title: Apheresis in the treatment of recalcitrant atopic dermatitis: case series and review of the literature.
abstract: BACKGROUND
  Atopic dermatitis is a chronic disabling inflammatory skin disorder, typically characterized by intensely itching, oozing, crusted, eroded vesicles or papules developing on erythematous plaques. Conventional treatments, both topical and systemic, may produce unsuccessful and unsatisfactory results.
  
  
  OBJECTIVE
  we aimed to assess the efficacy of apheretic treatments in patients with severe, recalcitrant AD, in particular, the pruritic component.
  
  
  METHODS
  four patients affected by recalcitrant and debilitating atopic dermatitis, who had previously received conventional topical and systemic therapies with poor clinical improvement, were treated with extracorporeal photopheresis or therapeutic plasma exchange.
  
  
  RESULTS
  a satisfactory response to apheresis was observed with a reduction of pruritus and skin lesions.
  
  
  CONCLUSIONS
  In our experience, apheretic therapies might be used as monotherapy but, more effectively, in combination with topical and/or systemic treatments. Indeed, they proved to be a safe "enhancer" for increasing the efficacy of conventional therapeutics.
authors.affiliation: Dermatology Department, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chiricozzi
authors.affiliation: Dermatology Department, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Faleri
authors.affiliation: SIMT Tor Vergata Hospital, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lanti
authors.affiliation: SIMT Tor Vergata Hospital, Rome, Italy,, Immunohematology Section, Tor Vergata University, Rome, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Adorno
authors.affiliation: Department of Oral and Maxillofacial Surgery, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lorè
authors.affiliation: Dermatology Department, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Chimenti
authors.affiliation: Dermatology Department, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Rosita
authors.initials: R
authors.lastname: Saraceno
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001781:Blood Component Removal / Q000009:adverse effects; D065095:Calcineurin Inhibitors / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003876:Dermatitis, Atopic / Q000628:therapy*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D017893:Photopheresis; D019233:Retreatment / Q000379:methods; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D008727:Methotrexate
keywords: atopic dermatitis; extracorporeal photopheresis; therapeutic plasma exchange