Allergy, Asthma & Respiratory Disease

  • 제12권4호
  • /
  • Pages.170-176
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  • 2024
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  • 2288-0402(pISSN)
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  • 2288-0410(eISSN)
대한천식알레르기학회 (The Korean Academy of Asthma, Allergy and Clinical Immunology)
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DOI QR코드

DOI QR Code

대한 소아알레르기 호흡기학회 소아청소년 아토피피부염 진료지침: 1편. 피부관리 및 국소치료

The KAPARD guidelines for atopic dermatitis in children and adolescents: Part I. Skin care and topical treatment

  • 이은 (전남대학교 의과대학 전남대학교병원 소아청소년과) ;
  • 김환수 (가톨릭대학교 의과대학 소아청소년과학교실) ;
  • 김경훈 (서울대학교 의과대학 소아청소년과학교실) ;
  • 민택기 (순천향대학교 의과대학 서울병원 소아청소년과) ;
  • 서동인 (서울대학교 의과대학 소아청소년과학교실) ;
  • 황윤하 (부산성모병원 소아청소년과) ;
  • 정성수 (부산대학교 의과대학 양산부산대병원 소아청소년과) ;
  • 정민영 (고신대학교 의과대학 복음병원 소아청소년과) ;
  • 박영아 (이화여자대학교 의과대학 소아청소년과학교실) ;
  • 김민지 (충남대학교 의과대학 세종충남대학교병원 소아청소년과) ;
  • 설인숙 (연세대학교 의과대학 세브란스병원 소아청소년과) ;
  • 전유훈 (한림대학교 의과대학 동탄성심병원 소아청소년과) ;
  • 우성일 (충북대학교 의과대학 충북대학교병원 소아청소년과) ;
  • 이용주 (연세대학교 의과대학 용인세브란스병원 소아청소년과) ;
  • 김종덕 (연세대학교 의과대학 세브란스병원 소아청소년과) ;
  • 양현종 (순천향대학교 의과대학 서울병원 소아청소년과) ;
  • 장광천 (국민건강보험 일산병원 소아청소년과) ;
  • 대한 소아알레르기 호흡기학회 진료지침위원회 (대한 소아알레르기 호흡기학회)
  • Eun Lee (Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Hwan Soo Kim (Department of Pediatrics, The Catholic University of Korea) ;
  • Kyunghoon Kim (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Taek Ki Min (Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University School of Medicine) ;
  • Dong In Suh (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Yoon Ha Hwang ( Department of Pediatrics, Busan St. Mary's Hospital) ;
  • Sungsu Jung (Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Minyoung Jung (Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Young A Park (Department of Pediatrics, College of Medicine, Ewha Women's University) ;
  • Minji Kim (Department of Pediatrics, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine) ;
  • In Suk Sol (Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine) ;
  • You Hoon Jeon (Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Sung-Il Woo (Department of Pediatrics, Chungbuk National University Hospital, Chungbuk National University College of Medicine) ;
  • Yong Ju Lee (Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Jong Deok Kim (Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine) ;
  • Hyeon-Jong Yang (Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University School of Medicine) ;
  • Gwang Cheon Jang (Department of Pediatrics, National Health Insurance Service Ilsan Hospital) ;
  • Guideline Development Committee of the Korean Academy of Pediatric Allergy and Respiratory Disease ( Korean Academy of Pediatric Allergy and Respiratory Disease)
  • 투고 : 2024.06.01
  • 심사 : 2024.07.02
  • 발행 : 2024.10.30
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초록

Atopic dermatitis is one of the most common chronic skin inflammatory diseases in children. Appropriate treatment is difficult due to chronic course with frequent exacerbations, especially in children. Treatment requires caution due to a lack of safety data and information regarding the long-term prognosis of management strategies. The Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD) published the Atopic Dermatitis Treatment Guidelines in 2008, which has been used to direct atopic dermatitis treatment. Accumulating evidence suggests that the guidelines need to be updated regarding bathing methods (duration of bath, temperature, etc.), wet wrap therapy, and topical treatments in line with environmental changes over time and changes in the management strategies of atopic dermatitis. This KAPARD guidelines for atopic dermatitis applied an adaptation based on a systematic review and analysis of selected literature. They are intended to support front-line doctors treating pediatric and adolescent patients with atopic dermatitis in making reasoned, safe, effective empirical treatment decisions. In Part I of the KAPARD guidelines for atopic dermatitis, we included evidence-based skin care management strategies and topical treatment options.

키워드

과제정보

본 소아청소년 아토피피부염 진료지침 제작에 참여해 주신 대한 소아알레르기 호흡기학회 진료지침 위원회의 모든 선생님들께 감사드립니다.

참고문헌

  1. Park YM, Lee SY, Kim WK, Han MY, Kim J, Chae Y, et al. Risk factors of atopic dermatitis in Korean schoolchildren: 2010 international study of asthma and allergies in childhood. Asian Pac J Allergy Immunol 2016;34:65-72.
  2. Kim JH, Lee E, Ha EK, Shin J, Lee GC, Rha YH, et al. Cascade of atopic dermatitis comorbidities in children after birth for 15 years. Allergy 2024;79:153-63.
  3. Ahn J, Shin S, Lee GC, Han BE, Lee E, Ha EK, et al. Unraveling the link between atopic dermatitis and autoimmune diseases in children: insights from a large-scale cohort study with 15-year follow-up and shared gene ontology analysis. Allergol Int 2024;73:243-54.
  4. The guideline for atopic dermatitis in children and adolescents [Internet]. Seoul (Korea): Korean Academy of Pediatric Allergy and Respiratory Disease; 2008 [cited 2024 May 12]. Available from: https://www.kapard.or.kr/func/download.php?path=L2hvbWUxL3ZpcnR1YWwva2FwYXJkL2h0ZG9jcy8vZmlsZS9jb21tdW5pdHkv7IaM7JWEIOyyreyGjOuFhCDslYTthqDtlLztlLzrtoDsl7wg7KeE66OM6rCA7J2065Oc65287J24LnBkZg==&filename=7IaM7JWEIOyyreyGjOuFhCDslYTthqDtlLztlLzrtoDsl7wg7KeE66OM6rCA7J2065Oc65287J24LnBkZg==.
  5. Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol 2018;32:657-82.
  6. Saeki H, Ohya Y, Furuta J, Arakawa H, Ichiyama S, Katsunuma T, et al. Executive summary: Japanese guidelines for atopic dermatitis (ADGL) 2021. Allergol Int 2022;71:448-58.
  7. LePoidevin LM, Lee DE, Shi VY. A comparison of international management guidelines for atopic dermatitis. Pediatr Dermatol 2019;36:36-65.
  8. Weidinger S, Illig T, Baurecht H, Irvine AD, Rodriguez E, Diaz-Lacava A, et al. Loss-of-function variations within the filaggrin gene predispose for atopic dermatitis with allergic sensitizations. J Allergy Clin Immunol 2006;118:214-9.
  9. Wollenberg A, Christen-Zach S, Taieb A, Paul C, Thyssen JP, de Bruin-Weller M, et al. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol 2020;34:2717-44.
  10. Akerstrom U, Reitamo S, Langeland T, Berg M, Rustad L, Korhonen L, et al. Comparison of moisturizing creams for the prevention of atopic dermatitis relapse: a randomized double-blind controlled multicentre clinical trial. Acta Derm Venereol 2015;95:587-92.
  11. Tay YK, Chan YC, Chandran NS, Ho MS, Koh MJ, Lim YL, et al. Guidelines for the management of atopic dermatitis in Singapore. Ann Acad Med Singap 2016;45:439-50.
  12. Rubel D, Thirumoorthy T, Soebaryo RW, Weng SC, Gabriel TM, Villafuerte LL, et al. Consensus guidelines for the management of atopic dermatitis: an Asia-Pacific perspective. J Dermatol 2013;40:160-71.
  13. Wollenberg A, Oranje A, Deleuran M, Simon D, Szalai Z, Kunz B, et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. J Eur Acad Dermatol Venereol 2016;30:729-47.
  14. Kim JE, Kim HJ, Lew BL, Lee KH, Hong SP, Jang YH, et al. Consensus guidelines for the treatment of atopic dermatitis in Korea (Part I): general management and topical treatment. Ann Dermatol 2015;27:563-77.
  15. Wollenberg A, Schnopp C. Evolution of conventional therapy in atopic dermatitis. Immunol Allergy Clin North Am 2010;30:351-68.
  16. Grimalt R, Mengeaud V, Cambazard F, Study Investigators G. The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology 2007;214:61-7.
  17. Dinkloh A, Worm M, Geier J, Schnuch A, Wollenberg A. Contact sensitization in patients with suspected cosmetic intolerance: results of the IVDK 2006-2011. J Eur Acad Dermatol Venereol 2015;29:1071-81.
  18. Wollenberg A, Wetzel S, Burgdorf WH, Haas J. Viral infections in atopic dermatitis: pathogenic aspects and clinical management. J Allergy Clin Immunol 2003;112:667-74.
  19. Lee JH, Kim JE, Park GH, Bae JM, Byun JY, Shin MK, et al. Consensus update for systemic treatment of atopic dermatitis. Ann Dermatol 2021; 33:497-514.
  20. Nicol NH, Boguniewicz M. Wet wrap therapy in moderate to severe atopic dermatitis. Immunol Allergy Clin North Am 2017;37:123-39.
  21. Devillers AC, Oranje AP. Wet-wrap treatment in children with atopic dermatitis: a practical guideline. Pediatr Dermatol 2012;29:24-7.
  22. Wong SM, Ng TG, Baba R. Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia. J Dermatol 2013;40:874-80.
  23. Hon KL, Tsang YC, Lee VW, Pong NH, Ha G, Lee ST, et al. Efficacy of sodium hypochlorite (bleach) baths to reduce Staphylococcus aureus colonization in childhood onset moderate-to-severe eczema: a randomized, placebo-controlled cross-over trial. J Dermatolog Treat 2016;27:156-62.
  24. Katoh N, Ohya Y, Ikeda M, Ebihara T, Katayama I, Saeki H, et al. Clinical practice guidelines for the management of atopic dermatitis 2018. J Dermatol 2019;46:1053-101.
  25. Mohan GC, Lio PA. Comparison of dermatology and allergy guidelines for atopic dermatitis management. JAMA Dermatol 2015;151:1009-13.
  26. Ruzicka T, Bieber T, Schopf E, Rubins A, Dobozy A, Bos JD, et al. A short-term trial of tacrolimus ointment for atopic dermatitis. European tacrolimus multicenter atopic dermatitis study group. N Engl J Med 1997;337:816-21.
  27. Thaci D, Salgo R. Malignancy concerns of topical calcineurin inhibitors for atopic dermatitis: facts and controversies. Clin Dermatol 2010;28:52-6.
  28. Luger T, Boguniewicz M, Carr W, Cork M, Deleuran M, Eichenfield L, et al. Pimecrolimus in atopic dermatitis: consensus on safety and the need to allow use in infants. Pediatr Allergy Immunol 2015;26:306-15.
  29. Paller AS, Folster-Holst R, Chen SC, Diepgen TL, Elmets C, Margolis DJ, et al. No evidence of increased cancer incidence in children using topical tacrolimus for atopic dermatitis. J Am Acad Dermatol 2020;83:375-81.
  30. Lubbe J, Pournaras CC, Saurat JH. Eczema herpeticum during treatment of atopic dermatitis with 0.1% tacrolimus ointment. Dermatology 2000;201:249-51.
  31. Wetzel S, Wollenberg A. Eczema molluscatum in tacrolimus treated atopic dermatitis. Eur J Dermatol 2004;14:73-4.
  32. Mayser P, Kupfer J, Nemetz D, Schafer U, Nilles M, Hort W, et al. Treatment of head and neck dermatitis with ciclopiroxolamine cream--results of a double-blind, placebo-controlled study. Skin Pharmacol Physiol 2006;19:153-8.
  33. Song Y, Alonso-Coello P, Ballesteros M, Cluzeau F, Vernooij RWM, Arayssi T, et al. A reporting tool for adapted guidelines in health care: the RIGHT-Ad@pt Checklist. Ann Intern Med 2022;175:710-9.