atopic eczema的八卦，Yahoo名人娛樂都在討論

【蕁麻疹全身紅腫癢怎麼辦？】醫師圖文教你如何治療、保養與預防！
　
你曾經不知為何就全身發癢紅腫，抓到哪癢到哪嗎？你曾經吃消炎藥後整個眼睛像是金魚眼，嘴唇腫得像香腸嘴一樣嗎？你不是孤單的，你只是發生了世界上超過 20% 的人都發生過的過敏反應。

近期有兩位朋友可能因為壓力誘發了慢性尋麻疹，看到他們身體不舒服，人不在他們附近也幫不上什麼忙，因此就趕緊寫了這篇文章，分享給他們，也分享給更多需要的人。

小小的蕁麻疹，卻是超多人長期的困擾。這次團隊醫師回顧了許多文獻，配合設計師一起製作圖表，希望這篇文章可以幫助到廣大的患者，也彌補我們平常看診時間匆促衛教的不足。請大家一起幫我們把正確知識傳播出去吧！（握拳）
　

〖延伸閱讀〗惱人的紅腫癢皮膚疾病家族
　
■ 濕疹的治療、保養與預防
https://www.medpartner.club/eczema-care-treatment-introduc…/
　
■ 異位性皮膚炎的治療、保養與預防
https://www.medpartner.club/atopic-dermatitis-care-cure/
　
＃蕁麻疹 ＃皮膚紅腫 ＃皮膚癢 ＃皮膚疾病
　
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【藥事知多D】抗組織胺知多D：止痕不止痕？

舉凡大部分皮膚過敏，例如異位性濕疹(Atopic Dermatitis)，患處往往可能會出現紅、腫、熱、癢。

其中最重要的是止痕。

為什麼？

唔……因為相較紅、腫、熱而言，要是情況還是不太嚴重，往往只可能會影響外觀，你不看、我不說，自己往往未必會察覺得到這些症狀，對吧？

所以眼不見為淨還是可以自欺欺人的。

問題是，痕，你是不會不知道的。

當然單是痕癢，問題本來不大。真正的問題是，基於本能反應，痕癢便可能會抓癢，抓癢便可能會抓傷表皮(Epidermis)，體外的致敏原便可能突破這層物理性屏障刺激皮膚誘發痕癢。簡單說，愈痕便會愈抓，愈抓便會愈痕，最後便可能會形成一個「愈痕愈抓，愈抓愈痕(Itch-scratch Cycle)」的惡性循環。

還有要是抓出傷口，還可能會增加患處出現感染的風險。

所以止痕是非常重要的一環。

至於其中一種常用的止痕藥一般主要是抗組織胺(Antihistamine)。
抗組織胺主要透過跟H1-受體(H1-receptor)的作用抗衡組織胺(Histamine)止痕，目的在截斷「愈痕愈抓，愈抓愈痕」的惡性循環，簡單說，不痕便不抓，不抓便不痕，從而希望能夠改善症狀，控制情況。

在劑型上，主要分為口服、外用兩種。

理論上，相較外用而言，口服可能是一個較理想的選項。因為外用抗組織胺裡面的藥用輔料(Excipient)可能會誘發皮膚致敏(Cutaneous Sensitization)，抗敏不成反致敏，未必適用於紓緩異位性濕疹的症狀。[1]

值得一提，在異位性濕疹上，組織胺只是其中一種介質，不是唯一一種介質，甚至可能不是一種主要介質誘發痕癢。[1][2]

所以抗組織胺固然能夠抗衡組織胺，不過還是可能會「錯重點」。

這方面，抗組織胺可能是一種常用的選項，不過未必是一種理想的選項。

話雖如此，不過抗組織胺還是有一定的用途的。

這話怎麼解？

首先相較早上而言，晚上一般會較痕癢。

為什麼？

答案很簡單。

早上的時候，不論有事無事，當大家睜開眼睛後，便會忙著東、忙著西，其中一個，不用問，當然是滑手機，對吧？

這樣子，忙著忙著，注意力便會開始分散，從而可能會忘記異位性濕疹所產生的搔癢感。

不過待到晚上，情況便會截然不同。

這時候，人們唯一要做的便是睡覺。在這個情況下，人們便可能會較容易覺得痕癢，自然較難入睡。

這時候，抗組織胺便可以派得上用場。

這話怎麼解？

相較而言，第一代抗組織胺(First Generation Antihistamine)較常會產生睡意，所以一些第一代抗組織胺，例如Diphenhydramine、Hydroxyzine，順道便可以做一種助眠藥幫助因為夜間痕癢而難以入睡的用藥者入睡。

綜觀芸芸眾多抗組織胺裡，除了是一種抗組織胺外，Doxepin還是一種三環類抗抑鬱藥(Tricyclic Antidepressant, TCA)，除了可能會紓緩痕癢的症狀外，還可能會紓緩抑鬱的症狀，較適用於一些同時罹患抑鬱症的異位性濕疹人士。[1][2][3]

這是一個十分重要的考量，為什麼？

唔……暫時姑且撇開中醫不說，在西醫上，難聽一點，異位性濕疹暫時可以說是一種「不治之症」。這就是說，只能醫治，不能根治。

面對這種隨時可能會復發的病症，患者一直往往徘徊在受控、失控之間，換是你，抓著抓著，會不會抓出狂來？所以這些患者同時可能會罹患抑鬱症，Doxepin便可能是一個較適合的選項。

（如欲了解更多用藥資訊，歡迎看看「小小藥罐子」網誌。）

💊💊💊💊💊💊💊
BLOG➡️http://pegashadraymak.blogspot.com/
IG➡️https://www.instagram.com/pegashadraymak/
YT➡️https://www.youtube.com/channel/UCQOMojMd6q7XnESMWwldPhQ

📕📕📕📕📕📕📕
著作➡️藥事知多D、用藥知多D、藥房事件簿、家居用藥攻略（各大書店有售）

Reference:
1. Leung DY, Hanifin JM, the Work Group on Atopic Dermatitis, et al. Disease management of atopic dermatitis: a practice parameter. Ann Allergy Asthma Immunol. 1997;79:197-209.
2. Leung DYM, Eichenfield LF, Boguniewicz M. Atopic dermatitis (atopic eczema). In: Freedberg IM, Eisen AZ, et al, eds. Fitzpatrick' s Dermatology in General Medicine, 6th ed. New York, McGraw-Hill, 2003:1180-1194.
3. Klein PA, Clark RAF. An evidence-based review of the efficacy of antihistamines in relieving pruritus in atopic dermatitis. Arch Dermatol. 1999;135:1522-1525.

https://pegashadraymak.blogspot.com/2020/12/antihistamineforatopicdermatitis.html

PRODUCTS REVIEW - MOIA ELIXIRS

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濕疹 － 陳厚毅皮膚科專科醫生＠FindDoc.com

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（一）情緒壓力會誘發濕疹嗎？ 00:06

（二）濕疹如何影響患者的心理和情緒健康？ 01:01

（三）患者如何面對濕疹帶來的身心壓力？ 01:39

(本短片作健康教育之用，並不可取代任何醫療診斷或治療。治療成效因人而異，如有疑問，請向專業醫療人士諮詢。)

參考資料：
1. Kwok, & Law. (n.d.). 濕疹的預防. Retrieved September 25, 2020, from http://www.nur.cuhk.edu.hk/201800907-hkej-hk/
2. 香港過敏協會.濕疹. (2014). Retrieved September 25, 2020, from https://www.allergyhk.org/?page_id=37
3. Eczema and Mental Health: Atopic Dermatitis and Anxiety and Depression. (n.d.). Retrieved September 25, 2020, from https://nationaleczema.org/eczema-emotional-wellness/
4. Halvorsen, J., Lien, L., Dalgard, F., Bjertness, E., & Stern, R. (2015, December 08). Suicidal Ideation, Mental Health Problems, and Social Function in Adolescents with Eczema: A Population-Based Study. Retrieved September 25, 2020, from https://www.sciencedirect.com/science/article/pii/S0022202X15369074
5. Biologics: Dupixent: Atopic Dermatitis Treatment: Eczema Biologics. (2020, August 27). Retrieved September 25, 2020, from https://nationaleczema.org/eczema/treatment/dupixent/





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濕疹專題 － 陳上熙皮膚科專科醫生＠FindDoc.com

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（一）濕疹對日常生活有什麼影響？ 00:06

（二）濕疹會誘發什麼併發症？ 00:45

（三）濕疹有什麼治療方法？ 01:29

(本短片作健康教育之用，並不可取代任何醫療診斷或治療。治療成效因人而異，如有疑問，請向專業醫療人士諮詢。)

參考資料：
1. Schonmann, Y., Mansfield, K. E., Hayes, J. F., Abuabara, K., Roberts, A., Smeeth, L., & Langan, S. M. (2020). Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. The journal of allergy and clinical immunology. In practice, 8(1), 248–257.e16. https://doi.org/10.1016/j.jaip.2019.08.030
2. George SMC, Karanovic S, Harrison DA, Rani A, Birnie AJ, Bath‐Hextall FJ, Ravenscroft JC, Williams HC. Interventions to reduce Staphylococcus aureus in the management of eczema. Cochrane Database of Systematic Reviews 2019, Issue 10. Art. No.: CD003871. DOI: 10.1002/14651858.CD003871.pub3.
3. Sutherland M, Parent A. Cellulitis: Assessment, diagnosis and management. Dermatological Nursing 2017. 16(4): 24-28
4. Ekbäck M, Tedner M, Devenney I, Oldaeus G, Norrman G, Strömberg L, et al. (2014) Severe Eczema in Infancy Can Predict Asthma Development. A Prospective Study to the Age of 10 Years. PLoS ONE 9(6): e99609. https://doi.org/10.1371/journal.pone.0099609
5. Mayo Clinic. (2020). Atopic dermatitis (eczema). Retrieved from https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279
6. Meagher, L.J., Wines, N.Y. and Cooper, A.J. (2002), Atopic dermatitis: Review of immunopathogenesis and advances in immunosuppressive therapy. Australasian Journal of Dermatology, 43: 247-254. doi:10.1046/j.1440-0960.2002.00610.x
7. Deleanu, D., & Nedelea, I. (2019). Biological therapies for atopic dermatitis: An update. Experimental and therapeutic medicine, 17(2), 1061–1067. https://doi.org/10.3892/etm.2018.6989




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（一）失眠為什麼成濕疹病人常見問題？ 00:06

（二）為什麼濕疹常於晚上出現？ 00:30

（三）濕疹的治療 01:10

（四）濕疹病人安眠錦囊 02:11


(本短片作健康教育之用，並不可取代任何醫療診斷或治療。治療成效因人而異，如有疑問，請向專業醫療人士諮詢。)

參考資料：
1. Hong Kong Asthma Society(2015). Pathology and causes of Eczema. Retrieved from https://hkasthma.org.hk/en/about-allergies/pathology-and-causes-0
2. Department of health (2020). Other Physical Health Problems. Retrieved from
https://www.studenthealth.gov.hk/tc_chi/health/health_ophp/health_ophp_tet.html
3. Bartlet LB, Westbroek R, White JE. Sleep patterns in children with atopic eczema. Acta Derm Venereol. 1997 Nov;77(6):446-8. doi: 10.2340/0001555577446448. PMID: 9394978.
4. Li JC, Fishbein A, Singam V, et al. Sleep Disturbance and Sleep-Related Impairment in Adults With Atopic Dermatitis: A Cross-sectional Study. Dermatitis : Contact, Atopic, Occupational, Drug. 2018 Sep/Oct;29(5):270-277. DOI: 10.1097/der.0000000000000401.
5. Camfferman D, Kennedy JD, Gold M, Martin AJ, Lushington K. Eczema and sleep and its relationship to daytime functioning in children. Sleep Med Rev. 2010 Dec;14(6):359-69. doi: 10.1016/j.smrv.2010.01.004. Epub 2010 Apr 14. PMID: 20392655.
6. Chang, Y. S., & Chiang, B. L. (2016). Mechanism of Sleep Disturbance in Children with Atopic Dermatitis and the Role of the Circadian Rhythm and Melatonin. International journal of molecular sciences, 17(4), 462. https://doi.org/10.3390/ijms17040462
7. Ozawa M, Tsuchiyama K, Gomi R, Kurosaki F, Kawamoto Y, Aiba S. Neuroselective transcutaneous electrical stimulation reveals neuronal sensitization in atopic dermatitis. J Am Acad Dermatol. 2009 Apr;60(4):609-14. doi: 10.1016/j.jaad.2008.11.900. PMID: 19178984.
8. Hong Kong Asthma Society(2015).Treatment option of Eczema. Retrieved from https://hkasthma.org.hk/en/about-allergies/treatment-option-eczema




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