PMID- 27910751
OWN - NLM
STAT- MEDLINE
DCOM- 20170207
LR  - 20170207
IS  - 2162-660X (Electronic)
IS  - 0743-4863 (Linking)
VI  - 33
IP  - 3
DP  - 2016
TI  - Recent Advances in Pharmacotherapeutic Paradigm of Mild to Recalcitrant Atopic 
      Dermatitis.
PG  - 213-263
AB  - Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder 
      characterized by perivascular infiltration of immunoglobulin E (IgE), T 
      lymphocytes, and mast cells. The key factors responsible for the pathophysiology 
      of this disease are immunological disorders and defects in epidermal barrier 
      properties. Pruritus, intense itching, psychological stress, deprived physical 
      and mental performance, and sleep disturbance are the hallmark features of this 
      dermatological disorder. Preventive interventions such as educational programs, 
      avoidance of allergens, and exclusive care toward the skin could play a partial 
      role in suppressing the symptoms. Based on the available clinical evidence, 
      topical corticosteroids (TCs) are among the most commonly prescribed agents; 
      however, these should be selected with care. In cases of steroid phobia, 
      persistent adverse effects or chronic use, topical calcineurin inhibitors can be 
      considered as a promising adjunct to TCs. Recent advances in the 
      pharmacotherapeutic paradigm of atopic diseases exploring the therapeutic 
      dominance of nanocarrier-mediated delivery is also discussed in this 
      evidence-based review with regard to the treatment of AD. The present review 
      summarizes the available clinical evidence, highlighting the current and emerging 
      trends in the treatment of AD and providing evidence-based recommendations for 
      the clinicians and health care professionals. Available evidence for the 
      management of pediatric and adult atopic dermatitis (AD; atopic eczema) of all 
      severities is explored. The management of other types of dermatitis, such as 
      irritant contact dermatitis, seborrheic dermatitis, neurodermatitis, perioral 
      dermatitis, stasis dermatitis, and allergic contact dermatitis are outside the 
      scope of current review article. The presented studies were appraised using a 
      unified system called the "Strength of Recommendation Taxonomy (SORT)", which was 
      developed by the editors of several US family medicine and primary care journals 
      (i.e., American Family Physician, Family Medicine, Journal of Family Practice, 
      and BMJ USA).1 The searched studies were graded using a 3-point scale based on 
      the quality of methodology (e.g., randomized control trial, case control series, 
      clinical cohort studies, case series, etc.) and key emphasis of the trial (i.e., 
      diagnosis, treatment/prevention/ screening, or prognosis) as follows: I. 
      Good-quality patient-oriented evidence (i.e., evidence assessing consequences 
      that matter to patients: mortality, morbidity, improvement in signs and symptom, 
      quality of life, and socioeconomic factors); II. Limited-quality patient-oriented 
      evidence; and III. Other evidence such as consensus guidelines, expert opinion, 
      case control trial, or disease-related information. Recommendations for 
      nonpharmacological and pharmacological approaches were established based on the 
      best available evidence and are graded as follows: A. Recommendations based on 
      consistent and good-quality patient-oriented evidence; B. Recommendations based 
      on inconsistent or limited-quality patient-oriented evidence; and C. 
      Recommendations based on consensus, expert opinion, case control evidence, or 
      disease-related information.
FAU - Hussain, Zahid
AU  - Hussain Z
AD  - Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak 
      Alam 42300, Selangor, Malaysia.
FAU - Sahudin, Shariza
AU  - Sahudin S
AD  - Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, Bandar Puncak 
      Alam 42300, Selangor, Malaysia.
FAU - Thu, Hnin Ei
AU  - Thu HE
AD  - Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 
      Jalan Yaacob Latif, Bandar Tun Razak 56000 Cheras, Kuala Lumpur, Malaysia.
FAU - Shuid, Ahmad Nazrun
AU  - Shuid AN
AD  - Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 
      Jalan Yaacob Latif, Bandar Tun Razak 56000 Cheras, Kuala Lumpur, Malaysia.
FAU - Bukhari, Syed Nasir Abbas
AU  - Bukhari SN
AD  - Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan 
      Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia.
FAU - Kumolosasi, Endang
AU  - Kumolosasi E
AD  - Department of Pharmacology, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, 
      Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Crit Rev Ther Drug Carrier Syst
JT  - Critical reviews in therapeutic drug carrier systems
JID - 8511159
RN  - 0 (Dermatologic Agents)
RN  - 0 (Drug Carriers)
SB  - IM
MH  - Administration, Cutaneous
MH  - Dermatitis, Atopic/*drug therapy/prevention & control/therapy
MH  - Dermatologic Agents/*administration & dosage/*therapeutic use
MH  - Drug Carriers/*administration & dosage
MH  - Evidence-Based Medicine
MH  - Humans
MH  - Nanotechnology
EDAT- 2016/12/03 06:00
MHDA- 2017/02/09 06:00
CRDT- 2016/12/03 06:00
PHST- 2016/12/03 06:00 [entrez]
PHST- 2016/12/03 06:00 [pubmed]
PHST- 2017/02/09 06:00 [medline]
AID - 2a76b9041f3d17be,0413fc3516c676f7 [pii]
AID - 10.1615/CritRevTherDrugCarrierSyst.2016015219 [doi]
PST - ppublish
SO  - Crit Rev Ther Drug Carrier Syst. 2016;33(3):213-263. doi: 
      10.1615/CritRevTherDrugCarrierSyst.2016015219.