解惑AD | 人们应该知道的 “ 关于特应性皮炎的10个件事 ”

提高特应性皮炎对患者及其家属影响的认识

不仅仅是“皮疹”

特应性皮炎不仅是一种“皮疹”，它是一种慢性免疫介导的疾病，是全身性的、无法治愈的，在皮肤上可见，严重影响患者的生活质量。^[1,2]

患病率

特应性皮炎的全球患病率差异很大，据报道，儿童患者的患病率在5%-20%之间^[3,4] ，估计10%-40%的AD患儿为中重度。^[4-11]

全世界范围内，2–10%的成人受到特应性皮炎的影响^[12]，其中重度特应性皮炎的成人患者占2%-8%。^[13]

我国1-7岁儿童特应性皮炎的患病率为12.94%，其中，23.97%为中度，1.44%为重度。^[14]

成人期&儿童期起病

特应性皮炎在不同的起病年龄和严重程度下，遵循可变的自然病程^[15]。虽然特应性皮炎可以在青春期后消退，但月30%的特应性皮炎患儿在成年后仍继续患病。15%-30%的成人特应性皮炎起病与成年期。^[16-21]

对皮肤的影响

中重度特应性皮炎的特征是身体大部分或敏感部位出现疼痛性病变，可覆盖超过50%的体表^[23]。症状包括剧烈瘙痒、皮肤干燥、开裂、发红、结痂和渗出^[22,23]。在搔痒处持续搔抓会损害皮肤，增加感染风险。^[23-25]

对身体健康的影响

高达72%的中重度特应性皮炎患者存在由共同的潜在炎症过程引发的其他特应性共病，包括：哮喘、鼻息肉、过敏性鼻炎、过敏性结膜炎、食物过敏和慢性鼻窦炎。^[26]

对心理健康的影响

由于特应性皮炎的可见症状和病变通常出现在手和脸上，许多特应性皮炎成人患者会感到尴尬和自卑，经常会逃避工作和社交^[1,27,28]。在一项已发表的研究中，约40%的青少年和1/4的儿童特应性皮炎患者因患病而遭受欺凌，并且这两个年龄组的患者中均有一半感到不快乐或抑郁^[27]。

对社会的影响

特应性皮炎患者的睡眠紊乱会导致疲劳和日间功能受损^[29]，包括工作表现^[30,31]。特应性皮炎患者报告说，发病期间10%的工作表现会受到影响，平均旷工2.7天^[27] 。特应性皮炎儿童患者的学习成绩也会由于旷课而受到影响^{[27,28,32,33]}。特应性皮炎控制不良给患者、家庭和整个社会都带来了经济负担。随着疾病严重程度的增加，经济负担也随之增加。^[30,34-36]

现在治疗选择

目前特应性皮炎的管理策略包括恢复皮肤屏障、对症治疗、减少疾病恶化次数、严重程度和持续时间，同时尽量减少治疗相关的不良反应^[24,37]。当局部治疗控制不良时，患者需采用系统治疗^[18]。系统性使用免疫抑制剂通常是超说明书使用，且会导致广泛的免疫抑制。这些和口服糖皮质激素一样，都有潜在的副作用，可能会限制其长期使用。^[38-41]

未满足的额外选择需求

许多中重度特应性皮炎患者报告说，即使使用了局部和/或系统性治疗，仍有严重瘙痒和体征及症状加重，这表明仍需要额外的治疗选择。^[42-46]

达到最佳控制

新的治疗方案旨在为控制不良的特应性皮炎患者带来更有针对性的长期系统性治疗方案。^[47]

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有效期：2023年5月28

#顽固性湿疹就是AD

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