Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018

borlu, murat; Sarıcaoğlu, Hayriye; Odyakmaz Demirsoy, Evren; ALPER, Fatma Sibel; SU KÜÇÜK, ÖZLEM; KARADAĞ, Ayşe Serap; ERTAM SAĞDUYU, İLGEN

Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018

İLGEN ERTAM SAĞDUYU, (Ege Üniversitesi, Tıp Fakültesi, Deri ve Zührevi Hastalıkları Anabilim Dalı, İzmir, Türkiye)

ÖZLEM SU KÜÇÜK, (Bezm-i Alem Valide Sultan Vakıf Gureba Eğitim ve Araştırma Hastanesi, Dermatoloji Kliniği, İstanbul, Türkiye)

Fatma Sibel ALPER, (Koç Üniversitesi, Tıp Fakültesi, Deri ve Zührevi Hastalıklar Anabilim Dalı, İstanbul, Türkiye)

Hayriye SARICAOĞLU, (Uludağ Üniversitesi, Tıp Fakültesi, Dermatoloji Anabilim Dalı, Bursa, Türkiye)

Ayşe Serap KARADAĞ, (Medeniyet Üniversitesi, Tıp Fakültesi, Deri ve Zührevi Hastalıklar Anabilim Dalı, İstanbul, Türkiye)

Evren Odyakmaz DEMİRSOY, (Kocaeli Üniversitesi, Tıp Fakültesi, Dermatoloji Anabilim Dalı, Kocaeli, Türkiye)

Murat BORLU (Erciyes Üniversitesi, Tıp Fakültesi, Deri ve Zührevi Hastalıklar Anabilim Dalı, Kayseri, Türkiye)

Türkderm-Deri Hastalıkları ve Frengi Arşivi

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Yıl: 2018 Cilt: 52 Sayı: 1 Sayfa Aralığı: 6 - 23 Metin Dili: Türkçe İndeks Tarihi: 02-01-2019

Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018

Öz:

Amaç: Atopik dermatit (AD), tanı ve tedavisinde zaman zaman zorluklar yaşanan bir hastalıktır. Farklı yaklaşımların görülebildiği bir hastalık olması, hastalığın tanı, sınıflama, etiyopatogenez, tanısal testler ve tedavi yaklaşımları açısından bir algoritma içerisinde değerlendirilmesi gerekliliğini doğurmuştur. Bu amaçla Türk Dermatoloji Derneği Dermatoallerji Çalışma Grubu içerisinde yer alan yazarlar, AD tanı ve tedavisinde kanıta dayalı bir yol gösterici olması açısından bu AD kılavuzunu oluşturmayı hedeflemişlerdir.Gereç ve Yöntem: Kılavuz, her bölümü ayrı bir yazar tarafından yazılacak biçimde planlanmış; Kılavuzun ana hatları belirlendikten sonra yazarlar tarafından hazırlanan bölümler e-posta yazışmaları ile diğer yazarlar tarafından da değerlendirilmiştir ve bir araya gelinerek yapılan toplantıda tartışılmıştır. Son olarak, kılavuz tümüyle gözden geçirilerek hazır hale getirilmiştir.Bulgular: Kılavuz, tanım, patogenez, klinik bulgular, tanı, ayırıcı tanı, skorlama sistemleri, tanıda deri testleri ve tedavi yaklaşımlarını içermektedir. Günümüzde AD tanısında ve tetikleyici faktörlerin ortaya konulmasında kullanılabilecek sensitivite ve spesifitesi yüksek, uygulanması kolay in vivo/in vitro test bulunmamaktadır. Tedavinin ilk basamağını sırasıyla nemlendiriciler, topikal kortikosteroidler (TKS) ve kalsinörin inhibitörleri oluşturur. Nemlendiriciler AD'nin tüm formlarında tedavide kullanılır. Nemlendiricilerin yetersiz kaldığı durumlarda ilk kullanılacak ajanlar TKS'lerdir. TKS’lere dirençli lezyonlarda, uzun süreli kortikosteroid kullanımında, proaktif tedavide ve belli bölgelerde ise topikal kalsinörin inhibitörleri tercih edilmelidir. Antimikrobiyal ajanlar ve antiseptikler sadece klinik olarak enfeksiyon bulgularının olduğu durumlarda tedaviye eklenmelidir. Topikal tedavinin yanıtsız kaldığı durumlarda ikinci basamak tedavide fototerapi ve oral siklosporin yer alır. Ülkemizde henüz ruhsat almamış olan biyolojik ajan dupilumab şiddetli ve dirençli AD tedavisinde ümit vermektedir.Sonuç: AD hekimler için tanı, tedavi ve izlem açısından güçlükler yaratabilen bir hastalıktır. Olabildiğince kanıta dayalı verilerden yola çıkarak hazırlanan bu kılavuz, AD’li olgularda tanı ve tedavi yaklaşımlarının yönlendirilmesinde yol gösterici olacak ve hekimlerin bu süreçlerde yaşadıkları zorlukların aşılmasına katkı sağlayacaktır.

Anahtar Kelime:

Konular: Dermatoloji

The Turkish guideline for the diagnosis and management of atopic dermatitis-2018

Öz:

Background and Design: Atopic dermatitis (AD) has a complicated etiopathogenesis and difficulties in diagnosis and treatment from time to time. Because of the disease which different approaches can be seen rationalize the need for an algorithm for the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach. Therefore, authors from Dermatoallergy Working Group of the Turkish Society of Dermatology aimed to create an AD guideline for the diagnosis, treatment and followup. Materials and Methods: Each section of the guideline has been written by a different author. The prepared sections were evaluated in part by e-mail correspondence and have taken its final form after revision in the last meeting held by the participation of all authors. Results: The guideline includes the diagnosis, classification, etiopathogenesis, diagnostic tests and therapeutic approach of AD. Lesions show age-related morphology and distribution. There are no in vivo/in vitro tests that have high sensitivity and specificity that can be used to identify AD and trigger factors. The first step of treatment consists of moisturizers, topical corticosteroids and calcineurin inhibitors, respectively. Moisturizers are used therapeutically in all forms of AD. Topical corticosteroids are the first agents to be used when moisturizers are inadequate. Topical calcineurin inhibitors should be used in lesions resistant to corticosteroids, for proactive treatment, special areas. Antimicrobials agents and antiseptics should only be added to treatment when clinical signs of infection are present. And in topical treatment-resistant cases, second-line treatment is phototherapy or oral cyclosporine. The biologic agent, dupilumab, is promising in the treatment of severe AD. Conclusion: AD is a disease that can be challenging for the physician in terms of treatment and follow-up. Depending on evidence-based data (and individual experiences), this guideline will have a leading role in the diagnosis and treatment of AD and help the physician to overcome the challenges in the management.

Anahtar Kelime:

Konular: Dermatoloji

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık

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APA	ERTAM SAĞDUYU İ, SU KÜÇÜK Ö, ALPER F, Sarıcaoğlu H, KARADAĞ A, Odyakmaz Demirsoy E, borlu m (2018). Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. , 6 - 23.
Chicago	ERTAM SAĞDUYU İLGEN,SU KÜÇÜK ÖZLEM,ALPER Fatma Sibel,Sarıcaoğlu Hayriye,KARADAĞ Ayşe Serap,Odyakmaz Demirsoy Evren,borlu murat Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. (2018): 6 - 23.
MLA	ERTAM SAĞDUYU İLGEN,SU KÜÇÜK ÖZLEM,ALPER Fatma Sibel,Sarıcaoğlu Hayriye,KARADAĞ Ayşe Serap,Odyakmaz Demirsoy Evren,borlu murat Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. , 2018, ss.6 - 23.
AMA	ERTAM SAĞDUYU İ,SU KÜÇÜK Ö,ALPER F,Sarıcaoğlu H,KARADAĞ A,Odyakmaz Demirsoy E,borlu m Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. . 2018; 6 - 23.
Vancouver	ERTAM SAĞDUYU İ,SU KÜÇÜK Ö,ALPER F,Sarıcaoğlu H,KARADAĞ A,Odyakmaz Demirsoy E,borlu m Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. . 2018; 6 - 23.
IEEE	ERTAM SAĞDUYU İ,SU KÜÇÜK Ö,ALPER F,Sarıcaoğlu H,KARADAĞ A,Odyakmaz Demirsoy E,borlu m "Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018." , ss.6 - 23, 2018.
ISNAD	ERTAM SAĞDUYU, İLGEN vd. "Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018". (2018), 6-23.

APA	ERTAM SAĞDUYU İ, SU KÜÇÜK Ö, ALPER F, Sarıcaoğlu H, KARADAĞ A, Odyakmaz Demirsoy E, borlu m (2018). Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. Türkderm-Deri Hastalıkları ve Frengi Arşivi, 52(1), 6 - 23.
Chicago	ERTAM SAĞDUYU İLGEN,SU KÜÇÜK ÖZLEM,ALPER Fatma Sibel,Sarıcaoğlu Hayriye,KARADAĞ Ayşe Serap,Odyakmaz Demirsoy Evren,borlu murat Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. Türkderm-Deri Hastalıkları ve Frengi Arşivi 52, no.1 (2018): 6 - 23.
MLA	ERTAM SAĞDUYU İLGEN,SU KÜÇÜK ÖZLEM,ALPER Fatma Sibel,Sarıcaoğlu Hayriye,KARADAĞ Ayşe Serap,Odyakmaz Demirsoy Evren,borlu murat Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. Türkderm-Deri Hastalıkları ve Frengi Arşivi, vol.52, no.1, 2018, ss.6 - 23.
AMA	ERTAM SAĞDUYU İ,SU KÜÇÜK Ö,ALPER F,Sarıcaoğlu H,KARADAĞ A,Odyakmaz Demirsoy E,borlu m Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. Türkderm-Deri Hastalıkları ve Frengi Arşivi. 2018; 52(1): 6 - 23.
Vancouver	ERTAM SAĞDUYU İ,SU KÜÇÜK Ö,ALPER F,Sarıcaoğlu H,KARADAĞ A,Odyakmaz Demirsoy E,borlu m Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018. Türkderm-Deri Hastalıkları ve Frengi Arşivi. 2018; 52(1): 6 - 23.
IEEE	ERTAM SAĞDUYU İ,SU KÜÇÜK Ö,ALPER F,Sarıcaoğlu H,KARADAĞ A,Odyakmaz Demirsoy E,borlu m "Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018." Türkderm-Deri Hastalıkları ve Frengi Arşivi, 52, ss.6 - 23, 2018.
ISNAD	ERTAM SAĞDUYU, İLGEN vd. "Türkiye atopik dermatit tanı ve tedavi kılavuzu-2018". Türkderm-Deri Hastalıkları ve Frengi Arşivi 52/1 (2018), 6-23.