MEDICAL TREATMENT OF PRURITUS AND ATOPIC DERMATITIS

摘要

The mechanisms of allergy and pruritus are complex, and incompletely understood even in man. Historically, primary allergic disease was considered to be an IgE-mediated hypersensitivity response to an environmental allergen. Examining this concept inmore depth, we see that a major underlying immunologic abnormality in allergy is an alteration in lymphocyte responses to antigens, such that there is a change from IgG production to IgE production. We have viewed atopic dermatitis (AD) as a disease thatbegins on the "inside" of the individual—the immune system—and that following this, "outside" influences, such as allergens, irritants, bacteria, and yeast, would cause development and worsening of symptoms ("inside-outside"). Many years and thousandsof research studies focused on defining the abnormalities in the "inside"—the immune system and inflammatory response. Our diagnostic approach was focused on evaluating the immunologic IgE and immediate hypersensitivity response, and our treatment approach consisted mostly of attempting to modify the immune system and inflammatory response.