You can use your existing Medical Independent, MediLearning or PharmacistCPD account to log in.


Medicalindependent.ie is Ireland's only investigative medical news website for doctors, healthcare professionals and anyone with an interest in health issues.

Established in 2010, along with its sister publication The Medical Independent, our stated aim is to investigate and analyse the major issues affecting healthcare and the medical profession in Ireland. The Medical Independent has won a number of awards for its investigative journalism, and its stories are frequently picked up by national digital, broadcast and print media. The Medical Independent is published by GreenCross Publishing.

Address: Top Floor, 111 Rathmines Road Lr, Dublin 6

Tel: 353 (01) 441 0024

GreenCross Publishing is owned by Graham Cooke.


The benefits of registering: only registered users:
  • receive the ecCopy two days prior to the printed edition.
  • have automatic access to our free CPD sites.
  • can partake in our online MCQs.
  • can enter our online sports quiz.

Sign up now for ease of access to The Medical Independent, Ireland’s most frequently published medical newspaper, delivering award-winning news and investigative reporting.

Download the new Mindo app for both IOS & Android.

  • Get notified when a story goes live
  • Access Premium Content
  • Read Offline
 
[the_ad_placement id="main-ldb-public"]
[the_ad_placement id="main-ldb-mobile-public"]

You are reading 1 of 2 free-access articles allowed for 30 days

Atopic dermatitis overview

By Dermot - 23rd Mar 2020 | 12 views

CLOSE UP: Unrecognizable young woman suffering from autoimmune incurable dermatological skin disease called psoriasis. Female gently scratching red, inflamed, scaly rash on elbows. Psoriatic arthritis

The prevalence of atopic dermatitis (AD) in countries such as China and Africa is increasing, while cases may have peaked in some developed countries, PCDSI conference delegates were informed.

In his talk, an ‘Update on Eczema in 2020’, Prof Alan Irvine, Consultant Dermatologist in Children’s Hospital Ireland and St James’s Hospital, Dublin, noted that eczema impacts 3-to-10 per cent of adults and 20 per cent of children.

Around 80 per cent of cases present in children in the first two years of life, while some cases can present in adulthood, representing the persistence of AD or late-onset AD, said Prof Irvine.

There have been no new topical treatments for AD in Europe since 2003 but novel therapies are increasing, according to Prof Irvine.

Crisaborole, a non-steroidal topic medication for the treatment of AD, is available in the US but not in Europe.

Topical tofacitinib, a small-molecule JAK inhibitor, has also demonstrated effective results in the treatment of AD, said Prof Irvine.

A biologic drug for AD licensed in Europe but not yet widely available in Ireland, dupilumab, has shown promise and more biologics are in the pipeline, such as lebrikizumab, while three JAK inhibitors are awaiting approval.

Short-term oral steroids are suitable for quick-fix scenarios, such as weddings and exams, said Prof Irvine, but they are not very effective as a long-term solution.

Topical calcineurin inhibitors are “very safe” and 10-year data shows good safety, but side-effects of burning have been reported.

Prof Irvine suggested, therefore, calcineurin inhibitors are good for maintenance rather than active disease, due to the burning side-effects.

In patients on systemic therapy for AD, he reported that 80 per cent had flares within a month of treatment and 34 per cent still had sleep disruption within a week of treatment. The skin barrier, he said, is very difficult to fix and it may be better to regulate the immune system.

AD is associated with a number of comorbidities, including asthma, rhinitis, conjunctivitis; eosinophilic oesophagitis; food allergy; obesity; bacterial and viral infections; cardiovascular disease; and neuropsychiatric disorders, such as low mood, anxiety, conduct disorder and ADHD, said Prof Irvine.

Inadequate treatment results often arise due to a fear among patients of topical corticosteroids, he noted. Furthermore, adherence is usually a lot less than patients report because it is human nature over-estimate what we do, he said.

He explained that simple treatment regimens are best and recommended prescribing one treatment to patients and ensuring shared decision-making in order to improve adherence.

He advised that setting targets, such as using a certain amount of treatment by a certain time, can help patients with adherence.

Leave a Reply

[the_ad_placement id="main-ldb-public-2"]
[the_ad_placement id="main-ldb-mobile-public-2"]
Latest Issue
The Medical Independent – 24 June 2021

You need to be logged in to access this content. Please login or sign up using the links below.

[the_ad_placement id="main-mpu-public"]
Most Read
[the_ad_placement id="main-ldb-public-2"]
[the_ad_placement id="main-ldb-mobile-public-2"]