甚麼是過敏性皮膚炎?
過敏性皮膚炎是一種慢性的炎症及皮膚瘙癢症
亦是濕疹的其中一種。它是一種家族性疾病,
若患者或家庭成員患有敏感性疾病,如鼻敏感
及哮喘等,患上過敏性皮膚炎的機會亦相對增
加。
,
,
的部位。.
過敏性皮膚炎一般在五歲前發病,可以持續至
成年人階段。有些患者的過敏情形會偶爾發作
然後情況好轉一段時間後再次復發。雖然過敏
性皮膚炎未有根治的方法,但只要小心處理及
使用適當的藥物,大多數都能有效地控制病情。病況會因年齡增長而有
所改善,大約四份三的小孩患者會於青少年時期完全康復。
一般症狀
皮膚會因過敏而乾燥、痕癢及紅腫。若患
者不斷抓癢而令皮膚破損,更有機會令病
情惡化,使皮膚受到細菌及病毒的感染以
致流膿。過敏性皮膚炎能出現在身體任何
一個部分,但通常出現在手、腳、腳踝、
手腕,及手腳關節屈曲
常用的護理及治療性藥物
過敏性皮膚炎的護理主要是避免接觸刺激物,保持皮膚濕潤及利用藥物
控制痕癢和防止皮炎發作。.
藥物療法 用途 常見副作用 注意事項 潤膚劑 如:水分冷霜,乳
化軟膏,尿素霜
過敏性皮炎
的第一線療
法 滋潤皮膚,
緩和乾燥引
起的不適
副作用不常見 某些輔料
(excipients)或會引起敏感
應常塗潤膚劑以保持皮膚濕潤
避免使用含羊毛
脂的產品以防過
敏 焦油 消炎、止癢 氣味較濃烈
或會沾污衣物 刺激皮膚
避免用於滲水的傷口,以防刺激
皮膚 外用類固醇 如:
hydrocortisone, betamethasone, clobetasol
用於濕疹發
作時的短期
治療
副作用與類固
醇的效能
(potency)相關。過量使用
強效類固醇或
致 皮膚變薄 皮膚產生
委縮條紋 微絲血管
增生擴張 膚色變
淡,色素
流失 毛髮增生
應薄薄塗在患處以減少副作用。 一指尖單位(即藥膏擠出後從指尖
覆蓋至第一指間
關節的份量) 足夠塗滿相當於兩隻
成人手掌的面積 切勿用於傷口 建議逐漸減少劑量以防引起反彈
發作
外用免疫調節劑 如:Tacrolimus, pimecrolimus
外用類固醇
不適用的情
況下,此類
藥物會用於
短期治療
局部不適包括
灼熱感、痕癢
及刺激皮膚
避免長時間暴露於日光下
避免與其他免疫
調節劑同時使用 切勿用於受感染
的皮膚上 口服抗組織胺 如:hydroxyzine, diphenhydramine
減少痕癢 減少兒童睡
眠期間的無
意識抓癢
嗜睡、昏昏欲
睡、口腔乾燥 ‼ 與其他藥物(如:
抗抑鬱藥及安眠
藥)同用,或令嗜
睡的副作用加劇
ITCHY!
What is atopic dermatitis?
Atopic dermatitis is a chronic
inflammatory
and pruritic skin disorder, and is a type of eczema. It is a
familial disease which often occurs
together with other atopic diseases
like hay fever
and asthma.
Atopic dermatitis often begins in
childhood before the age of 5
and may persist
into adulthood. For some, it flares up occasionally and may subside for a period of time. Although there is
no cure for atopic dermatitis,
it can be effectively treated
through preventative measures and drug therapy. About 75% of children with atopic dermatitis will grow out of it when they reach adolescence.
Signs and Symptoms
The skin can be easily
irritated and becomes dry, itchy,
red and swollen. If scratched,
it may further worsen the condition and the skin surface
becomes more easily affected
by bacterial or viral infections
causing oozing. Atopic dermatitis can
affect any part of the body,
but it is more frequently seen
on the hands and feet, ankles,
wrists, and on the
flexural surfaces of the joints.
Common Drugs Used for Care and Treatment
The principle of care is to avoid irritants, manage dry skin and control itchiness and flare‐ups with medicines.
DrugDrug UseUse
Common side effectsCommon side effects
Remarks/Remarks/Precautions Precautions
Emollientse.g. aqueous cream, emulsifying ointment, urea cream
First‐line treatment for soothing and hydrating the skin
Uncommon; rarely some excipients may cause sensitization in individuals
Apply frequently
to ensure adequate hydration
Avoid lanolin as it may cause sensitization
Tar Reduce itching and inflammation
Strong odor and staining Skin irritation
Not to be used on oozing lesion due to stinging and irritation
Topical steroids e.g. hydrocortisone, betamethasone, clobetasol
Short‐term treatment for acute flare‐up
Side effects increasewith potency of steroids. Extensive application of potent steroid may cause
Thinning of skin
Irreversible striae and telangiectasia (visible blood vessels)
Skin depigmentation
Increased hair growth
Apply sparingly to minimize side effects. One finger‐tip unit (length measured from the tip of index finger to the first crease) is sufficient to cover an area equivalent to twice that of the adult palm
Not to be used on open wounds
Discontinue treatment gradually to prevent rebound flare
Topical immuno‐suppressants e.g. tacrolimus, pimecrolimus
Short‐term treatment when topical steroids cannot be used
Application site reaction including burning, itching and irritation
Avoid excessive exposure to sunlight
Avoid concomitant use with other immunosuppressants
Not to be used on infected site
Oral antihistamine e.g. hydroxyzine, diphenhydramine
Reduce itching and prevent night‐time scratching in children
Sleepiness, dizziness and dry mouth
‼
Increased sedation if also taking other sedative drugs e.g. hypnotics and antidepressants
ITCHY!
Living with atopic dermatitis
15 MIN
People with atopic dermatitis should avoid smoking and inhalation of dust in general, and any known irritants if at all possible.
Sudden and extreme
temperature swings, as well as
excessive in coldness and heat
can provoke attacks.
Choose cotton‐made clothing,
and avoid clothing of wool and
nylon texture.
Some food may trigger allergic
reactions, e.g. milk, nuts, cheese,
and wheat. Food allergy testing
can be done to find
out possible true allergens and avoid them.
Keep the body clean by
taking shower or bath once or
twice daily, but keep
it under 15 minutes to avoid skin dryness.
Avoid using soap with fragrance
or contains alkaline substance. During
bath, add 1 to 2 spoonfuls
of emulsifying ointment to water. After shower, allows
it to leave on skin by pat
drying using towel, or
apply moisturizer before the skin is completely dried.
If moisturizer and steroid cream
are to be used together, steroid
cream should be sparingly applied
followed by moisturizer used
20 minutes later.
Printed by the School of Pharmacy, CUHK
甚麼是過敏性皮膚炎What is atopic dermatitis