[What are means of preventing flares and the adjuvant measures to be taken in atopic dermatitis in children?].
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Biomedical subjects
Publications and source records attributed to C Chiaverini.
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We report the case of a 46-year-old patient in whom ulcerative colitis had been diagnosed three years ago. He was admitted to the hospital for swelling of the nose. Clinical course and complementary exams led us to diagnose atrophic polychondritis. Twelve cases of such an association have been published so far.
FUNDAMENTALS: The aim of treatment in psoriasis is to reduce the degree of extension to a point compatible with the patients social, occupational and personal lifestyle. The patient should be informed that there is no curative treatment. A good patient-doctor relationship is required for the patient to understand that the proposed treatment can provide symptomatic relief but must take into account an optimal balance between treatment benefit and risk. Therapeutic abstention must be recognized as a possibility. In all cases, efforts must be made to recognize and eliminate if possible any favoring factors. A TWO-PHASE TREATMENT: Initially, the aim of the treatment is to induce an involution of the active lesions. A second phase is aimed at avoiding subsequent fiare-ups. Local treatments: Local care should always be preferred in patients with limited lesions. Keratolytic agents, dermocorticoids and vitamin D3 derivatives can be used. Topical retinoids, particularly tazarotene are in the development stage. SYSTEMIC TREATMENTS: Systemic treatments should be reserved for extensive psoriasis and for failure after well-conducted local care. Photoherapy, particularly PUVA-therapy and more recently narrow-spectrum UVB-therapy play an important role. Systemic retinoids can be used alone or in combination with PUVA-therapy. The risks of methrotrexate and cyclosporin impose their use exclusively in specialized centers. Several other treatments are still in the experimental stage, particularly promising highly selective immunotherapy.