Recently in Japan, misunderstandings about the pathogenesis of atopic dermatitis (AD) and the strategies for the treatment of this disease, especially about the use of topical steroid, have led to a rapid increase of severe cases of AD caused by inadequate treatment. This prompted us to establish and distribute standard guidelines for AD therapy. In this guideline, the necessity of dermatological training to examine severe cases of AD is emphasized. It is stated that the present standard therapies for AD consist of the use of topical steroid and thaclolimus ointment (only for adult patients) for inflammation and emollient for dry and barrier—disrupted skin as the first line of attack, anti-histamines and anti-allergic drugs for pruritus, avoidance of apparent exacerbating factors, psychological counselling, and advice about daily life. The importance of correct selection of topical steroid according to the severity of the lesion is emphasized.
Elastic fibers are fibrous proteins in the dermis, then include elastin, fibrillins and microfibril-associated glycoproteins. Typical cutaneous disorders in which elastic fibers are primarily involved are pseudoxanthoma elasticum, actinic elastosis, cutis laxa, elastosis perforans serpiginosa, middermal elastolysis, and pseudoxanthoma elasticum-like papillary dermal elastolysis. Recent advances in the molecular pathology of these disorders were presented.