22nd World Congress of Dermatology「Current Strategy and the future -Update the new methodology of drug therapy and the active role of skincare in AD therapy」
- 開催日時 ：
- 2011年5月28日 17:00－18:15
- 開催場所 ：
- 韓国 ソウル市 ＣＯＥＸ国際展示場 １０１会場
- 共催 ：
宮地 良樹先生（京都大学 医学部皮膚科 教授）
松永 佳世子先生（藤田保健衛生大学 医学部皮膚科 教授）
Kyu Han Kim先生（ソウル国立大学 医学部皮膚科 教授）
Prof. Yoshiki Miyachi
Atopic dermatitis (AD) is a disease frequently encountered in medical examinations and treated in many countries. Japan and Korea are not exceptions. In this session, leading dermatologists of Japan and Korea would like to introduce the latest situation about the diagnosis and treatment of AD in each country. By sharing this new information, this seminar is expected to improve the QOL of AD patients through basic skincare.
Valuable 10 years experiences in Japan -setup and prevail the guideline
Prof. Kayoko Matsunaga
Because atopic dermatitis (AD) is a disease for which sufficient patient explanations and compliance with treatment and adherence should be taken into consideration, standard guidelines for the management (diagnosis, severity classification and therapy) of AD have been established. Standard guidelines for the management of AD were developed by the Japanese Dermatological Association for the first time in 2000, with the latest versions being revised in 2009. The standard therapies for AD consist of topical corticosteroids and tacrolimus ointment, systemic antihistamines and anti-allergic drugs as well as topical application of emollients (skincare). Skincare plays a major role in the progress of AD treatment.
In my presentation, reference is made to the elements required for skincare products simultaneously with the explanation about how to use skincare products and the importance of communication with the AD patient. Since the main purpose of skincare is to complement dryness and skin barrier dysfunction, it is also required to keep the skin clean and to protect from ultraviolet rays in addition to basic moisturizing effects. To complement the effective treatment of AD, the skin care products are insufficient that it is just effective, and safety must be checked by clinical and patch testing. For type or formulation, I recommend products that meet basic patient needs. It is necessary to spend sufficient time on guiding patients, and explaining the cause, the mechanism of skin dryness, and the importance of skin care.
General treatment of Atopic dermatitis patients in Korea
Prof. Kyu Han Kim (Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea)
We first recommend and educate patients or parents to pay special attention to general precautions to reduce or avoid aggravating factors and to take care of their dry skin. Then we prescribe topical corticosteroids (TCSs) as the first topical anti-inflammatory agent and then topical calcineurin inhibitors (TCIs) as the 2nd drug especially in head and neck lesions refractory to TCSs. To reduce the frequency of applications of TCSs, we strongly recommend patients that dryness of the skin be first managed with emollients as much as possible. These days much more emphasis is given on the proper skin care by frequent use of emollients. General recommendation is that emollients should be applied 2 times a day within 3 min after bath. There are many kinds of emollients, and some contain ceramide or ceramide with a specialized multi-lamellar structure similar to the physiologic lipid from the stratum corneum. Emollients made of special formula containing ceramide would be more promising for the treatment of AD, but the expecting superior efficacy over ordinary emollients has not been proved scientifically. Each skin care product (soaps, emollients and sunscreens) should not have any irritation or allergic potential, and have sufficient hydration or moisturizing capacity. Next we usually add antihistamines to reduce pruritus to a certain extent. Systemic antibiotics are used to treat acute flare up of AD occurred frequently after infection. In very severe patients other treatment modalities including immunosuppressants or immune modulators are tried.