Acupuncture attenuates comorbid anxiety- and depressive-like behaviors of atopic dermatitis through modulating neuroadaptation in the brain reward circuit in mice

Atopic dermatitis (AD) is highly comorbid with negative emotions such as anxiety and depression. Although acupuncture has demonstrated efficacy in AD, its influence on comorbid anxiety and depression remains unclear. We sought to explore the impact and mechanisms of action of acupuncture on comorbid anxiety and depression of AD. AD-like skin lesions were induced by the topical application of MC903 to the mouse cheek. Acupuncture was performed at Gok-Ji (LI11) acupoints. AD-like phenotypes were quantified by lesion scores, scratching behavior, and histopathological changes. The effects of acupuncture on comorbid anxiety and depression-like behaviors were assessed using the elevated plus-maze (EPM), open-field tests (OFT), and tail-suspension test (TST). In addition, biochemical changes in the brain reward regions were investigated by immunoblotting for the expression of tyrosine hydroxylase (TH), dopamine D1 receptor (D1R), phospho-dopamine and cAMP-regulated phosphoprotein-32 kDa (pDARPP-32), phospho-cAMP response element binding protein (pCREB), ΔFosB, and brain-derived neurotrophic factor (BDNF) in the nucleus accumbens, dorsolateral striatum, and ventral tegmental area. Acupuncture effectively improved the chronic itching and robust AD-like skin lesions with epidermal thickening. Additionally, it considerably reduced comorbid anxiety- and depression-like symptoms, as indicated by more time spent in the open arms of the EPM and in the center of the open field and less time spent immobile in the TST. Higher pCREB, ΔFosB, BDNF, and pDARPP-32 levels, and reduced TH and D1R protein expression in the brain reward regions of AD mice were reversed by acupuncture treatment. The beneficial effects of acupuncture on clinical symptoms (scratching behavior) and comorbid psychological distress in AD strongly correlated with dorsal striatal ΔFosB levels. Collectively, these data indicate that acupuncture had a significant, positive impact on comorbid anxiety- and depression-like behaviors by modulating neuroadaptation in the brain reward circuit in mice with AD, providing a novel perspective for the non-pharmacological management of psychiatric comorbidities of AD.

Acupoint Autohemotherapy Attenuates Atopic Dermatitis Lesions by Regulating Th1/Th2 Balance in DNCB-Induced BALB/c Mice / 中国结合医学杂志

OBJECTIVE@#To evaluate the therapeutic effects of acupoint autohemotherapy (A-AHT) on 1-chloro-2,4-dinitrobenzene (DNCB)-induced atopic dermatitis (AD) in mice focusing on regulating T helper 1/T helper 2 (Th1/Th2) immune responses.@*METHODS@#Thirty BALB/c mice were divided into 5 groups by a random number table, including normal control (NC), AD model (AD), A-AHT, sham A-AHT (sA-AHT), and acupoint injection of normal saline (A-NS) groups, 6 mice per group. Mice were challenged by DNCB for the establishment of experimental AD model. On the 8th day, except for the NC and AD groups, the mice in the other groups received management once every other day for a total of 28 days. For the A-AHT and sA-AHT groups, 0.05 mL of autologous whole blood (AWB) was injected into bilateral Zusanli (ST 36) and Quchi (LI 11) and sham-acupoints (5 mm lateral to ST 36 and LI 11), respectively. The A-NS group was administrated with 0.05 mL of normal saline by acupoint injection into ST 36 and LI 11. Dermatitis severity for dorsal skin of mice was determined using the Severity Scoring of Atopic Dermatitis (SCORAD) every week. The total immunoglobulin E (IgE), interleukin-4 (IL-4), and interferon-gamma (IFN-γ) cytokine levels in serum were examined by enzyme-linked immunosorbent assay (ELISA). Spleen Th1/Th2 expression were analyzed via flow cytometry and immunohistochemical assay was used to detect T-box expressed in T cell (T-bet) and GATA-binding protein 3 (GATA3) expressions in skin lesions of mice.@*RESULTS@#Compared with the AD group, both A-AHT and sA-AHT reduced the SCORAD index and serum IgE level (P<0.05 or P<0.01); A-AHT, sA-AHT and A-NS down-regulated serum IL-4 level and upregulated IFN-γ/IL-4 ratio (P<0.05 or P<0.01); A-AHT regulated the Th1/Th2 shift specifically and increased the related transcription factors such as T-bet expression and T-bet/GATA3 ratio (P<0.05).@*CONCLUSION@#A-AHT showed significant effectiveness on the AD model mice, through regulating Th1/Th2 immune responses.

Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy: A case report and hypothesized mechanism of the therapy / 中西医结合学报

Acupoint autohemotherapy at bilateral Zusanli (ST36) and Xuehai (SP10) was used to treat a 26-year-old female patient who had suffered from recalcitrant atopic eczema (AE) for five years. The treatment was applied at a frequency of once per week for the first month, followed by a three-month period of once every other week. At the end of treatment, the patient's AE symptoms were entirely resolved, and by the end of a six-month follow-up her immunoglobulin E level had returned to the normal range. Further, there was no relapse of AE symptoms during the six-month follow-up. Therefore, we hypothesized that after the repeated treatments the local inflammatory reaction induced by autologous blood injection triggered a local immune response, followed by a systemic immune response after the repeated treatment, finally leading to the anti-inflammation and immunomodulation effects. This case suggests that acupoint autohemotherapy could be used as an effective complementary treatment for recalcitrant AE, especially in cases where other treatments have failed. Further comparative studies are needed to corroborate the value and mechanisms of this therapy.

Dermatitis atópica del adulto: un desafío diagnóstico y terapéutico / Adult atopic dermatitis: a challenge diagnosis and therapy

Adult atopic dermatitis is a chronically recurring inflammatory dermatosis which presents in various forms. Some of these forms develop mostly in adults such as head and neck dermatitis and chronic hand eczema. Even though the diagnosis is clinical it frequently requires further investigations to exclude differential diagnosis. Once confirmed, it is crucial to classify its severity and exclude other comorbidities. Treatment includes general measures such as the use of emollients and soap substitutes which are applicable in all cases regardless of its severity. Other therapeutic options include topical corticosteroids, topical calcineurin inhibitors, phototherapy and immunosuppressants. Their use will depend on the degree of severity and specific characteristics of each individual. Newer biologics have proven to be a safe and effective alternative, and seem to be a promising option in cases of adult atopic dermatitis refractory to conventional treatments. (AU)

Use of probiotics in atopic dermatitis

SUMMARY Atopic dermatitis is a common skin disease. Its increased incidence has changed the focus of research on atopic dermatitis toward epidemiology, prevention, and treatment. Evidence suggests that intestinal microbiota plays an important role in the pathogenesis of atopic dermatitis inducing immunosuppression, but its exact mechanism is still unclear. Probiotics have been widely reported to act on the immune system. They are living microorganisms with immunomodulatory effects that stimulate Th1 cytokines and suppress the Th2 response, which are being researched for the treatment of several diseases. Probiotics most commonly used are part of the intestinal microflora like lactobacilli, bifidobacteria, and enterococci. We describe here a case of evident response to the use of probiotics in a girl with severe atopic dermatitis, with a significant change in severity scores of atopic dermatitis (BSA/SCORAD/FDLQI). Modulation of the intestinal microbiota with probiotics may offer a way to prevent or treat allergic diseases, including atopic dermatitis.

RESUMO A dermatite atópica é uma doença de pele comum. O aumento da incidência mudou o foco da pesquisa em dermatite atópica para epidemiología, prevenção e tratamento. Evidências sugerem que a microbiota intestinal desempenha um papel importante na patogênese da dermatite atópica, induzindo imunossupressão, mas o mecanismo exato ainda não está claro. Os probióticos foram amplamente divulgados para atuar no sistema imunológico. Eles são microrganismos vivos com efeitos imunomoduladores que estimulam as citocinas Th1 e suprimem a resposta Th2 que vem sendo pesquisada para o tratamento de diversas doenças. Probióticos mais comumente usados são parte da microflora intestinal como lactobacilos, bifidobactérias e enterococos. Descrevemos um caso de resposta evidente ao uso de probióticos em uma menina com dermatite atópica grave, com grande alteração nos escores de gravidade da dermatite atópica (BSA/Scorad/FDLQI). A modulação da microbiota intestinal com probióticos pode oferecer uma maneira de prevenir ou tratar doenças alérgicas, incluindo a dermatite atópica.

Compliance to mothers' instructions with medical treatment / Obediência às instruções maternas em situação de tratamento médico / Obediencia a las instrucciones maternas para el tratamiento médico

Atopic dermatitis is a chronic skin disease with unknown etiology and high incidence in childhood. Although the response of following medical recommendations is an important behavior to control the symptoms, there are high rate responses of nonfollowing prescriptions, described as noncompliance. This study evaluated, in a brief direct assessment, the control exerted by direct and indirect instructions, verbalized by mothers, in compliance with medical treatment. Four girls, ages 9, 12, 13 and 14, diagnosed with atopic dermatitis and theirs mothers. They were scheduled outpatients at the dermatology department of a tertiary university hospital. The behavioral assessment was conducted according to a brief multielement experimental design in three phases. The use of direct instructions increased the probability of compliance behaviors, especially when associated with physical guide and praise. The results of this study can be important to identify the most important variables in the treatment of children with atopic dermatitis and to develop group or individual intervention programs.

A dermatite atópica é uma doença crônica de pele com etiologia desconhecida e alta incidência na infância. Embora a emissão de respostas para o seguimento de recomendações médicas seja um importante comportamento para o controle dos sintomas, existe elevadas taxas de respostas de não seguimento das recomendações médicas, compreendida como desobediência ou não adesão. O presente estudo avaliou, em uma breve avaliação direta, o controle exercido por instruções diretas e indiretas, verbalizadas pelas mães, no comportamento de obediência às em situação de tratamento médico. Participaram do estudo quatro meninas, com idades entre 9 e 14 anos, diagnosticadas com dermatite atópica e suas mães. Elas foram recrutadas no departamento de dermatologia de ambulatório de especialidades de um hospital escola. A avaliação comportamental foi realizada por meio do delineamento experimental de multielementos, realizado em três fases. O uso de instruções diretas aumentou a probabilidade de emissão de comportamentos de obediência, especialmente quando associados ao uso de condução física e elogios. Os resultados deste estudo podem ser importantes para identificar as variáveis mais importantes no tratamento de crianças com dermatite atópica e para desenvolver programas de intervenção individuais ou em grupo com esta população.

La dermatitis atópica es una enfermedad crónica de la piel con etiología desconocida y de alta incidencia en la infancia. Aunque es importante seguir las recomendaciones médicas, hay altas influencias para no seguir las recomendaciones médicas, descriptas como desobediencia. Este estudio evaluó, en una breve evaluación directa, el control ejercido por las instrucciones directas e indirectas, verbalizada por las madres durante la situación de tratamiento médico. El estudio evaluó a cuatro niñas con dermatitis atopica, entre nueve y catorce años, y a sus madres. Las evaluaciones ocurrirán con pacientes reclutado en el departamento de dermatología de un hospital-escuela. Las evaluaciones ocurrirán en tres etapas según el delineamiento experimental de multielementos. El uso de instrucciones directas e indirectas aumentó la probabilidad de conductas de obediencia, especialmente asociada con la conducción física y el elogio. Los resultados de este estudio pueden ser relevantes para identificar las variables más importantes para el tratamiento de niños con dermatitis atópica y para el desarrollo de programas de intervenciones individuales o grupales.

Eficácia da ciclosporina no controle da dermatite atópica em cães / Efficacy of cyclosporine in the control of atopic dermatitis in dogs

A dermatite atópica é uma dermatopatia inflamatória, pruriginosa, crônica, de origem genética, resultante da perda da função de barreira física da pele e da hiperreatividade à alérgenos ambientais, trofoalérgenos, alérgenos microbianos e a irritantes primários. Este estudo avaliou a eficácia da ciclosporina no controle do prurido e das lesões associadas à dermatite atópica em cães. Selecionaram-se 24 cães com diagnóstico de dermatite atópica baseados nos critérios de Favrot et al. (2010), os quais foram divididos em dois grupos de 12 cães, onde o Grupo 1, recebeu ciclosporina (5mg/kg/vo/24h), e o Grupo 2, foi tratado com prednisona (0,5mg/kg/vo/24h) em doses decrescentes, ambos por 60 dias. Os animais foram continuamente avaliados, e seus escores sintomato-lesionais, baseados na escala de CADESI-03, estabelecidos nos dias 0, 30 e 60. Em adição, os escores de prurido de cada animal, baseado nos critérios de Rybnicek, foram semanalmente avaliados, do dia 0 ao 63. Todos os dados coletados foram analisados pelo teste não paramétrico de Kruskal-Wallis, seguido do teste de Dunn´s e para as análises entre os grupos foi utilizado o teste t, considerado o nível de significância mínimo de 5%. A ciclosporina teve uma eficácia similar, no controle lesional, ao grupo que recebeu prednisona no dia (+30) (p<0,05) e no dia (+60) (p<0,001) do tratamento, em relação ao dia zero. Uma diferença significativa do escore do prurido foi observada nos dias +28, +35, +42, +49, +56 e +63 (p<0,001), e no dia +21 (p<0,01) em relação ao momento inicial do tratamento, porém sua eficácia foi inferior ao Grupo 2, a partir do 42º dia de avaliação, mantendo-se esta diferença nos dias +49, +56 e +63 (p>0,05). Apesar da ciclosporina ter sido menos eficaz no controle do prurido, este se manteve em níveis aceitáveis, e seu uso contínuo não foi associado a efeitos colaterais relevantes.(AU)

Atopic dermatitis is an itchy, chronic inflammatory skin disease of genetic origin, resulting from loss of the physical barrier function of the skin and hyper-reactivity to environmental allergens, trofoallergens, microbial allergens and to primary irritants. The efficacy of cyclosporine in the control of pruritus and lesions associated with atopic dermatitis in dogs was evaluated. Twenty-four dogs with atopic dermatitis were selected, based on Favrot et al.'s criteria (2010). They were divided into two groups of 12 dogs, where Group 1 received cyclosporine (5mg/kg/vo/24h), and Group 2 was treated with prednisone (0.5mg/kg/vo/24h) in decreasing doses, both for 60 days. The animals were continuously evaluated, and theirits lesional symptomatology scores were based on a Cadesi-03 scale, set on days 0, 30 and 60. Pruritus scores of each dog, based on Rybnicek´s criteria, were weekly evaluated, from day 0 to day 63. All collected data were analyzed by the nonparametric Kruskal-Wallis´ test, followed by Dunn's test, and for the analysis between the groups, considered the minimum significance level of 5%, t-test was used. Cyclosporin had similar efficacy in lesional control in the group which received prednisone on day (+30) (p<0.05) and on the day (+60) (p<0.001) of treatment, compared with day zero. A significant difference of the itching score was observed on days +28, +35, +42, +49, +56 and +63 (p<0.001), and on day +21 (p<0.01) when compared to initial treatment. However, its efficacy was lower than Group 2, from 42 days of evaluation on, keeping such difference on days +49, +56 and +63 (p>0.05). Although cyclosporin have been less effective in controlling itching, it remained at acceptable levels, and its continued use was not associated with significant side effects.(AU)

Retrospective Analysis on the Effects of House Dust Mite Specific Immunotherapy for More Than 3 Years in Atopic Dermatitis

PURPOSE: In extrinsic atopic dermatitis (AD), house dust mites (HDM) play a role in eliciting or aggravating allergic lesions. The nature of skin inflammation in AD has raised a growing interest in allergen-specific immunotherapy (SIT). Thus, we assessed clinical improvement and laboratory parameters for evaluation of the benefit of long-term SIT. MATERIALS AND METHODS: A total of 217 AD patients who were treated with SIT for at least 3 years were retrospectively assessed, by using their investigator global assessment, pruritus scores, loss of sleep (LOS), total serum IgE, and eosinophil counts collected. Patients were additionally classified into subgroups according to age, initial AD severity and mono- or multi-sensitization to include different individual factors in the evaluation of SIT efficacy. Lastly, we compared laboratory data of good responders to SIT with that of poor responders to SIT. RESULTS: Improvement after SIT therapy was observed in 192 out of 217 patients (88.4%). Among these patients, 138 (63.5%) achieved excellent, near-complete or complete clinical remission. Significant reduction of pruritus, LOS, and the mean value of total serum IgE were observed (p0.05). CONCLUSION: We emphasize the usefulness of long-term HDM SIT as a disease-modifying therapy for AD.

Dermatitis atópica: actualización en el diagnóstico y tratamiento / Atopic dermatitis: update on diagnosis and treatment

La Dermatitis Atópica es una dermatosis inflamatoria crónica y pruriginosa, muy frecuente en todo el mundo. En esta actualización revisamos aspectos históricos que consideramos relevantes para el entendimiento de la patología, buscando consenso en los criterios diagnósticos, que cada vez son más concordantes entre las diferentes escuelas y por otra parte revisamos la importancia de la terapia tópica y sus novedades.

Atopic dermatitis (AD) A is a chronic, pruritic, inflammatory dermatosis, very common in all parts of the world. In this update we review the historical aspects that we consider relevant for the understanding of the pathology, seeking consensus in the great variety of diagnosis criteria that are every day more similar among different dermatological groups. We also review the importance of topical therapy and the new findings.

Educational Programs for the Management of Childhood Atopic Dermatitis: An Integrative Review

PURPOSE: The purpose of this integrative review was to synthesize the available research on educational programs for the management of childhood atopic dermatitis. METHODS: Articles were retrieved from the following databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PubMed, and SCOPUS. Inclusion criteria were publication in the English or Korean language prior to March 2013, as a peer-reviewed empirical study focused on educational programs for childhood atopic dermatitis. RESULTS: Fifteen papers met the inclusion criteria. Four themes were derived from the data: (a) children of all ages and symptom severity, and their families as learners; (b) well-trained and family-preferred health professionals as educators; (c) long-term follow-up with diverse interventions as educational methods; and (d) quality of life for the child and family as educational goals. CONCLUSIONS: This review indicates the challenges that health professionals face in improving symptoms of atopic dermatitis. The identified strategies can be used in the development of more effective evidencebased programs. Future studies should focus on the development and evaluation of educational programs that include these themes.

Dermatite atópica / Atopic dermatitis

Os autores fazem uma revisão bibliográfica sobre as manifestações clínicas e manejo da dermatite atópica, com ênfase nos conceitos mais atuais sobre diagnóstico e possibilidades terapêuticas.

The authors make a literature review on the clinical manifestations and management of atopic dermatitis, with emphasis on the most current concepts in the diagnosis and therapeutic possibilities.

Piel en el siglo XXI / The skin in the 21st Century

En el campo de la dermatología en los últimos años se han producido grandes avances en el diagnóstico y tratamiento de las enfermedades cutáneas. La extensión del tegumento, su gran diversidad celular y su fácil accesibilidad han estimulado la realización de múltiples estudios e investigación. De gran relevancia han sido los que han utilizado células madre mesenquimáticas de la piel, ya que tendrán un gran impacto en la medicina de este siglo en relación al aporte terapéutico que esto implica. La farmacogenética, que es el estudio del efecto de la variabilidad genética en un individuo para aumentar las posibilidades de una respuesta terapéutica y disminuir las chances de una reacción adversa a drogas, se acerca al ideal de una medicina personalizada y se ha constituido en una realidad en algunas enfermedades de la piel. Finalmente la fotonanodermatología (interface entre fotobiología, dermatología y nanotecnología), es una tecnología que ha crecido rápidamente en el campo de la medicina y especialmente la dermatología, donde tiene aplicaciones múltiples tanto en productos para la protección de la piel, como en el diagnóstico y tratamiento de enfermedades cutáneas.

In the dermatology field in the last years, there have been great advances in the diagnosis and treatment of cutaneous diseases. The skin with their large surface and easy accesibility has stimulated the realization of multiples studies and research. The skin mesenchymal stems cells research is expected to have a great impact on the medicine of the 21st century, specially related with their therapeutic implications. Pharmacogenetics refers to the study of the genetic variability between patients that is been used to optimizate drug efficacy, minimizing toxicity is near the ideal of a personalized medicine and it is being used in some skin diseases. Finally photo nanodermatology (interface of photobiology, dermatology and nanotechnology) is a technology that has grown quickly in medicine and specially dermatology, where it has multiple uses in skin protection products and in diagnosis and treatment of skin diseases.

Dermatitis atópica / Atopic dermatitis

La dermatitis atópica (DA) es una dermatosis pruriginosa crónica caracterizada por múltiples exacerbaciones y remisiones que se manifiestan de distintas formas según la edad del paciente. La DA es una de las patologías dermatológicas más comunes en los niños, con una prevalencia que varía entre el 5 y 20 por ciento en la primera década de la vida. En los pacientes con DA hay una tendencia a desarrollar otras condiciones alérgicas como eczema, asma y rinitis alérgica, lo que se denomina diátesis atópica, sin embargo, el fundamento fisiopatológico de esta asociación aún no ha sido aclarado y/o incluso es controversial. La DA es el resultado de interacciones genéticas, metabólicas, infecciosas, inmunes, neuroendocrinas y ambientales, por este motivo el manejo es complejo, multifactorial y las estrategias son hacia los distintos focos patológicos de cada caso en particular.

The atopic dermatitis (AD) is a chronic pruritic dermatitis, typified by multiple flare ups and remissions, which can vary according to the patients age. The AD is one of the most common childhood pathologies affecting between 5 to 20 per cent of the children before they reach the age of 10. Patients suffering from AD are prone to developing other allergic reactions such us eczema, asthma and allergic rhinitis. This condition is known as atopic diathesis; however, the physio-pathological basis of this association has not yet been clarified and is rather controversial.AD is the end result of a number of genetic, metabolic, infectious, immune, endocrine and environmental interactions, which makes it hard to treat because of the various aspects involved and the management strategies needed to deal with each particular case.

O uso da medicina alternativa ou complementar em crianças com dermatite atópica / The use of alternative or complementary medicine for children with atopic dermatitis

Medicina alternativa ou complementar é definida como forma de terapia que não possui bases científicas ou eficácia comprovadas. O objetivo deste estudo foi investigar a prevalência do uso dessas terapias por pacientes pediátricos com dermatite atópica no Hospital Universitário de Brasília, no período de março de 2007 a dezembro de 2008. Um total de 54 pacientes (63,5 por cento) utilizou algum tipo de recurso alternativo, fitoterapia e homeopatia foram os recursos alternativos mais utilizados.

Complementary or Alternative Medicine is defined as a form of therapy that has no scientific basis or proven effectiveness. The aim of this study was to investigate the prevalence of the use of such therapies for pediatric patients with atopic dermatitis at the University Hospital of Brasília, in the period between March 2007 and December 2008. A total number of 54 patients (63.5 percent) used some kind of alternative resource and phytotherapy and homeopathy were the most used ones.

Dermatite atópica em pediatria: atualização / Atopic dermatitis in pediatrics: a review

O trabalho discorre sobre a importância da dermatite atópica (DA) em Pediatria, descrevendo as formas de apresentação clínica, critérios diagnósticos, fisiopatologia, alterações na imunidade inata e nas respostas imunes adaptativas, papel das citocinas, inter-relações entre infecções e DA e os recursos terapêuticos, compreendendo hidratação da pele, controle da inflamação e do prurido, identificação e afastamento dos fatores desencadeantes e formas alternativas de tratamento.

Dermatite atopica: avaliação de terapêutica complementar / Atopic dermatitis: an assessment of complementary therapeutic

Avaliar métodos terapêuticos não convencionais ou complementares no tratamento da dermatite atópica, por meio de uma revisão bibliográfica, enfocando o uso de probióticos, óleos essenciais, ervas chinesas e a possibilidade de uma terapia comportamental para o controle do prurido. Fontes pesquisadas: Foram revisadas as bases de dados LILACS, MEDLINE e SciFinder Schollar, com os descritores dermatite atópica, ácidos graxos essenciais, ervas medicinais, probióticos, psiquiatria e psicologia. Síntese de dados: A dermatite atópica, crônica e frequente na infância, requer tratamento que envolva desde medidas gerais até o uso de imunossupressores. A suplementação com ácidos graxos poliinsaturados ômega-3 na dieta destes pacientes pode diminuir a produção de mediadores inflamatórios e, até o momento, não há demonstração da sua eficácia na dermatite atópica. O uso de probióticos no início da vida pode reduzir a ocorrência de dermatite atópica pelo desvio da resposta imunológica para um perfil TH1, sem evidências científicas até o momento. O uso de ervas chinesas ocasionou melhora no prurido da dermatite atópica. A intervenção no comportamento destes pacientes é muito importante para melhorar a qualidade de vida, devido ao estresse ser um fator desencadeante para a dermatite atópica. Conclusões: Não há evidências científicas da eficácia do uso de ácidos graxos essenciais, probióticos e medidas comportamentais na dermatite atópica, porém são necessárias maiores pesquisas, pois algumas sugeriram melhora parcial de sintomas e sinais da doença...

To search complementary or nonconventionals therapeutics methods to treat atopic dermatitis through a bibliographic review, focusing on the use of probiotics, essential oils, chinese herbal medicine and the possibility of a behavioural therapy to reduce pruritus. Data Source: The LILACS, MEDLINE and SciFinder Schollar were searched with the keywords atopic dermatitis, essential fatty acids, medicinal plants, probiotics, psychiatry and psychology. Data Synthesis: Atopic dermatitis, achronic condition that often presents in early infancy, requires a treatment that includes ancillary therapies and immunomodulators. Oral a-linoleic polyunsaturated fatty acid supplementation showed decreased production of inflammatory mediators and, at this moment, there is no effectiveness in atopic dermatitis. The use of probiotics in early infancy can reduce the incidence of atopic dermatitis due the change to a TH1 immunological response, at this moment, with no scientific evidences. Chinese herbs caused improvement in pruritus on atopic dermatitis. Stress is a trigger for atopic dermatitis, so behavioural inverventions are very important to improve the quality of life of this patients. Conclusions: There is no scientific evidence of effectiveness about the use of essential fatty acids, probiotics and behavioural interventions in atopic dermatitis. However, more researchs are necessary, because some of them suggest partial improvement of symptoms and signals of the disease...