維基百科

異位性皮膚炎

異位性皮膚炎Atopic dermatitis（AD），又叫做異位性濕疹，呢個係一種長期嘅皮膚發炎[1]。 AD通常亦簡稱做濕疹，但係呢個術語亦都係用嚟指稱皮膚炎，呢個係皮膚病嘅一個大類 [1][2]。AD會搞到皮膚發痕、發紅、腫脹同損裂[1]。受影響嘅區域可能會滲出透明液體，嗰啲液體隨著時間會變得濃稠[1]。

大約20%有異位性皮膚炎嘅人係會喺佢哋成世人嘅某個階段受到異位性皮膚炎嘅影響[1][3]。呢個喺年紀細啲嘅細路入面更加常見[4]。女性比男性更加容易受到影響[5]。好多人會隨住年齡嘅增長就會擺脫呢種狀況[4]。

雖然呢種情況可能喺任何年齡發生，但通常喺童年開始，嚴重程度會隨著時間嘅推進而改變[1][4]。對於一歲以下嘅細路，佢哋塊面、手腳同埋身體嘅大部分部位都可能會受到影響[4]。嗰啲細路隨住年齡嘅增長，佢哋嘅膝頭哥內側、手肘摺位同埋頸周圍嘅區域成日最受影響[4]。在大人裡面，手同腳通常都會受到影響[4]。𢱑痕最受影響嘅區域會搞到濕疹惡化仲會增加皮膚感染嘅風險[1]。好多患咗異位性皮膚炎嘅人都會出現鼻敏感或者氣喘[1]。

異位性皮膚炎嘅發病原因到而家都仲係未知嘅，但相信係涉及同遺傳、免疫系統功能障礙、環境暴露同埋皮膚半透膜（中文：半透膜）嘅滲透性有困難有關[1][4]。如果同卵雙胞胎入面嘅其中一個受到影響，咁另一個就會有85%嘅機會患咗呢種病[6]。住喺城市同埋氣候乾燥嘅人會更容易受到影響[1]。接觸某啲化學物質或者洗手得好密令症狀惡化[1]。雖然情緒壓力可能會令症狀惡化，但呢個並唔係原因[1]。 呢種疾病並唔係傳染病[1]。 診斷通常係根據體徵、症狀同埋家族史[4]。

異位性皮膚炎嘅治療包括咗避免去做令病情惡化嘅嘢，同埋透過皮膚護理去增強皮膚屏障同埋調和皮膚底層嘅炎症。潤膚膏係用嚟令到皮膚唔會太乾燥，同埋預防AD嘅發作。抗發炎皮質類固醇（中文：皮質類固醇）乳霜係用嚟控制發作[4]。如果其他措施都無效嘅話，亦可以用基於鈣調神經磷酸酶抑制劑（他克莫司或者吡美莫司）嚟控制耀斑[1][7]。某啲抗組織胺藥丸可能對止痕有幫助[4]。通常會令情況惡化嘅因素包括咗屋塵蟎、壓力同埋季節性因素[8]。光照治療（中文：光照治療）可能對某些人有用[1]。除非有繼發性嘅細菌感染或者係患者身體唔舒服，如果唔係抗生素（口服或局部使用）通常就無幫助[9]。對大多數人嚟講，排除飲食（中文：排除飲食）並無好處，淨係喺懷疑食物過敏嗰陣時先至需要咁樣做[10]。比較嚴重嘅AD病例可能需要全身性藥物，例如係環孢素、甲氨蝶呤、 杜皮魯馬或者係巴里西替尼 。

呢個症狀嘅其他名包括有「嬰兒濕疹infantile eczema」、「彎曲濕疹flexural eczema」、「貝氏癢疹prurigo Besnier」、「過敏性濕疹allergic eczema」同埋「神經性皮膚炎neurodermatitis」[11]。

患咗異位性皮膚炎嘅細路。

症狀係指異位性皮膚炎患者感受到嘅感覺，而體徵係指對AD引起可見變化嘅描述。

特應性濕疹嘅模式會隨年齡而變化。

異位性皮膚炎嘅主要症狀係𢱑痕，而且可能好劇烈。有啲人會覺得有灼熱感、酸痛或者痛[1]。

患咗異位性皮膚炎（AD）嘅人皮膚通常比較乾燥，膚色深啲嘅人看起上嚟會呈灰色。AD嘅區域界線唔會好明確，通常會發炎（淺色嘅皮膚會呈紅色，深色嘅皮膚會呈紫色或者深啡色）[12]。 表面嘅變化包括：

  • 鱗屑龜裂（皮膚破損）
  • 腫脹（水腫）
  • 刮傷（擦傷）
  • 凹凸洞（丘疹（中文：丘疹））
  • 滲出透明清澈嘅液體
  • AD 長期存在嘅皮膚變厚（地衣化）[1]。

濕疹通常喺BB嘅臉頰、四肢外圍同埋身體開始，濕疹隨著細路嘅成長會沉澱喺皮膚嘅褶皺嗰度，例如係膝頭後面、手肘嘅褶皺位、頸嘅周圍、手腕同埋屁股嘅褶皺下面[13]。身體嘅任何部位都可以受到異位性皮膚炎嘅影響[14]。

異位性皮膚炎引起嘅發炎通常會留低「足跡」，叫做發炎後色素沉著，佢嘅顏色可能比正常嘅皮膚深咗或者淺咗。呢啲痕跡唔係疤痕，只要有效治療底層嘅異位性皮膚炎，嗰啲痕跡最後會喺幾個月內恢復返正常[15]。

異位性皮膚炎患者通常會出現成身乾燥同鱗狀皮膚嘅（除咗尿片區域之外），仲喺手臂或腳嘅彎曲位、塊面同條頸形成極之痕嘅紅色、斑點、凸起嘅病變[16][17][18][19][20]。

成因

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而家仲未清楚異位性皮膚炎嘅病因，但一啲證據表明同環境、免疫仲有潛在嘅遺傳因素有關[21]。

污染

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美國同英國嘅異位性皮膚炎自1970年以嚟嘅發生率增加咗３-６倍[22]。即使係今時今日，喺４歲之前由發展中國家移民去到工業化國家嘅人，經歷異位性皮膚炎嘅風險都會急劇咁上升，而且當住喺工業國家嘅城市化地區嗰陣時，嗰啲人仲會有額外嘅風險[23]。最近嘅研究都揭示咗呢啲嘢同其他數據，強烈咁表明早期嘅工業接觸可能會引起異位性皮膚炎[22][24]。異氰酸酯同二甲苯呢啲化學物質會阻止皮膚細菌產生神經酰胺-獅人脂家族嘅脂質[22][24]。早期缺乏呢啲脂質就可以預測到邊啲細路將會繼續患上異位性皮膚炎[25][26][27][28]。呢啲化學物質亦都會直接激活皮膚入面嘅一種叫做TRPA1嘅痕癢受體[29]。二甲苯和二異氰酸酯嘅工業製造同使用量由1970年開始就大大咁增加，從而令到對呢啲物質嘅平均接觸量大大咁擴大。例如，呢啲化學物質係已知會增加異位性皮膚炎風險或者搞到症狀惡化嘅幾種接觸成分，包括咗：燃燒劑、汽車廢氣、壁紙黏合劑、油漆、非乳膠泡沫傢俬、香煙煙霧，仲有聚酯、尼龍同埋氨綸[22][23][24]。

氣候

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低濕度同低溫都會增加異位性皮膚炎患者出現紅斑嘅發病率同埋風險[30]。

遺傳學

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可能導致異位性皮膚炎嘅基因主要係負責免疫反應嘅基因（例如TH2細胞激素同埋JAK-STAT途徑基因）仲有皮膚屏障嘅基因（例如係絲聚蛋白Filaggrin、claudin-1、洛麗蛋白Loricrin）。

免疫反應：好多AD患者都有家族史或者係個人過敏體質史。過敏體質係一個用嚟形容產生大量IgE個體嘅術語。呢啲人會增加咗患氣喘、鼻敏感、皮膚炎、風癩同埋過敏性鼻炎嘅傾向[16][17]。高達80%嘅異位性皮膚炎患者嘅總IgE水平或過敏原特異性IgE水平都升高咗[31]。

皮膚屏障：大約有30%嘅AD患者產生絲聚蛋白（英文：Filaggrin）FLG嘅基因發生突變，呢個會增加咗早期異位性皮膚炎嘅發作同發展成哮喘嘅風險[32][33]。不過，絲聚蛋白或分解產物嘅表達對異位性皮膚炎嘅風險並無提供預測嘅作用[26]。

AD患者亦都有緊密連接蛋白Claudin-1嘅表達跌咗，呢個會搞到表皮嘅生物電屏障功能惡化咗[34]。

衛生假說

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根據衛生假說，兒童早期接觸某啲微生物（例如係腸道菌叢同埋蠕蟲寄生蟲）可以促進免疫系統嘅發育嚟預防過敏性疾病[35]。呢種接觸喺現代「衛生」環境入面係有限嘅，而免疫系統發育唔正確就會好容易對無害嘅物質產生過敏。

關於異位性皮膚炎，呢個假設存在一啲支持[36]。嗰啲喺成長過程入面接觸過狗嘅人，佢哋患AD嘅風險會低啲[37]。另外，流行病學研究亦都支持蠕蟲對AD嘅保護作用[38]。同樣，衛生條件差嘅細路患AD嘅風險低啲，飲用未經高溫消毒牛奶嘅細路亦都係咁樣[38]。

致敏原

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異位性皮膚炎喺一小部分嘅情況下係由對牛奶呢啲食物過敏引起嘅[39]，但係越來越多人認為食物過敏好可能係由AD引起嘅皮膚屏障功能障礙引起，而唔係食物過敏引起嘅皮膚問題[40]。異位性皮膚炎有時同乳糜瀉同非乳糜瀉麩質敏感性有關。由於無麩質飲食（英文：Gluten-free diet）GFD可以改善呢啲病例嘅症狀，所以麩質似乎係呢啲病例入面造成異位性皮膚炎嘅原因[41][42]。富含水果嘅飲食似乎對預防異位性皮膚炎有保護作用，而對於深度加工食品（英文：Convenience food）就啱啱相反[38]。

接觸食物或環境入面嘅致敏原都有可能加劇現有嘅異位性皮膚炎症狀[43]。例如，啲人認為接觸塵蟎會增加患上AD嘅風險[44]。

金黃葡萄球菌定植喺皮膚上面喺異位性皮膚炎患者入面極為普遍[45]。AD患者嘅皮膚屏障異常會俾金黃葡萄球菌利用嚟觸發細胞激素嘅表達嚟加重病情[46]。不過，異位性皮膚炎係非傳染性嘅，所以唔可能係由高傳染性微生物直接去引起。另外，抗葡萄球菌治療對於治療感染或未感染濕疹嘅金黃葡萄球菌嘅有效性並冇足夠嘅證據[47]。

硬水

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細路嘅異位性皮膚炎嘅發病率可能同屋企飲用水嘅碳酸鈣水平或者「硬度」有關[48][49]。喺硬水地區生活亦都可能係早期AD發展嘅一部分。不過，當AD已經形成嗰時，喺屋企用軟水器並唔能夠減輕症狀嘅嚴重程度[49][50]。

病理生理學

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過度嘅２型發炎係異位性皮膚炎病理生理學嘅基礎[51][52]。

表皮屏障嘅破壞被認為喺異位性皮膚炎嘅發病機制入面發揮住重要嘅作用[31]。表皮屏障嘅破壞會令過敏原穿透表皮去到更深層嘅皮膚。呢個會活化咗表皮炎症樹突狀細胞同埋先天淋巴樣細胞，跟住將輔助T細胞吸引去到皮膚[31]。呢種失調嘅Th2炎症反應被認為係會導致濕疹病變[31]。Th2輔助T細胞被活化，搞到發炎細胞因子釋放咗出嚟，包括IL-4 、 IL-13同IL-31，呢啲細胞因子會激活下游嘅JAK激酶 (Jak)路徑。活躍嘅Jak路徑會搞到活化咗發炎同埋漿細胞同B淋巴細胞嘅下游嚟釋放抗原特異性IgE，搞到進一步嘅發炎[31]。其他被認為係參與異位性皮膚炎發炎嘅CD4+輔助T細胞途徑包括咗Th1、Th17同埋Th22途徑[31]。一啲特定嘅CD4+輔助T細胞發炎路徑更加成日見到喺AD患者嘅特定種族群體入面（例如Th-2同Th-17路徑成日見喺亞洲人裡面），呢個可能解釋到異位性皮膚炎嘅表型喺唔同族群表現嘅差異[31]。

絲聚蛋白基因FLG嘅突變亦都會搞到皮膚屏障受損，進一步搞到異位性皮膚炎嘅發生[31]。絲聚蛋白Filaggrin係由表皮皮膚角質層（中文：角質層）細胞（角質形成細胞）產生。絲聚蛋白刺激皮膚細胞去釋放保濕因子同脂質基質材料，令到隔離嘅角質細胞黏附，對皮膚屏障有幫助[31]。絲聚蛋白嘅功能喪失突變會令到呢個脂質基質同外部保濕因子嘅流失，跟住搞到皮膚屏障嘅破壞。皮膚屏障嘅破壞會搞到透皮水分流失（搞到異位性皮膚炎裡面成日見嘅乾燥症或者係皮膚乾燥），仲有抗原同過敏原滲透去到表皮層[31]。聚絲蛋白突變亦都同皮膚上發現嘅天然抗菌肽嘅減少有關；跟住搞到皮膚菌群破壞同埋細菌過度生長（通常係金黃葡萄球菌過度生長或者係定植）[31]。

異位性皮膚炎亦都同皮膚入面嘅搔癢原（刺激去𢱑痕或者發痕嘅分子）嘅釋放有關[31]。角質形成細胞、肥大細胞、嗜酸性白血球同T細胞喺皮膚度釋放搔癢原；令到表皮和真皮入面嘅Aδ纖維同C組神經纖維激活咗嚟產生痕同埋痛嘅感覺[31]。搔癢原包括咗Th2細胞激素 IL-4、IL-13、IL-31、組織胺，仲有各種神經肽[31]。去𢱑病灶部位嘅機械刺激亦都會搞到痕癢原釋放出嚟，令到𢱑痕-刮傷循環，即係喺病灶部位𢱑痕之後，會增加咗搔癢或者痕癢嘅程度[31]。慢性去𢱑病變嘅部位可以引起皮膚加厚或者苔癬化，又或者係結節性癢疹嘅結節性痕癢（嚴重痕癢嘅全身性結節）[53]。

異位性皮膚炎患者嘅屏障失調同埋免疫調節障礙嘅另一個因素可能係因為少咗緊密連接蛋白Claudin-1。有研究已經被證明話抑制人類角質形成細胞入面嘅Claudin-1嘅表現既可以降低緊密連接功能，又可以增加體外角質形成細胞嘅增殖。呢個亦發現會損害表皮生物電屏障嘅功能[34]。

診斷

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異位性皮膚炎通常係要透過臨床診斷，意味呢樣嘢只係根據體徵同症狀而冇特別測試[54]。為咗研究而制定嘅幾個唔同嘅標準亦都已經得到驗證嚟幫手診斷[55]。其中，英國嘅診斷標準係基於哈尼芬Hanifin同埋拉吉卡嘅研究，已經得到咗最廣泛嘅驗證[55][56]。

英國嘅診斷標準[56]
啲人實有皮膚發痕，或者有摩擦或者刮損嘅跡象，仲有以下３種或更多嘅症狀：
涉及皮膚皺紋：腳踝前面、手坳位、腳坳位、眼周或者頸部皮膚（或10歲以下細路嘅面珠）嘅屈曲性皮膚炎
有哮喘或鼻敏感病史（或者如果病人係≤４歲嘅細路，就有呢啲病嘅家族史）
２歲之前就出現症狀（淨係適用喺≥４歲嘅病人）
皮膚乾燥症病史（過去一年內）
皮膚炎係可以喺彎曲表面見到（≥４歲病人），又或者喺臉頰、額頭同伸肌表面（患者<4歲）

診斷之前必須要排除嘅其他疾病，包括接觸性皮膚炎、牛皮癬同埋脂漏性皮膚炎。 [4]

預防

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目前仲未有用喺飲食或者外用藥物嘅策略嚟抑製或者去預防異位性皮膚炎嘅既定實證醫學。懷孕期同幼兒期嘅具體飲食計劃，例如食用富含脂肪嘅魚（或者服用奧米加３補充劑）並冇效果[57]。懷孕期嗰陣服用益生菌（例如鼠李糖乳酸桿菌），同埋餵益生菌俾嬰兒係而家正喺度研究嘅策略，只有初步證據表明呢啲嘢可能有預防作用[58][59]。

喺BB出世嘅第１年每日用保濕霜無幫助去預防異位性皮膚炎，甚至可能會增加皮膚感染嘅風險[50][60]。

治療

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就算治療可能會降低異位性皮膚炎發作嘅嚴重程度同頻率，但目前仲未有醫得好異位性皮膚炎嘅方法[16]。最成日用嘅局部治療方法係局部皮質類固醇（以控制發作）和保濕劑（潤膚劑）以幫助控制病情。 [61]臨床試驗通常使用嚴重程度量表（例如SCORAD指數或濕疹面積和嚴重程度指數）來衡量治療效果。 [54] [62]

保濕霜

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每日嘅基本護理係為咗穩定皮膚嘅屏障功能嚟減輕皮膚對過敏原嘅刺激同埋滲透嘅敏感性。受影響嘅人成日會報告話皮膚水份嘅改善同異位性皮膚炎症狀嘅改善係同時發生。保濕霜（或潤膚劑）可以改善皮膚嘅舒適度，仲可以減少呢種病嘅發作[63]。呢兩種用品可以用嚟做免沖洗護理劑、沐浴添加劑或者係番梘嘅替代品，呢啲包括好多唔同嘅產品，但係大多數免沖洗護理劑都係是乳液、凝膠、乳霜（中文：乳霜）或者係軟膏（由最唔油膩去到最油膩）。所有唔同類型嘅保濕霜都係一樣有效，所以患者需要根據自己嘅年齡、受影響嘅身體部位、氣候／季節同個人喜好嚟揀一種或幾種啱自己嘅產品[64]。非藥物處方嘅保濕霜亦都可能唔會比非處方保濕霜更有效[65]。

用潤膚沐浴添加劑唔會帶來任何額外嘅好處[50][66][67]。

藥物

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專題

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直接將含有皮質類固醇嘅乳霜同軟膏（局部）搽喺皮膚上面可以有效咁管理異位性皮膚炎[65][68]。比較新嘅（第二代）皮質類固醇，例如係丙酸氟替卡松同埋糠酸莫米松，比起舊嘅皮質類固醇更加有效同更安全。強效同中度嘅皮質類固醇嘅效果會比弱效皮質類固醇更加好。呢啲通常都係安全嘅，間歇性咁用嚟治療異位性皮膚炎發作唔會搞到皮膚變薄。每個禮拜用兩次嚟預防發作（亦都叫做週末治療）亦都係安全嘅[69][65][70]。每日搽一次同每日搽兩次以上一樣咁有效[68]。

除咗局部去用皮質類固醇之外，外用鈣蛋白抑制劑（例如他克莫司或吡美莫司）亦都被推薦作為治療異位性皮膚炎嘅第一線治療[65][71]。他克莫司同埋吡美莫司都係有效同安全咁用嚟治療異位性皮膚炎[72][73]。克立硼羅係一種PDE-4抑制劑，作為輕度至中度異位性皮膚炎嘅局部治療亦都係有效而且安全[74][75]。一種詹努斯激酶抑制劑—魯索替尼，呢種藥而家仲未確定佢嘅療效同安全性[65][71]。

系統性

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當局部嘅皮膚治療都無辦法去控制嚴重異位性皮膚炎發作嘅紅斑嗰陣時，可以用到口服藥物嚟做全身性治療[50]。

治療異位性皮膚炎嘅傳統口服藥物包括全身性免疫抑制劑，例如係環孢素、甲氨蝶呤、硫唑嘌呤同埋麥考酚酯[76][77][78][79][50]。抗憂鬱藥同埋納曲酮可以用嚟控制搔癢症（搔癢）[80]。

例如單株抗體同埋JAK抑制劑呢啲新啲嘅藥對於治療異位性皮膚炎非常有效，但係就會適度咁增加結膜炎嘅風險。呢啲藥包括杜匹魯單抗（杜皮克斯Dupixent）、特拉洛基單抗（阿德拉爾扎Adtralza、阿德布里Adbry）、阿布羅西替尼（西賓高Cibinqo）、巴瑞替尼（奧魯米安特Olumiant）同埋厄帕達西替尼（烏帕替尼Rinvoq）[71][76][81]。喺單株抗體裡面，杜匹魯單抗同特拉洛基單抗特拉洛基單抗喺美國同歐盟被批准用嚟治療中度至重度嘅濕疹[82][83][84][85]。雷布里基珠單抗亦都喺歐盟批准咗用嚟去醫中度至重度異位性皮膚炎 [86]，但呢隻藥喺美國嘅批准因為製造嘅問題而被拒絕咗[87]。阿布羅西替尼同厄帕達西替尼厄帕達西替尼亦都已經喺美國得到批准用喺治療中度去到重度嘅濕疹。

例如係孟魯司特咁嘅白三烯素受體拮抗劑可能對於治療異位性皮膚炎有幫助，但呢樣嘢嘅有效性仲未被研究去證實[88][89][90]。

過敏原免疫療法可能有效緩解異位性皮膚炎嘅症狀，但亦都會增加不良反應事件嘅風險[91]。呢種治療包括喺條脷下面注射或者滴入一系列含有過敏原嘅溶液[92]。

異位性皮膚炎患者嘅皮膚可以容易受感染，最成日見嘅係金黃色葡萄球菌（中文：金黃色葡萄球菌）。徵狀包括有液體滲出嚟、皮膚上出現黃色嘅痂、濕疹嘅症狀惡化同埋發燒。抗生素通常用嚟治療金黃色葡萄球菌嘅過度生長，但佢嘅益處有限，而且佢哋會增加抗生素抗藥性（中文：抗生素抗藥性）嘅風險。因為呢啲原因，淨係建議俾唔單止皮膚出現症狀，而且感覺全身有系統性唔舒服嘅人去用[47][50][93]。

飲食

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維他命D對於異位性皮膚炎嘅作用仲係未清楚，但係補充維他命D可能會改善佢嘅症狀[94][95][96]。

孕婦服用奧米加３長鏈多元不飽和脂肪酸（LCPUFA）對於預防仔女罹患異位性皮膚炎並冇明顯嘅好處[97][98]。

幾種益生菌似乎有積極嘅作用，可以令異位性皮膚炎嘅發病率降低大約20%[99][100][101]。含有幾種細菌菌株嘅益生菌嘅效果似乎最好[102]。

利用血液裡面嘅特異性IgE或者係皮膚點刺測試嚟指導飲食排除去改善呢個病嘅嚴重程度或者控制係有爭議性嘅。臨床醫生為呢個目的而用呢啲測試嘅方式都各不相同，而且表明任何益處嘅證據都非常有限[103]。

生活方式

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有啲健康專家成日建議異位性皮膚炎患者定期去浸溫水浴嚟滋潤皮膚，尤其係鹽水[17][104]。稀釋咗嘅漂白水浴可能對中度同重度嘅濕疹患者有幫助，但淨係適用喺啲金黃色葡萄球菌患者[105]。

對於異位性皮膚炎患者嚟講，佢哋通常被建議避免去著一啲用大直徑嘅羊毛衣物或者係令人發痕嘅纖維，因為呢啲衣物都會引發紅斑[106][107]。安全嘅代替品係用直徑細啲而且光滑纖維布料整成嘅衫，呢啲包括超細緻同超細嘅美利奴羊毛同埋有抗菌紡織品布料嘅織物。穿著絲綢亦都好安全，但係唔會改善到異位性皮膚炎嘅症狀[50][106][108]。

自我管理

編輯

異位性皮膚炎患者需要有高度嘅自我管理（例如係避免觸發因素）同埋遵守治療（定期用藥）。良好嘅自我管理對改善呢個病嘅結果同埋生活質素都有幫助[109][110]。不過，擔心局部治療、對病情嘅誤解、醫生嘅訊息唔明確同埋溝通唔適當可能會令異位性皮膚炎患者嘅生活變得更加難[50]。

AD患者好多時都唔會將濕疹睇成係長期病症，仲希望濕疹會隨住佢哋嘅長大而消失或者醫得好。咁樣可能會搞到對必要嘅長期治療嘅依從性變差。醫生唔應該暗示呢個係一種短期嘅病，而係應該強調就算無辦法醫返好，但係都可以有效咁控制[110][111]。

醫生嘅適當溝通係可以支援自我管理。醫生需要解決有關治療嘅疑慮，仲提供有關病情嘅清晰同一致嘅資訊[110][111]。治療方案可能會搞到人好迷惘，而書面嘅行動計劃可能幫到啲人去知道幾時喺邊度去用邊啲治療方法[112]。有研究顯示，一個支援自我管理嘅網站可以改善父母、

一個支持自我管理的網站已被證明可以改善父母、細路、青少年同埋後生仔女嘅AD症狀[113][114]。

光

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光照治療涉及暴露喺寬頻或者窄頻嘅紫外線（UV）光。紫外線輻射嘅暴露已經發現對受影響嘅組織有局部嘅免疫調節作用，仲可以用嚟減低紅斑嘅嚴重程度同埋頻率[115][116]。喺唔同類型嘅光照治療入面，只有窄頻NB嘅照射可能對於減輕異位性皮膚炎嘅嚴重程度同埋緩解痕癢嘅情況[81][117]。不過，各種類型嘅皮膚癌亦都同紫外線輻射有關，所以紫外線治療亦都並唔係無沒有風險[118]。紫外線光照治療並唔適用喺後生仔女同埋細路身上，因為長期去用或者接觸會有皮膚癌嘅風險[31]。

替代醫學

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雖然有幾種中藥可以用嚟治療異位性濕疹，無論係口服或者局部去敷都冇證據顯示呢啲治療方法係可以減輕細路或者成年人濕疹嘅嚴重性[119]。

影響

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異位性皮膚炎嚴重損害受影響個體嘅生活質素[120][121]。AD嘅影響唔單止係身體嘅症狀，仲包括實質嘅人文同埋社會心理影響。呢個疾病負擔係好大嘅，特別係考慮到間接成本高昂同埋對生活質素嘅心理影響[120][122]。

根據全球疾病負擔研究，異位性皮膚炎係傷殘調整生命年負擔最高嘅皮膚病，喺所有非致命嘅疾病裡面排名頭15位。同例如係牛皮癬同埋蕁麻疹等等呢啲其他皮膚病去相比，AD嘅負擔明顯高啲[121]。

雖然AD仍然無辦法醫得好，但係降低佢嘅嚴重性可以大大咁減輕佢嘅負擔。明白到AD嘅負擔程度可以幫手更好咁樣分配資源同埋優先去處理干預措施，對病人同醫療系統都有好處[123]。

人文負擔

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異位性皮膚炎透過影響患者生活嘅各個方面嚟大大咁降低佢哋嘅生活質素。心理影響通常會搞到有憂鬱同埋焦慮呢啲情況，呢啲係搞到患者生活質素下降嘅主要因素。AD患者身上常見嘅睡眠障礙會進一步咁加重咗人文負擔，影響佢哋日常嘅工作效率同埋專注力[120]。

臨床和經濟負擔

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AD喺經濟上對醫療保健系統造成咗沉重嘅負擔，每個患者嘅平均直接成本估計係每年$4,411美金，平均間接成本去到每年$9,068美金[120]。呢啲數字突顯咗呢個病對醫療系統同埋病人造成相當大嘅財務影響[124][125]。

AD亦都對生產力有明顯嘅影響。對於一般嘅AD人口嚟講，每年因為呢啲因素而損失嘅總日數大約係68.8日，裡面大部分係帶病工作日數[120]。AD對生產力嘅影響會隨住嘅嚴重程度唔同而有好大嘅差異，患者嘅情況越嚴重，佢損失咗嘅日數就會越多[120][126]。

中東和非洲的疾病負擔

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喺中東同非洲，異位性皮膚炎相比其他皮膚病，呢樣嘢導致嘅傷殘調整生命年嘅損失最高[127]。呢啲地區嘅AD患者每年都會因為呢個病而損失咗大約 0.19 個調整後質素生命年（英文：Quality-adjusted life year）QALY。埃及嘅QALY損失最高，而科威特最低[127]。

每位患者嘅平均每年醫療費都各有唔同，阿聯酋最高，估計係美金$3,569，而最低係阿爾及利亞嘅為$312美金。呢啲成本受到每個國家嘅經濟狀況同埋醫療成本影響。標靶治療同埋光照治療等等先進嘅治療方法係主要嘅成本驅動因素[127]。

喺呢啲國家嘅間接成本平均大約係67%，主要係因為缺勤同出勤造成嘅生產力損失。沙地阿拉伯嘅間接成本係嗰個地區最高嘅，估計去到$3.64億美金[127]。呢啲估計並未有充分去考慮心理健康嘅影響、治療副作用同埋個人護理產品等等其他間接成本嘅因素，呢個表明實際負擔可能更加高[127]。

為了減輕異位性皮膚炎嘅負擔，專家建議喺５個關鍵領域嗰度採取策略行動：能力建設、指引、研究、公眾意識同埋病人支援同教育。重點措施包括增加皮膚科醫生嘅人數、建立以證據為本嘅治療指引、投資喺病人教育，仲有提高公眾嘅意識嚟減少污名[128]。改善有效治療嘅機會同埋進一步研究異位性皮膚炎嘅影響對於減少呢個病喺中東同非洲地區嘅臨床、經濟同人文負擔亦都係最重要[128]。

流行病學

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好多發炎性皮膚病自20世紀初以嚟變得更加常見。異位性皮膚炎係呢種病嘅典型例子。雖然AD以前主要被睇成係一種細路嘅病，但係而家啲人認為呢樣嘢啲成年人入面非常之普遍，估計全球成年人嘅患病率係３-５%[120][121]。而家，呢個病喺發達國家影響咗１５-３０%嘅細路同埋２-１０%嘅成年人，而喺美國，呢個數字喺過去３０-４０年之間幾乎增加咗兩倍[17][129]。超過1,500萬美國嘅成年人同細路都患有異位性皮膚炎[130]。

社會與文化

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陰謀論

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網路上面出現咗好多關於異位性皮膚炎嘅虛假同陰謀論，仲被社交媒體放大。呢啲陰謀論包括聲稱異位性皮膚炎係由5G、食物入面嘅甲醛、疫苗同埋外用類固醇引起嘅。各種未經證實嘅理論仲聲稱純素飲食、蘋果醋、金盞花仲有金縷梅屬可以醫得好異位性皮膚炎，同埋空氣清新機可以減低患AD嘅風險[131]。

參見

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  • 汗水過敏

參考

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  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 "Handout on Health: Atopic Dermatitis (A type of eczema)". National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2013. 原先內容歸檔喺30 May 2015. 喺19 June 2015搵到.
  2. ↑ Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TA, Ring J, Thien F, Van Cauwenberge P, Williams HC (May 2004). "Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003". The Journal of Allergy and Clinical Immunology. 113 (5): 832–836. doi:10.1016/j.jaci.2003.12.591. PMID 15131563.
  3. ↑ Thomsen SF (2014). "Atopic dermatitis: natural history, diagnosis, and treatment". ISRN Allergy. 2014: 354250. doi:10.1155/2014/354250. PMC 4004110. PMID 25006501.
  4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 Tollefson MM, Bruckner AL (December 2014). "Atopic dermatitis: skin-directed management". Pediatrics. 134 (6): e1735–e1744. doi:10.1542/peds.2014-2812. PMID 25422009. 引用錯誤 Invalid <ref> tag; name "Toll2014" defined multiple times with different content
  5. ↑ "Atopic Dermatitis". National Institute of Arthritis and Musculoskeletal and Skin Diseases (英文). September 2019. 喺29 August 2022搵到.
  6. ↑ Williams H (2009). Evidence-Based Dermatology. John Wiley & Sons. p. 128. ISBN 978-1-4443-0017-8. 原先內容歸檔喺2017-09-08.
  7. ↑ Carr WW (August 2013). "Topical calcineurin inhibitors for atopic dermatitis: review and treatment recommendations". Paediatric Drugs. 15 (4): 303–310. doi:10.1007/s40272-013-0013-9. PMC 3715696. PMID 23549982.
  8. ↑ Langan SM, Williams HC (September 2006). "What causes worsening of eczema? A systematic review". The British Journal of Dermatology. 155 (3): 504–514. doi:10.1111/j.1365-2133.2006.07381.x. PMID 16911274.
  9. ↑ Ong PY, Boguniewicz J, Chu DK (May 2023). "Skin Antiseptics for Atopic Dermatitis: Dissecting Facts From Fiction". The Journal of Allergy and Clinical Immunology. In Practice (English). 11 (5): 1385–1390. doi:10.1016/j.jaip.2023.01.012. PMID 36702247. {{cite journal}}: Check |pmid= value (help)CS1 maint: unrecognized language (link)
  10. ↑ Oykhman P, Dookie J, Al-Rammahy H, de Benedetto A, Asiniwasis RN, LeBovidge J, Wang J, Ong PY, Lio P, Gutierrez A, Capozza K, Martin SA, Frazier W, Wheeler K, Boguniewicz M, Spergel JM, Greenhawt M, Silverberg JI, Schneider L, Chu DK (October 2022). "Dietary Elimination for the Treatment of Atopic Dermatitis: A Systematic Review and Meta-Analysis". The Journal of Allergy and Clinical Immunology. In Practice (English). 10 (10): 2657–2666.e8. doi:10.1016/j.jaip.2022.06.044. PMID 35987995.{{cite journal}}: CS1 maint: unrecognized language (link)
  11. ↑ Williams HC (October 2000). "Epidemiology of atopic dermatitis". Clinical and Experimental Dermatology. Cambridge University Press. 25 (7): 522–529. doi:10.1046/j.1365-2230.2000.00698.x. ISBN 978-0-521-57075-6. PMID 11122223. 原先內容歸檔喺2015-06-19.
  12. ↑ Kaufman BP, Guttman-Yassky E, Alexis AF (April 2018). "Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment". Experimental Dermatology. 27 (4): 340–357. doi:10.1111/exd.13514. PMID 29457272.
  13. ↑ Rook A, Burns T (2010). "Atopic dermatitis". Rook's Textbook of Dermatology (第8版). Chichester, UK: Wiley-Blackwell. ISBN 978-1-4443-1764-0. OCLC 605909001.
  14. ↑ Friedmann PS, Holden CA (January 2004). "Atopic Dermatitis". 出自 Burns T, Breathnach S, Cox N, Griffiths C (編). Rook's Textbook of Dermatology (英文). Malden, Massachusetts, USA: Blackwell Publishing, Inc. pp. 755–786. doi:10.1002/9780470750520.ch18. ISBN 978-0-470-75052-0.
  15. ↑ "Skin pigmentation and eczema". National Eczema Society (英文). 2021-02-09. 喺2023-04-06搵到.
  16. ↑ 16.0 16.1 16.2 Berke R, Singh A, Guralnick M (July 2012). "Atopic dermatitis: an overview" (PDF). American Family Physician. 86 (1): 35–42. PMID 22962911. 原先內容歸檔 (PDF)喺2015-09-06.
  17. ↑ 17.0 17.1 17.2 17.3 "Atopic Dermatitis". Medscape Reference. WebMD. 21 January 2014. 原先內容歸檔喺10 February 2014. 喺3 March 2014搵到. 引用錯誤 Invalid <ref> tag; name "MSR" defined multiple times with different content
  18. ↑ Brehler R (2009). "Atopic Dermatitis". 出自 Lang F (編). Encyclopedia of molecular mechanisms of diseases. Berlin: Springer. ISBN 978-3-540-67136-7.
  19. ↑ Baron SE, Cohen SN, Archer CB (May 2012). "Guidance on the diagnosis and clinical management of atopic eczema". Clinical and Experimental Dermatology. 37 (Suppl 1): 7–12. doi:10.1111/j.1365-2230.2012.04336.x. PMID 22486763.
  20. ↑ Schmitt J, Langan S, Deckert S, Svensson A, von Kobyletzki L, Thomas K, Spuls P (December 2013). "Assessment of clinical signs of atopic dermatitis: a systematic review and recommendation". The Journal of Allergy and Clinical Immunology. 132 (6): 1337–1347. doi:10.1016/j.jaci.2013.07.008. PMID 24035157.
  21. ↑ Grey K, Maguiness S (August 2016). "Atopic Dermatitis: Update for Pediatricians". Pediatric Annals (Review). 45 (8): e280–e286. doi:10.3928/19382359-20160720-05. PMID 27517355.
  22. ↑ 22.0 22.1 22.2 22.3 "NIAID Researchers Identify Link Between Common Chemicals and Eczema | NIH: National Institute of Allergy and Infectious Diseases". www.niaid.nih.gov (英文). 2023-01-23. 喺2023-11-23搵到.
  23. ↑ 23.0 23.1 Zeldin J, Chaudhary PP, Spathies J, Yadav M, D'Souza BN, Alishahedani ME, Gough P, Matriz J, Ghio AJ, Li Y, Sun AA, Eichenfield LF, Simpson EL, Myles IA (January 2023). "Exposure to isocyanates predicts atopic dermatitis prevalence and disrupts therapeutic pathways in commensal bacteria". Science Advances. 9 (1): eade8898. Bibcode:2023SciA....9E8898Z. doi:10.1126/sciadv.ade8898. PMC 9821876. PMID 36608129. {{cite journal}}: Check |pmc= value (help); Check |pmid= value (help)
  24. ↑ 24.0 24.1 24.2 "Eczema's cause could be in the air we breathe". NBC News (英文). 2023-03-26. 喺2023-11-23搵到.
  25. ↑ Chaudhary PP, Myles IA, Zeldin J, Dabdoub S, Deopujari V, Baveja R, Baker R, Bengtson S, Sutton A, Levy S, Hourigan SK (October 2023). "Shotgun metagenomic sequencing on skin microbiome indicates dysbiosis exists prior to the onset of atopic dermatitis". Allergy. 78 (10): 2724–2731. doi:10.1111/all.15806. PMC 10543534. PMID 37422700. {{cite journal}}: Check |pmc= value (help); Check |pmid= value (help)
  26. ↑ 26.0 26.1 Berdyshev E, Kim J, Kim BE, Goleva E, Lyubchenko T, Bronova I, Bronoff AS, Xiao O, Kim J, Kim S, Kwon M, Lee S, Seo YJ, Kim K, Choi SJ, Oh SY, Kim SH, Yu SY, Hwang SY, Ahn K, Leung DY (May 2023). "Stratum corneum lipid and cytokine biomarkers at age 2 months predict the future onset of atopic dermatitis". The Journal of Allergy and Clinical Immunology. 151 (5): 1307–1316. doi:10.1016/j.jaci.2023.02.013. PMID 36828081. {{cite journal}}: Check |pmid= value (help)
  27. ↑ Rinnov MR, Halling AS, Gerner T, Ravn NH, Knudgaard MH, Trautner S, Goorden SM, Ghauharali-van der Vlugt KJ, Stet FS, Skov L, Thomsen SF, Egeberg A, Rosted AL, Petersen T, Jakasa I, Riethmüller C, Kezic S, Thyssen JP (March 2023). "Skin biomarkers predict development of atopic dermatitis in infancy". Allergy. 78 (3): 791–802. doi:10.1111/all.15518. PMID 36112082.
  28. ↑ Yamamoto-Hanada K, Saito-Abe M, Shima K, Fukagawa S, Uehara Y, Ueda Y, Iwamura M, Murase T, Kuwano T, Inoue T, Ohya Y (July 2023). "mRNAs in skin surface lipids unveiled atopic dermatitis at 1 month". Journal of the European Academy of Dermatology and Venereology. 37 (7): 1385–1395. doi:10.1111/jdv.19017. PMID 36897437. {{cite journal}}: Check |pmid= value (help)
  29. ↑ Yadav M, Chaudhary PP, D'Souza BN, Ratley G, Spathies J, Ganesan S, Zeldin J, Myles IA (2023). "Diisocyanates influence models of atopic dermatitis through direct activation of TRPA1". PLOS ONE. 18 (3): e0282569. Bibcode:2023PLoSO..1882569Y. doi:10.1371/journal.pone.0282569. PMC 9987805. PMID 36877675. {{cite journal}}: Check |pmc= value (help); Check |pmid= value (help)
  30. ↑ Engebretsen KA, Johansen JD, Kezic S, Linneberg A, Thyssen JP (February 2016). "The effect of environmental humidity and temperature on skin barrier function and dermatitis". Journal of the European Academy of Dermatology and Venereology. 30 (2): 223–249. doi:10.1111/jdv.13301. PMID 26449379.
  31. ↑ 31.00 31.01 31.02 31.03 31.04 31.05 31.06 31.07 31.08 31.09 31.10 31.11 31.12 31.13 31.14 31.15 Ständer S (March 2021). "Atopic Dermatitis". The New England Journal of Medicine. 384 (12): 1136–1143. doi:10.1056/NEJMra2023911. PMID 33761208.
  32. ↑ Park KD, Pak SC, Park KK (December 2016). "The Pathogenetic Effect of Natural and Bacterial Toxins on Atopic Dermatitis". Toxins (Review). 9 (1): 3. doi:10.3390/toxins9010003. PMC 5299398. PMID 28025545.
  33. ↑ Irvine AD, McLean WH, Leung DY (October 2011). "Filaggrin mutations associated with skin and allergic diseases". The New England Journal of Medicine (Review). 365 (14): 1315–1327. doi:10.1056/NEJMra1011040. PMID 21991953.
  34. ↑ 34.0 34.1 Benedetto De, Anna (2010). "Tight Junction Defects in Atopic Dermatitis". Journal of Allergy and Clinical Immunology. 127 (3): 773–786 –透過PubMed.
  35. ↑ Scudellari M (February 2017). "News Feature: Cleaning up the hygiene hypothesis". Proceedings of the National Academy of Sciences of the United States of America. 114 (7): 1433–1436. Bibcode:2017PNAS..114.1433S. doi:10.1073/pnas.1700688114. PMC 5320962. PMID 28196925.
  36. ↑ Bieber T (April 2008). "Atopic dermatitis". The New England Journal of Medicine. 358 (14): 1483–1494. doi:10.1056/NEJMra074081. PMID 18385500.
  37. ↑ Pelucchi C, Galeone C, Bach JF, La Vecchia C, Chatenoud L (September 2013). "Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies". The Journal of Allergy and Clinical Immunology. 132 (3): 616–622.e7. doi:10.1016/j.jaci.2013.04.009. PMID 23711545. {{cite journal}}: |hdl-access= requires |hdl= (help)
  38. ↑ 38.0 38.1 38.2 Flohr C, Mann J (January 2014). "New insights into the epidemiology of childhood atopic dermatitis". Allergy. 69 (1): 3–16. doi:10.1111/all.12270. PMID 24417229.
  39. ↑ di Mauro G, Bernardini R, Barberi S, Capuano A, Correra A, De' Angelis GL, Iacono ID, de Martino M, Ghiglioni D, Di Mauro D, Giovannini M, Landi M, Marseglia GL, Martelli A, Miniello VL, Peroni D, Sullo LR, Terracciano L, Vascone C, Verduci E, Verga MC, Chiappini E (2016). "Prevention of food and airway allergy: consensus of the Italian Society of Preventive and Social Paediatrics, the Italian Society of Paediatric Allergy and Immunology, and Italian Society of Pediatrics". The World Allergy Organization Journal (Review). 9: 28. doi:10.1186/s40413-016-0111-6. PMC 4989298. PMID 27583103.
  40. ↑ Brough HA, Nadeau KC, Sindher SB, Alkotob SS, Chan S, Bahnson HT, Leung DY, Lack G (September 2020). "Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented?". Allergy. 75 (9): 2185–2205. doi:10.1111/all.14304. PMC 7494573. PMID 32249942.
  41. ↑ Fasano A, Sapone A, Zevallos V, Schuppan D (May 2015). "Nonceliac gluten sensitivity". Gastroenterology (Review). 148 (6): 1195–1204. doi:10.1053/j.gastro.2014.12.049. PMID 25583468. Many patients with celiac disease also have atopic disorders. About 30% of patients' allergies with gastrointestinal (GI) symptoms and mucosal lesions, but negative results from serologic (TG2 antibodies) or genetic tests (DQ2 or DQ8 genotype) for celiac disease, had reduced GI and atopic symptoms when they were placed on GFDs. These findings indicated that their symptoms were related to gluten ingestion.
  42. ↑ Mansueto P, Seidita A, D'Alcamo A, Carroccio A (2014). "Non-celiac gluten sensitivity: literature review". Journal of the American College of Nutrition (Review). 33 (1): 39–54. doi:10.1080/07315724.2014.869996. PMID 24533607. {{cite journal}}: |hdl-access= requires |hdl= (help)
  43. ↑ Williams H, Flohr C (July 2006). "How epidemiology has challenged 3 prevailing concepts about atopic dermatitis" (PDF). The Journal of Allergy and Clinical Immunology. 118 (1): 209–213. doi:10.1016/j.jaci.2006.04.043. PMID 16815157. 原著 (PDF)喺2018-07-19歸檔. 喺2019-02-05搵到.
  44. ↑ Fuiano N, Incorvaia C (June 2012). "Dissecting the causes of atopic dermatitis in children: less foods, more mites". Allergology International. 61 (2): 231–243. doi:10.2332/allergolint.11-RA-0371. PMID 22361514.
  45. ↑ Goh CL, Wong JS, Giam YC (September 1997). "Skin colonization of Staphylococcus aureus in atopic dermatitis patients seen at the National Skin Centre, Singapore". International Journal of Dermatology. 36 (9): 653–657. doi:10.1046/j.1365-4362.1997.00290.x. PMID 9352404.
  46. ↑ Nakatsuji T, Chen TH, Two AM, Chun KA, Narala S, Geha RS, Hata TR, Gallo RL (November 2016). "Staphylococcus aureus Exploits Epidermal Barrier Defects in Atopic Dermatitis to Trigger Cytokine Expression". The Journal of Investigative Dermatology. 136 (11): 2192–2200. doi:10.1016/j.jid.2016.05.127. PMC 5103312. PMID 27381887.
  47. ↑ 47.0 47.1 George SM, Karanovic S, Harrison DA, Rani A, Birnie AJ, Bath-Hextall FJ, Ravenscroft JC, Williams HC (October 2019). "Interventions to reduce Staphylococcus aureus in the management of eczema". The Cochrane Database of Systematic Reviews. 2019 (10). doi:10.1002/14651858.CD003871.pub3. PMC 6818407. PMID 31684694.
  48. ↑ Sengupta P (August 2013). "Potential health impacts of hard water". International Journal of Preventive Medicine (Review). 4 (8): 866–875. PMC 3775162. PMID 24049611.
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  50. ↑ 50.0 50.1 50.2 50.3 50.4 50.5 50.6 50.7 Eczema in children: uncertainties addressed (報告) (英文). NIHR Evidence. 2024-03-19. doi:10.3310/nihrevidence_62438.
  51. ↑ Gandhi NA, Bennett BL, Graham NM, Pirozzi G, Stahl N, Yancopoulos GD (January 2016). "Targeting key proximal drivers of type 2 inflammation in disease". Nature Reviews. Drug Discovery. 15 (1): 35–50. doi:10.1038/nrd4624. PMID 26471366.
  52. ↑ Akdis CA, Arkwright PD, Brüggen MC, Busse W, Gadina M, Guttman-Yassky E, Kabashima K, Mitamura Y, Vian L, Wu J, Palomares O (July 2020). "Type 2 immunity in the skin and lungs". Allergy. 75 (7): 1582–1605. doi:10.1111/all.14318. PMID 32319104.
  53. ↑ Ständer S (March 2021). "Atopic Dermatitis". The New England Journal of Medicine. 384 (12): 1136–1143. doi:10.1056/NEJMra2023911. PMID 33761208. S2CID 232355341.
  54. ↑ 54.0 54.1 Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R (February 2014). "Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis". Journal of the American Academy of Dermatology. 70 (2): 338–351. doi:10.1016/j.jaad.2013.10.010. PMC 4410183. PMID 24290431.
  55. ↑ 55.0 55.1 Brenninkmeijer EE, Schram ME, Leeflang MM, Bos JD, Spuls PI (April 2008). "Diagnostic criteria for atopic dermatitis: a systematic review". The British Journal of Dermatology. 158 (4): 754–765. doi:10.1111/j.1365-2133.2007.08412.x. PMID 18241277.
  56. ↑ 56.0 56.1 Williams HC, Burney PG, Pembroke AC, Hay RJ (September 1994). "The U.K. Working Party's Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation". The British Journal of Dermatology. 131 (3): 406–416. doi:10.1111/j.1365-2133.1994.tb08532.x. PMID 7918017.
  57. ↑ Trikamjee T, Comberiati P, D'Auria E, Peroni D, Zuccotti GV (2021-01-12). "Nutritional Factors in the Prevention of Atopic Dermatitis in Children". Frontiers in Pediatrics. 8: 577413. doi:10.3389/fped.2020.577413. PMC 7874114. PMID 33585361.
  58. ↑ Sun S, Chang G, Zhang L (June 2022). "The prevention effect of probiotics against eczema in children: an update systematic review and meta-analysis". The Journal of Dermatological Treatment. 33 (4): 1844–1854. doi:10.1080/09546634.2021.1925077. PMID 34006167.
  59. ↑ Voigt J, Lele M (November 2022). "Lactobacillus rhamnosus Used in the Perinatal Period for the Prevention of Atopic Dermatitis in Infants: A Systematic Review and Meta-Analysis of Randomized Trials". American Journal of Clinical Dermatology. 23 (6): 801–811. doi:10.1007/s40257-022-00723-x. PMC 9576646. PMID 36161401. {{cite journal}}: Check |pmc= value (help)
  60. ↑ Kelleher MM, Phillips R, Brown SJ, Cro S, Cornelius V, Carlsen KC, Skjerven HO, Rehbinder EM, Lowe AJ, Dissanayake E, Shimojo N, Yonezawa K, Ohya Y, Yamamoto-Hanada K, Morita K, Axon E, Cork M, Cooke A, Van Vogt E, Schmitt J, Weidinger S, McClanahan D, Simpson E, Duley L, Askie LM, Williams HC, Boyle RJ (November 2022). "Skin care interventions in infants for preventing eczema and food allergy". The Cochrane Database of Systematic Reviews. 2022 (11): CD013534. doi:10.1002/14651858.CD013534.pub3. PMC 9661877. PMID 36373988. {{cite journal}}: Check |pmc= value (help)
  61. ↑ "What are Topical Treatments for Eczema and How Should They Be Used?". National Eczema Association (美國英文). 喺2023-06-22搵到.
  62. ↑ Chopra R, Silverberg JI (2018). "Assessing the severity of atopic dermatitis in clinical trials and practice". Clinics in Dermatology. Atopic Dermatits: Part II. 36 (5): 606–615. doi:10.1016/j.clindermatol.2018.05.012. PMID 30217273.
  63. ↑ Ridd MJ, Roberts A, Grindlay D, Williams HC (October 2019). "Which emollients are effective and acceptable for eczema in children?". BMJ. 367: l5882. doi:10.1136/bmj.l5882. PMID 31649114.
  64. ↑ Ridd MJ, Santer M, MacNeill SJ, Sanderson E, Wells S, Webb D, Banks J, Sutton E, Roberts A, Liddiard L, Wilkins Z, Clayton J, Garfield K, Barrett TJ, Lane JA, Baxter H, Howells L, Taylor J, Hay AD, Williams HC, Thomas KS (August 2022). "Effectiveness and safety of lotion, cream, gel, and ointment emollients for childhood eczema: a pragmatic, randomised, phase 4, superiority trial". The Lancet. Child & Adolescent Health. 6 (8): 522–532. doi:10.1016/S2352-4642(22)00146-8. PMID 35617974. {{cite journal}}: |hdl-access= requires |hdl= (help)
  65. ↑ 65.0 65.1 65.2 65.3 65.4 Chu DK, Chu AW, Rayner DG, Guyatt GH, Yepes-Nuñez JJ, Gomez-Escobar L, Pérez-Herrera LC, Díaz Martinez JP, Brignardello-Petersen R, Sadeghirad B, Wong MM, Ceccacci R, Zhao IX, Basmaji J, MacDonald M, Chu X, Islam N, Gao Y, Izcovich A, Asiniwasis RN, Boguniewicz M, De Benedetto A, Capozza K, Chen L, Ellison K, Frazier WT, Greenhawt M, Huynh J, LeBovidge J, Lio PA, Martin SA, O'Brien M, Ong PY, Silverberg JI, Spergel JM, Smith Begolka W, Wang J, Wheeler KE, Gardner DD, Schneider L (December 2023). "Topical treatments for atopic dermatitis (eczema): Systematic review and network meta-analysis of randomized trials". The Journal of Allergy and Clinical Immunology. 152 (6): 1493–1519. doi:10.1016/j.jaci.2023.08.030. PMID 37678572. {{cite journal}}: Check |pmid= value (help)
  66. ↑ Evidence reviews for adding bath emollients to the management of atopic eczema in children under 12 years: Atopic eczema in under 12s: diagnosis and management: Evidence review A. NICE Evidence Reviews Collection. London: National Institute for Health and Care Excellence (NICE). 2023. ISBN 978-1-4731-5235-9. PMID 37616434. {{cite book}}: Check |pmid= value (help)
  67. ↑ Santer M, Ridd MJ, Francis NA, Stuart B, Rumsby K, Chorozoglou M, Becque T, Roberts A, Liddiard L, Nollett C, Hooper J, Prude M, Wood W, Thomas KS, Thomas-Jones E, Williams HC, Little P (May 2018). "Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness". BMJ. 361: k1332. doi:10.1136/bmj.k1332. PMC 5930266. PMID 29724749.
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  70. ↑ Axon E, Chalmers JR, Santer M, Ridd MJ, Lawton S, Langan SM, Grindlay DJ, Muller I, Roberts A, Ahmed A, Williams HC, Thomas KS (July 2021). "Safety of topical corticosteroids in atopic eczema: an umbrella review". BMJ Open. 11 (7): e046476. doi:10.1136/bmjopen-2020-046476. PMC 8264889. PMID 34233978.
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  72. ↑ Cury Martins J, Martins C, Aoki V, Gois AF, Ishii HA, da Silva EM (July 2015). "Topical tacrolimus for atopic dermatitis". The Cochrane Database of Systematic Reviews. 2015 (7): CD009864. doi:10.1002/14651858.CD009864.pub2. PMC 6461158. PMID 26132597.
  73. ↑ Devasenapathy N, Chu A, Wong M, Srivastava A, Ceccacci R, Lin C, MacDonald M, Wen A, Steen J, Levine M, Pyne L, Schneider L, Chu DK (January 2023). "Cancer risk with topical calcineurin inhibitors, pimecrolimus and tacrolimus, for atopic dermatitis: a systematic review and meta-analysis". The Lancet. Child & Adolescent Health. 7 (1): 13–25. doi:10.1016/S2352-4642(22)00283-8. PMID 36370744.
  74. ↑ McDowell L, Olin B (August 2019). "Crisaborole: A Novel Nonsteroidal Topical Treatment for Atopic Dermatitis". The Journal of Pharmacy Technology. 35 (4): 172–178. doi:10.1177/8755122519844507. PMC 6600556. PMID 34861031.
  75. ↑ He Y, Liu J, Wang Y, Kuai W, Liu R, Wu J (2023-02-06). "Topical Administration of Crisaborole in Mild to Moderate Atopic Dermatitis: A Systematic Review and Meta-Analysis". Dermatologic Therapy (英文). 2023: 1–9. doi:10.1155/2023/1869934. ISSN 1529-8019.
  76. ↑ 76.0 76.1 Davis DM, Drucker AM, Alikhan A, Bercovitch L, Cohen DE, Darr JM, Eichenfield LF, Frazer-Green L, Paller AS, Schwarzenberger K, Silverberg JI, Singh AM, Wu PA, Sidbury R (February 2024). "Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies". Journal of the American Academy of Dermatology. 90 (2): e43–e56. doi:10.1016/j.jaad.2023.08.102. PMID 37943240. {{cite journal}}: Check |pmid= value (help)
  77. ↑ Paolino A, Alexander H, Broderick C, Flohr C (May 2023). "Non-biologic systemic treatments for atopic dermatitis: Current state of the art and future directions". Clinical and Experimental Allergy. 53 (5): 495–510. doi:10.1111/cea.14301. PMID 36949024. {{cite journal}}: Check |pmid= value (help)
  78. ↑ Flohr C, Rosala-Hallas A, Jones AP, Beattie P, Baron S, Browne F, Brown SJ, Gach JE, Greenblatt D, Hearn R, Hilger E, Esdaile B, Cork MJ, Howard E, Lovgren ML, August S, Ashoor F, Williamson PR, McPherson T, O'Kane D, Ravenscroft J, Shaw L, Sinha MD, Spowart C, Taams LS, Thomas BR, Wan M, Sach TH, Irvine AD (November 2023). "Efficacy and safety of ciclosporin versus methotrexate in the treatment of severe atopic dermatitis in children and young people (TREAT): a multicentre parallel group assessor-blinded clinical trial". The British Journal of Dermatology. 189 (6): 674–684. doi:10.1093/bjd/ljad281. PMID 37722926. {{cite journal}}: Check |pmid= value (help)
  79. ↑ Kim K (November 2012). "Neuroimmunological mechanism of pruritus in atopic dermatitis focused on the role of serotonin". Biomolecules & Therapeutics. 20 (6): 506–512. doi:10.4062/biomolther.2012.20.6.506. PMC 3762292. PMID 24009842.
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  82. ↑ "FDA approves new eczema drug Dupixent". US Food & Drug Administration. 28 March 2017. 原先內容歸檔喺28 March 2017. 喺29 March 2017搵到.
  83. ↑ EMA (2018-09-17). "Dupixent". European Medicines Agency (英文). 喺2023-03-22搵到.
  84. ↑ "Adtralza EPAR". European Medicines Agency (EMA). 20 April 2021. 喺9 July 2021搵到. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
  85. ↑ "Drug Approval Package: ADBRY". US Food & Drug Administration. December 27, 2021. 喺March 6, 2022搵到.
  86. ↑ "Ebglyss". European Medicines Agency. 21 November 2023. 喺2024-04-15搵到.
  87. ↑ "FDA Rejects Lilly's Eczema Treatment Over Third-Party Manufacturing Issues". BioSpace. 2 October 2023. 喺2023-10-03搵到.
  88. ↑ Chin WK, Lee SW (October 2018). "A systematic review on the off-label use of montelukast in atopic dermatitis treatment". International Journal of Clinical Pharmacy. 40 (5): 963–976. doi:10.1007/s11096-018-0655-3. PMID 29777328.
  89. ↑ Ferguson L, Futamura M, Vakirlis E, Kojima R, Sasaki H, Roberts A, Mori R (October 2018). "Leukotriene receptor antagonists for eczema". The Cochrane Database of Systematic Reviews. 2018 (10): CD011224. doi:10.1002/14651858.cd011224.pub2. PMC 6517006. PMID 30343498.
  90. ↑ Toledo LM, Rodriguez R, Sivesind TE, Vakirlis E, Kojima R, Dellavalle RP (April 2024). "From the Cochrane Library: Leukotriene Receptor Antagonists for Eczema". JMIR Dermatology. 7: e50434. doi:10.2196/50434. PMC 11053388. PMID 38607671. {{cite journal}}: Check |pmc= value (help); Check |pmid= value (help)
  91. ↑ Yepes-Nuñez JJ, Guyatt GH, Gómez-Escobar LG, Pérez-Herrera LC, Chu AW, Ceccaci R, Acosta-Madiedo AS, Wen A, Moreno-López S, MacDonald M, Barrios M, Chu X, Islam N, Gao Y, Wong MM, Couban R, Garcia E, Chapman E, Oykhman P, Chen L, Winders T, Asiniwasis RN, Boguniewicz M, De Benedetto A, Ellison K, Frazier WT, Greenhawt M, Huynh J, Kim E, LeBovidge J, Lind ML, Lio P, Martin SA, O'Brien M, Ong PY, Silverberg JI, Spergel J, Wang J, Wheeler KE, Schneider L, Chu DK (January 2023). "Allergen immunotherapy for atopic dermatitis: Systematic review and meta-analysis of benefits and harms". The Journal of Allergy and Clinical Immunology. 151 (1): 147–158. doi:10.1016/j.jaci.2022.09.020. PMID 36191689. {{cite journal}}: |hdl-access= requires |hdl= (help)
  92. ↑ Tam H, Calderon MA, Manikam L, Nankervis H, García Núñez I, Williams HC, Durham S, Boyle RJ (February 2016). "Specific allergen immunotherapy for the treatment of atopic eczema". The Cochrane Database of Systematic Reviews. 2016 (2): CD008774. doi:10.1002/14651858.CD008774.pub2. PMC 8761476. PMID 26871981. {{cite journal}}: |hdl-access= requires |hdl= (help)
  93. ↑ "Secondary bacterial infection of eczema and other common skin conditions: antimicrobial prescribing. NICE guideline [NG190]". National Institute for Health and Care Excellence. 2021-03-02. 喺2024-07-26搵到.
  94. ↑ Dębińska A, Sikorska-Szaflik H, Urbanik M, Boznański A (2015). "The role of vitamin D in atopic dermatitis". Dermatitis (Review). 26 (4): 155–161. doi:10.1097/DER.0000000000000128. PMID 26172483.
  95. ↑ Kim G, Bae JH (September 2016). "Vitamin D and atopic dermatitis: A systematic review and meta-analysis". Nutrition (Systematic Review and Meta-Analysis). 32 (9): 913–920. doi:10.1016/j.nut.2016.01.023. PMID 27061361.
  96. ↑ Hattangdi-Haridas SR, Lanham-New SA, Wong WH, Ho MH, Darling AL (August 2019). "Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children". Nutrients. 11 (8): 1854. doi:10.3390/nu11081854. PMC 6722944. PMID 31405041.
  97. ↑ Venter C, Agostoni C, Arshad SH, Ben-Abdallah M, Du Toit G, Fleischer DM, Greenhawt M, Glueck DH, Groetch M, Lunjani N, Maslin K, Maiorella A, Meyer R, Antonella M, Netting MJ, Ibeabughichi Nwaru B, Palmer DJ, Palumbo MP, Roberts G, Roduit C, Smith P, Untersmayr E, Vanderlinden LA, O'Mahony L (November 2020). "Dietary factors during pregnancy and atopic outcomes in childhood: A systematic review from the European Academy of Allergy and Clinical Immunology". Pediatric Allergy and Immunology. 31 (8): 889–912. doi:10.1111/pai.13303. PMC 9588404. PMID 32524677. {{cite journal}}: Check |pmc= value (help)
  98. ↑ Trikamjee T, Comberiati P, D'Auria E, Peroni D, Zuccotti GV (2021-01-12). "Nutritional Factors in the Prevention of Atopic Dermatitis in Children". Frontiers in Pediatrics. 8: 577413. doi:10.3389/fped.2020.577413. PMC 7874114. PMID 33585361.
  99. ↑ Makrgeorgou A, Leonardi-Bee J, Bath-Hextall FJ, Murrell DF, Tang ML, Roberts A, Boyle RJ (November 2018). "Probiotics for treating eczema". The Cochrane Database of Systematic Reviews. 2018 (11): CD006135. doi:10.1002/14651858.CD006135.pub3. PMC 6517242. PMID 30480774.
  100. ↑ Rusu E, Enache G, Cursaru R, Alexescu A, Radu R, Onila O, Cavallioti T, Rusu F, Posea M, Jinga M, Radulian G (August 2019). "Prebiotics and probiotics in atopic dermatitis". Experimental and Therapeutic Medicine. 18 (2): 926–931. doi:10.3892/etm.2019.7678. PMC 6639913. PMID 31384325.
  101. ↑ Umborowati MA, Damayanti D, Anggraeni S, Endaryanto A, Surono IS, Effendy I, Prakoeswa CR (August 2022). "The role of probiotics in the treatment of adult atopic dermatitis: a meta-analysis of randomized controlled trials". Journal of Health, Population, and Nutrition. 41 (1): 37. doi:10.1186/s41043-022-00318-6. PMC 9386980. PMID 35978397.
  102. ↑ Chang YS, Trivedi MK, Jha A, Lin YF, Dimaano L, García-Romero MT (March 2016). "Synbiotics for Prevention and Treatment of Atopic Dermatitis: A Meta-analysis of Randomized Clinical Trials". JAMA Pediatrics. 170 (3): 236–242. doi:10.1001/jamapediatrics.2015.3943. PMID 26810481.
  103. ↑ Roberts K, Gilbertson A, Dawson S, Turner N, Ridd MJ (March 2022). "Test-guided dietary exclusions for treating established atopic dermatitis in children: A systematic review". Clinical and Experimental Allergy. 52 (3): 442–446. doi:10.1111/cea.14072. PMID 34862822. {{cite journal}}: |hdl-access= requires |hdl= (help)
  104. ↑ Lio PA (October 2013). "Non-pharmacologic therapies for atopic dermatitis". Current Allergy and Asthma Reports. 13 (5): 528–538. doi:10.1007/s11882-013-0371-y. PMID 23881511.
  105. ↑ Bakaa L, Pernica JM, Couban RJ, Tackett KJ, Burkhart CN, Leins L, Smart J, Garcia-Romero MT, Elizalde-Jiménez IG, Herd M, Asiniwasis RN, Boguniewicz M, De Benedetto A, Chen L, Ellison K, Frazier W, Greenhawt M, Huynh J, LeBovidge J, Lind ML, Lio P, O'Brien M, Ong PY, Silverberg JI, Spergel JM, Wang J, Begolka WS, Schneider L, Chu DK (June 2022). "Bleach baths for atopic dermatitis: A systematic review and meta-analysis including unpublished data, Bayesian interpretation, and GRADE". Annals of Allergy, Asthma & Immunology. 128 (6): 660–668.e9. doi:10.1016/j.anai.2022.03.024. PMID 35367346.
  106. ↑ 106.0 106.1 Jaros J, Wilson C, Shi VY (August 2020). "Fabric Selection in Atopic Dermatitis: An Evidence-Based Review". American Journal of Clinical Dermatology. 21 (4): 467–482. doi:10.1007/s40257-020-00516-0. PMID 32440827.
  107. ↑ "Clothing and eczema". National Eczema Society (英文). 2020-02-11. 喺2023-04-10搵到.
  108. ↑ Thomas KS, Bradshaw LE, Sach TH, Cowdell F, Batchelor JM, Lawton S, Harrison EF, Haines RH, Ahmed A, Dean T, Burrows NP, Pollock I, Buckley HK, Williams HC, Llewellyn J, Crang C, Grundy JD, Guiness J, Gribbin A, Wake EV, Mitchell EJ, Brown SJ, Montgomery AA (April 2017). "Randomised controlled trial of silk therapeutic garments for the management of atopic eczema in children: the CLOTHES trial". Health Technology Assessment. 21 (16): 1–260. doi:10.3310/hta21160. PMC 5410632. PMID 28409557.
  109. ↑ Ridd MJ, King AJ, Le Roux E, Waldecker A, Huntley AL (September 2017). "Systematic review of self-management interventions for people with eczema". The British Journal of Dermatology. 177 (3): 719–734. doi:10.1111/bjd.15601. PMC 5637890. PMID 28432696.
  110. ↑ 110.0 110.1 110.2 Teasdale E, Muller I, Sivyer K, Ghio D, Greenwell K, Wilczynska S, Roberts A, Ridd MJ, Francis N, Yardley L, Thomas KS, Santer M (April 2021). "Views and experiences of managing eczema: systematic review and thematic synthesis of qualitative studies". The British Journal of Dermatology. 184 (4): 627–637. doi:10.1111/bjd.19299. PMID 32531800. {{cite journal}}: |hdl-access= requires |hdl= (help)
  111. ↑ 111.0 111.1 Addressing misconceptions about eczema could help people manage their condition over the long term (報告) (英文). NIHR Evidence. 2020-12-09. doi:10.3310/alert_42973.
  112. ↑ Thandi CS, Constantinou S, Vincent R, Ridd MJ (June 2023). "Where and how have written action plans for atopic eczema/dermatitis been developed and evaluated? Systematic review". Skin Health and Disease. 3 (3): e213. doi:10.1002/ski2.213. PMC 10233085. PMID 37275422. {{cite journal}}: Check |pmc= value (help); Check |pmid= value (help)
  113. ↑ "Online support improved eczema symptoms in children and young people". NIHR Evidence (Plain English summary) (英文). National Institute for Health and Care Research. 2023-04-11. doi:10.3310/nihrevidence_57579.
  114. ↑ Santer M, Muller I, Becque T, Stuart B, Hooper J, Steele M, Wilczynska S, Sach TH, Ridd MJ, Roberts A, Ahmed A, Yardley L, Little P, Greenwell K, Sivyer K, Nuttall J, Griffiths G, Lawton S, Langan SM, Howells LM, Leighton P, Williams HC, Thomas KS (December 2022). "Eczema Care Online behavioural interventions to support self-care for children and young people: two independent, pragmatic, randomised controlled trials". BMJ. 379: e072007. doi:10.1136/bmj-2022-072007. PMID 36740888. {{cite journal}}: |hdl-access= requires |hdl= (help); Check |pmid= value (help)
  115. ↑ Tintle S, Shemer A, Suárez-Fariñas M, Fujita H, Gilleaudeau P, Sullivan-Whalen M, Johnson-Huang L, Chiricozzi A, Cardinale I, Duan S, Bowcock A, Krueger JG, Guttman-Yassky E (September 2011). "Reversal of atopic dermatitis with narrow-band UVB phototherapy and biomarkers for therapeutic response". The Journal of Allergy and Clinical Immunology. 128 (3): 583–93.e1–4. doi:10.1016/j.jaci.2011.05.042. PMC 3448950. PMID 21762976.
  116. ↑ Beattie PE, Finlan LE, Kernohan NM, Thomson G, Hupp TR, Ibbotson SH (May 2005). "The effect of ultraviolet (UV) A1, UVB and solar-simulated radiation on p53 activation and p21". The British Journal of Dermatology. 152 (5): 1001–1008. doi:10.1111/j.1365-2133.2005.06557.x. PMID 15888160.
  117. ↑ Musters AH, Mashayekhi S, Harvey J, Axon E, Lax SJ, Flohr C, Drucker AM, Gerbens L, Ferguson J, Ibbotson S, Dawe RS, Garritsen F, Brouwer M, Limpens J, Prescott LE, Boyle RJ, Spuls PI (October 2021). "Phototherapy for atopic eczema". The Cochrane Database of Systematic Reviews. 10 (10): CD013870. doi:10.1002/14651858.CD013870.pub2. PMC 8552896. PMID 34709669.
  118. ↑ Jans J, Garinis GA, Schul W, van Oudenaren A, Moorhouse M, Smid M, Sert YG, van der Velde A, Rijksen Y, de Gruijl FR, van der Spek PJ, Yasui A, Hoeijmakers JH, Leenen PJ, van der Horst GT (November 2006). "Differential role of basal keratinocytes in UV-induced immunosuppression and skin cancer". Molecular and Cellular Biology. 26 (22): 8515–8526. doi:10.1128/MCB.00807-06. PMC 1636796. PMID 16966369.
  119. ↑ Gu S, Yang AW, Xue CC, Li CG, Pang C, Zhang W, Williams HC (September 2013). "Chinese herbal medicine for atopic eczema". The Cochrane Database of Systematic Reviews. 2013 (9): CD008642. doi:10.1002/14651858.CD008642.pub2. PMC 10639001. PMID 24018636. {{cite journal}}: Check |pmc= value (help)
  120. ↑ 120.0 120.1 120.2 120.3 120.4 120.5 120.6 Fasseeh AN, Elezbawy B, Korra N, Tannira M, Dalle H, Aderian S, Abaza S, Kaló Z (December 2022). "Burden of Atopic Dermatitis in Adults and Adolescents: a Systematic Literature Review". Dermatology and Therapy. 12 (12): 2653–2668. doi:10.1007/s13555-022-00819-6. PMC 9674816. PMID 36197589. {{cite journal}}: Check |pmc= value (help) 引用錯誤 Invalid <ref> tag; name "Fasseeh-2022" defined multiple times with different content
  121. ↑ 121.0 121.1 121.2 Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (March 2021). "The PRISMA 2020 statement: an updated guideline for reporting systematic reviews". BMJ. 372: n71. doi:10.1136/bmj.n71. PMC 8005924. PMID 33782057. 引用錯誤 Invalid <ref> tag; name "Page-2021" defined multiple times with different content
  122. ↑ Marron SE, Cebrian-Rodriguez J, Alcalde-Herrero VM, Garcia-Latasa de Aranibar FJ, Tomas-Aragones L (2020-07-01). "Psychosocial Impact of Atopic Dermatitis in Adults: A Qualitative Study". Actas Dermo-Sifiliograficas. 111 (6): 513–517. doi:10.1016/j.ad.2019.03.018. PMID 32401725.
  123. ↑ Silverwood RJ, Mansfield KE, Mulick A, Wong AY, Schmidt SA, Roberts A, Smeeth L, Abuabara K, Langan SM (May 2021). "Atopic eczema in adulthood and mortality: UK population-based cohort study, 1998-2016". The Journal of Allergy and Clinical Immunology. 147 (5): 1753–1763. doi:10.1016/j.jaci.2020.12.001. PMC 8098860. PMID 33516523.
  124. ↑ Pedersen CJ, Uddin MJ, Saha SK, Darmstadt GL (2021-04-16). "Prevalence and psychosocial impact of atopic dermatitis in Bangladeshi children and families". PLOS ONE. 16 (4): e0249824. Bibcode:2021PLoSO..1649824P. doi:10.1371/journal.pone.0249824. PMC 8051797. PMID 33861780.
  125. ↑ "World Bank Country and Lending Groups – World Bank Data Help Desk". datahelpdesk.worldbank.org. 喺2024-01-14搵到.
  126. ↑ Avena-Woods C (June 2017). "Overview of atopic dermatitis". The American Journal of Managed Care. 23 (8 Suppl): S115–S123. PMID 28978208.
  127. ↑ 127.0 127.1 127.2 127.3 127.4 Elezbawy B, Fasseeh AN, Fouly E, Tannira M, Dalle H, Aderian S, Abu Esba LC, Al Abdulkarim H, Ammoury A, Altawil E, Al Turaiki A, Albreiki F, Al-Haddab M, Al-Lafi A, Alowayesh M, Al-Sheikh A, Elsayed M, Elshamy A, Eshmawi M, Farag A, Hamadah I, Hedibel M, Kannenberg S, Karam R, Metni M, Raboobee N, Steinhoff M, Abaza S, Farghaly M, Kaló Z (January 2023). "Humanistic and Economic Burden of Atopic Dermatitis for Adults and Adolescents in the Middle East and Africa Region". Dermatology and Therapy. 13 (1): 131–146. doi:10.1007/s13555-022-00857-0. PMC 9823172. PMID 36445612. {{cite journal}}: Check |pmc= value (help); Check |pmid= value (help) 引用錯誤 Invalid <ref> tag; name "Elezbawy-2023" defined multiple times with different content
  128. ↑ 128.0 128.1 Elezbawy B, Farghaly M, Al Lafi A, Gamal M, Metni M, Visser W, Al-Abdulkarim H, Hedibel M, Fasseeh AN, Abaza S, Kaló Z (July 2024). "Strategic Approaches to Reducing the Burden of Atopic Dermatitis in the Middle East and Africa Region". Value in Health Regional Issues. 42: 100987. doi:10.1016/j.vhri.2024.100987. PMID 38703753. {{cite journal}}: Check |pmid= value (help)
  129. ↑ Saito H (August 2005). "Much atopy about the skin: genome-wide molecular analysis of atopic eczema". International Archives of Allergy and Immunology. 137 (4): 319–325. doi:10.1159/000086464. PMID 15970641.
  130. ↑ "Atopic Dermatitis". www.uchospitals.edu. 1 January 2015. 原著喺2015-04-08歸檔. 喺2 April 2015搵到.
  131. ↑ O'Connor C, Murphy M (December 2021). "Scratching the surface: a review of online misinformation and conspiracy theories in atopic dermatitis". Clinical and Experimental Dermatology. 46 (8): 1545–1547. doi:10.1111/ced.14679. PMID 33864398. {{cite journal}}: |hdl-access= requires |hdl= (help)

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