Use Of Cream Research Articles

Topical therapy of dermatoses in children with complex localizations

The skin of children has its own anatomical and physiological characteristics, the epidermis is much thinner than in adults, the layers of the dermis and basement membrane are poorly developed and differentiated, the rate of transepidermal water loss is increased and the level of natural moisturizing factor (NMF) is reduced. Such a structure of the skin predisposes to a violation of its barrier function, contributes to the occurrence of skin diseases, provides an increased resorptive capacity of the skin and requires special attention when prescribing external therapy. The use of high-quality emollients is an important part of the basic treatment of chronic dermatoses and has its own characteristics in childhood. The use of emollients prevents the development of exacerbations and reduces the need for anti-inflammatory topical drugs. With the localization of the inflammatory process on the face, neck, genitals and large folds, it is necessary to give preference to short courses of topical glucocorticosteroids (THCS) with sufficient anti-inflammatory activity, rapid onset of action, minimal side effects. Given the high risk of side effects in children in these areas of the skin, strong fluorinated THCS, high-potency THCS, and the use of THCS under occlusive dressings are not recommended. The Russian experience of using 0.1% methylprednisolone aceponate in children of various age groups in the treatment of allergic dermatoses, including those with localization in sensitive areas, has shown good efficacy, tolerance and the absence of side effects. he article presents own clinical observations of the effectiveness of the use of combination therapy: an emollient agent - a special cream with physiological lipids omega 3-6-9 and cream methylprednisolone aceponate (with ceramides in the base) in the treatment of skin diseases in children with an emphasis on complex localizations, such as face, folds, genital area.

Preventing skin tears among older adults in general practice

In this article, Sarah Jane Palmer discusses the importance of the prevention of skin tears and the role practice nurses can play Skin tears can present a complex and chronic problem for an older patient with fragile skin, and can be very disabling, reducing quality of life dramatically in some cases. The right care is essential from all members of the wider team caring for older patients, in order to identify risk factors for skin tears, as well as formulating a care plan of prevention that relates to these risk factors. Good skin care is essential, as well as patient education, and identifying ongoing issues with the patient's health that present a factor to consider when caring for them, such as mobility issues. Self-care should be encouraged where possible, and the correct use and choice of emollients that are pH balanced is crucial. By preventing skin tears we not only give the patient a far better quality of life, but we also reduce the need for very limited NHS resources.

The Psychosocial Burden Associated With and Effective Treatment Approach for Atopic Dermatitis: A Literature Review.

Atopic Dermatitis (AD) is chronic relapsing inflammatory skin condition that is marked by a high degree of psychosocial and emotional burden in both pediatric and adult populations. In addition to physical symptoms of pruritus and visible skin lesions, AD is associated with decreased quality of life, psychosocial stress, low self-esteem, low work productivity, irritability, decreased physical intimacy, disturbed sleep, depression, anxiety, and suicidal ideation. Since AD is a chronic disease, treatment includes achieving long-term disease control for noticeable symptom reduction. For mild symptoms of AD, dermatologists should recommend basic skin care maintenance, use of emollients, and avoidance of triggers. If that fails, treatment with TCS, TCIs, phototherapy, and systemic immunosuppressants is generally advised. Dupilumab is the most effective immunomodulating therapy available for treating moderate-to-severe symptoms associated with AD, including itching, poor sleep quality, anxiety, and depression. Topical agents and phototherapy have been shown to be less efficacious and more suited for achieving remission in mild-to-moderate disease. Overall, the treatment of emotional and psychosocial factors linked with moderate to severe AD remains challenging and calls for more research. The purpose of our review is to explore the extent and severity of psychosocial and emotional burden that patients with atopic dermatitis may potentially experience, and list up-to-date treatment choices available for symptoms associated with AD. J Drugs Dermatol. 2021;20(10): 1046-1050.doi:10.36849/JDD.6328.

Effects of an emollient application on newborn skin from birth for prevention of atopic dermatitis: a randomized controlled study in Thai neonates.

Enhancing the skin barrier in high-risk neonates by daily use of emollients during infancy might prevent atopic dermatitis (AD); however, there have been no studies on this topic in a country with a tropical climate. Climate may affect the results of the use of emollients in neonates for AD prevention and possible adverse cutaneous eruptions. To test the hypothesis that emollients used during infancy can prevent AD in high-risk neonates in a country with a tropical climate and to evaluate other possible adverse cutaneous eruptions in this population. This was a randomized controlled study in a tertiary care hospital with a 6 months' duration. Eligible neonates were randomly assigned to receive either emollient and skincare advice (emollient group) or skincare advice only (control group). The intervention was started within 3 weeks of birth. The emollient group showed a significant reduction in the cumulative incidence of AD at 6 months (relative risk, 0.39; 95% CI 0.24-0.64; P < 0.001). The emollient group started to develop AD later and had a lower severity of AD than the control group (P < 0.001). Compared to moderate adherence, low adherence to emollient application was associated with a lower number of patients with AD (P = 0.008). Potentially emollient-related cutaneous eruptions, such as miliaria, and suspected cutaneous infections, such as impetigo, were more frequent in the emollient group. Exposure to passive smoking showed a significant difference in the development of AD compared to non-smoking exposure, both during pregnancy and after the child's birth (P < 0.001). This study suggests that, in a tropical climate, emollient applied to the skin of at-risk neonates on an 'as needed' basis (depending on environmental factors, level of skin dryness), rather than on a 'daily basis', can provide a substantial benefit for AD prevention.

Place of anti-histamine in therapy of itching skin of children

Itching is a frequent condition at a doctor's appointment of any speciality. A quarter of patients complain of itching of various etiology. In real practice, H1-histamine receptor blockers are prescribed for itching in the first place. The article considers a complex of diseases accompanied by itching of the skin.&#x0D; The itching is a reflex. The classification contains a lot of forms:local and systemic; prurigogenic, neuropathic and psychogenic. Itching has no stable pathogenesis and can be provoked by various conditions. The main types of sensory neurons are opiate and 5-HT-receptors. Urticaria and food allergy are associated with irritation of the skin receptors with histamine and other mast cell mediators. In these cases, antihistamines are the drug of choice regardless of the aetiology of urticaria.&#x0D; In atopic dermatitis, the itching has a complex aetiology: transepidermal water loss, chronic inflammation of the skin with the participation of many cells, secondary hyperinervation of the skin with the formation of a pathological activity focus in the brain. This requires a comprehensive approach to therapy. Xerosisis overcome by the use of emollients and rational skincare. The presence of exacerbation makes it necessary to prescribe topical steroids or calcineurin inhibitors for an acute period s. In the case of the addition of psychogenic itching, antiserotonin 5-HT-blockers drugs, hydroxyzine can be considered. H1-receptor blockers do not affect the intensity of skin lesions in dermatitis, but some molecules can reduce the itching.&#x0D; Quifenadine is the antihistamine dug of the second generation. It can be used in the treatment of allergic itching dermatoses. The rapid onset of action allows you to reach the maximum concentration in the tissues within 1 hour, activate monooxidase and neutralise histamine in the tissue. Quifenadine absence a sedative effect and no respiratory depression.Instructions for the use of the medicinal product can increase the dose by 1,5–2 times.It makes the drug useful for the treatment of manifestations of food allergies and urticaria. The dual antihistamine and antiserotonin action allow the successful use of quifenadine in the acute period of atopic dermatitis, especially provoked by contact with an allergen.

Effect of sunflower seed oil emollient therapy on newborn infant survival in Uttar Pradesh, India: A community-based, cluster randomized, open-label controlled trial.

Hospitalized preterm infants with compromised skin barrier function treated topically with sunflower seed oil (SSO) have shown reductions in sepsis and neonatal mortality rate (NMR). Mustard oil and products commonly used in high-mortality settings may possibly harm skin barrier integrity and enhance risk of infection and mortality in newborn infants. We hypothesized that SSO therapy may reduce NMR in such settings. This was a population-based, cluster randomized, controlled trial in 276 clusters in rural Uttar Pradesh, India. All newborn infants identified through population-based surveillance in the study clusters within 7 days of delivery were enrolled from November 2014 to October 2016. Exclusive, 3 times daily, gentle applications of 10 ml of SSO to newborn infants by families throughout the neonatal period were recommended in intervention clusters (n = 138 clusters); infants in comparison clusters (n = 138 clusters) received usual care, such as massage practice typically with mustard oil. Primary analysis was by intention-to-treat with NMR and post-24-hour NMR as the primary outcomes. Secondary analysis included per-protocol analysis and subgroup analyses for NMR. Regression analysis was adjusted for caste, first-visit weight, delivery attendant, gravidity, maternal age, maternal education, sex of the infant, and multiple births. We enrolled 13,478 (52.2% male, mean weight: 2,575.0 grams ± standard deviation [SD] 521.0) and 13,109 (52.0% male, mean weight: 2,607.0 grams ± SD 509.0) newborn infants in the intervention and comparison clusters, respectively. We found no overall difference in NMR in the intervention versus the comparison clusters [adjusted odds ratio (aOR) 0.96, 95% confidence interval (CI) 0.84 to 1.11, p = 0.61]. Acceptance of SSO in the intervention arm was high at 89.3%, but adherence to exclusive applications of SSO was 30.4%. Per-protocol analysis showed a significant 58% (95% CI 42% to 69%, p < 0.01) reduction in mortality among infants in the intervention group who were treated exclusively with SSO as intended versus infants in the comparison group who received exclusive applications of mustard oil. A significant 52% (95% CI 12% to 74%, p = 0.02) reduction in NMR was observed in the subgroup of infants weighing ≤1,500 g (n = 589); there were no statistically significant differences in other prespecified subgroup comparisons by low birth weight (LBW), birthplace, and wealth. No severe adverse events (SAEs) were attributable to the intervention. The study was limited by inability to mask allocation to study workers or participants and by measurement of emollient use based on caregiver responses and not actual observation. In this trial, we observed that promotion of SSO therapy universally for all newborn infants was not effective in reducing NMR. However, this result may not necessarily establish equivalence between SSO and mustard oil massage in light of our secondary findings. Mortality reduction in the subgroup of infants ≤1,500 g was consistent with previous hospital-based efficacy studies, potentially extending the applicability of emollient therapy in very low-birth-weight (VLBW) infants along the facility-community continuum. Further research is recommended to develop and evaluate therapeutic regimens and continuum of care delivery strategies for emollient therapy for newborn infants at highest risk of compromised skin barrier function. ISRCTN Registry ISRCTN38965585 and Clinical Trials Registry-India (CTRI/2014/12/005282) with WHO UTN # U1111-1158-4665.

Dermatitis in Sun-Exposed Areas in a 4-year-old Boy

Dermatitis in Sun-Exposed Areas in a 4-year-old Boy

An Overview on Contact Dermatitis: Simple Review

Contact dermatitis (CD) is usually the result of cumulative exposure to sensitive irritants and accounts for 80% of all contact dermatitis cases. ICD can coexist with atopic dermatitis (AD) and allergic contact dermatitis (ACD). Patients with Alzheimer's disease and ACD may also have a lower infection threshold for ICD. Therefore, it must stand out from EA and CAD lesions. People with ICD have experienced uncontrolled tingling and burning sensations. Itching is typically manifested in patients with AD and ACD. Compared with AD and ACD, ICD lesions are usually well described. The prognosis of ICD is based on the exclusion method. Monitor patients to rule out type 1 and type 4 hypersensitivity reactions. A negative result indicates the prognosis of ICD. Management includes identifying and avoiding irritants through the normal use of emollients. Although ICD is older, it is not uncommon in some majors, and genetics and environment play a vital role in its development.

Using emollients to promote safe and effective skin care for patients

The role of emollients in the treatment of dry skin conditions is often underestimated. Emollients promote optimal skin health and prevent skin breakdown, and their use can improve patients' quality of life. However, when advising patients on emollient use, nurses must consider the challenges involved such as the extensive choice of products and the necessity of regular applications. This article explores the development of dry skin conditions and outlines the role of emollients in maintaining the skin barrier function. The author also details optimal nursing practice in areas such as emollient prescribing and application.

25442 Relationship between topical corticosteroid utilization and atopic dermatitis severity and burden: A population-based cross-sectional study

Treatment of atopic dermatitis (AD) includes the use of emollients, topical corticosteroids (TCS), topical calcineurin inhibitors, phototherapy, and systemic therapy in severe or persistent cases. We analyzed the cumulative amount of TCS use over a 12-month period among a cohort of Danish adults with AD. Data were presented as the total TCS anti-inflammatory activity (TTAA) exposure. To calculate the TTAA exposure, all TCS prescribed over the previous 12 months were converted into equipotent doses of grams (g) of momethasone based on their anti-inflammatory potency. We included 2341 AD patients. Of these, 11 patients were currently asymptomatic (PO-SCORAD = 0), 952 had mild AD (PO-SCORAD >0 and 50). There was a strong female predominance (68.2-73.4%), and the median age was 45.1 (IQR 35.6-55.2) years. We observed a considerable undertreatment; 65.3% of the total population did not receive any prescription topical or systemic treatment, and 31.4% of severe AD patients were treated with topical therapy alone. Among those filling at least one TCS prescription within the last 12 months, the overall TTAA was 216 g. The highest use was seen among those that had severe AD (434 g, interquartile range [IQR] 162 g-1296 g), and with current involvement of the face (555 g, IQR 300 g-1545 g) or hands (518 g, IQR 289 g-2086 g). In conclusion, while some patient subgroups displayed a high TCS use, including those with severe AD with involvement of the hands or face, many patients were undertreated even though they presented with severe symptoms.

Evidence Based Skin Care in Preterm Neonates- A Short Review

Preterm neonates are the neonates born alive before completion of 37 weeks of gestation. Prematurity is the real threat for survival of these neonates, especially those who are very-preterm (less than 32 weeks). In developing countries due to lack of basic care such as maintenance of warm chain, breast feeding support, infection control and scarcity of resources to tackle respiratory difficulties; the mortality in preterm infants is very high. Good skin care is a critical component of the basic neonatal care, that can directly reduce complications of prematurity as well address issues arising during the handling of these preterm infants such as injuries due to adhesives or devices, skin dryness, the use of skin emollients and disinfectants etc. In contemporary era, evidence-based practices are the need of hour to guide clinical practice. There are limited research articles dealing with skin care in preterm neonates that offer strong recommendations for skin care modalities. In this short review, the authors have compiled the recent evidences to address various issues related to skin care in very preterm neonates. In this article the evidences related to bathing practices in preterm infants, and the use of disinfectants and emollients for premature skin care has been discussed; besides making general recommendation related to skin care in preterm infants. Keywords: Preterm, skin care, emollients, disinfectant, neonate, prematurity, premature skin.

Duration of topical therapy in the maintenance of atopic dermatitis remission in paediatric age.

BACKGROUND Topical corticosteroids (TCS) are the first-choice treatment for atopic dermatitis (AD) flares. In literature there are clear advice about the potency, dosage and frequency of application of TCS, but there are no shared indications about duration of the treatment during a flare. The aim of the study is to demonstrate if the use of a steroid cream for less than or 5 days, could be equal or more effective than the application for more than 5 days during a flare episode, in keeping a remission state of AD. METHODS The study population (N.=122) was selected according to the following inclusion criteria: at least one specialist allergological and dermatological examination in the period November 2015 to February 2017, age between 1 and 11 years; mild to moderate atopic dermatitis. All patients were given a standardized telephone questionnaire, which concerns on multiple aspects: parents' self-reported perceptions of the severity of their child's condition; actual use of emollients, moisturizers and steroid creams; number of consecutive days of using of topical steroid cream during an exacerbation of AD; average number of AD exacerbations per month in the last year; total number of AD exacerbations in the last year. RESULTS Data from 96 patients was examined. We classified three groups of patients from data collected: group 1 (N.=40): use of TCS for ≤5 consecutive days during an exacerbation event of AD; group 2 (N.=12): use of TCS for >5 consecutive days during an exacerbation event of AD; group 3 (N.=44): nonuse of TCS or use of TCS with a different posology. We found a further subgroup in group 3 (3a, N.=27) with patients using only emollient creme in AD management. In group 1, 27 patients (67.5%) did not show a good AD control; on the contrary, 13 patients (27.5%) reported a good AD control. In group 2, 4 patients (25%) did not show a good AD control; on the contrary, 8 patients (75%) reported a good AD control. By comparing the data obtained in the presence of good AD control, the difference between the percentages obtained was found to be statistically significant (P=0.034). CONCLUSIONS The results obtained show that a therapeutic pattern based on the use of TCS for a duration of more than 5 consecutive days during an episode of AD exacerbation is more efficient than the proposed alternative therapeutic scheme in the maintenance of AD remission.

Prevalence of diabetic foot ulcers and their associated factors in patients from public hospitals in manaus-am

AimThe purpose of this study was to identify and analyze the prevalence of diabetic foot ulcers (DFU) as well as associating factors in the city of Manaus, Amazonas State, Brazil. MethodsThis was an observational, epidemiological, cross-sectional study, point prevalence, with 229 adults’ diabetic inpatients from seven hospitals. Written signed consent was obtained from all participants or their legal representative if they had a cognitive impairment. Sociodemographic and clinical data were collected through interviews and medical records. Each participant was examined by the research team to evaluate for foot deformity. ResultsOf the 229 patients diagnosed with DM, 60 presented DFU, resulting in a prevalence of 26.2 %. The logistic regression model that included all variables with a significance level of 5 % (p ≤ 0.05) shows: Patients with PAD were more likely to have DFU (OR = 2956; p = 0,01). The use of emollients (OR = 0.097; p < 0.001) and anticoagulants (OR = 0.149; p = 0.002) were related to reduced likelihood for developing DFU. ConclusionThis study contributes to a better understanding of DFU epidemiology in hospitalized patients, as well as the factors associated with them. The results are important for nursing in order to develop early prevention and intervention strategies.

Study of Skin Barrier Function in Psoriasis: The Impact of Emollients.

Psoriasis is a chronic multi-systemic inflammatory disease that affects the epidermal barrier. Emollients can be used as a coadjutant therapy for psoriasis management, but little is known about how the epidermal barrier function in psoriatic patients is modified by moisturizers. The objective of this study is to evaluate the effect of Vaseline jelly and a water-based formula on epidermal barrier function in psoriatic patients. Thirty-one patients with plaque-type psoriasis and thirty-one gender and age-matched healthy controls were enrolled in the study. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity and the erythema index were measured using non-invasive tools before and after applying Vaseline jelly and a water-based formula. TEWL was higher in psoriatic plaques than uninvolved psoriatic skin (13.23 vs. 8.54 g·m−2·h−1; p < 0.001). SCH was lower in psoriatic plaques than uninvolved psoriatic skin and healthy skin (13.44 vs. 30.55 vs. 30.90 arbitrary units (AU), p < 0.001). In psoriatic plaques, TEWL decreased by 5.59 g·m−2·h−1 (p = 0.001) after applying Vaseline Jelly, while it increased by 3.60 g·m−2·h−1 (p = 0.006) after applying the water-based formula. SCH increased by 9.44 AU after applying the water-based formula (p = 0.003). The use of emollients may improve epidermal barrier function in psoriatic patients. TEWL is decreased by using Vaseline, and SCH is increased by using the water-based formula.

Combined pathogenetic therapy of allergic dermatoses in children

Allergodermatoses make up the majority of allergic skin diseases in childhood, have a recurrent course and significantly disrupt the quality of life of patients and their families. The constant use of emollients, allowing to lengthen periods of remission and reduce the need for topical drugs, is associated with defects in the skin barrier function. Treatment with topical glucocorticosteroids (TCS) and topical calcineurin inhibitors (TCI), which are the basis of pharmacotherapy, should be carried out differentially, taking into account the localization, stage and activity of the inflammatory process, the area of the lesion, the age of the child and the multifactorial genesis of the disease. The basic principles of rational local therapy include the choice of the degree of activity of the drug, its concentration, dosage form, dosage frequency, duration of use to obtain a therapeutic effect and minimize side effects. In case of severe exacerbation and localization of inflammatory elements on the body and limbs in children, it is necessary to start treatment with class 2–3 THCS. When the process is localized on the face and other sensitive areas of the skin (neck and large folds), it is recommended to use class 7 TCS or give preference to TCI. The duration of a continuous course of TCS therapy in children depends on the severity of the exacerbation and should not exceed 2 weeks. The most effective way to reduce the course steroid load and avoid side effects is the early and correct use of TCS during an exacerbation. The advantages of TCI in comparison with TCS are the low incidence of side effects, the absence of contraindications for use on sensitive skin areas, and the possibility of longer use. The article contains Russian and foreign literature data on the use of THCS and TEC in the treatment of allegodermatosis in children and our own clinical observations of the effectiveness of the use of combination therapy: Comfoderm K cream (methylprednisolone aceponate with ceramides in the base), 0.03% tacrolimus ointment and emollient means - special cream Sensoderm with physiological lipids omega 3–6–9.

Increased prevalence of irritant hand eczema in health care workers in a dermatological clinic due to increased hygiene measures during the SARS-CoV-2 pandemic.

BackgroundHand hygiene measures in the general population and in health care workers have increased considerably since the outbreak of the COVID-19 pandemic.ObjectivesTo investigate the prevalence and symptoms of hand eczema, as well as hygiene measures and concepts of care, in German health care workers.Materials & MethodsThis was an observational questionnaire study to investigate hygiene and skin care habits, as well as the prevalence and symptoms of hand eczema in 66 nurses and doctors of our dermatology department before and during the SARS-CoV-2 pandemic.ResultsHand washing and hand disinfection procedures increased significantly during the COVID-19 pandemic. Self-diagnosed hand eczema was reported by 33% of the participants, with a median duration of 14 days. The majority of staff currently affected by hand eczema were free of eczema a month previously (82%) and would treat their skin condition with emollients (77%). Erythema, scaling, burning and fissures were reported by 66.1% of the participants and were classified as predominant signs of toxic-irritant hand dermatitis rather than contact allergy.ConclusionOverall, the SARS-CoV-2 pandemic has led to a significant increase in the incidence of signs of irritant hand eczema despite intensified emollient use as a preventive measure. Awareness of the prevalence of hand eczema in health care workers in Germany during the COVID-19 pandemic should be raised, and preventive measures should be intensified.

Atopic dermatitis – Recent advances in the management

Atopic dermatitis (AD) is a chronic skin disorder resulting from complex interactions between skin barrier defects and a dysregulated immune system, marked by activation of multiple T cell subsets at different stages of the disease. Until recently, the management of AD rested mainly on the judicious use of emollients, topical steroids, and topical calcineurin inhibitors in the majority of patients and systemic immunosuppressants were advocated in severely diseased. However, in the last few years, new therapeutic strategies were designed and developed to target the various steps in the chain of molecular events that lead to the AD phenotype. This review article will focus on the recent advances in the management of AD.

Synthetic hair extensions causing irritant contact dermatitis in patients with a history of atopy: A report of 10 cases.

We present a case series of 10, atopic, African women who developed irritant contact dermatitis (ICD) from synthetic hair extensions. Ten consecutive African female patients who presented with a pruritic cutaneous eruption on the neck over a period of 2 years are described. Patients underwent skin patch testing using both standard and hair commercial patch test panels and samples of their own hair extensions. Hair care products were not tested. All 10 patients used synthetic hair extensions. A strong history of atopy was documented for all the patients and examination was significant for eczematous, lichenified plaques at the location of contact with the free end of the hair extension. Patch test results yielded no relevant reactivity and a diagnosis of ICD was made for all patients. The lesions resolved completely on removal of the hair extensions and the use of topical steroids and emollients, dependent on eczema severity. Artificial hair extensions should be considered as a potential irritant, resulting in ICD. Patients with a history of atopy are at risk of developing ICD from synthetic hair extensions.

Evaluating the communication within fire and rescue services and the NHS on the fire risk of emollients in accordance of the MHRA safety update

SUMMARYThe Medicines and Healthcare products Regulatory Agency update in 2018 reported 50 fatal fires linked with emollient use. It detailed the fire risk and new advice aimed at fire service and health care professionals in reporting of such fire incidents and educating the public on safer use of emollients. This study investigates how this has been communicated internally and publicly, with 52 Fire and Rescue Services (FRSs) websites and, 191 Clinical Commissioning Groups (CCGs), and 21 Local Health Boards (LHBs) formularies accessed. A Freedom of Information Request (FOIR) was also made, giving further details of implementations. Our study revealed that 63% of FRSs, 32% of CCGs and, 72% of LHBs gave no safety advice within their website or formularies. Of the 37% of FRSs and 68% of CCGs that did, only 5% and 4% were sufficiently up to date. 27% of FRSs and 28% of CCGs/LHBs revealed that they had no warning/advice internally in their FOIR responses and 25% of FRSs and, 35% of CCG/LHBs had not disseminated advice on using emollient safely to the public. We suggest improvements in safety campaigns using a multiagency and national approach and recommend organizations to educate professionals to improve reporting and effective dissemination.

Role of emollients in the prevention of skin diseases in young children

Epidermis plays an important role in protecting the body from negative environmental influences. The horny layer plays a special role in carrying out these functions. Skin defense mechanisms are multistage and include 5 protective barriers responsible for maintaining the integrity and performing the main functions of the skin. The first one is a microbial barrier – determined by commensal flora which prevents contamination of pathogenic microorganisms; the second one is a physical barrier preventing mechanical skin damage, penetration of allergens and microorganisms; the third one is a chemical barrier achieved by forming pH and components of natural moisturizing factor as well as epidermal lipids; the fourth one – immune barrier – Langerhans cells, tissue basophils, lymphocytes etc.;the fifth is the neurosensory barrier – numerous nerve endings transmitting signals of skin integrity damage and controlling metabolic processes and homeostasis maintenance. Epidermal barrier of newborns and infants is imperfect and differs in its structure and functional activity from that of adults. Children’s skin is prone to excessive dryness, irritation, allergic reactions and inflammation. For young children, it is very important to minimize the risk of these manifestations. Individual selection and use of emollients in the basic care of infants promotes the functional stability of five protective «frontiers» of the epidermal barrier: prevents skin damage when exposed to unfavorable environmental factors, reduces TEWL, supports the normal microbiome, has antipruritic and anti-inflammatory action. Modern emollients restore the hydrolipidic layer of the epidermis and prevent the development of dermatitis and skin infection in children. An important role when choosing an emollient is played by its texture, which can be represented by a lotion, cream, balm, ointment. Chemically, creams, lotions and balms are emulsions, i.e. they consist of two immiscible components – fat (oil) and water. In this case, one of the components is in the other in the form of tiny droplets. Most skin diseases faced by young children are related to the integrity of the epidermis, which is why daily care should be primarily focused on protecting the skin barrier