Skin Care and Intervention
Atopic dermatitis (AD) is a chronic inflammatory skin disorder and also recognized as one of the allergic diseases that has increased within a half century when rapid environmental and lifestyle changes have occurred as a background. Most randomized contr
- PDF / 244,329 Bytes
- 10 Pages / 439.37 x 666.142 pts Page_size
- 28 Downloads / 213 Views
23
Yukihiro Ohya
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder and also recognized as one of the allergic diseases that has increased within a half century when rapid environmental and lifestyle changes have occurred as a background. Most randomized controlled trials (RCTs) for high-risk infants with an intention of allergen elimination failed to prevent the onset of AD. Although some RCTs that administered probiotics during both prenatal and postnatal periods showed preventive effects on AD, a meta-analysis showed that probiotics were not effective as a viable treatment of established AD. Now, skin barrier dysfunction is recognized as a key initiator to progress AD, and the hypothesis that improving the properties of skin barrier early in life by applying emollients might prevent or delay the onset of AD was verified by two independent RCTs. One was a multicenter RCT carried out in the United States (USA) and United Kingdom (UK) applying emollients from birth to 6 months resulting in 50% reduction of the onset of AD. The other was a single-center RCT carried out in Japan applying an emollient from birth to 8 months resulting in 34% reduction of the onset. Skin care seems to be important not only for the prevention and treatment of AD but also for prevention of food allergy and other allergic diseases. In the future, larger-scale RCTs are expected to confirm preventive effect of skin care with emollients on AD and other allergic diseases in later life. Keywords
Emollients • Food allergy • Prevention • RCT • Skin care
Y. Ohya Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagayaku, Tokyo 157-8535, Japan e-mail: [email protected] © Springer Nature Singapore Pte Ltd. 2018 I. Katayama et al. (eds.), Evolution of Atopic Dermatitis in the 21st Century, https://doi.org/10.1007/978-981-10-5541-6_23
301
302
Y. Ohya
23.1 Preventive Intervention by Allergen Avoidance Atopic dermatitis (AD) is a chronic inflammatory skin disorder and also recognized as one of the representative allergic disorders that has been increased worldwidely starting from industrialized countries in a half century. Rapid environmental and lifestyle changes caused by economic growth in advanced countries might have altered immunological diathesis from birth and increased prevalence of allergic diseases including AD. As a general concept of allergy, onset of allergic diseases was thought to be preceded by allergen sensitization. An old randomized controlled trial (RCT) carried out three decades ago showed successful prevention of eczema and wheezing in the first year of life by multiple allergen avoidance measures from birth [1]; however, most of the larger-scale RCTs done later with an intention of eliminating environmental allergens could not reproduce successful outcomes [2–4]. Although a large proportion of patients with infantile AD are sensitized to any food allergen, maternal-specific food allergen avoidance during pregnancy and/or l
Data Loading...
