What's new in the topical treatment of allergic skin diseases

Curr Opin Allergy Clin Immunol. 2014 Oct;14(5):436-50. doi: 10.1097/ACI.0000000000000093.

Abstract

Purpose of review: To review recent literature on the topical treatment of allergic skin diseases to help clinicians make informed evidence-based decisions.

Recent findings: Twenty-four publications were identified from a PubMed search of randomized controlled trials and systematic reviews of topical treatment of atopic dermatitis and allergic contact dermatitis published from 1 January 2013 to 31 January 2014. Studies on the topical treatment of atopic dermatitis largely supported the recommended use of topical corticosteroids and topical calcineurin inhibitors. Barrier therapy continues to play an important role without evidence supporting use of one emollient over another. Lipoxin A4, an eicosanoid with anti-inflammatory properties, and a 5% cis-urocanic acid emulsion cream were effective in the treatment of atopic dermatitis, although studies were small. Adjunct therapy with bleach baths, natural oils, and textiles all showed some benefit; however, studies are limited. Literature on topical treatment of allergic contact dermatitis was limited to one publication, providing evidence for a natural multicomponent cream as maintenance therapy after control of disease with a topical corticosteroid.

Summary: There is strong evidence for the use of topical anti-inflammatory therapies in the treatment of atopic dermatitis. There is little evidence to suggest that one emollient is better than others.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Topical
  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Inflammatory Agents / therapeutic use*
  • Calcineurin Inhibitors / therapeutic use*
  • Dermatitis, Allergic Contact / drug therapy*
  • Dermatitis, Atopic / drug therapy*
  • Evidence-Based Medicine
  • Humans
  • Lipoxins / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Skin / drug effects*
  • Skin / immunology
  • Skin / pathology
  • Urocanic Acid / therapeutic use*

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Calcineurin Inhibitors
  • Lipoxins
  • lipoxin A4
  • Urocanic Acid