Infant Skin Research Articles

Procedural Pain Assessment in Infants Without Analgosedation: Comparison of Newborn Infant Parasympathetic Evaluation and Skin Conductance Activity - A Pilot Study

Objective: New technologies to measure pain responses, such as heart rate variability and skin conductance hold promise in the development of tools that can be reliable and quantifiable of detecting pain. The main objective of this study was to assess the capability of two monitors i.e., Newborn Infant Parasympathetic Evaluation (NIPE) and Skin Conductance Algesimeter for detecting procedural pain in non-anesthetized infants.Materials and Methods: Thirty-three non-anesthetized infants were enrolled to the study. To detect pain caused by heel stick, NIPE, and Skin Conductance monitors and behavioral pain scales were used. Three minutes before and just after heel stick, pain was evaluated by behavioral scales, and simultaneously over the whole period by NIPE and SCA.Results: A statistically significant decrease of NIPE Index and an increase of SCA values were found after the HS procedure. There were no statistically significant differences between the decrease in NIPEi values and the increase in PPS values between subgroups based on pain assessment by behavioral-scale scores.Conclusion: Both NIPE and SCA can be useful for detection of procedural pain and may constitue an additional valuable tool for better handling of pain among patients treated in NICUs. More studies on larger groups of patients are needed.

Expert consensus on ceramides containing skincare in newborns and infants and potential mitigation of atopic dermatitis.

The vulnerable skin of neonates and infants is still developing anatomically and functionally and more susceptible to skin barrier disruption. The current consensus paper explores challenges in caring for neonates and infants' skin, skincare use and evaluates the role of ceramides (CERs) containing cleansers and moisturizers. A panel of eight clinicians who treat neonates and infants developed a consensus paper on new-born and infant skin barrier integrity and CERs-containing skincare importance. The consensus process consisted of a modified Delphi technique. The selected information from the literature searches, coupled with the panel's opinion and experience, was used to adopt statements to provide clinical data for pediatric dermatologists, dermatologists, and pediatric healthcare providers who treat neonates and infants. Increasingly, evidence supports skincare starting early in life, recognizing the benefits of ongoing daily use of non-alkaline cleansers and moisturizers to maintain skin barrier function. Skincare for neonates and infants should be safe, effective, and fragrance as well as sensitizing agent-free. Skincare with CERs may benefit the stratum corneum's lipid and water content. When applied from birth onwards, gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier and soothe the skin with long-term moisturizing benefits.

Association of Frequent Moisturizer Use in Early Infancy With the Development of Food Allergy

It has been hypothesized that food allergy may develop through transcutaneous sensitization, especially in the presence of skin barrier impairment and inflammation. With this study, researchers sought to determine if regular moisturizer use in infants could potentially promote food sensitization and the development of food allergy.This hypothesis was studied in the Inquiring About Tolerance study population. The Inquiring About Tolerance study was a population-based randomized clinical trial conducted from January 15, 2008, to August 31, 2015, including 1303 exclusively breastfed 3-month-old infants and their families from England and Wales.At enrollment at 3 months, families completed a questionnaire that included questions about the frequency and type of moisturizer applied, use of corticosteroid creams, and parental report of dry skin or eczema. Infants were examined for visible eczema at the enrollment visit.A statistically significant dose-response relationship was observed between parent-reported moisturization frequency at 3 months of age and the subsequent development of food allergy. Each additional moisturization per week was associated with an adjusted odds ratio of 1.20 (95% confidence interval [CI]: 1.13 to 1.27; P < .0005) for developing a food allergy. For infants with no visible eczema at the enrollment visit, the corresponding adjusted odds ratio was 1.18 (95% CI: 1.07 to 1.30; P = .001), and, for those with eczema at the enrollment visit, corresponding adjusted odds ratio was 1.20 (95% CI: 1.11 to 1.31; P < .0005). Moisturizer frequency revealed similar dose-response relationships, with the development of both food and aeroallergen sensitization at 36 months.These findings support the idea that regular application of moisturizers to the skin of young infants may promote the development of food allergy through transcutaneous sensitization.The notion of transcutaneous sensitization has become popular over the past decade, and there is now an increasing body of research to support it. In short, it is hypothesized that early oral exposure is likely to induce tolerance, whereas skin exposure is more likely to lead to sensitization. This appears to be especially common in infants with eczema, likely because of both an impaired skin barrier and a greater inherited predisposition to develop allergy. It is also interesting to note that other studies have suggested that early and aggressive eczema care might prevent food allergy. There may therefore be a precarious balance, with the likely tipping point being the presence of allergen on the hands of the person applying the moisturizer.

An integrative multi‐omic analysis reveals a major metabolic rewiring between baby foreskin keratinocytes and adult female abdominal keratinocytes

Even though its development starts early in utero, neonatal skin is still immature at birth relative to adult and undergoes a maturation process extending to the first years of life. It is now established that the stratum corneum is thinner and dryer and that skin contains less natural moisturizing factors and lipids in newborns compared to children and adults. Moreover, it has been shown that skin surface area expansion is not linear throughout life and is peaking perinatally, suggesting that baby skin has a higher epidermal cellular turnover. Despite growing resources showing differences between adult and infant skin physiology, molecular and metabolic specificities of baby skin are still poorly understood. To address this critical knowledge gap, we performed an integrative transcriptomic and metabolomic study comparing human primary foreskin and abdominal keratinocytes from male babies and female adults, respectively. Based on state‐of‐the‐art integrative frameworks, our analyses revealed a major shift in the global energetic metabolism in baby foreskin keratinocytes compared to adult abdominal keratinocytes, highlighting increased amino acid metabolism and mitochondrial oxidative phosphorylation in baby cells to fuel the citric acid cycle, while showing glycolysis as the major cell energy source in adult cells.

Physiological Skin Characteristics of Infants and Children Compared to Those of Women.

IntroductionThere is little information regarding skin conditions in infants and children, especially with respect to age, anatomical sites, and seasonal variations. This study aimed to compare the physiological skin characteristics of infants and children with those of women.MethodsThis study involved skin measurements and a questionnaire-based survey assessing healthy infants and children aged one month to six years and four months (37 males and 48 females) and 15 healthy women in their twenties in the summer, and healthy infants and children aged two months to six years and seven months (34 males and 45 females) and 15 healthy women in their twenties in the winter. The physiological characteristics of the skin of infants and children were surveyed by age. We excluded infants and children with allergic symptoms at the time of measurement. There were 11 subjects with a history of atopic dermatitis.ResultsCompared with women, infants and children had lower stratum corneum water content and higher transepidermal water loss (TEWL) at most sites. Minimal sebum secretion was observed throughout the body in infants and children aged ≥1 year. The skin surface pH of infants and children was low throughout the body. The questionnaire revealed that skin issues were most common at the anterior neck and cubital fossa, where TEWL was markedly high. These results suggest that barrier function is less developed in the skin of infants and children than in the skin of women.ConclusionsThe physiological characteristics of skin varied depending on age, anatomical site, and season; hence, skincare guidance must be provided according to these factors.

Impact of diaper change frequency on preterm infants' vital sign stability and skin health: A RCT

BackgroundBundling nurse caregiving interventions are promoted to minimize infant stress. PurposeTo evaluate impact of bundled nursing care and diaper change frequency on vital sign stability and skin health of preterm infants born ≤32 weeks gestation. MethodStable preterm infants on a 3-hour feeding schedule were randomly assigned to 3- vs. 6-hour diaper changes. Diapers were changed prior to 6 h if stool was present. Direct observation of bundled care events (BCE) identify caregiving activities during each BCE. Skin pH, transepidermal water loss (TEWL), and neonatal skin condition scores (NSCS) were obtained. Vital sign data (HR, RR, O2 saturation) was downloaded from bedside monitors. ResultsForty-six infants contributed to 605 BCEs. BCEs lasted on average 28 min and included nine different activities (e.g., vital signs, feeding). Significant increases in heart rate during BCEs occurred in approximately half of the observations. Among observations with a diaper change increases in heart rate during diapering occurred in over 74% of observations Infants who were awake at the beginning of BCEs had 48% lower odds of having a change in heart rate than infants who were sleeping (p = .02). There were no group differences (3- vs. 6-hour diaper change) in skin health outcomes (TEWL, pH, NSCS). ConclusionReducing diaper change frequency without stool present should be considered to minimize caregiving stress in preterm infants. Additional research should evaluate the intrusiveness and clusters of activities that significantly impact physiologic stability to better individualize the timing of routine yet intrusive activities.Clinicaltrials.gov registry # NCT03370757

Interrelationships between Skin Structure, Function, and Microbiome of Pregnant Females and Their Newborns: Study Protocol for a Prospective Cohort Study.

Background Pregnancy leads to several skin changes, but evidence about structural and functional skin changes is scarce. Findings on skin structure and function in children in their first year reveal rapid skin maturation, but evidence indicates that in particular, water holding and transport mechanisms are different from adults. Important questions include whether maternal cutaneous properties predict infant skin condition, and if so, how. This is especially relevant for the skin's microbiome because it closely interacts with the host and is assumed to play a role in many skin diseases. Therefore, the study objective is to explore characteristics of skin and hair of pregnant women and their newborns during pregnancy and in the first six months after delivery and their associations. Methods The study has an observational longitudinal design. We are recruiting pregnant females between 18 and 45 years using advertisement campaigns in waiting areas of gynecologists and hospital's outpatient services. A final sample size of n = 100 women is the target. We perform noninvasive, standardized skin, hair, and skin microbiome measurements. We establish the baseline visit during pregnancy until at the latest four weeks before delivery. We schedule follow-up visits four weeks and six months after birth for mothers and their newborns. We will calculate descriptive statistical methods using frequencies and associations over time depending on scale levels of the measurements. Discussion. The majority of previous studies that have investigated infants' skin microbiome and its associations used cross-sectional designs and focused on selected characteristics in small samples. In our longitudinal study, we will characterize a broad range of individual and environmental characteristics of mothers and their newborns to evaluate interrelationships with skin parameters and their changes over time. Considering the combination of these multiple variables and levels will allow for a deeper understanding of the complex interrelationship of the newborn's skin maturation. This trial is registered with ClinicalTrials.gov (Identifier: NCT04759924).

Newborn Skin Care is the Basis for Prevention of Atopic Dermatitis Development

Healthy newborn skin care is challenging task. The basic principles of care should be taught to both medical staff and parents. This care is more crucial in children with atopic dermatitis who have abnormal skin acidity due to multifactorial exposure. Significant pH reduction leads to aggravation of the skin process that requires active therapeutic measures. The article presents guidelines for the first infant's skin cleaning, for conducting first and daily bathing, for using cleansing agents and daily care solutions to prevent skin acidity disorders and the development of atopic dermatitis.

Newborn infant skin gene expression: Remarkable differences versus adults.

At birth, human infants are poised to survive in harsh, hostile conditions. An understanding of the state of newborn skin development and maturation is key to the maintenance of health, optimum response to injury, healing and disease. The observational study collected full-thickness newborn skin samples from 27 infants at surgery and compared them to skin samples from 43 adult sites protected from ultraviolet radiation exposure, as the standard for stable, mature skin. Transcriptomics profiling and gene set enrichment analysis were performed. Statistical analysis established over 25,000 differentially regulated probe sets, representing 10,647 distinct genes, in infant skin compared to adult skin. Gene set enrichment analysis showed a significant increase in 143 biological processes (adjusted p < 0.01) in infant skin, versus adult skin samples, including extracellular matrix (ECM) organization, cell adhesion, collagen fibril organization and fatty acid metabolic process. ECM organization and ECM structure organization were the biological processes in infant skin with the lowest adjusted P-value. Genes involving epidermal development, immune function, cell differentiation, and hair cycle were overexpressed in adults, representing 101 significantly enriched biological processes (adjusted p < 0.01). The processes with the highest significant difference were skin and epidermal development, e.g., keratinocyte differentiation, keratinization and cornification intermediate filament cytoskeleton organization and hair cycle. Enriched Gene Ontology (GO) biological processes also involved immune function, including antigen processing and presentation. When compared to ultraviolet radiation-protected adult skin, our results provide essential insight into infant skin and its ability to support the newborn’s preparedness to survive and flourish, despite the infant’s new environment laden with microbes, high oxygen tension and potential irritants. This fundamental knowledge is expected to guide strategies to protect and preserve the features of unperturbed, young skin.

The Importance of Skincare for Neonates and Infants: An Algorithm.

The skin of neonates and infants undergoes a maturation process from birth and is susceptible to barrier disruption. The current algorithm follows a US-based consensus paper on skincare approaches using gentle cleansers and moisturizers in neonatal and healthy infant skin. This summary provides clinical information for pediatric dermatologists, dermatologists, and pediatric healthcare providers treating neonates and infants. The project used a modified Delphi process comprising virtual discussions followed by an online follow-up replacing the use of a questionnaire. During the virtual meeting, the systematic literature review results and a draft algorithm addressing over-the-counter skincare for neonates and infants with healthy skin were discussed and adopted using evidence coupled with the expert opinion and experience of the panel. The algorithm addresses three clinical signs: xerosis, erythema, and erosion/bulla. A growing body of evidence recognizes the benefits of ongoing daily use of non-alkaline cleansers and ceramides containing moisturizers to reduce inflammation and maintain a healthy skin barrier function. Diaper rash is common in infants presenting as erythema or, in more severe cases, skin erosion. Skin protection with a barrier cream and frequent diaper changes using disposable diapers resolves most cases; however, if the rash continuous despite appropriate care, rule out a candida infection. The current algorithm focuses on neonatal and infant healthy skin that can benefit from skincare. When applied from birth onwards, gentle cleansers and moisturizers containing barrier lipids help maintain the protective skin barrier. J Drugs Dermatol. 2021;20(11):1195-1205. doi:10.36849/JDD.6219.

Influence of silver/silver chloride electroless plating on the Shore hardness of polyurethane substrates for dry EEG electrodes

Abstract Dry electrodes enable a shorter preparation time for infant EEG. Since infant skin is more sensitive than adult skin, soft electrodes are required to reduce the mechanical stress for this sensitive skin. Thus, soft electrodes are crucial for eventual repetitive and long-term use like in neonatal intensive care units. A biocompatible polyurethane (PU) can be produced in low hardness resulting in a soft and flexible electrode substrate. Silver/silver chloride (Ag/AgCl) electroless plating provides a conductive, electrochemically stable coating but the process may alter the mechanical properties of the electrode substrate. In this study, we assess the hardness of PU material before and after Ag/AgCl plating. The test sample design for Shore hardness measurement is based on ISO 7619-1:2010. Sample production consists of a 3D print master model, silicone molding, PU casting, and finally electroless plating. UPX 8400-1 (Sika AG, Switzerland) is used for the sample substrates. Test samples are produced with 7 different Shore hardness (range A40-A95) and 14 samples (each hardness: 1 uncoated and 1 coated). The hardness measurements are carried out with a lever-operated test stand Shore hardness tester model with a digital hardness tester (TI-AC with HDA 100-1, KERN &amp;SOHN GmbH, Germany).. It is shown that there is a hardness increase (Shore A) due to Ag/AgCl coating with a grand average of 1.1±0.7 (p&lt;0.05). The largest increase of 2.1±0.2 is seen on the initial lowest Shore hardness sample (Shore hardness: 43.4±0.1). The absolute increase of hardness due to the Ag/AgCl coating decreases with increasing substrate hardness. It is concluded that there is no strong hardness increase of PU substrates due to Ag/AgCl plating. Therefore, the material is suitable as a soft electrode for repetitive and long-term use in infant applications.

Viability-Resolved Metagenomics Reveals Antagonistic Colonization Dynamics of Staphylococcus epidermidis Strains on Preterm Infant Skin.

ABSTRACTPreterm infants are at increased risk of infections caused by coagulase-negative staphylococci (CoNS) that colonize skin. Technical barriers in sequencing low-microbial-biomass skin swabs from preterm infants hinder attempts to gain a strain-level understanding of CoNS colonization dynamics within their developing skin microbiome. Here, the microbiome of five skin sites and available stool was studied from four preterm infants hospitalized over their first 2 months of life. We used propidium monoazide treatment of samples to enrich for the viable microbiome and metagenomic shotgun sequencing to resolve species and strains. The microbiome of different skin sites overlapped with each other, was dominated by the CoNS species Staphylococcus epidermidis and Staphylococcus capitis, and was distinct from stool. Species diversity on skin increased over time despite antibiotic exposure. Evidence of antagonism between the most common S. epidermidis strains, ST2 and ST59, included negative relationships for species correlation networks and in situ replication rates and that ST2 colonized skin earlier but was often replaced by ST59 over time. Experiments done with reference isolates showed that ST2 produced more biofilm than ST59 on plastic surfaces, which was reduced in mixed culture. We also discovered that a rare S. epidermidis strain, ST5, grew rapidly in stool in association with Stenotrophomonas maltophilia from a suspected episode of infection. Viability treatment of samples and moderate throughput shotgun sequencing provides strain-level information about CoNS colonization dynamics of preterm infant skin that ultimately might be exploited to prevent infections.IMPORTANCE The skin is a habitat for microbes that commonly infect preterm infants, but the use of sequencing for fine-scale study of the microbial communities of skin that develop in these infants has been limited by technical barriers. We treated skin swabs of preterm infants with a photoreactive dye that eliminates DNA from nonviable microbes and then sequenced the remaining DNA. We found that two strains of the most common species, Staphylococcus epidermidis, showed an antagonistic relationship on skin by cooccurring with different species, replicating fastest in different samples, and dominating skin sites at different times. Representatives of these strains also differed in their ability to stick to plastic surfaces—an important pathogenicity trait of this species. Our study shows the feasibility of gaining detailed information about strain colonization dynamics from this difficult-to-sequence body site of preterm infants, which might be used to guide novel approaches to prevent infections.

Case report: risk of skin necrosis related to injectable vancomycin in critically ill newborn infants

BackgroundVancomycin is commonly used as part of empiric antibiotic therapy in the preterm infants who develop signs and symptoms of infection. Although skin necrosis has been noted to occur following injection of vancomycin into a peripheral vein in an adult patient, this complication has not been previously described in a preterm infant.Case presentationWe report the case of a very low birthweight male infant born at 30 weeks gestational age who developed skin necrosis, most likely as a complication of vancomycin administration via a peripheral venous catheter. The immature skin and endothelial cells of this preterm infant may have increased the risk of drugs related venous and skin toxicity. In this case, assumption of a cumulative toxicity with other drugs administered concomitantly via the same catheter can’t be excluded.ConclusionsTo prevent the risk of skin damage, we advocate that in newborn infants, the administration of vancomycin should be limited to a concentration of < 2.5 mg/mL via a peripheral intravenous catheter if a central venous catheter is not available.

Deciphering the Role of Skin Surface Microbiome in Skin Health: An Integrative Multiomics Approach Reveals Three Distinct Metabolite‒Microbe Clusters

The advent of 16S RNA profiling and shotgun metagenomics has enabled a holistic approach to the study of the skin microbiome composition. Despite the interesting findings in this rapidly developing scientific area, the big question remains: What role does the microbiome play in skin physiology? To begin answering this question, we employed an integrative methodology for microbiome and metabolome analysis of skin surface samples collected from the volar forearm of healthy infants aged 3-6-months. Whereas the infant skin metabolome was dominated by amino acids, lipids, and xenobiotics, the primary phyla of the microbiome were Firmicutes, Actinobacteria, and Proteobacteria. Zooming in on the species level revealed a large contribution of commensals belonging to the Cutibacterium and Staphylococcus genera, including Cutibacterium acnes, Staphylococcus epidermidis, and S.aureus. This heterogeneity was further highlighted when combining the microbiome with metabolome data. Integrative analyses delineated the coexistence of three distinct metabolite‒microbe clusters: one dominated by Cutibacterium linked to hydrophobic elements of the skin barrier, one associating Staphylococcus genus with amino acids relevant to the water holding capacity and pH regulation of the skin surface, and one characterized by Streptococcus and independent of any particular metabolomic profile.

Pilot Feasibility, Reliability, and Validity Assessment of Infant Skin Carotenoids Measured by Reflection Spectroscopy as a Non-invasive Biomarker of Carotenoid Intake

Abstract Objectives Skin carotenoid measurement by reflection spectroscopy offers a rapid, non-invasive assessment of carotenoid intake and status. However, feasibility, reliability, and validity have not been established in infants. We hypothesize that skin carotenoid measurement of infants’ heels and fingers will be feasible, reliable, and valid. Methods Skin carotenoid score (SCS) was measured by a modified, portable reflection spectroscopy device (Veggie Meter) at the index finger and heel of the foot in infants at 4 (n = 21), 6 (n = 12), and 8 (n = 9) months of age. Infant plasma, milk formula, and mother's breast milk carotenoid concentrations were measured by HPLC, while infant carotenoid intake was estimated from 7-day food diaries and 3 × 24-hour parent recalls. Feasibility was assessed by time to acquire triplicate reads and reliability was assessed by the coefficient of variation (CV) of triplicates and the Pearson's correlation between mean heel and finger SCS. Validity was established in 4-month-olds if skin carotenoid scores were moderately correlated (r &amp;gt; 0.5) with breast milk carotenoid concentrations during exclusive milk-feeding (n = 16) and with infant plasma carotenoid concentrations (n = 11). Results Twenty-one infants (52% female) were enrolled (47% non-Hispanic white, 29% Hispanic white, 14% African American, and 10% Asian). Triplicate heel and finger SCSs were feasibly acquired in 56 ± 11 to 87 ± 32 seconds, respectively. Heel and finger SCS reliability was similar (mean CV range 18 ± 13 to 32 ± 22%), and mean within-subject heel and finger SCSs were highly correlated (r = 0.81, P = 1 × 10−5) in 4-month-olds. Finger and heel SCSs were valid correlates of total infant plasma carotenoid concentrations (r = 0.77, P = 0.006 and r = 0.66, P = 0.026, respectively). Finger SCS significantly correlated with breast milk carotenoids (r = 0.66, P = 0.006), while heel SCS non-significantly correlated (r = 0.40, P = 0.13). Conclusions This pilot suggests that infant skin carotenoids can be feasibly measured by reflection spectroscopy and that finger SCSs are correlated with both infant plasma carotenoid concentrations and maternal breast milk carotenoid concentrations. Skin carotenoid measurement should be further investigated to facilitate the assessment of infant dietary intake and health outcomes. Funding Sources Texas Children's Hospital, USDA-ARS.

Improving newborn skin health: Effects of diaper care regimens on skin pH and erythema.

Background/ObjectiveNewborn infant skin is functional but immature, and diapering products can play a significant role in infant diapered skin health. Previous work demonstrated a regimen consisting of a diaper with an emollient and apertures on the inner liner (topsheet) with an acidic, pH‐buffered wipe (Regimen A) lowered newborn skin pH and reduced the enzymatic activity on skin post‐stool cleaning versus a regimen without these features (Regimen B). This study extends these findings to determine the impact of Regimen A on diaper area erythema severity over a 2‐week use period.MethodsThis IRB‐approved, blinded, randomized, crossover study enrolled newborn infants >7 days and ≤8 weeks. Participants exclusively used two unique diaper and wipe combinations, Regimen A and Regimen B (non‐emollient, non‐aperture containing topsheet and wipe with limited buffering capacity), each for 14 days and preceded by a 3‐day washout regimen.ResultsDiapered skin pH was reduced during Regimen A use to values similar to that of a non‐diapered control site (chest), while use of Regimen B was associated with a more alkaline skin pH. Regimen A resulted in significantly fewer severe erythema episodes. At the site of highest erythema, the perianal space, the average erythema score was significantly lower and more newborns were free of erythema while using Regimen A vs. Regimen B (P < .05).ConclusionsThese findings demonstrate that diapering products can have a significant impact on newborn skin. They reinforce the need to support the physiological normalization of skin pH and protection from skin irritation and damage.

Part 2: a qualitative description of participation in an eight-week infant skin integrity study

Background This is the second paper in a two-part series; the first paper was published in volume 29, issue 4 of the British Journal of Midwifery. The qualitative phase of the Baby Skin Integrity Comparison Survey (BaSICS) study was designed to address a dearth of information about research recruitment and retention, and how mothers make decisions about neonatal skincare. Aims The aim of the qualitative phase of the BaSICS study was to explore participants’ experience of participating in the research and how this interrelated with the experience of newborn skincare. Methods Semi-structured, face-to-face or telephone interviews were used to collect data. Interviews were transcribed verbatim. Data analysis used both software and manual methods. Findings Motivation included both altruism and personal benefits. The bespoke smartphone application was a convenient and easy tool for data collection, and being afforded full responsibility for observing and recording infant skin condition increased mothers' awareness of skin changes. Family, friends and the internet were the most commonly used sources of information about baby skincare. Conclusion The qualitative interview component of the BaSICS study provided information that could not have been deduced from the daily survey and final questionnaire alone. This provides valuable guidance for future research in the field of infant skincare.

417 The molecular features of normal and atopic dermatitis skin in infants, children, adolescents and adults

417 The molecular features of normal and atopic dermatitis skin in infants, children, adolescents and adults

Part 1: a qualitative description of participation in an eight-week infant skin integrity study

Background The qualitative phase of the Baby Skin Integrity Comparison Survey (BaSICS) study was designed to address a dearth of information about research recruitment and retention, and how mothers make decisions about neonatal skincare. Aims The aim of the qualitative phase of the BaSICS study was to explore participants' experience of participating in the research and how this interrelated with the experience of newborn skincare. Methods Semi-structured, face-to-face or telephonic interviews were used to collect data. Interviews were transcribed verbatim. Data analysis used both software and manual methods. Findings Motivation included both altruism and personal benefits. The bespoke smartphone application was a convenient and easy tool for data collection, and being afforded full responsibility for observing and recording infant skin condition increased mothers' awareness of skin changes. Family, friends and the internet were the most commonly used sources of information about baby skincare. Conclusion The qualitative interview component of the BaSICS study provided information that could not have been deduced from the daily survey and final questionnaire alone. This provides valuable guidance for future research in the field of infant skincare.

Diaper dermatitis: differential diagnosis and prevention issues

The skin of newborns and infants is characterized by structural and functional immaturity. Diaper dermatitis is one of the most common skin conditions in this age period. This condition has a complex and multifactorial etiology. The interaction of several causes, including high humidity under the diaper, skin maceration, and prolonged contact with irritants, leads to destruction of the immature epidermal barrier, microbial invasion, and inflammation. Diaper dermatitis should be differentiated from allergic contact dermatitis, candidiasis, atopic dermatitis, seborrheic dermatitis, psoriasis. Effective measures to prevent diaper dermatitis are to keep the skin dry, reduce friction, limit the time of contact with urine and feces, as well as the topical application of protective products. Today, of all the disposable diapers on the market, the high quality disposable diapers developed and produced by the Japanese company KAO Corporation are proven effective in preventing diaper dermatitis.