Barrier-Restoring Therapies in Atopic Dermatitis: Current Approaches and Future Perspectives

Atopic dermatitis is a multifactorial, chronic relapsing, inflammatory disease, characterized by xerosis, eczematous lesions, and pruritus. The latter usually leads to an “itch-scratch” cycle that may compromise the epidermal barrier. Skin barrier abnormalities in atopic dermatitis may result from mutations in the gene encoding for filaggrin, which plays an important role in the formation of cornified cytosol. Barrier abnormalities render the skin more permeable to irritants, allergens, and microorganisms. Treatment of atopic dermatitis must be directed to control the itching, suppress the inflammation, and restore the skin barrier. Emollients, both creams and ointments, improve the barrier function of stratum corneum by providing it with water and lipids. Studies on atopic dermatitis and barrier repair treatment show that adequate lipid replacement therapy reduces the inflammation and restores epidermal function. Efforts directed to develop immunomodulators that interfere with cytokine-induced skin barrier dysfunction, provide a promising strategy for treatment of atopic dermatitis. Moreover, an impressive proliferation of more than 80 clinical studies focusing on topical treatments in atopic dermatitis led to growing expectations for better therapies

Management of mild‐to‐moderate atopic dermatitis with topical treatments by dermatologists: a questionnaire‐based study

Needs edits as it misses the important point of specifying the non-corticosteroids and should not be in the past tense. “Atopic dermatitis (AD) is a skin disease that causes red, dry skin patches that may itch intensely, and may be persistent or intemittent. Most patients with mild-to-moderate AD use topical corticosteroids or topical non-steroids to help them get better. This study looked at how dermatologists treat AD in different parts of the world. Dermatologists in North America, the Middle East, Asia, South America and the UK were asked questions about how they treat AD with topical medications. Most dermatologists use a type of cream or ointment called topical corticosteroids (TCSs) as the first treatment for ≤ 4 weeks. Weaker TCSs are used for younger patients and sensitive parts of the body. After using TCSs for a few weeks, patients visit their dermatologist to check if the treatment is working. Dermatologists advise patients to continue with the same TCS, use less of the TCS or change to non-steroid topical creams or ointments such as calcineurin inhibitors, crisaborole or topical JAK inhibitors. Sometimes treatments are changed if the patient's skin becomes infected, reacts badly to the medication or there are concerns about side effects. Patients also change treatment if their AD worsens. Sometimes it is difficult for patients to access treatments where they live. This study gives important information about how dermatologists treat mild-to-moderate AD. Treatment depends on factors like the patient's age, how severe the disease is, and if the patient is worried about using some creams and ointments. This information should help dermatologists plan the best treatment for patients with AD

Assumption without representation: the unacknowledged abstraction from communities and social goods

We have not clearly acknowledged the abstraction from unpriceable “social goods” (derived from communities) which, different from private and public goods, simply disappear if it is attempted to market them. Separability from markets and economics has not been argued, much less established. Acknowledging communities would reinforce rather than undermine them, and thus facilitate the production of social goods. But it would also help economics by facilitating our understanding of – and response to – financial crises as well as environmental destruction and many social problems, and by reducing the alienation from economics often felt by students and the public

Treatment of Verrucous Epidermal Nevus: Experience with 71 Cases

&lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; The aim of this study was to evaluate the clinical results of 71 cases with verrucous epidermal nevus (VEN) treated by cryotherapy or CO&lt;sub&gt;2&lt;/sub&gt; laser. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The files and photographs of patients with VEN who were treated in the laser unit of a tertiary hospital between January 2005 and December 2011 were evaluated. Pretreatment and 12-month follow-up photographs were evaluated using a 5-point scale: ‘excellent' (75-100% clearance), ‘good' (50-75% clearance), ‘fair' (25-50% clearance), ‘poor' (&lt;25% clearance) or ‘worse'. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Of 71 patients, 62 responded well to cryotherapy alone, and 9 facial VEN required CO&lt;sub&gt;2&lt;/sub&gt; laser treatment. Small VEN required relatively few treatments (mean 3.4) with 90% scoring ‘excellent' and 10% scoring ‘good'. Larger VEN required more treatments (mean 7.4) and did not respond as well, with 71% scoring ‘excellent', 14% scoring ‘good' and 14% scoring ‘fair'. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Our experience suggests that cryotherapy is the ideal treatment for small facial VEN, while ablation by CO&lt;sub&gt;2&lt;/sub&gt; laser should be considered an option for resistant facial lesions.</jats:p