湿疹皮炎的外用药物治疗北大三院李林峰课件

《湿疹皮炎的外用药物治疗北大三院李林峰课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、湿疹皮炎的外用治疗北医三院李邻峰湿疹皮炎“三无病”无特异病因、无根治方法、“无生命之忧”三不病不明白、治不了、死不了可能病机皮肤屏障破坏免疫异常可能是其后果刺激过敏微生物心理(Dr.Rycroft)病因解释禅不可说上帝不能问病因病机决定治疗要求高效果好、快不良反应少外用治疗为主中国湿疹指南2011小于体表面积30%的局限性皮损，外用治疗为主泛发？WavesBasicrequirementsAtleastnoharm,eventhoughwithoutanybenefit.Avoidirritation(NURSE)Avoidallergen,hypoallergeni

2、cskincareproductsControlsuperinfectionTopicalapplicationsMoisturizersBarriercreamAnti-itchagentsAntisepticsAntiinflammatoryTCMOthersCombinationandsequentialtopicaltherapyMoisturizers/emollientsrestoretheskinbarriertrapwaterandreversedryskinpreventthepenetrationofirritantsandallergensred

3、uctionsintheamountoftopicalmedicationsrequiredIndicationsPatientswithimpairedskinbarrierfunction覆巢之下岂有完卵？MoisturizersNon-irritantLowallergenic,beperfumefreeApplicationofasmuchas50gramsofmoisturizerdailyforchildrenMoisturizersMoisterizersappliedimmediaelyaftercleansingavoidsoapsmildsoap-

4、freecleansers,preferablyliquidEADVTopicaltreatmentshouldalwaysbeappliedonhydratedskin.Theemollientshouldbeappliedfirstwhenitisacream,15minbeforetheanti-inflammatorytopicalisappliedandwhenitisanointment15minafter.(Addanemolienttoaprescriptedmedicine)Anti-itchagentsAnti-pruritusCamphorMen

5、tholCalamineAntihistamines?(myfirstpaperonCD)DoxepinAntibioticsSecondaryinfectionheavycolonizationoftheskinparticularlywithStaphaureusMupirocin(Bactroban)orFucidicacid(Fucidin)ointmentAnti-bacterialimpairedskinbarrierfunctionAnumberofdefectsininnatecutaneousimmunologymayexplainthehighra

6、teofcutaneouscolonizationwithS.aureus(upto90%inmoderatetosevereeczema)inAD.ThereisevidenceforanassociationofS.aureus-derivedsuperantigenswithdiseaseexacerbationADmayimprove(butnotbecured)byantistaphylococcaltreatment.Intense,fleshyerythemainskinfoldsofchildrenwithaflareofADmaywarrantase

7、archforstreptococcalskininfection(Littlegirlmis-ascandidiasis)beta-haemolyticstreptococciAntibioticstoreducebacterialloadbenefitedeventhoughtherearenoobvioussignsofinfection(manystuidesproved)topicalantisepticstopicalantisepticsliketriclosan,chlorhexidineorcrystalviolet0.3%Anti