التفاصيل البيبلوغرافية
| العنوان: |
Consenso mexicano para el diagnóstico y tratamiento de la dermatitis atópica en adolescentes y adultos. (Spanish) |
| العنوان البديل: |
Mexican consensus on the diagnosis and treatment of atopic dermatitis in adolescents and adults. (English) |
| المؤلفون: |
Rincón-Pérez, Catalina, Larenas-Linnemann, Désirée, Figueroa-Morales, Marco Antonio, Luna-Pech, Jorge, García-Hidalgo, Linda, Macías-Weinmann, Alejandra, Gómez-Vera, Javier, Barba-Gómez, José Fernando, Matta-Campos, Juan José, Guevara-Sangines, Esther, Jurado-Santacruz, Fermín, Tello-Santillán, Adriana López, Ortega-Martell, José Antonio, Pulido-Díaz, Nancy, Serrano-Jaén, Liliana Guadalupe, Toledo-Bahena, Mirna, Villanueva-Quintero, Guadalupe, Mayorga-Butrón, José Luis |
| المصدر: |
Revista Alergia de Mexico; 2018 Supplement, Vol. 65, ps8-s88, 81p |
| الملخص (بالإنجليزية): |
Background: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. Objective: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients . 12 years with AD to improve their care. Methods: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from intense electronic communication, several issues of disagreement were discussed in two face-to-face meetings. Results: The clinical experts reached consensus on 46 statements related to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to general care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes .low level evidence.) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimination diet, if there is an IgE-mediated respiratory or food allergy, respectively. Conclusion: The panel of experts reached consensus on relevant aspects of AD with a focus on the transcultural adaptation of recent evidence. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): |
Antecedentes: Los abordajes diagnosticos y las estrategias terapeuticas de la dermatitis atopica generalmente son inconsistentes entre los medicos y entre las instituciones de salud. Objetivo: Consensar las opiniones de expertos para reducir las variaciones en la practica respecto al diagnostico y tratamiento de pacientes . 12 anos con dermatitis atopica para mejorar su cuidado. Metodos: Busqueda sistematica de la literatura en PubMed y GREAT. Con apoyo metodologico y utilizando el metodo Delphi se desarrollo un consenso formal entre 16 expertos en dermatologia y alergologia, basandose en la evidencia actual y su aplicabilidad en el contexto mexicano. A parte de una comunicacion electronica intensa, se discutieron los puntos en desacuerdo en dos reuniones presenciales. Resultados: Los expertos clinicos alcanzaron consenso en 46 declaraciones relacionadas con la definicion, clasificacion, estrategias de diagnostico y tratamiento de la dermatitis atopica. Para el diagnostico sugerimos se usan los criterios de Williams y el SCORAD (por parte del medico) y POEM (por parte del paciente) para definir la gravedad. Aunado a cuidados generales y educacion terapeutica, sugerimos cuatro pasos para tratamiento, segun gravedad: 1. Manejo topico con antiinflamatorio (y sistemico: antihistaminico/ antileucotrieno .evidencia reducida.) 2. Fototerapia, 3. Ciclosporina A y 4. Dupilumab, con la posibilidad de manejarlo antes si se necesita efecto rapido. En la dermatitis atopica extrinseca sugerimos agregar inmunoterapia con alergenos o una dieta de eliminacion si existe una alergia IgE-mediada, inhalatoria o alimentaria, respectivamente. Conclusion: El panel de expertos realizo consenso en aspectos relevantes de la dermatitis atopica con enfoque en la adaptacion transcultural de evidencia reciente. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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