The historical basis of a misconception leading to undertreating atopic dermatitis (eczema): facts and controversies.
The quest for clarifying the pathophysiology of atopic dermatitis (eczema) has lasted for 25 centuries. Yearning to discern the primum movens of atopic dermatitis, physicians aimed to identify the curative therapy. Recent scientific efforts has brought to the light an ever-growing amount of interplaying pathophysiologic factors, including the epidermal barrier, the digestive flora, food, early infections and antigenic stimulations, and innate and adaptive immune response; however, overfocusing on some of these factors, along with misconceptions about the benefit/risk balance of topical therapies, has sometimes led topical therapies being disregarded. Reviewing the history of pathophysiologic concepts, we aim to return topical therapies to the center of the clinical management of atopic dermatitis.
Farhi
David
D
Service de Dermatologie, Pavillon Tarnier, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université René Descartes - Paris V, 75014 Paris, France. david.farhi@cch.aphp.fr
Taïeb
Alain
A
Tilles
Gérard
G
Wallach
Daniel
D
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D000529:Complementary Therapies / Q000379:methods; D003876:Dermatitis, Atopic / Q000145:classification / Q000517:prevention & control / Q000628:therapy*; D003879:Dermatologic Agents / Q000008:administration & dosage; D003888:Desensitization, Immunologic / Q000379:methods; D004035:Diet Therapy / Q000379:methods; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D004485:Eczema / Q000145:classification / Q000517:prevention & control / Q000628:therapy*; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D012107:Research Design
D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D003879:Dermatologic Agents; D004365:Drugs, Chinese Herbal; D007166:Immunosuppressive Agents