Nouveaux traitements de la dermatite atopique

摘要: Topical steroids are still used suboptimally, but remain the mainstay of atopic dermatitis treatment. steroid phobia is rampant in many countries, a real advantage for entry on market topical immunomodulators (TIMs), which inhibit both antigen specific and non-specific T cell activation skin, by blockade gene transcription proinflammatory cytokines such as IL2 TNF alpha. tacrolimus pimecrolimus have most advanced clinical development. Tacrolimus, already orally transplantation medicine, available France since 2003 0.03% ointment children (Protopic, Fujisawa). Its introduction has substantially changed prescription habits dermatitis. Recalcitrant adolescent adult head neck lesions major target, drug also widely children, with good safety profile. The risk herpes virus superinfections did not increase significantly trials needs further monitoring. Long-term will need closer look at much debated increased skin cancer risk. marked efficacy thin sites absence atrophogenic properties balance its side effects first applications inflamed (pruritus, burning sensation). Clinical studies using (Elidel, Novartis), marketed 1% cream, show satisfactorily profile adults including infants. better tolerated introduced international 2002 pediatric positioning, nor yet 2004 France. Besides phototherapy, systemic immunosuppressants useful drugs severe disease especially older adolescents, cyclosporin remaining leading drug. Preventive immunomodulation modifying intestinal microflora very promising approach deserves large-scale assessment.