Alternativ behandling av pasienter med atopisk dermatitt

Abstract

Abstract

Atopic dermatitis is a persistent, chronic, relapsing inflammatory skin disease, presenting most often in early childhood. It is strongly linked to hay fever, asthma an bronkitis. The cause of atopic dermatitis is unknown, though a genetic pre-dispotition and a combination of allergic and non-allergic factors appear to be important in determining disease expression. Conventional treatment consists of emollients and corticosteroids, dietary manipulation and habit reversal. The incidence and prevalence of this disease is increasing, likely due to changes in lifesstyle and environment.

The incidence of the use of complementary therapies is also increasing, and more common amongst pasients with chronic diseases such as atopic dermatitis. Herbal remedies, homeopathy and acupuncture are most often used by patients with atopic dermatitis. The patients choose alternative medicine because of unresponsiveness to conventional treatments, fear of adverse effects by topical corticosteroids and lack of empathy shown by their doctors.

A distinct lack of randomized clinical trials (RCT) of the efficacy and and safety of alternative therapies for atopic dermatitis is noted. Only four RCTs on Zemophyte, a chinese herbal medicine, have been published. Three of these trials show benefit of the treatment with Zemophyte but were criticized due to inadequate power, as a result of insufficient sample size, and failure to include intention to treat analysis. Adverse events were reported, including two cases of liver function abnormalities. This could suggest possible toxigenicity. It is questionable if RCT is a suitable method to illustrate the effect of alternative therapies. Many of these therapy forms are based on individual approach and demand familiarity with the context and philosophy behind the treatment.

A dialog with the therapists practicing alternative medicine as well as with the patients having atopic dermatitis is important.