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      Effectiveness of Cimetidine as Adjuvant Therapy in the Treatment of Acute-Extrinsic Atopic Dermatitis: A Double-Blind Randomized Controlled Trial

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          Abstract

          Introduction

          Acute extrinsic atopic dermatitis (AD) requires long-term treatment. Cimetidine could be used as an adjuvant therapy for acute-extrinsic AD due to immunomodulatory effects. This study aims to assess the effectiveness of cimetidine as an adjuvant to standard treatment in acute extrinsic AD.

          Methods

          This is a double-blind randomized controlled trial involving 26 AD patients aged 12–60 years from 2017 to 2020. Effectiveness of cimetidine was assessed by comparing SCORing Atopic Dermatitis (SCORAD) and objective SCORAD changes in both groups at week 2, 4, 6, and 8. Serum levels of immunoglobulin E (IgE), interferon (IFN)-γ, interleukin (IL)-12, and IL-4 were also documented.

          Results

          Significant differences were observed in SCORAD changes at week 2, 4, 6, and 8 ( p = 0.004; p = 0.001; p < 0.001; and p < 0.001 respectively), objective SCORAD changes at week 2, 4, 6, and 8 ( p = 0.004, p = 0.001, p < 0.001, and p < 0.001 respectively), and IgE level changes at week 8 ( p = 0.002) between the two groups. However, there were no significant changes in IFN-γ, IL-12, and IL-4 levels between the two groups.

          Conclusion

          Cimetidine is a safe and effective adjuvant therapy for acute-extrinsic AD.

          Trial Registration

          NCT04018131.

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          Most cited references27

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          Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies.

          Atopic dermatitis is a common and chronic, pruritic inflammatory skin condition that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this second of 4 sections, treatment of atopic dermatitis with nonpharmacologic interventions and pharmacologic topical therapies are reviewed. Where possible, suggestions on dosing and monitoring are given based on available evidence.
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            Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents.

            Atopic dermatitis is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in atopic dermatitis management and care, providing recommendations based on the available evidence. In this third of 4 sections, treatment of atopic dermatitis with phototherapy and systemic immunomodulators, antimicrobials, and antihistamines is reviewed, including indications for use and the risk-benefit profile of each treatment option.
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              • Abstract: found
              • Article: not found

              Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches.

              Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It often precedes the development of food allergy and asthma. Recent insights into AD reveal abnormalities in terminal differentiation of the epidermal epithelium leading to a defective stratum corneum, which allows enhanced allergen penetration and systemic IgE sensitization. Atopic skin is also predisposed to colonization or infection by pathogenic microbes, most notably Staphylococcus aureus and herpes simplex virus. Causes of this abnormal skin barrier are complex and driven by a combination of genetic, environmental, and immunologic factors. These factors likely account for the heterogeneity of AD onset and the severity and natural history of this skin disease. Recent studies suggest prevention of AD can be achieved through early interventions to protect the skin barrier. Onset of lesional AD requires effective control of local and systemic immune activation for optimal management. Early intervention might improve long-term outcomes for AD and reduce the systemic allergen sensitization that leads to associated allergic diseases in the gastrointestinal and respiratory tract.
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                Author and article information

                Contributors
                drendinovianto@gmail.com
                Journal
                Dermatol Ther (Heidelb)
                Dermatol Ther (Heidelb)
                Dermatology and Therapy
                Springer Healthcare (Cheshire )
                2193-8210
                2190-9172
                17 February 2022
                17 February 2022
                March 2022
                : 12
                : 3
                : 715-726
                Affiliations
                [1 ]GRID grid.9581.5, ISNI 0000000120191471, Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, , Dr. Cipto Mangunkusumo National Central General Hospital, ; 6 Salemba Raya, Central Jakarta, Jakarta, 10430 Indonesia
                [2 ]GRID grid.9581.5, ISNI 0000000120191471, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, , Dr. Cipto Mangunkusumo National Central General Hospital, ; 6 Salemba Raya, Central Jakarta, Jakarta, 10430 Indonesia
                [3 ]GRID grid.9581.5, ISNI 0000000120191471, Department of Pharmacology and Therapeutics, , Faculty of Medicine Universitas Indonesia, ; 6 Salemba Raya, Central Jakarta, Jakarta, 10430 Indonesia
                [4 ]GRID grid.9581.5, ISNI 0000000120191471, Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia, , Dr. Cipto Mangunkusumo National Central General Hospital, ; 6 Salemba Raya, Central Jakarta, Jakarta, 10430 Indonesia
                [5 ]GRID grid.11553.33, ISNI 0000 0004 1796 1481, Department of Dermatology and Venereology, Faculty of Medicine Universitas Padjajaran, , Hasan Sadikin General Hospital, ; 38 Pasteur, Bandung, 40161 West Java Indonesia
                Author information
                http://orcid.org/0000-0002-8688-4948
                Article
                688
                10.1007/s13555-022-00688-z
                8940995
                35175572
                06e5087b-81d8-4fee-becb-c2b6d8bba255
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 14 December 2021
                : 27 January 2022
                Categories
                Original Research
                Custom metadata
                © The Author(s) 2022

                Dermatology
                atopic dermatitis,cimetidine,efficacy,ige level,scorad
                Dermatology
                atopic dermatitis, cimetidine, efficacy, ige level, scorad

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