Pitching, burning of the skin, insomnia, nervousness and difficulties in social relations: these are just some of the problems that torment the daily life of those suffering from psoriasis and atopic dermatitis, two pathologies that in addition to the clinical aspect also have serious repercussions on the psyche and on the quality of life of those who suffer from them. But important news is on the way, as emerges from the 95th SIDeMaST Congress, the Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases. The Congress, in progress until October 16 in digital version, focuses on the new therapies capable of eliminating not only the lesions, but also relieving the disabling itching and the annoying burning sensation in cases of atopic dermatitis. .
Atopic Dermatitis: the numbers
Atopic dermatitis is the most common inflammatory skin disease, which in Italy affects 7.7% of adolescents between 13 and 14 years and 6.6% of adults. In the majority of cases the onset of symptoms occurs in childhood and in about 60% of cases a significant improvement is observed during adolescence, although in a certain percentage of cases the disease may reappear in adulthood. Fortunately, in about 90% of cases, atopic dermatitis occurs in a mild-moderate form. The main symptom is itching and the lesions are eczema located more frequently in the folds of the limbs, neck and face and, in adults, also on the hands and mammary areolas. In the most common cases, the disease is characterized by phases of remission and relapse caused by triggering events: “To the question that patients most frequently ask: ‘Can atopic dermatitis be cured? What cure? – says Ketty Peris, president of SIDeMaST- we reply by explaining that, being a chronic inflammatory disease, our goal is the disappearance of eczema and itching ”.
The cure
There are various treatments today, according to Gabriella Fabbrocini, SIDeMaST director: “We have the classic topical therapies based on corticosteroids and topical calcineurin inhibitors and systemic therapies with traditional drugs such as cyclosporine and with new biological therapies such as dupilumab or tralokinumab, or small molecules such as Jak inhibitors”.
In addition, the European Commission recently approved Upadacitinib, a selective and reversible inhibitor of Jak that is taken orally and has been shown to be very effective in the treatment of moderate-to-severe atopic dermatitis in adults and adolescents aged 12 years and over. In international clinical studies, which also included Italy, Upadacitinib was used alone or in combination with topical cortisone and acted rapidly not only on pruritus but also on skin lesions. With these innovative therapies will make it possible to better treat a complex and disabling disease such as atopic dermatitis. For this reason, dermatologists hope that it will soon be possible in Italy as well. In the meantime, patients must continue to adopt simple precautions: respect good daily habits of skin care and hygiene; maintaining a healthy lifestyle by taking care of nutrition and doing regular physical activity; 3) use emollients frequently; avoid coming into contact with irritating or allergenic substances such as soaps, wool, excessive temperatures and allergens present in the environment such as plants and grasses; avoid do-it-yourself and rely on the care of experts.
There are also important innovations in the treatment of psoriasis, with innovative treatments that allow for ever greater control of the disease. Psoriasis is the most common chronic inflammatory skin disease that affects approx 3% of the Italian population. In addition to the skin, it can also affect other organs and systems such as the articular, cardiovascular and intestinal systems; for this reason a multidisciplinary approach is often required. Fortunately, the dermatologists of SIDeMaST point out, we have it available today innovative biotechnological drugs that act in a targeted manner on the inflammatory processes that support psoriatic pathology, allowing optimal management of the disease. Particularly, the most recent biotechnological drugs such as interleukin inhibitors 17 and 23, are able to make skin lesions completely disappear in a few weeks, allowing a quick and long-term control of psoriatic disease: “Our aim is to identify the right therapy for the right patient, or to carry out a personalized therapy tailored to the patient and his peculiarities, being able to make use of 11 different biotechnological drugs, each with its own distinctive characteristics.”, Underlines Fabbrocini.