-191.

2. Hanifin JM. Atopic dermatitis: broadening the perspective. J Am Acad Dermatol 2004; 51 (Suppl. 1): s23-s24.

3. Patrizi A, Capitano B, Neri I, Giacomini F, Sinagra JL, Raone B, Berardesca E. A doublé- blind, randomized, vehicle-controlled clinical study to evaluate the efficacy and safety of MAS063DP (ATOPICLAIR) in the management of atopic dermatitis in paediatric patients. Pediatr Allergy Immunol 2008; 19: 619-25.

4. Boguniewicz M, Zeichner JA, Eichenfield LF, Hebert AA, Jarratt M, Lucky AW, Paller AS. MAS063DP is effective monotherapy for mild to moderate atopic dermatitis in infants and children: a multicenter, randomized, vehicle-controlled study. J Pediatr 2008; 152: 854-859.

5. Eberlein B, Eicke C, Reinhardt HW, Ring J. Adjuvant treatment of atopic eczema: assessment of an emollient containing Npalmitoylethanolamine (ATOPA study). J Eur Acad Dermatol Venereol 2008; 22: 73-82.

6. Glazenburg EJ, Wolkerstorfer A, Gerretsen AL, Mulder PG, Oranje AP. Efficacy and safety of fluticasone propionate 0.005% ointment in the long-term maintenance treatment of children with atopic dermatitis: differences between boys and girls? Pediatr Allergy Immunol 2008; 20: 59-66.

7. Schuttelaar ML, Coenraads PJ. A randomized, double-blind study to assess the efficacy of addition of tetracycline to triamcinolone acetonide in the treatment of modera te to severe atopic dermatitis. J Eur Acad Dermatol Venereol 2008; 22: 1076-82.

8. Wong AW, Hon EK, Zee B. Is topical antimycotic treatment useful as adjuvant therapy for flexural atopic dermatitis: randomized, double-blind, controlled trial using one side of elbow or knee as a control. Int J Dermatol 2008; 47: 187-91.

9. Bigliardi PL, Stammer H, Jost G, Ruffi T, Büchner S, Bigliardi-Qi M. Treatment of pruritus with topically applied opiate receptor antagonist. J Am Acad Dermatol 2007; 56: 979-88.

10. Segaert S. Vitamin D regulation of cathelicidin in the skin: toward a renaissance of vitamin D in dermatology? J Invest Dermatol 2008; 128: 773-5.

11. Syed S, Weibel L, Kennedy H, Harper JI. A pilot study showing pulsed-dye laser treatments improves localized areas of chronic atopic dermatitis. Clin Exp Dermatol 2008; 33: 243-8.

12. Nisticò SP, Saraceno R, Capriotti E, Felice CD, Chimenti S. Efficacy of monochromatic excimer light (308 nm) in the treatment of atopic dermatitis in adults and children. Photomed Laser Surg 2008; 26: 14-8.

13. Grüber C, Wendt M, Sulser C, Lau S, Kulig M, Wahn U, Werfel T, Niggemann B. Randomized, placebo-controlled trial of Lactobacillus rhamnosus GG as treatment of atopic dermatitis in infancy. Allergy 2007; 62: 1270-6.

14. Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. J Allergy Clin Immunol 2008; 121: 116-21.

15. Koch C, Dölle S, Metzger M, Rasche C, Jungclas H, Rühl R, Renz H, Worm M. Docosahexaenoic acid (DHA) supplementation in atopic eczema: a randomized, double-blind, controlled trial. Br J Dermatol 2008; 158: 786-92.

16. Friedmann PS, Palmer R, Tan E, Ogboli M, Barclay G, Hotchkiss K, Berth-Jones J. A double-blind, placebo-controlled trial of montelukast in adult atopic eczema. Clin Exp Allergy 2007; 37: 1536-40.

17. Behshad R, Cooper KD, Korman NJ. A retrospective case series review of the peroxisome proliferator-activated receptor ligand rosiglitazone in the treatment of atopic dermatitis. Arch Dermatol 2008; 144: 84-8.

18. Heller M, Shin HT, Orlow SJ, Schaffer JV. Mycophenolate mofetil for severe childhood atopic dermatitis: experience in 14 patients. Br J Dermatol 2007; 157: 127-32.

19. Forman SB, Garrett AB. Success of omalizumab as monotherapy in adult atopic dermatitis: case report and discussion of the high-affinity immunoglobulin E receptor, FcepsilonRI. Cutis 2007; 80: 38-40.

20. Belloni B, Ziai M, Lim A, Lemercier B, Sbornik M, Weidinger S, Andres C, Schnopp C, Ring J, Hein R, Ollert M, Mempel M. Lowdose anti-IgE therapy in patients with atopic eczema with high serum IgE levels. J Allergy Clin Immunol 2007; 120: 1223-5.

21. Sheinkopf LE, Rafi AW, Do LT, Katz RM, Klaustermeyer WB. Efficacy of omalizumab in the treatment of atopic dermatitis: a pilot study. Allergy Asthma Proc 2008; 29: 530-7.

22. Simon D, Hösli S, Kotstylina G, Yawalkar N, Simon HU. Anti-CD20 (rituximab) treatment improves atopic eczema. J Allergy Clin Immunol 2008; 121: 122-8.

23. Sedivá A, Kayserová J, Vernerová E, Poloucková A, Capková S, Spísek R, Bartundová J. Anti-CD20 (rituximab) treatment for atopic eczema. J Allergy Clin Immunol 2008; 121: 1515-6.

24. Moul DK, Routhouska SB, Robinson MR, Korman NJ. Alefacept for moderate to severe atopic dermatitis: a pilot study in adults. J Am Acad Dermatol 2008; 58: 984-9.

25. Simon D, Wittwer J, Kostylina G, Buettiker U, Simon HU, Yawalkar N. Alefacept (lymphocyte function-associated molecule 3/IgG fusion protein) treatment for atopic eczema. J Allergy Clin Immunol 2008; 122: 423-4.

26. Jacobi A, Antoni C, Manger B, Schuler G, Hertl M. Infliximab in the treatment of moderate to severe atopic dermatitis. J Am Acad Dermatol 2005; 52: 522-6.

27. Buka RL, Resh B, Roberts B, Cunningham BB, Friedlander S. Etanercept minimally effective in 2 children with atopic dermatitis. J Am Acad Dermatol 2005; 53: 358-9.

28. Rullan P, Murase J. Two cases of chronic atopic dermatitis treated with soluble tumor necrosis factor receptor therapy. J Drug Dermatol 2009; 8: 873-6.

29. Weinberg JM, Siegfried EC. Successful treatment of severe atopic dermatitis in a child and an adult with the T-cell modulator efalizumab. Arch Dermatol 2006; 142: 555-8.

30. Takiguchi R, Tofte S, Simpson B, Harper E, Blauvelt A, Hanifin J, Simpson E. Efalizumab for severe atopic dermatitis: a pilot study in adults. J Am Acad Dermat 2007; 56: 222-7.

31. Siegfried EC. Long-term follow-up of a child treated with efalizumab for atopic dermatitis. Arch Dermatol 2007; 143: 1077-8.

32. Ibler K, Dam TN, Gniadecki R, Kragballe K, Jemec GBE, Agner T. Efalizumab for severe refractory atopic eczema: retrospective study on 11 cases. J Eur Acad Dermatol Venereol 2010; 24: 837-9.

33. Alvarez MA, Jiménez RJ, Garnacho G, Salido R, Casas E, Vélez AJ, Moreno JC. Dermatitis atópica del adulto tratada con ustekinumab. Reunión Anual de la Sección Territorial Andaluza de la AEDV. Almería, 12-13 de marzo de 2010. [Libro de Resúmenes, pp: 58-59].

34. Heymann WR. Antipsoriatic biologic agents for the treatment of atopic dermatitis. J Am Acad Dermatol 2007; 56: 854-85.