Family History Of Atopic Dermatitis Research Articles

The Impact of Infant Feeding Regimen on Cow's Milk Protein Allergy, Atopic Dermatitis and Growth in High-Risk Infants during the First 6 Months of Life: The Allergy Reduction Trial.

The development of early-onset cow's milk protein allergy and atopic dermatitis during the first months of life is multifactorial, including both genetic and nutritional aspects. This study aims to assess the impact of different feeding patterns on the incidence of cow's milk protein allergy, atopic dermatitis, and growth among infants with a family history of allergy. A total of 551 high-risk infants were randomly recruited from 3 European countries in three feeding regimens: exclusive breastfeeding, partially hydrolyzed formula, or standard formula with intact protein either exclusively or supplementary to breastfeeding. During the first 6 months of intervention, amongst infants with a family history of atopic dermatitis, 6.5% of partially hydrolyzed formula-fed infants and 22.7% of exclusively breastfed infants (p = 0.007) presented with atopic dermatitis respectively. Growth as assessed by weight increase did not differ between the aforementioned groups. Although cow's milk protein allergy was not related to the different milk feeding regimens in the whole cohort, when adjusting for high breast milk intake, the respective incident was significantly lower in the infants consuming partially hydrolyzed formula (p < 0.001). This data indicates that a specific partially hydrolyzed formula could serve as a more appropriate complement to breast milk compared to a standard intact protein formula in high-risk infants, to reduce the incidence of atopic dermatitis.

Alopecia areata

Alopecia areata, which is a condition with characteristic regional hair loss on the top of the head, is quite common in outpatient departments and clinics. The hair loss is rather rapid during the acute phase and the development into a severe form of alopecia may be related to the younger onset, along with nail changes, family history of atopic dermatitis, allergic rhinitis, asthmatic bronchitis, etc., or other autoimmune diseases. Physically, a large area of hair loss can be observed, as well as other typical features, including broken hair roots and exclamation mark hairs. The classic histopathological sign is the infiltration of lymphocytes around the hair follicles. Moreover, alopecia is not limited to the scalp, and hairs on any part of the body are subjected to the effect of this disease.

Exploratory analyses of biomarkers in blood and stratum corneum in patients with atopic dermatitis.

Background:The pathogenesis of atopic dermatitis (AD) involves various mediators, including cytokines and chemokines, which are produced by immune cells, such as dendritic cells and lymphocytes, and non-immune cells, such as epidermal cells. Several mediators, including thymus and activation-regulated chemokine (TARC), are used as biomarkers for AD severity and activity. However, additional local and systemic biomarkers of AD are required.Methods:This study will include 10 male patients with AD and 5 healthy adult males (age range: 20–80 years). The Eczema Area and Severity Index will be used to objectively evaluate the clinical findings. In addition, the severity of eruptions will be assessed on a 5-point scale by scoring symptoms (erythema, edema/papules, oozing/crusting, excoriation, lichenification, and xerosis), and the total intensity will be calculated by adding the symptom scores together. Subjective symptoms will be assessed using a peak pruritus numerical rating scale. Laboratory tests, including measurements of peripheral eosinophil count and serum total immunoglobulin E, TARC, and lactate dehydrogenase levels, will be performed. Using blood samples and extracts of stratum corneum samples obtained by tape stripping, we will conduct an exploratory analysis of protein expression using an antibody array to identify mediators whose levels are significantly altered in patients with AD. After 4 to 8 weeks, blood samples and stratum corneum samples will be collected again from AD patients. Moreover, we will examine whether the candidate proteins can be quantified using enzyme-linked immunosorbent assays.Discussion:This is an important study exploring potential local and systemic biomarkers of AD. The results of this study will be clinically meaningful for the discovery of new biomarkers for diagnosing and assessing the severity of AD.

Prevalence of adult self-reported atopic dermatitis in Greece: results from a nationwide survey

Atopic dermatitis (AD) is a common chronic inflammatory skin disorder. In Greece, there is a lack of data on AD epidemiology. The objective of the present study was to estimate the self-reported prevalence of AD and the prevalence of moderate/severe AD in the adult population in Greece. A nationwide cross-sectional survey with a structured questionnaire was conducted, between June 17th, 2021 and July 12th, 2021, using Computer Assisted Telephone Interviewing (CATI) and Computer Assisted web Interviewing (CAWI) data collection methods. Several different self-reported AD definitions, as extracted from the literature, were used. Self-reported moderate/severe atopic dermatitis was estimated using the Patient Oriented Eczema Measure (POEM). More than 30,500 persons were invited to participate; among them, 3,001 were recruited for the survey. The 12-month self-reported AD prevalence in Greece ranged from 1.7% to 6.4%, while lifetime prevalence reached 11.4%. At least half of the responders who identified with AD during the last 12 months had moderate to very severe eczema. The multivariate analysis confirmed that age, atopy-related comorbidities (asthma, allergies, and rhinitis), a family history of AD, rhinitis, and asthma were factors that are independently associated with AD, irrespective of the definition used. The 12-month and lifetime prevalence of AD in adults in Greece ranges from 1.7% to 6.4% and 3.7% to 11.4%, respectively. At least half of the adults with AD suffer from moderate-to-severe disease. Our study is a first step in understanding AD epidemiology in Greece and may provide useful insights for healthcare decision makers.

A low level of health literacy is a predictor of corticophobia in atopic dermatitis

BackgroundTopical corticosteroids (TCS) are the mainstay of treatment in atopic dermatitis (AD) flares. The fears and worries concerning TCS are known as corticophobia. Corticophobia is common in patients with AD and can lead to suboptimal TCS application and treatment failure. Health literacy (HL) may influence corticophobia. TOPICOP© and HLS-EU-PT questionnaires have been developed to evaluate corticophobia and HL, respectively. ObjectiveEvaluate the relationship between corticophobia and the degree of HL in patients with AD. MethodsProspective cross-sectional study with AD patients followed at a Dermatology Department, between September 2019 and February 2020. Patients, or their parents (if patients had ≤ 15 years), were invited to answer TOPICOP© questionnaire, HLS-EU-PT questionnaire, and a disease characterization and demographic questionnaire. ResultsWe included 61 patients (57.4% females, mean age 20 ± 13.8 years, mean disease duration of 12.5 ± 11.4 years). TOPICOP© mean score was 44.8 ± 20.0 (8.3 to 88.9) and HLS-EU-PT mean score was 30.5 ± 8.5 (1.1 to 47.9). TOPICOP© score was negatively correlated with HLS-EU-PT score (p = 0.002, r = -0.382, r2 = 0.146). There was no statistical difference between TOPICOP© score and disease characteristics (disease severity, family history of AD or personal history of other atopic diseases). Study limitationsSmall and heterogenous cohort composed of patients and patients’ parents. ConclusionThe degree of corticophobia is similar to the values reported in other studies. HL had an inverse correlation with corticophobia. Lower HL was shown to be a predictor of higher corticophobia. The promotion of health literacy is essential for the correct use of TCS and good control of AD.

Understanding immunological origins of atopic dermatitis through multi-omic analysis.

The pathophysiology of atopic dermatitis (AD) is multifactorial, impacted by individual medical, demographic, environmental, and immunologic factors. This study used multi-omic analyses to assess how host and microbial factors could contribute to infant AD development. This longitudinal cohort study included 129 term infants, identified as AD (n=37) or non-AD (n=92) using the Infant Feeding Practices-II survey and review of medical records. Standardized surveys were used to assess medical and demographic traits (gestational age, sex, race, maternal AD, and atopy family history), and environmental exposures (delivery method, maternal tobacco use, pets, breastfeeding duration, and timing of solid food introduction). Saliva was collected at 6months for multi-omic assessment of cytokines, microRNAs, mRNAs, and the microbiome. The contribution of each factor to AD status was assessed with logistic regression. Medical, demographic, and environmental factors did not differ between AD and non-AD infants. Five "omic" factors (IL-8/IL-6, miR-375-3p, miR-21-5p, bacterial diversity, and Proteobacteria) differed between groups (p < .05). The severity of AD was positively associated with levels of miR-375-3p (R=.17, p=.049) and Proteobacteria (R=.22, p=.011), and negatively associated with levels of miR-21-5p (R=.20, p=.022). Multi-omic features accounted for 17% of variance between groups, significantly improving an AD risk model employing medical, demographic, and environmental factors (X2 =32.47, p=.006). Interactions between the microbiome and host signaling may predispose certain infants to AD by promoting a pro-inflammatory environment.

The Risk Reduction Effect of a Nutritional Intervention With a Partially Hydrolyzed Whey-Based Formula on Cow's Milk Protein Allergy and Atopic Dermatitis in High-Risk Infants Within the First 6 Months of Life: The Allergy Reduction Trial (A.R.T.), a Multicenter Double-Blinded Randomized Controlled Study

BackgroundThe role of partially hydrolyzed formulas (pHF) as part of nutritional interventions to prevent the development of allergic manifestations (AM) is questioned, and efficacy of each specific pHF should be substantiated.ObjectiveTo investigate the risk-reduction effect of a whey-based pHF on the development of cow's milk protein allergy (CMPA) and atopic dermatitis (AD) in infants at high-risk for allergy within the first 6 months of life.Materials and MethodsIn a multicenter double-blinded randomized controlled setting, healthy non-exclusively breastfed full-term infants, received either a specific whey-based pHF or a standard cow's milk-based formula (SF) and were clinically assessed for AM at 2, 4, and 6 months of age, supported by the objective scoring tools SCORAD and CoMiSS. CMPA was confirmed by open food challenge. Intention-to-Treat (ITT) and Per-Protocol (PP) analyses were performed.ResultsOf 331 randomized subjects (ITT analysis set), 160 received the pHF and 171 the SF. Six (3.8%) infants in the pHF and 12 (7%) in the SF group developed CMPA (p = 0.186). AD incidence was significantly lower in those receiving pHF as compared to SF (10.6% vs. 18.7%, p = 0.024) with a relative risk (RR, 95% CI) of 0.54 (0.32, 0.92), in particular when adjusting for family history of AD [6.5% vs. 27.3%, RR 0.24 (0.07, 0.78), p = 0.018] representing a risk reduction of 76%. The PP analysis showed similar results.ConclusionThis specific whey-based pHF reduced the risk of AD development, particularly in those with a family history of AD, and tended to reduce the development of CMPA in non-exclusively breastfed infants at high-risk for allergy. The A.R.T. study suggests that this particular pHF may contribute to measures aimed at prevention of allergic manifestations. However, further studies are needed to confirm this risk-reduction effect.

Clinical Characteristics of Atopic Dermatitis in Korean School-Aged Children and Adolescents According to Onset Age and Severity

BackgroundAtopic dermatitis (AD) is a heterogeneous disease with different age of onset, disease course, clinical symptoms, severity, and risk of comorbidity. The characteristics of children with AD also vary by age or country. However, little is known about the clinical characteristics of AD in Korean school-aged children and adolescents. Furthermore, there are few studies on phenotypic differences according to onset age. This study aimed to explore the clinical characteristics and phenotypes according to onset age and severity of AD in children and adolescents in Korea.MethodsAD patients aged 6–18 years who presented to 18 hospitals nationwide were surveyed. The patients were examined for disease severity by pediatric allergy specialists, and data on history of other allergic diseases, familial allergy history, onset age, trigger factors, lesion sites, treatment history and quality of life were collected. The results of the patient’s allergy test were also analyzed. The patients were classified into infancy-onset (< 2 years of age), preschool-onset (2–5 years of age), and childhood-onset (≥ 6 years of age) groups. Study population was analyzed for clinical features according to onset-age groups and severity groups.ResultsA total of 258 patients with a mean age of 10.62 ± 3.18 years were included in the study. Infancy-onset group accounted for about 60% of all patients and presented significantly more other allergic diseases, such as allergic rhinitis and asthma (P = 0.002 and P = 0.001, respectively). Food allergy symptoms and diagnoses were highly relevant to both earlier onset and more severe group. Inhalant allergen sensitization was significantly associated with both infancy-onset group and severe group (P = 0.012 and P = 0.024, respectively). A family history of food allergies was significantly associated with infancy-onset group (P = 0.036). Severe group was significantly associated with a family history of AD, especially a paternal history of AD (P = 0.048 and P = 0.004, respectively). Facial (periorbital, ear, and cheek) lesions, periauricular fissures, hand/foot eczema, and xerosis were associated with infancy-onset group. The earlier the onset of AD, the poorer the quality of life (P = 0.038). Systemic immunosuppressants were used in only 9.6% of the patients in the severe group.ConclusionThis study analyzed the clinical features of AD in Korean children and adolescents through a multicenter nationwide study and demonstrated the phenotypic differences according to onset age and severity. Considering the findings that the early-onset group is more severe and accompanied by more systemic allergic diseases, early management should be emphasized in young children and infants.

Prevalence and Characteristics of Dupilumab-Induced Ocular Surface Disease in Adults With Atopic Dermatitis.

Dupilumab-induced ocular surface disease (DIOSD) is a common reaction among patients treated for atopic dermatitis. This study aimed to identify the clinical characteristics, associated risk factors, treatment strategies, and long-term outcomes of DIOSD. We conducted a multicenter retrospective cohort study of consecutive adult outpatients treated with dupilumab for moderate-to-severe atopic dermatitis from 2017 through 2021 at 2 tertiary care centers. We used stepwise multivariable logistic regression to assess the association between patient characteristics and development of DIOSD. Among 210 patients treated with dupilumab, 37% (n = 78) developed DIOSD over the 52-week follow-up period. Vision-threatening complications including corneal scarring and cicatricial ectropion were noted in 1% (n = 3) of patients. Clinical features were blepharoconjunctivitis (68%, n = 53), burning/stinging/dryness (14%, n = 29), epiphora (13%, n = 10), pruritus (13%, n = 10), blurred vision (3%, n = 2), and photophobia (1%, n = 1). DIOSD was associated with a history of asthma (odds ratio: 2.94, 95% confidence interval: 1.26-6.87, P = 0.01) and a family history of atopic dermatitis (odds ratio: 2.58, 95% confidence interval: 1.08-6.17, P = 0.03). Interventions were initiated for 63% of patients with DIOSD, with artificial tears (56%) and corticosteroid drops (29%) most commonly used. Dupilumab was discontinued because of DIOSD in 4% of patients. DIOSD is a common adverse event that is usually mild but may lead to treatment interruption and vision-threatening complications. A personal history of asthma and family history of atopic dermatitis may be associated with a higher risk of developing DIOSD.

Relationship Between Concomitant Atopic Diseases With Atopic Dermatitis Severity And Persistence.

Introduction: The atopic march consists of atopic dermatitis (AD), allergic rhinitis or sinusitis (AR), allergic conjunctivitis (AC) and bronchial asthma (BA). The influence of concomitant atopic diseases on AD is under-explored. We determined the relationship between personal and family history of atopic diseases with AD severity and persistence. Methods: A cross sectional study involving AD patients was performed at dermatology clinics of two tertiary hospitals. Inclusion criterion was all patients diagnosed with AD. Demographic data, personal and family history of atopy (BA, AR and AC) were obtained by face-to-face interview. AD severity was evaluated using Investigator’s Global Assessment (IGA). AD was considered persistent if continued beyond age 12 years. Results: Sixty patients aged 21.6±17.2 participated. There were 25(41.7%) with concomitant AR, 16(26.7%) BA and 12(20%) AC. Forty seven (78.3%) patients had family history of atopy, 25(41.7%) had eczema, 24(40%) AR, 19(31.7%) BA and 2(3.3%) AC. Patients with BA [OR=3.8, 95%CI 1.04 to 14.4)], BA and AR [OR=9.74, 95%CI 1.13 to 83.67) and family history of BA [OR= 4.00, 95%CI 1.20 to 13.27) were more likely to exhibit moderate-severe AD. Personal AR, AC and family history of AD and BA were significantly more prevalent in patients with persistent AD. Conclusions: AR was the most common atopic disease associated with AD. Family history of eczema and AR were common. Personal BA, BA with AR and family history of BA were predictors of severe AD. Personal AR, AC and family history of AD and BA were associated with AD persistence.

A Cross-Sectional Evaluation of the Usefulness of the Minor Features of Hanifin and Rajka Diagnostic Criteria for the Diagnosis of Atopic Dermatitis in the Pediatric Population.

Background:Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease. Hanifin and Rajka's criteria is the most common diagnostic criteria used for the clinical diagnosis of this condition. However, many find that it is too exhaustive to be used in routine practice, and the specificity of many of the minor criteria poses challenges, particularly from Asian countries with type III, IV, and V skin.Aims and Objectives:The aim of the study is to evaluate the effectiveness of the minor features of the Hanifin and Rajka criteria for AD in comparison to the UK working party's diagnostic criteria in pediatric populations of India.Methodology:A hospital-based cross-sectional study of 100 patients in the pediatric age group (3 months–12 years) with AD was conducted based on history, clinical, and laboratory evaluation. An age-matched control group of 100 pediatric patients who did not have a personal or family history of atopic dermatitis was included after obtaining informed consent to find out the prevalence of minor criteria among the control group.Results:Mean of the number of minor clinical criteria found positive in our study population in the infantile and toddler (below 2 years) and childhood groups (2–12 years) was (4.72 ± 1.75) and (5.67 ± 1.78), respectively. Early-onset of disease was the most consistent feature among the minor criteria found in 83% of patients, followed by xerosis (71%), hyperlinearity of palm (56%), pityriasis alba (54%), Denny Morgan fold (52%), elevated serum IgE (47%), perifollicular accentuation (37%), and tendency toward cutaneous infections (37%).Conclusion:We found that though some of the minor criteria are highly sensitive and specific to the diagnosis of AD (xerosis, ichthyosis, palmar hyperlinearity, tendency of cutaneous infections, Dennie–Morgan infraorbital fold, pityriasis alba, and perifollicular accentuation), some other criteria were either very rare or nonspecific for AD. We suggest that many of the minor criteria of Hanifin and Rajka may not have much significance for Indian patients and a multicentric nationwide study with a larger patient pool is required to create a trimmed and improved version of Hanifin and Rajka criteria.

Growth parameters in children with atopic dermatitis in Erbil City, Kurdistan Region-Iraq

Background: Atopic dermatitis is a chronic inflammatory skin condition that significantly impacts patients' quality of life. A disturbed sleep pattern, frequent potent topical and sometimes systemic corticosteroid use, and diet restriction, all of which could affect child's growth.Objective: This study determined height and weight impairment in children with atopic dermatitis.Patients and Methods: A cross-sectional study took children with atopic dermatitis ≤18 years, which was conducted in the "Erbil Dermatology Teaching Center." The patients' data included sociodemographic information, family history, drug history, and present complaints. The severity of the disease evaluated using SCORAD score. The weight was recorded using a medical electronic weighing machine, and standing height was recorded using a stadiometer.  Results: Among 100 children with atopic dermatitis, their mean of age was 6.84±1.8 years. Males and Females frequencies were 54 and 46, respectively. The family history of atopic dermatitis was positive in 73%. Generally disturbed sleep pattern was dominant, and almost all severe AD patients had disturbed sleep (87.5%). The severity of AD was classified by SCORAD score to mild (23%), moderate (69%), and severe (8%). Patients having their growth percentile for weight and height for age below 3rd percentile were 10% and 3%, respectively. Patients' weight and height for age below 25th percentile were 15% and 9%, respectively.Conclusions: Atopic dermatitis can affect the height and weight of the children inversely. The study sample's most dominant character was sleep pattern disturbances, which can affect both weight and height.

Clinical study on prevention of atopic dermatitis by oral administration of probiotics in infants.

This study aimed to investigate the preventive effects of oral administration of probiotics on the incidence and severity of atopic dermatitis (AD) in infants. A total of 396 full-term infants were enrolled in this study. Of these, 132 newborns without a family history of AD were assigned to group A, and the other 264 newborns were randomly divided into groups B and C. Infants in groups A and B were solely breastfed, while probiotics were administered to those in group C as well as breastfeeding. The information of all subjects was recorded, and the incidence of AD was followed up. The levels of serum IgE and IL-4 were measured at the age of 3 years. The incidence of AD in infants in group B was higher than that in group A at 3 months, 4-6 months, and 7-36 months after birth, together with increased symptom scores. For infants in group C, the incidence of AD at 4-6 months and 7-36 months after birth and the SCORAD scores at 0-3 months and 4-6 months after birth were lower than those in group B. The levels of IgE and IL-4 in group B were higher than those in groups A and C at 36 months old. Adding probiotics could favor the establishment of the intestinal microecological balance in the neonatal period, thereby reducing the incidence of AD, decreasing the levels of serum immune indexes and alleviating the severity of the disease.

Familial aggregation of atopic dermatitis and co-aggregation of allergic diseases in affected families in Taiwan

BackgroundAtopic dermatitis (AD) is contributed from a result of genetic and environmental interaction. The evidence for familial aggregation in AD has been reported but population-based studies and co-aggregation with other allergic diseases are rarely reported. ObjectiveThis study examined familial aggregation and heritability of atopic dermatitis (AD) and to estimate the relative risks (RRs) of other allergic diseases in individuals with relatives diagnosed with AD. MethodsWe used Taiwan National Health Insurance Research Database to identify all registered beneficiaries (n = 26,525,074) in 2015; among them, 1,248,594 individuals had AD. We estimated familial risks of AD and other allergic diseases by using marginal Cox proportional models. ResultsPrevalence of AD in individuals with relatives affected with atopic dermatitis was 3.1-fold higher than the general population (12.4 % vs. 4.0 %, respectively). The adjusted relative risks (RR) for individuals with an affected first-degree relative (FDR) was 2.25 (95 % CI, 2.25–2.26). The adjusted RRs for subjects with an affected parent, an affected offspring or an affected sibling was 2.39 (95 % CI, 2.37–2.41), 2.26 (95 % CI, 2.24–2.28) and 2.30 (95 % CI, 2.29–2.31) respectively. The RRs in individuals with an FDR with AD was 1.34 (95 %CI, 1.34 – 1.34) for asthma and 1.23 (95 %CI, 1.23–1.24) for allergic rhinitis. ConclusionThis nationwide study ascertains that a family history of atopic dermatitis is a risk factor for atopic dermatitis. Individuals with relatives affected by atopic dermatitis have slightly higher risks of developing asthma and allergic rhinitis.

Atopic dermatitis incidence and risk factors in young adults in Castellon (Spain): A prospective cohort study

IntroductionThere are few atopic dermatitis (AD) incidence cohort studies in young adults, the etiology of this disease remains obscure, and AD risk factors in adults are not well understood. The objective of this study was to estimate AD ten-year incidence and prevalence in a cohort of adolescent aged 14–16 at inception in Castellon province in Valencia Region, Spain and describe related risk factors. Material and methodsFrom 2002 to 2012, a population-based prospective cohort study was carried out. Questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were used with an additional questionnaire for related factors completed by participants and their parents, respectively, in 2002. In 2012 the same questionnaires were completed by the participants’ through a telephone interview, and incidence and prevalence of AD were estimated. Directed acyclic graphs, Poisson regression and inverse probability weighted regression adjustment were used. ResultsThe participation rate was 79.5% (1435/1805) with AD lifetime prevalence of 34.9% and AD incidence of 13.5 per 1000 person years. Females presented higher prevalence and incidence than males. After adjustment significant risk factors were being female, history of asthma or allergic rhinitis, family history of AD, history of respiratory infections, history of bronchitis, history of pneumonia, history of sinusitis, and birthplace outside Castellon province. The highest AD population attributable risks were female, 30.3%, and history of respiratory infections 15.3%. Differences with AD childhood risk factors were found. ConclusionsAD incidence in our cohort was high and several risks factors were related to AD.

The pattern of atopic dermatitis in a group of patients attending two private clinics in Erbil city

Background and objective: Atopic dermatitis is a chronic, relapsing inflammatory disease of the skin. It is a common disease that primarily affects young children. It results from complex interactions between genetic susceptibility genes. This study aimed to assess atopic dermatitis among the affected cases, mainly in terms of age and gender distribution, and its clinical and laboratory findings. Methods: A descriptive cross sectional study was carried out in two private clinics in Erbil city. A convenience sampling method was used to recruit 70 study participants who were clinically examined by the investigator. A questionnaire was specially designed for interviewing these patients. The diagnosis was made on the clinical ground. Patients were also sent for blood investigations and a skin swab for microscopic examination. Results: The mean ± SD of the participants' age was 20.57 ± 17.94 years. Females constituted 68.6% of the participants. More than 64% of the patients had generalized body lesions, 54.3% had a positive family history of atopic dermatitis, and 48.5% had a history of other atopic diseases. The majority (58.3%) of those aging less than two years had face lesions while the majority (74.4%) of the patients aging more than 15 years had generalized body lesions, and this was statistically significant. Conclusion: Atopic dermatitis affects a wide age group, and different age categories have different sites of the lesion. Family history is a prominent feature of the disease. Clinically, lichenification is more among older age groups compared to the eczematous lesion, which is more among younger age groups.

Short-term skin problems in infants aged 0\u20133\xa0months affect food allergies or atopic dermatitis until 2\xa0years of age, among infants of the general population

BackgroundThis study examined whether infants aged 0–3 months exhibited long-term effects of using a moisturizer skincare intervention and whether a short-term skin problem resulted in the subsequent development of food allergies or atopic dermatitis (AD) until the age of 2 years.MethodsThis study was a follow-up of a completed randomized control trial (RCT) of moisturizer skincare for infants aged 0–3 months. A self-reported questionnaire was mailed to the parents of children aged 1–2 years who had participated in the RCT. Data were analyzed using a Chi square test, by intention to treat analysis, and by multiple logistic regression.ResultsOf 155 infants, 22 (14.2%) and 28 (18.1%) had food allergies and AD/eczema until 2 years of age, respectively. No significant difference was seen in food allergies or AD between the group that received moisturizer skincare intervention and the control group. On the contrary, food allergies until 2 years of age were significantly associated with short-term (4–7 days) and long-term (more than 7 days) body skin problems occurring in the first 3 months of life, a family history of AD, and the time of starting complementary food. High value of face transepidermal water loss at 3 months of age was also associated with food allergies. Moreover, a short duration of severe diaper dermatitis during the first 3 months, a family history of AD, and being male were significantly associated with AD/eczema until the age of 2 years.ConclusionsAfter adjusting for family history of AD, a short-term skin problem in the first 3 months of life was significantly associated with the development of food allergies or AD/eczema until the age of 2 years. Prevention or prompt treatment of skin problems in newborns is essential for preventing future allergic diseases.Trial registration This was a follow-up study conducted 2 years after the completed RCT of a moisturizer skincare intervention for early infants, which was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000013260)

Infant skin care: updates and recommendations.

Neonatal skin acclimates rapidly to dry, aerobic conditions at birth and skin function gradually matures throughout infancy. Gentle skin care practices support the ongoing development and function of newborn skin. This article reviews research updates and current skin care recommendations for full-term infants, premature infants, and infants born with severe cutaneous manifestations of genetic skin disorders. Although safe early bathing of full-term infants with environmental controls is possible, delaying the first newborn bath for 12-24 h of life offers benefits of increased parental bonding and breastfeeding success. Swaddled bathing every 4 days is an effective bathing strategy for premature neonates. Among infants with a family history of atopic dermatitis, regular application of bland skin moisturizers reduces their risk of developing the disease. For newborns with erosive or blistering genetic skin conditions, use of specialized wound dressings and emollients promotes wound healing and helps limit skin damage. Environmental control with humidified incubators helps prevent life-threatening hypernatremic dehydration among babies born with collodion membranes; however, affected infants can tolerate breaks outside of the humidifier to promote parent-infant bonding. This article reviews infant skin care recommendations relevant to pediatric practice. Research to further optimize newborn skin care is ongoing, particularly, for the special populations of premature neonates and infants born with severe skin disease.

Topical corticosteroid phobia among caretakers of children with atopic dermatitis: A cross-sectional study using TOPICOP in Japan.

The TOPICOP scale is an easy-to-use scale for assessing topical corticosteroid (TCS) phobia in atopic dermatitis (AD) patients and their caretakers. TCS phobia is a common problem among AD patients and their caretakers. The aim of this study was to examine the relationship between TCS phobia in caretakers of children with AD and the characteristics of patients using the TOPICOP scale. Caretakers of AD patients who visited the allergy clinic at the National Center for Child Health and Development in Tokyo between February 2014 and May 2014 were recruited. Caretakers of patients in follow-up had already attended an education session on treatment at the institution. All participants completed an anonymous questionnaire on the characteristics of the respondents and patients using the Patient-Oriented Eczema Measure (POEM) and the Japanese version of TOPICOP. In total, 243 participants (88.9% female) completed the survey. The average TOPICOP score was 40.3 and the median POEM score was 4. The TOPICOP score was significantly higher for patients younger than 12months old with moderate to very severe AD (POEM≥8) whose caretaker had not attended an educational session (P<0.01, respectively). There was no significant difference in the family history of AD, age, or gender of the respondents. In multivariable analysis, preattendance at an education session was the only significant factor accounting for a higher TOPICOP score (P<0.001). Regardless of their background, caretakers of AD patients can be affected from TCS phobia. Attending an educational session might ease their anxiety.

Camel's milk allergy.

Camel's milk is a safe and therapeutic nutrient. Camel's milk allergy is almost unknown. To identify the clinical and laboratory features of camel's milk allergy. In this retrospective study, the records of patients with camel's milk allergy were reviewed. Data collected included age, sex, clinical presentation, concomitant allergies, family history, laboratory tests (complete blood cell count [CBC], white blood cell [WBC] count, total immunoglobulin E [IgE], food specific IgE), and skin-prick tests (SPT) to camel's milk and other foods. Nine patients (four male patients, five female patients; mean age ± SD 4.3 ± 2.4 years) presented with cutaneous urticaria and/or angioedema (five patients [55.6%]) and anaphylaxis (four patients [44.4%]). Allergic reactions occurred within the first 15 minutes of ingesting camel's milk in all the patients (100%). Concurrent allergies were observed in 77.8% of the patients, of whom, five patients (71.4%) had atopic dermatitis (AD) and two patients (22%) had cow's milk allergy that exacerbated AD. All the patients (100%) had a family history of allergies. The family farm was the source of camel's milk in all the patients (100%). The WBC count was 9425 ± 1452.8 (mean ± SD) cells/μL, and eosinophils was 612 ± 455.4 (mean ± SD) cells/μL, and the median IgE was 301.5 kU/mL. A camel's milk SPT resulted in a wheal of 8.7 ± 4.9 (mean ± SD) mm. Camel's milk allergy is a distinct, yet very rare, disease entity. Cutaneous and systemic allergic reactions are the main clinical manifestations. Concomitant other allergies, viz., AD, and positive family history are risk factors. Early life exposure to camel's milk is a possible risk factor. High blood eosinophil counts and total IgE levels were observed in patients with camel's milk allergy. In the presence of a consistent and specific clear-cut history of camel's milk-related symptoms, a SPT was a dependable confirmatory test.