Text | Shewen
Ms. Wu, who works in a multinational company in Hangzhou, usually pays great attention to her personal image, but she is also very helpless. An "unspeakable secret" has been bothering her-severe itching of the back skin!
Itching! Itching! Itching! Anyone who itches knows how uncomfortable it is.
When no one is around, Ms. Wu will scratch. After years of scratching, the skin has formed pigmentation. Once I went out to travel with my girlfriend, and her girlfriend asked with concern: Are you being abused?
Ms. Wu always felt that this problem did not need to go to the hospital, but this concern of her best friend prompted her to see a doctor. After diagnosis, Ms. Wu's skin disease is called atopic dermatitis (AD).
Professor Gu Jun, Chairman of the Professional Committee of Dermatology and Venereal Diseases of the Chinese Society of Integrated Traditional Chinese and Western Medicine and Professor of Dermatology of Changhai Hospital of the Second Military Medical University, said that Ms. Wu's experience was very common in his clinic. In recent years, the number of patients with atopic dermatitis (AD) has increased significantly. One of the reasons for the increase is the change of lifestyle, and another reason is that more patients are diagnosed in hospitals.
Professor Gu Jun, Chairman of the Professional Committee of Dermatology and Venereal Diseases of China Association of Integrated Traditional Chinese and Western Medicine and Professor of Dermatology of Changhai Hospital of the Second Military Medical University.
May of 20021year was the first "Advertising Care Month" in China. Experts remind that online knowledge about skin itching is mixed, so don't make a good judgment only by online information. Atopic dermatitis needs to be diagnosed and treated in regular medical institutions.
Professor Dai Erhong from Shanghai Dermatology Hospital reminded that there are more patients with atopic dermatitis (AD) in infants and young children. If not treated in time, some children will feel inferior because of itchy skin, and even be prone to depression. Parents should pay attention to their children's skin condition and go to the hospital for consultation and diagnosis in time.
Children are prone to "strokes" and are accompanied by other allergies.
There are many small patients in Professor Dai Erhong's clinic. It is reported that atopic dermatitis (AD) does "favor" infants and adolescents. One in three infants 1 suffers from AD, and the incidence of AD in children is rising, and the prevalence of AD in adults is 4.6%.
Professor Dai Erhong from Shanghai Dermatology Hospital
Atopic dermatitis (AD) is a chronic, recurrent and inflammatory skin disease with familial genetic tendency. The main clinical manifestation is recurrent chronic eczema-like rash, accompanied by obvious itching and dry skin. Scratching due to severe itching is more likely to worsen the condition, showing chapped skin, scales and exudation.
AD is not only a skin disease, patients often suffer from allergic asthma, allergic rhinitis, allergic conjunctivitis and so on.
About 70% of children are mild patients. In most cases, children's AD symptoms will be relieved as they enter adulthood, but some children can continue to progress slowly and relapse after adulthood, which requires long-term effective management.
The problem is that parents lack professional knowledge and it is difficult to judge whether their children need treatment. Professor Dai Erhong suggested that parents should take their children to a regular hospital for professional diagnosis if they find that their children have abnormal skin. "After a doctor's diagnosis, some children may not need medication, as long as they are usually moisturized. However, some children will get treatment. If it is not treated early, the condition will become more serious and will recur. "
Why are there more and more advertisements?
The etiology of AD is unclear, and its mechanism is extremely complicated. Immune abnormality is considered to be one of the main pathogenesis of AD.
The name "atopic dermatitis (AD)" is unfamiliar to everyone, but everyone has heard of "eczema". Professor Gu Jun said that in the textbooks of 1980s, AD was listed as a special type of eczema, and there were fewer patients before. "When we did clinical research in 2005, it was not easy to find adult AD patients."
But now, according to epidemiological survey data, there are 80 million AD patients in China, most of whom are mild to moderate. He believes that there are two reasons for the increase in patients. First, with the improvement of industrialization, the incidence of AD will increase, and second, the medical community's understanding of AD has improved.
Professor Gu Jun introduced several key words in the clinical diagnosis of AD.
The first is that the patient has a history of eczema and dermatitis for more than 6 months;
The second is the patient's family history. Family members have allergic diseases such as allergic rhinitis, bronchial asthma and allergic conjunctivitis.
The third is the conclusion of laboratory examination.
Professor Gu said that the diagnosis technology of AD is not difficult, but some dermatologists know little about AD and are easily overlooked. "We have been training dermatologists in AD, hoping that more doctors can master the relevant knowledge."
In addition, the genetic tendency of AD is obvious. Professor Gu Jun compared psoriasis with AD.
If one parent suffers from psoriasis, the probability of their children getting sick is about 14%, and if both parents suffer from psoriasis, the probability of their children getting sick is 42%.
As for AD, if one parent has AD, the probability of the child getting sick is 50%. If both parents have AD, the literature shows that the probability of the child getting sick is 79.8%.
As mentioned earlier, infants with AD are easily "recruited". Another peak of this disease is the elderly, and the elderly also need to pay attention.
Professor Gu Jun said that AD is a disease that needs long-term treatment, so more popular science education should be provided to the public.
Fear of hormones? Standardize treatment and listen to the doctor.
After years of popular science propaganda, many people have some understanding of hormones, but some people are too worried about hormones.
Some drugs for external use in skin diseases do contain hormones. What medicine is better to take? Experts emphasize that doctors must make judgments according to their illness. Now there are innovative drugs to treat atopic dermatitis (AD), and doctors will give a plan according to the treatment needs.
Professor Gu Jun pointed out that topical glucocorticoids are the first-line treatment drugs for AD, which can effectively control inflammation and relieve symptoms in the short term, but long-term large-scale use may lead to skin and systemic adverse reactions, such as local hirsutism and vasodilation.
In the past, due to the limited types of drugs, some patients who were afraid of using hormones simply did not use drugs, which brought difficulties to the long-term treatment of AD.
With the introduction of PDE-4 inhibitors with innovative mechanisms, there are now more therapeutic drugs to choose from. According to Professor Gu Jun, the innovative PDE-4 inhibitor is a small molecule, non-hormonal anti-inflammatory drug, which can control the inflammatory reaction of AD by degrading cyclic adenosine monophosphate and improving its intracellular level, participating in regulating the release of pro-inflammatory cytokines and reducing the production of pro-inflammatory transmitters.
PDE-4 inhibitor has small molecular weight and is easily absorbed through the skin, which can avoid the adverse reaction of glucocorticoid and make it possible for children and adults with AD to maintain treatment for a long time, thus helping patients to relieve symptoms, repair skin barrier and reduce recurrence.
Talking about the treatment of AD, Professor Gu Jun emphasized that long-term management is advocated in clinic at present, aiming at reducing or eliminating itching, rash and factors that induce or aggravate inflammation, reducing and preventing recurrence and reducing or alleviating complications.
Specifically, skin lesions should be effectively controlled according to the patient's condition, and active maintenance treatment should be carried out after the acute stage. Although atopic dermatitis is difficult to cure, the symptoms of AD can be completely subsided or significantly improved through proper treatment and disease management.
Professor Dai Erhong often meets parents who can't insist on giving drugs to their children. "There is a concept that needs to be corrected. The child's rash seems to be better, but it's not. Compared with normal skin, there are still some problems. There is a slight inflammation below and the moisturizing function is missing, so we have to have a slow reduction process. "
In this way, atopic dermatitis (AD) can still be cured, but it needs long-term treatment and maintenance, and patients have to be patient with themselves.
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