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Atopic dermatitis (AD) (or atopic eczema) is a chronic skin condition that affects the quality of life of both adults and children. Topical corticosteroids (TCS) are the main ointments used for treatment, but there is a risk of side‐effects with their use, such as skin thinning. A class of drugs called topical calcineurin inhibitors, which include topical tacrolimus (and pimecrolimus), might provide an alternative to this problem, but since tacrolimus is a newer ointment compared with corticosteroids, there are still some questions about its effectiveness and safety.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 1, 2015

Due to the expanded clinical use of pimecrolimus, a review of both the evidence of its efficacy and of its potential economic evaluation is of importance for a more evidence- based clinical and policy decision making process. This is particularly relevant in reference to three clinical conditions: adult atopic dermatitis, adult seborrheic dermatitis, and adult psoriasis.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 25, 2017

Bibliographic details: Li RX, Zhu HL, Fan LM, Ni SK, Feng CE, Wu ZH.  Efficacy and tolerability of topical tacrolimus in the treatment of atopic dermatitis: a systematic review of randomized controlled trials. Journal of Clinical Dermatology 2007; 36(12): 757-760

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Eczema is a skin condition characterised by an itchy, red rash, which affects 5% to 20% of people worldwide. There is no cure, but many treatments can help improve the skin's condition, making life easier. In those for whom these treatments do not work well or who fear their long‐term effects, there is often a belief that either something in their diet, or something missing in their diet, is making their eczema worse.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 15, 2012

Atopic eczema (atopic dermatitis or childhood eczema) is a big problem worldwide. The skin of people with atopic eczema often contains high numbers of a bacterium called Staphylococcus aureus (S. aureus).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 16, 2008

Atopic eczema is the most common inflammatory skin disease of childhood in developed countries. The cause of atopic eczema is probably due to a combination of genetic and environmental factors. Atopic eczema varies in severity, often from one hour to the next and the disease can be associated with complications such as bacterial and viral infections. There is a substantial economic cost not only to the family of the person with atopic eczema but also to health services. Although there is currently no cure for atopic eczema, a wide range of treatments are used to control the symptoms. One such approach is a dietary one, whereby certain foods such as cows' milk are excluded on the basis that they are thought to cause eczema to worsen. The reason for undertaking this review is because the effectiveness of removing various foods from the diet in the short term management of atopic eczema is unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 23, 2008

Atopic eczema (eczema in short) is a common skin condition, where skin changes occur and cause redness, scaling, swelling, and skin thickening due to chronic scratching. It is associated with loss of sleep, self‐esteem, and quality of life. The frequency of eczema has increased over the past 10 years.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 10, 2013

At least one in seven children and one in 50 adults suffer from atopic eczema, a skin condition characterised by an itchy red rash. People with atopic eczema are allergic to things in the environment, such as house dust mites, and exposure to what they are allergic to may make their eczema worse. Specific allergen immunotherapy is a treatment that involves a course of injections or drops under the tongue containing the substance to which a person is allergic. The treatment can reduce the severity of a person's allergy and may therefore be able to reduce symptoms of atopic eczema. We evaluated whether specific allergen immunotherapy was better or worse than a standard treatment or placebo at improving disease severity and symptoms as assessed by participants, parents, or investigators.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 12, 2016

Atopic eczema is an itchy, inflammatory skin condition, which affects the quality of life of children with eczema and their parents or carers. It affects large and increasing numbers of children worldwide. Psychological and educational approaches have been used to complement medication in managing eczema, for example, by using simple psychological techniques to manage itching and scratching or sleep disturbance. Educational interventions, provided to individuals and groups by nurses or teams of specialists in hospital or community settings, have been used to help parents and children to understand the condition and their role in managing it successfully. However, the effect of these approaches has not been systematically measured.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 7, 2014

Bibliographic details: Pereira AM.  [Efficacy of allergen-specific immunotherapy for atopic dermatitis: a systematic review and meta-analysis of randomized controlled trials]. Revista Portuguesa de Imunoalergologia 2013; 21(3): 215-216 Available from: http://rpia.spaic.pt/arquivos/?imr=8&fmo=artigo&ia=1&ano=2013&edicao=639&id_pub=1&opcao=2013

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Evidence is inadequate to advise women to avoid specific foods during pregnancy or breastfeeding to protect their children from allergic diseases like eczema and asthma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 12, 2012

Bibliographic details: Penaloza Hidalgo B, Knight T, Burls A.  A systematic review of effectiveness and cost effectiveness of tacrolimus ointment for topical treatment of atopic dermatitis in adults and children. Birmingham: University of Birmingham, Department of Public Health and Epidemiology. West Midlands Health Technology Assessment Collaboration Report; 47. 2003 Available from: http://www.birmingham.ac.uk/research/activity/mds/projects/HaPS/PHEB/WMHTAC/REP/reports-list.aspx

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

The goal of this study was to perform a meta-analysis on randomized controlled trials of topical therapies compared against their vehicles, and systemic therapies compared against their placebos, and to record how these therapies changed the magnitude of pruritus associated with atopic dermatitis. A systematic search of the literature was performed using Medline, Embase, and the Cochrane Controlled Clinical Trials Register, as well as follow-up references in retrieved articles. Data regarding the magnitude of the change in pruritus was extracted from eligible publications and categorized according to the type of treatment modality. Standard inverse variance fixed-effects meta-analysis was used to calculate the pooled estimates for randomized controlled trials falling under each type of treatment. Overall, the topical treatments were more successful at reducing atopic pruritus compared to the systemic treatments. Calcineurin inhibitors were the most effective antipruritic agent.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

PURPOSE OF REVIEW: To update and assess the quality of the evidence concerning the efficacy of allergen immunotherapy for atopic eczema. Desensitization for eczema as a clinical manifestation of food allergy was not a target of this review.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2007

BACKGROUND: Controversy exists regarding the potential role of specific immunotherapy (SIT) as a therapeutic intervention for patients with atopic dermatitis (AD) and aeroallergen sensitivity.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Atopic dermatitis (AD) is a relapsing inflammatory skin disease with a considerable social and economic burden. Functional textiles may have antimicrobial and antipruritic properties and have been used as complementary treatment in AD. We aimed to assess their effectiveness and safety in this setting. We carried out a systematic review of three large biomedical databases. GRADE approach was used to rate the levels of evidence and grade of recommendation. Meta-analyses of comparable studies were carried out. Thirteen studies (eight randomized controlled trials and five observational studies) met the eligibility criteria. Interventions were limited to silk (six studies), silver-coated cotton (five studies), borage oil, and ethylene vinyl alcohol (EVOH) fiber (one study each). Silver textiles were associated with improvement in SCORAD (2 of 4), fewer symptoms, a lower need for rescue medication (1 of 2), no difference in quality of life, decreased Staphyloccosus aureus colonization (2 of 3), and improvement of trans-epidermal water loss (1 of 2), with no safety concerns. Silk textile use was associated with improvement in SCORAD and symptoms (2 of 4), with no differences in quality of life or need for rescue medication. With borage oil use only skin erythema showed improvement, and with EVOH fiber, an improvement in eczema severity was reported. Recommendation for the use of functional textiles in AD treatment is weak, supported by low quality of evidence regarding effectiveness in AD symptoms and severity, with no evidence of hazardous consequences with their use. More studies with better methodology and longer follow-up are needed.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

INTRODUCTION: Atopic dermatitis (AD) is a disease that mainly affects the pediatric population involving chronic and repetitive inflammatory skin manifestations. Its evolution is known as atopic march, which is characterized by the occurrence of respiratory and food allergies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

PURPOSE: To summarize success rates of the topical calcineurin inhibitors tacrolimus and pimecrolimus in treating atopic dermatitis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

OBJECTIVE: To identify whether nutrient supplementation with probiotics, prebiotics, formula, or fatty acids prevents the development of atopic dermatitis (AD) or reduces the severity of AD in newborns to children younger than 3 years.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

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