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Abstract

Atopic dermatitis (AD) is the most common inflammatory skin disease. However, recent reports concerning the simple clinical aspects of treatment with topical glucocorticosteroids (TCS) and calcineurin inhibitors (TCI) are lacking. The objective of this study is providing an update on these characteristics of AD management. A group of 150 adults suffering from AD treated with TCS during last year was asked to fill an anonymous questionnaire. The course of topical treatment was analyzed in the context of the severity of symptoms and the knowledge of the patients about therapy. During the last year, the majority of patients (66%) were treated with class IV TCS; however, in the last two weeks, class I TCS was used the most frequently (35%). Only 11% were familiar with the concept of intermittent therapy and 4% used the fingertip unit (FTU). In total, 77% of them used TCI. Most of the patients used the same class of TCS permanently. Unfortunately, patients are unaware of simple approaches (like intermittent therapy or FTU) that increase both the effectiveness and safety of the treatment. Practicians should be aware of these problems to identify and eliminate them, primarily through the education of patients.
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Authors and Affiliations

Przemysław Hałubiec
1
ORCID: ORCID
Andrzej Kazimierz Jaworek
2
Anna Wojas-Pelc
2

  1. University Hospital, Kraków, Poland
  2. Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Atopic dermatitis (AD) is a chronic, recurrent inflammatory dermatosis. The most characteristic symptoms of the disease include itch, eczematous eruptions and excessive dryness of the skin. Elderly patients with AD represent a poorly characterized population because the physiological ageing, possible comorbidity and polypharmacy modify the clinical presentation typically observed in the younger age groups. The aim of the study is to comprehensively assess the clinical characteristics of elderly patients (>60 years old) with AD. Data were collected from 26 AD patients treated in the Department of Derma-tology of the University Hospital in Krakow. Late-onset AD with generalized/prurigo lesions was the most predominant phenotype. Skin biopsy was required in 15 (58%) patients in the differential diagnosis process. Allergic rhinitis, a positive family history of atopy and xerosis were associated with a higher number of hospitalizations during the year prior to the last admission (p = 0.034, p = 0.046 and p = 0.036, respectively). Xerosis was more prevalent among subjects with polypharmacy (p = 0.046) and higher serum total IgE concentration (p = 0.048). AD in elderly patients is a new phenotype of the disease that requires careful differential diagnosis. Aged patients with an individual or family history of atopy, due to the increased incidence of severe exacerbations of AD, may benefit from the introduction of proactive therapy.
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Authors and Affiliations

Andrzej Kazimierz Jaworek
1
Przemysław Hałubiec
2
ORCID: ORCID
Natalia Kachnic
3
Alicja Podolska
3
Julia Radzikowska
3
Arletta Kozłowska
2
Anna Wojas-Pelc
1

  1. Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
  2. University Hospital, Kraków, Poland
  3. Student Scientific Group of Dermatology, Jagiellonian University Medical College, Kraków, Poland

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