Crisis situations upset the theoretical therapeutic strategy, which ranges from topical treatments to systemic treatments, and from treatments with the fewest side effects to treatments with potentially more serious side effects.
It is all about facing up to an urgent request on the part of the patient: holidays, wedding etc. It is about facing up to the stark psychological suffering by a patient whose relationship with his chronic illness swings back and forth. In a patient whose treatment is well balanced, it is about facing up to an abrupt attack of the disease, triggered by an external event: stress, contact eczema, toxidermia, etc., and that will always need to be tracked down and identified. Of the systemic treatments, topical corticosteroids are the best crisis therapy known to date, being fully well aware that once topical corticotherapy has been started, it will be necessary to devote some thought to its relay, and to the means of avoiding a rebound or a self-perpetuation of the disease. Among the general treatments, phototherapy or PUVA therapy are excellent crisis therapies, when usable. Cyclosporine is also an excellent crisis treatment. Methotrexate acts more slowly and retinoids far more slowly.
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Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Off-label studies on apremilast in dermatology: a review.
Maloney NJ et al.
Off-label studies on apremilast in dermatology: a review.
J Dermatolog Treat.
2020 Mar , 31, (2):131-140.
Apremilast is a phosphodiesterase-4 inhibitor FDA approved for psoriatic arthritis and moderate to severe plaque psoriasis. In recent years, multiple studies have suggested other potential uses for apremilast in dermatology. A summary of these various studies will be a valuable aid to dermatologists considering apremilast for an alternative indication. The PubMed/MEDLINE and ClinicalTrials.gov databases were queried with the term 'apremilast,' with results manually screened to identify (...)
see on pubmed
Our ambition in a changing landscape of psoriasis treatments.
van de Kerkhof PCM et al.
Our ambition in a changing landscape of psoriasis treatments.
J Dermatolog Treat.
2020 Mar , 31, (2):105-107.
CARD14/CARMA2sh and TANK differentially regulate poly(I:C)-induced inflammatory reaction in keratinocytes.
J. Cell. Physiol..
2020 Mar , 235, (3):1895-1902.
CARD14/CARMA2sh (CARMA2sh) is a scaffold protein whose mutations are associated with the onset of human genetic psoriasis and other inflammatory skin disorders. Here we show that the immunomodulatory adapter protein TRAF family member-associated NF-κB activator (TANK) forms a complex with CARMA2sh and MALT1 in a human keratinocytic cell line. We also show that CARMA2 and TANK are individually required to activate the nuclear factor κB (NF-κB) response following exposure to (...)
see on pubmed
on Atopic Dermatitis
Off-label studies on apremilast in dermatology: a review.
Maloney NJ et al.
Off-label studies on apremilast in dermatology: a review.
J Dermatolog Treat.
2020 Mar , 31, (2):131-140.
Apremilast is a phosphodiesterase-4 inhibitor FDA approved for psoriatic arthritis and moderate to severe plaque psoriasis. In recent years, multiple studies have suggested other potential uses for apremilast in dermatology. A summary of these various studies will be a valuable aid to dermatologists considering apremilast for an alternative indication. The PubMed/MEDLINE and ClinicalTrials.gov databases were queried with the term 'apremilast,' with results manually screened to identify (...)
see on pubmed
Atopic dermatitis induces anxiety- and depressive-like behaviors with concomitant neuronal adaptations in brain reward circuits in mice.
Prog. Neuropsychopharmacol. Biol. Psychiatry.
2020 Mar 02, 98:109818.
Clinically, it has been reported that atopic dermatitis (AD) has been linked with negative emotional problems such as depression and anxiety, thereby reducing the quality of life, but little is known about the molecular mechanism that underlies AD-associated emotional impairments. We sought to determine whether AD could induce anxiety- and depressive-like symptoms in mice and to identify pertinent signaling changes in brain reward circuitry. AD-like lesions were induced by the repeated (...)
see on pubmed
Efficacy and safety of indigo naturalis ointment in Treating Atopic Dermatitis: A randomized clinical trial.
J Ethnopharmacol.
2020 Mar 25, 250:112477.
Indigo naturalis, a herbal medicine with a history of use dating back to ancient times, may be a good alternative topical treatment for atopic dermatitis (AD).
see on pubmed
