Atopic eczema treatment

Lipid-based carrier systems have been investigated to improve treatment of inflammatory skin diseases such as atopic eczema and psoriasis by glucocorticoids and T-cell inhibitors such as ciclosporin and tacrolimus. 

Glaucoma and ocular hypertension have been reported after dermal application of glucocorticoids for facial atopic eczema (SEDA-19,376) (64), and after treatment with beclomethasone by nasal spray and inhalation (SEDA-20, 373 65). 

Glucocorticoid creams applied topically to the skin are routinely used in the treatment of many skin disorders, and their use on the face in severe atopic eczema is relatively common. Three patients developed advanced glaucoma while using topical facial glucocorticoids. Two other patients developed ocular hypertension secondary to topical facial glucocorticoids (430). 

Kowalzick L, Kleinheinz A, Neuber K, Weichenthal M, Kohler I, Ring J Elevated serum levels of soluble adhesion molecules ICAM-1 and ELAM-1 in patients with severe atopic eczema and influence of UVA1 treatment. Dermatology 1995 190 14-18. 

A number of clinical implications of drug reservoir formation in the upper skin layers by delivery from liposomes have been reported [4-6,13], From these studies it appears that the efficiency of liposomal-incorporated drugs was superior to other formulations in the treatment of disorders, which do not affect the deep layers of the skin. For example, in a doubleblind, randomized paired study on patients suffering from atopic eczema or psoriasis vulgaris, a liposomal betamethasone dipropionate was more efficient than a nonliposomal preparation in eczematous but not in psoriatic patients [6],... 

Evening primrose oil is rich in the essential fatty acid linoleic acid and its metabolite, y-linolenic acid. In the U.K., evening primrose oil preparations have received approval as medicines for the relief of atopic eczema and for the symptomatic treatment of breast pain. 

Schalin-Karrila, M., Mattila, L., Jansen, C.T., and Uottila, P., Evening primrose oil in the treatment of atopic eczema effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins, Br J. Dermatol., 117, 11, 1987. 

Morse, P.F., Horrobin, D.F., Manku, M.S. etal., Meta-analysis of placebo-controlled studies of the efficacy of Epogam in the treatment of atopic eczema. Relationship between plasma essential fatty acid changes and clinical response, Br. J. Dermatol., 121, 75, 1989. 

Kunz, B., Ring, J., and Braun-Falco, O., Eicosapentaenoic acid (EPA) treatment in atopic eczema a prospective double-blind trial, J. Allergy Clin. Immunol., 83, 196, 1987. 

Abeck, D. et al., Treatment of acute exacerbated atopic eczema with emollient-antiseptic preparations using the wet wrap ( wet pyjama ) technique. Hautarzt, 50, 418 121, 1999. 

Limitation of PST include active atopic eczema on the test side, local treatment with steroids or immunomodulator ointment, use of antihistamines (should be avoided at least 3 days prior to PST) (H0st et al., 2003). 

Hoare C, Li Wan Po A and Williams H (2000) Systematic review of treatments for atopic eczema. Health Technology Assessment 4 1-191. 

Gamma-linolenic acid (18 3n-6) is an important unsaturated fatty acid. It is the precursor for biosynthesis of arachidonic acid that is a precursor for prostaglandin formation. Recently, y-linolenic acid has been recognized for its potential health benefits in prevention and treatment of cardiovascular disorders, premenstrual syndrome, atopic eczema, rheumatic arthritis, and alcoholism (13, 14). Seed oils of blackcurrant and other Ribes species, as well as evening primrose seed oils, are rich sources of natural y-linolenic acid. 

OEP is regulated as a dietary supplement in the United States. It is approved in Canada as an over-the-counter product for use in EFA-deficiency conditions and as a dietary supplement to increase EFA intake. In the United Kingdom, it is on the General Sales List. In Germany, OEP is approved for use as food and is approved there in the treatment and symptomatic relief of atopic eczema. In Sweden, OEP is classified as a natural product. OEP has a Class 1 Safety Rating with the American Herbal Product Association (1,2,7). 

Kerscher Ml, Korting HC. Treatment of atopic eczema with evening primrose oil rationale and clinical results. Clin Investig 1992 70 167-171. 

Non-prescription treatments - atopic eczema Moisturisers and emollients... 

Broberg A, Kalimo K, Lindblad B, Swanbeck G Parental education in the treatment of childhood atopic eczema. Acta Derm Venereol 1990 70 495-499. 

Lovell, C.R., Burton, J.L., and Horrobin, D.F. (1981) Treatment of Atopic Eczema with Evening Primrose Oil, Lancet i, 278. 

Frequently the advice given to eczema sufferers is to wear cotton clothing (British Skin Foundation, 2006) but to quote Williams (2001) in his review of treatments of atopic eczema there was no evidence to support any clear clinical benefit on the use of...cotton clothing as opposed to soft-weave synthetics.. " The experimental work that follows tends to agree. 

H Williams, 2001 Systematic review of treatments of atopic eczema. The Research Findings Register. Summary number 468. Retrieved 19 September 2006 from http //www.ReFeR.nhs.ukA iewRecord.asp ID=468. 

A slightly dry skin may be treated with an extra fat containing hydrophUic cream. Patients with a very dry skin use cutaneous preparatirms with a high amount of hpophUic components. Lipophilic creams are suitable for the treatment of the chronic state of atopic eczema. Hydrophobic ointments or saturated hydrocarbons are not indicated because they have an occlusive effect, which causes heat accumulation and enhances itching. 

Atopic eczema in 32 children treated by massage with and without essential oils (Anderson et al., 2000) in a single case experimental design across subjects showed that this complementary therapy provided no statistically signi cant differences between the two groups after 8 weeks of treatment. This indicated that massage and thereby regular parental contact and attention showed positive... 

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