The skin facilitates a number of key roles but its functioning can be impaired by disease. Atopic eczema is a chronic inflammatory disease where the skin barrier has become leaky, and inflammation occurs. It affects u...The skin facilitates a number of key roles but its functioning can be impaired by disease. Atopic eczema is a chronic inflammatory disease where the skin barrier has become leaky, and inflammation occurs. It affects up to 20% of children and 3% of adults worldwide, manifesting as red itchy patches of skin with varying severity. This review aims to investigate the leaky skin barrier and immune mechanisms from the perspective of potential novel treatments. The complexity of atopic eczema as a disease is what makes it difficult to treat. Genome-wide association studies have highlighted possible genetic variations associated with atopic eczema, however in some cases, individuals develop the disease without these genetic risk factors. Loss of function mutations in the filaggrin gene are one of these associations and this is plausible due to its key role in barrier function. The Th2 immune response is the link with regards to the immune mechanisms as atopic inflammation often occurs through increased levels of interleukin(IL)-4 and IL-13. Eczematous inflammation also creates susceptibility to colonisation and damage by bacteria such as Staphylococcus aureus. Potential novel treatments are becoming ever more specific, offering the hope of fewer side effects and better disease control. The best new treatments highlighted in this review target the immune response with human beta defensin 2, phosphodiesterase-4 inhibitors and monoclonal antibodies all showing promise.展开更多
Background: Previous studies have demonstrated inappropriate advice from health profes- sionals advocating therapeutic sun exposure during infancy and the post-partum period. This study examines the proportion of Aust...Background: Previous studies have demonstrated inappropriate advice from health profes- sionals advocating therapeutic sun exposure during infancy and the post-partum period. This study examines the proportion of Australian midwives and related hospital nursing staff who recommend therapeutic sun exposure during this period. Methods: Questionnaires were completed by 363 Australian nurses (57.2% response) responsible for nursing post-partum women in 11 maternity hospitals in Queensland (QLD) and the Australian Capital Territory (ACT). Results: Many nurses believed sun exposure was beneficial in treating: cracked nipples (QLD 41.3%, ACT 65.8%;p specified exposure time limits. Nursing staff from public hospitals in QLD, but not the ACT, were more likely than nurses from private hospitals to hold one or more such beliefs (p = 0.008). Approximately 40% of respondents thought people generally looked healthier with a suntan;79% of this group also held one or more risky beliefs about therapeutic sun exposure (p = 0.043). Conclusion: A high proportion of these nurses held risky beliefs about the beneficial uses of sunlight for post-partum women and their infants and made recommendations consistent with their beliefs. Professional education is needed to change the beliefs and practices of nursing staff about intentional sun exposure of women and their babies to reduce their long- term skin cancer risk, particularly as Australia has such a high prevalence of skin cancer.展开更多
文摘The skin facilitates a number of key roles but its functioning can be impaired by disease. Atopic eczema is a chronic inflammatory disease where the skin barrier has become leaky, and inflammation occurs. It affects up to 20% of children and 3% of adults worldwide, manifesting as red itchy patches of skin with varying severity. This review aims to investigate the leaky skin barrier and immune mechanisms from the perspective of potential novel treatments. The complexity of atopic eczema as a disease is what makes it difficult to treat. Genome-wide association studies have highlighted possible genetic variations associated with atopic eczema, however in some cases, individuals develop the disease without these genetic risk factors. Loss of function mutations in the filaggrin gene are one of these associations and this is plausible due to its key role in barrier function. The Th2 immune response is the link with regards to the immune mechanisms as atopic inflammation often occurs through increased levels of interleukin(IL)-4 and IL-13. Eczematous inflammation also creates susceptibility to colonisation and damage by bacteria such as Staphylococcus aureus. Potential novel treatments are becoming ever more specific, offering the hope of fewer side effects and better disease control. The best new treatments highlighted in this review target the immune response with human beta defensin 2, phosphodiesterase-4 inhibitors and monoclonal antibodies all showing promise.
文摘Background: Previous studies have demonstrated inappropriate advice from health profes- sionals advocating therapeutic sun exposure during infancy and the post-partum period. This study examines the proportion of Australian midwives and related hospital nursing staff who recommend therapeutic sun exposure during this period. Methods: Questionnaires were completed by 363 Australian nurses (57.2% response) responsible for nursing post-partum women in 11 maternity hospitals in Queensland (QLD) and the Australian Capital Territory (ACT). Results: Many nurses believed sun exposure was beneficial in treating: cracked nipples (QLD 41.3%, ACT 65.8%;p specified exposure time limits. Nursing staff from public hospitals in QLD, but not the ACT, were more likely than nurses from private hospitals to hold one or more such beliefs (p = 0.008). Approximately 40% of respondents thought people generally looked healthier with a suntan;79% of this group also held one or more risky beliefs about therapeutic sun exposure (p = 0.043). Conclusion: A high proportion of these nurses held risky beliefs about the beneficial uses of sunlight for post-partum women and their infants and made recommendations consistent with their beliefs. Professional education is needed to change the beliefs and practices of nursing staff about intentional sun exposure of women and their babies to reduce their long- term skin cancer risk, particularly as Australia has such a high prevalence of skin cancer.
