{"id":1002,"date":"2023-09-05T12:16:43","date_gmt":"2023-09-05T15:16:43","guid":{"rendered":"https:\/\/peledigital.com\/blog\/?p=1002"},"modified":"2023-09-05T12:30:14","modified_gmt":"2023-09-05T15:30:14","slug":"vitiligo-dermatite-atopica-upadacitinibe","status":"publish","type":"post","link":"https:\/\/peledigital.com\/blog\/vitiligo-dermatite-atopica-upadacitinibe\/","title":{"rendered":"Vitiligo \u2022 Dermatite At\u00f3pica \u2022 Upadacitinibe"},"content":{"rendered":"\n

Vitiligo \u2022 Dermatite At\u00f3pica \u2022 Upadacitinibe este \u00e9 o trio que vamos conversar neste post<\/h2>\n\n\n\n

Quem a companhou a s\u00e9rie como os\u00a0Inibidores de\u00a0JAK v\u00e3o mudar a dermatologia<\/a> deve ter se perguntado:<\/p>\n\n\n\n

\n

Ser\u00e1 que se o paciente tiver vitiligo e dermatite at\u00f3pica eu poderia tratar com inibidor de JAK como por exemplo o upadacitinibe?<\/p>\n<\/blockquote>\n\n\n\n

Afim de ajudar na resposta desta pergunta \u00e9 a proposta deste artigo Concurrent vitiligo and atopic dermatitis successfully treated with upadacitinib: a case report<\/a><\/p>\n\n\n\n

Associa\u00e7\u00e3o entre vitiligo e dermatite at\u00f3pica \u00e9 relatada na literatura<\/h3>\n\n\n\n

Antes de seguir no artigo n\u00e3o podemos perder a oportunidade de lembrar como estas duas doen\u00e7\u00e5s imunomediadas se encontram.<\/p>\n\n\n\n

Quando olhamos para a imunopatog\u00eanese de cada uma destas doen\u00e7as, especula-se que os seguintes fatores contribuam para o surgimento de vitiligo em portadores de Dermatite at\u00f3pica:<\/p>\n\n\n\n

    \n
  • Ambiente desviado para o bra\u00e7o Th2<\/li>\n\n\n\n
  • Prurido constante com trauma epid\u00e9rmico <\/li>\n\n\n\n
  • Predisposi\u00e7\u00e3o para a destrui\u00e7\u00e3o dos melan\u00f3citos<\/li>\n<\/ul>\n\n\n\n

    Concordo que faltam muitas pe\u00e7as deste quebra-cabe\u00e7a, portanto n\u00e3o poderemos parar de estudar.<\/p>\n\n\n\n

    De volta \u00e0 pergunta: como podemos tratar pacientes que apresentam as duas condi\u00e7\u00f5es? <\/p>\n\n\n\n

    A resposta \u00f3bvia \u00e9 com subst\u00e2ncias que funcionem para as duas condi\u00e7\u00f5es.<\/p>\n\n\n\n

    Os inibidores de calcineurina t\u00f3pica, assim como os corticoester\u00f3ides, para casos localizados com certeza s\u00e3o op\u00e7\u00f5es.<\/p>\n\n\n\n

    E para os casos com indica\u00e7\u00e3o de tratamento oral, qual medica\u00e7\u00e3o voc\u00ea indicaria? <\/h3>\n\n\n\n

    Corticoester\u00f3ides? Apesar de ser uma op\u00e7\u00e3o, conhecemos bem as vantagens e desvantagens desta medica\u00e7\u00e3o.<\/p>\n\n\n\n

    Hoje com os inibidores de JAK, temos portanto mais uma op\u00e7\u00e3o oral que tem se mostrado mais segura, pelo menos quando comparado com os corticoester\u00f3ides.\u00a0<\/p>\n\n\n\n

    Este artigo \u00e9 o relato de caso de um garoto de 16 anos de idade com os seguintes \u00edndices:<\/p>\n\n\n\n

      \n
    • Vitiligo Activity score [VIDA] = 2 <\/li>\n\n\n\n
    • Vitiligo Area Scoring Index [VASI] = 0.35<\/li>\n\n\n\n
    • EASI = 10.5<\/li>\n\n\n\n
    • Number Rating Scale of Pruritus e [NRSp] = 6<\/li>\n<\/ul>\n\n\n\n

      Iniciaram upadacitinibe 15mg, um inibidor com maior seletividade para JAK 1, associado ao uso t\u00f3pico de crisaborole (inibidor da fosfodiesterase 4), ainda indispon\u00edvel no Brasil. <\/p>\n\n\n\n

      Ap\u00f3s 4 meses de tratamento os \u00edndices ficaram nos seguintes valores (os autores relatam melhora de 90% do vitiligo na face e de 60% no tronco):<\/p>\n\n\n\n

        \n
      • Vitiligo Activity score [VIDA] = n\u00e3o informado<\/li>\n\n\n\n
      • Vitiligo Area Scoring Index [VASI] = n\u00e3o informado<\/li>\n\n\n\n
      • EASI = 4.1<\/li>\n\n\n\n
      • Number Rating Scale of Pruritus e [NRSp] = 0 <\/li>\n<\/ul>\n\n\n\n

        Este \u00e9 um relato que mostra que quando conhecemos os mecanismos imunopatog\u00eanicos das doen\u00e7as imunomediadas inegavelmente saberemos identificar as melhores op\u00e7\u00f5es terap\u00eauticas para os nossos pacientes<\/p>\n\n\n\n

        Ou seja, poderemos otimizar o tratamento de forma a termos uma boa resposta cl\u00ednica minimizando os efeitos colaterais.\u00a0<\/p>\n\n\n\n

        Nunca abriremos m\u00e3o das melhores evid\u00eancias para a nossa tomada de decis\u00e3o e para o cuidado de nossos pacientes<\/p>\n\n\n\n

        Dessa forma eu pergunto: voc\u00ea aprova o trio Vitiligo \u2022 Dermatite At\u00f3pica \u2022 Upadacitinibe<\/p>\n\n\n\n

        <\/p>\n","protected":false},"excerpt":{"rendered":"

        Como tratar um paciente portador de vitiligo e dermatite at\u00f3pica?<\/p>\n","protected":false},"author":1,"featured_media":1004,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22],"tags":[37,36,24,29,31,35,76],"class_list":["post-1002","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-imunologia","tag-dermatite-atopica","tag-inibidor-de-jak","tag-inibidores-de-jak","tag-pele-digital","tag-perfil-th2","tag-upadacitinibe","tag-vitiligo"],"acf":[],"yoast_head":"\nVitiligo \u2022 Dermatite At\u00f3pica \u2022 Upadacitinibe - Pele Digital<\/title>\n<meta name=\"description\" content=\"Vitiligo \u2022 Dermatite At\u00f3pica \u2022 Upadacitinibe \u00e9 o novo trio da dermatologia e \u00e9 sobre ele que vamos conversar neste post\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/peledigital.com\/blog\/vitiligo-dermatite-atopica-upadacitinibe\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vitiligo \u2022 Dermatite At\u00f3pica \u2022 Upadacitinibe - 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