Title ATOPIJSKI DERMATITIS: KLINIČKA SLIKA I SUVREMENA TEAPIJA
Author Lucija Krčelić
Mentor Larisa Prpić Massari (mentor)
Committee member Marija Kaštelan (predsjednik povjerenstva)
Committee member Sandra Peternel (član povjerenstva)
Committee member Srđan Banac (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Dermatovenerology) Rijeka
Defense date and country 2020-07-17, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Dermatovenerology
Abstract Atopijski dermatitis je kronična, recidivirajuća, upalna bolest kože u kojoj se izmjenjuju epizode egzacerbacije i remisije. Od patogenetskih mehanizama nastanka spominju se poremećena funkcija epidermalne barijere, imunosnog odgovora, kolonizacija kože mikroorganizmima i pojačana sklonost infekcijama kože. Hanifin i Rajka su 1980. godine odredili velike i male kriterije kliničke slike za postavljanje dijagnoze ove bolesti, a 2014. godine predloženi su njihovi revidirani kriteriji koji su sada dijagnostički standard. Bolest ima tri klinička stadija – dojenački, dječji i odrasli stadij, a kod najvećeg broja pacijenata bolest se prvi put pojavljuje u dojenačkoj dobi. U dojenačkoj dobi lezije zahvaćaju lice i tjeme te ekstenzorne površine ekstremiteta dok je pelensko područje pošteđeno. U dječjoj dobi papule i plakovi prekrivaju zapešća, gležnjeve, te antekubitalne i poplitealne jame, dok se u odrasloj dobi promjene uglavnom nalaze na fleksornim površinama ekstremiteta te na području lica i vrata. Zajedničke osobine svih stadija bolesti neovisno o dobi su svrbež i suha koža. Svrbež može biti prisutan tijekom dana, ali je intenzivniji tijekom večeri i noći što često dovodi do problema sa spavanjem i drugih psihosocijalnih problema. Otprilike 80% svih oboljelih će kasnije u djetinjstvu razviti alergijski rinitis ili astmu, a s razvojem ovih bolesti, veliki broj oboljelih navodi poboljšanje simptoma atopijskog dermatitisa. Sekvencionalna pojava atopijskog dermatitisa, astme i alergijskog rinitisa obilježena je terminom „atopijski marš“. Blagi atopijski dermatitis liječi se primarno lokalnim kortikosteroidima u periodima egzacerbacije, ili ponekad drugim lokalnim pripravcima. U terapiju srednje teškog atopijskog dermatitisa uvodi se i fototerapija uz lokalno liječenje, dok se teški atopijski dermatitis liječi sistemskom imunosupresijom. Dupilumab spada u novu biološku terapiju i za sada je jedini biološki lijek registriran za liječenje teških oblika atopijskog dermatitisa.
Abstract (english) Atopic dermatitis is a chronic inflammatory skin condition with episodes of egzacerbation and remission. It is characterized by the involvment of skin barrier defects, innate immune response, colonization of the skin with microorganisms and frequent skin infections. In 1980. Hanifin and Rajka suggested diagnostic criteria based on the minor and major features of the clinical presentation which was revisited in 2014. when a simplified version was suggested as the new diagnostic criteria. There are three stages of atopic dermatitis – the infantile stage, the childhood stage and the adult stage, and the condition most often first appears during infancy. In the infantile stage the lesions affect the face and the scalp, extensor surfaces of the extremities while the diaper area is spared. In the childhood stage lesions appear on the wrists, ankles, hands and feet and elbow and knee flexures, while in the adult stage they mostly appear on the flexor surfaces of the extremities, the face and the neck and the distal extremities. Pruritus and xerosis are two characteristics that appear in all three stages. Pruritus can be present during the day but it is more intense during the night which often leads to trouble with sleeping and other problems with psychosocial functioning. About 80% of all patients will develop allergic rhinitis or asthma, and with the development of these conditions, the symptoms of atopic dermatitis sometimes improve. „Atopic march“ is a term developed to describe the progress of atopic dermatitis to allergic rhinitis and asthma. Mild atopic dermatitis is treated primarly with local corticosteroids in the periods of egzacerbation, or sometimes other local medication. Moderate atopic dermatitis is alongside local corticosteroids also treated with phototherapy. Severe forms of atopic dermatitis require systematic imunosupressors. Dupilumab is a new biologic medication which is currently the only one registered for the treatment of severe forms of atopic dermatitis.
Keywords
atopijski dermatitis
atopijski marš
biološka terapija
fototerapija
lokalni kortikosteroidi
svrbež
Keywords (english)
atopic dermatitis
atopic march
biologic therapy
itch
local corticosteroids
phototherapy
Language croatian
URN:NBN urn:nbn:hr:184:347558
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-11-30 12:05:31