1
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Mutton T, Bocchi C, Gaban A, Marzola E, Schettini N, Borghi A. Hickam versus Ockham: atopic dermatitis and bullous pemphigoid or pemphigoid nodularis? Dupilumab solves the problem. Ital J Dermatol Venerol 2024; 159:361-363. [PMID: 38695597 DOI: 10.23736/s2784-8671.24.07741-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Affiliation(s)
- Talita Mutton
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy -
| | - Chiara Bocchi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alba Gaban
- Section of Anatomical Pathology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Elisa Marzola
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Natale Schettini
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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2
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Vassilopoulou E, Comotti A, Douladiris N, Konstantinou GΝ, Zuberbier T, Alberti I, Agostoni C, Berni Canani R, Bocsan IC, Corsello A, De Cosmi V, Feketea G, Laitinen K, Mazzocchi A, Monzani NA, Papadopoulos NG, Peroni DG, Pitsios C, Roth-Walter F, Skypala I, Tsabouri S, Baldeh AK, O'Mahony L, Venter C, Milani GP. A systematic review and meta-analysis of nutritional and dietary interventions in randomized controlled trials for skin symptoms in children with atopic dermatitis and without food allergy: An EAACI task force report. Allergy 2024. [PMID: 38783644 DOI: 10.1111/all.16160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/09/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
This systematic review and meta-analysis aimed to consolidate evidence on dietary interventions for atopic eczema/dermatitis (AD) skin symptoms in children without food allergies, following PRISMA 2020 guidelines. Systematic review updates were conducted in May 2022 and June 2023, focusing on randomized placebo-controlled trials (RCTs) involving children with AD but without food allergies. Specific diets or supplements, such as vitamins, minerals, probiotics, prebiotics, symbiotics, or postbiotics, were explored in these trials. Exclusions comprised descriptive studies, systematic reviews, meta-analyses, letters, case reports, studies involving elimination diets, and those reporting on food allergens in children and adolescents. Additionally, studies assessing exacerbation of AD due to food allergy/sensitization and those evaluating elimination diets' effects on AD were excluded. Nutritional supplementation studies were eligible regardless of sensitization profile. Evaluation of their impact on AD clinical expression was performed using SCORAD scores, and a meta-analysis of SCORAD outcomes was conducted using random-effect models (CRD42022328702). The review encompassed 27 RCTs examining prebiotics, Vitamin D, evening primrose oil, and substituting cow's milk formula with partially hydrolyzed whey milk formula. A meta-analysis of 20 RCTs assessing probiotics, alone or combined with prebiotics, revealed a significant reduction in SCORAD scores, suggesting a consistent trend in alleviating AD symptoms in children without food allergies. Nonetheless, evidence for other dietary interventions remains limited, underscoring the necessity for well-designed intervention studies targeting multiple factors to understand etiological interactions and propose reliable manipulation strategies.
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Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Comotti
- Occupational Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nikolaos Douladiris
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - George Ν Konstantinou
- Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Ilaria Alberti
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Ioana Corina Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Antonio Corsello
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Valentina De Cosmi
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Gavriela Feketea
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Pediatrics, "Karamandaneio" Children's Hospital of Patra, Patras, Greece
| | - Kirsi Laitinen
- Faculty of Medicine, Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology and Nutrition and Food Research Center, University of Turku, Turku, Finland
| | - Alessandra Mazzocchi
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Nicola A Monzani
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | | | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
| | | | - Franziska Roth-Walter
- Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Isabel Skypala
- Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK
- Department of Inflammation & Repaid, Imperial College of London, London, UK
| | - Sophia Tsabouri
- Child Health Department, University of Ioannina School of Medicine, Ioannina, Greece
| | - Abdoulie K Baldeh
- Department of Public Health and Community Medicine, Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Liam O'Mahony
- APC Microbiome Ireland, Department of Medicine, School of Microbiology, University College Cork, Cork, Ireland
| | - Carina Venter
- Pediatric Allergy and Clinical Immunology, Children's Hospital Colorado/University of Colorado, Aurora, Colorado, USA
| | - Gregorio Paolo Milani
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
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3
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Krupka-Olek M, Bożek A, Aebisher D, Bartusik-Aebisher D, Cieślar G, Kawczyk-Krupka A. Potential Aspects of the Use of Cytokines in Atopic Dermatitis. Biomedicines 2024; 12:867. [PMID: 38672221 PMCID: PMC11048200 DOI: 10.3390/biomedicines12040867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Atopic dermatitis (AD) is an abnormal inflammatory response in the skin to food, environmental IgE, or non-IgE allergens. This disease belongs to a group of inflammatory diseases that affect both children and adults. In highly developed countries, AD is diagnosed twice as often in children than in adults, which may possibly be connected to increased urbanization. The immune system's pathomechanisms of AD involve humoral mechanisms with IgE, cellular T lymphocytes, dendritic cells occurring in the dermis, Langerhans cells occurring in the epidermis, and other cells infiltrating the site of inflammation (eosinophils, macrophages, mast cells, neutrophils, and basophils). Cytokines are small proteins that affect the interaction and communication between cells. This review characterizes cytokines and potential aspects of the treatment of atopic dermatitis, as well as new strategies that are currently being developed, including targeting cytokines and their receptors.
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Affiliation(s)
- Magdalena Krupka-Olek
- Clinical Department of Internal Diseases and Geriatrics, Chair of Internal Diseases, Dermatology and Allergology in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland (A.B.)
- Doctoral School, Medical University of Silesia, 40-055 Katowice, Poland
| | - Andrzej Bożek
- Clinical Department of Internal Diseases and Geriatrics, Chair of Internal Diseases, Dermatology and Allergology in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland (A.B.)
| | - David Aebisher
- Department of Photomedicine and Physical Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Dorota Bartusik-Aebisher
- Department of Biochemistry and General Chemistry, Medical College of the University of Rzeszów, 35-959 Rzeszów, Poland;
| | - Grzegorz Cieślar
- Department of Internal Diseases, Angiology and Physical Medicine, Centre for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Batorego 15, 41-902 Bytom, Poland;
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Diseases, Angiology and Physical Medicine, Centre for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, Batorego 15, 41-902 Bytom, Poland;
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4
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Lazar M, Zhang AD, Vashi NA. Topical Treatments in Atopic Dermatitis: An Expansive Review. J Clin Med 2024; 13:2185. [PMID: 38673458 PMCID: PMC11050343 DOI: 10.3390/jcm13082185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Atopic dermatitis (AD) is a common inflammatory skin condition found worldwide. It impacts patient quality of life (QoL) and is thought to arise as an inflammatory response to epidermal barrier dysfunction and hypersensitivity. AD can lead to large out-of-pocket costs and increased healthcare expenses over a lifetime. An analysis of all randomized control trials conducted since 1990 on topical therapies for AD were reviewed, including 207 trials in the final analysis. It was found that an average of 226 patients were enrolled over 2.43 arms. Common topical treatments included corticosteroids, calcineurin inhibitors, JAK inhibitors, and phosphodiesterase inhibitors. The most utilized tools to identify treatment efficacy were the EASI, IGA, SCORAD, and PGA. There was a paucity of data on trials that evaluated efficacy, QoL, and cost of treatment simultaneously. This review highlights the need for comprehensive trials that evaluate multiple aspects of treatment, including financial cost and QoL impact, to ensure each patient has the best treatment modality for the management of their AD.
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Affiliation(s)
| | | | - Neelam A. Vashi
- Department of Dermatology, Boston University School of Medicine, 609 Albany St., J502, Boston, MA 02118, USA
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5
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Lima M, Paulino LC. Oral Postbiotics as a Therapeutic Strategy for Atopic Dermatitis: A Systematic Review of Randomized Controlled Trials. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:139-146. [PMID: 37459239 DOI: 10.1080/27697061.2023.2232021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/27/2023] [Indexed: 01/27/2024]
Abstract
Atopic dermatitis (AD) is a prevalent chronic skin disease affecting all age groups. The connection with the gut microbiome led to oral probiotics as a therapeutic strategy. However, being viable microorganisms, probiotics might present risks. Thus, non-viable postbiotics have been considered as an alternative. We aimed to evaluate the efficacy of oral Lactobacillus postbiotics for managing symptoms of AD in pediatric and adult patients. A systematic review was conducted following PRISMA guidelines. Nine randomized controlled trials assessing the effects of non-viable Lactobacillus spp. administered orally to patients diagnosed with AD were included in the review, in which 512 subjects were evaluated after the intervention. Most studies allowed the concomitant usage of corticosteroids. Three studies focused on adults and indicated symptom improvement. In contrast, three out of six trials evaluating pediatric patients did not report postbiotics-favoring results. The dosage seems to be relevant for outcome determination. Two trials compared postbiotics with their viable analogs, and only one reported positive results in both groups. Postbiotics-associated shifts in gut microbial communities were reported in one trial. Mild adverse effects were detected by a single study. The overall results suggested that Lactobacillus postbiotics might be successfully used as adjuvant AD therapy in adults. Thus far, data do not indicate efficacy in pediatric patients. Standardizing nomenclatures and experimental procedures, as well as expanding the studies to more geographic locations and assessing comprehensively the effects on the gut microbiome would provide better perspectives of postbiotics as a therapeutic option for AD.
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Affiliation(s)
- Madalena Lima
- Center for Natural Sciences and Humanities, Federal University of ABC, Santo André-SP, Brazil
| | - Luciana Campos Paulino
- Center for Natural Sciences and Humanities, Federal University of ABC, Santo André-SP, Brazil
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6
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Cazzaniga S, Simon D. Decoding atopic dermatitis: unveiling phenotypes through data-driven methods. Br J Dermatol 2024; 190:146-147. [PMID: 37976182 DOI: 10.1093/bjd/ljad453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/04/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Simone Cazzaniga
- Department of Dermatology, Inselspital University Hospital of Bern, Bern , Switzerland
- Centro Studi GISED, Bergamo , Italy
| | - Dagmar Simon
- Department of Dermatology, Inselspital University Hospital of Bern, Bern , Switzerland
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7
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Tseng CF, Lin HC, Tzeng CY, Huang JY, Yeh CJ, Wei JCC. Association of Kawasaki disease with urbanization level and family characteristics in Taiwan: A nested case-control study using national-level data. PLoS One 2024; 19:e0296505. [PMID: 38180955 PMCID: PMC10769101 DOI: 10.1371/journal.pone.0296505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/14/2023] [Indexed: 01/07/2024] Open
Abstract
Kawasaki disease (KD) is an inflammatory vasculitis disorder of unknown etiology. It is a rare but fatal disease and the leading cause of acquired coronary heart disease in children under the age of 5 years. We examined the association of KD with the demographics of family members, parents' characteristics, and perinatal factors in Taiwanese children. This nested case-control study used data from Taiwan's Health and Welfare Data Science Center and initially included children born in Taiwan between January 1, 2006, and December 31, 2015 (n = 1,939,449); the children were observed for KD development before the age of 5 years (n = 7870). The control group consisted of children without KD who were matched with each KD case by sex and birth date at a ratio of 8:1. The odds ratio (ORs) of the aforementioned associations were estimated using conditional logistic regression. The risk of KD decreased in children with younger parents [<25 years; younger maternal age, OR = 0.72, 95% confidence interval (CI), 0.66-0.79; younger paternal age, OR = 0.68, 95% CI, 0.59-0.78], lower socioeconomic status, more than 2 siblings (OR = 0.80, 95% CI, 0.73-0.89), and siblings with a history of KD (OR = 4.39, 95% CI, 3.29-5.86). Children living in suburban (OR = 0.95, 95% CI, 0.90-1.00) and rural (OR = 0.81, 95%CI, 0.74-0.90) areas exhibited a lower risk of KD than children living in urban areas. In conclusion, a higher incidence rate of KD was observed in children aged <5 years who had an urban lifestyle, had siblings with KD, were born to older mothers, and belonged to high-income and smaller families. Parental allergic or autoimmune diseases were not associated with the risk of KD.
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Affiliation(s)
- Chung-Fang Tseng
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Hsiao-Chen Lin
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Chung-Yuh Tzeng
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Jung Yeh
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
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8
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Deng F, Qiu Y, Zhang X, Guo N, Hu J, Yang W, Shang W, Liu B, Qin S. GB12-09, a bispecific antibody targeting IL4Rα and IL31Rα for atopic dermatitis therapy. Antib Ther 2024; 7:77-87. [PMID: 38371956 PMCID: PMC10873276 DOI: 10.1093/abt/tbad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/27/2023] [Accepted: 12/18/2023] [Indexed: 02/20/2024] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by dysregulated immune responses. The key mediators of AD pathogenesis are T helper 2 (TH2) cells and TH2 cytokines. Targeting interleukin 4 (IL4), IL13 or IL31 has become a pivotal focus in both research and clinical treatments for AD. However, the need remains pressing for the development of a more effective and safer therapy, as the current approaches often yield low response rates and adverse effects. In response to this challenge, we have engineered a immunoglobulin G-single-chain fragment variable (scFv) format bispecific antibody (Ab) designed to concurrently target IL4R and IL31R. Our innovative design involved sequence optimization of VL-VH and the introduction of disulfide bond (VH44-VL100) within the IL31Rα Ab scFv region to stabilize the scFv structure. Our bispecific Ab efficiently inhibited the IL4/IL13/IL31 signaling pathways in vitro and reduced serum immunoglobulin E and IL31 levels in vivo. Consequently, this intervention led to improved inflammation profiles and notable amelioration of AD symptoms. This research highlighted a novel approach to AD therapy by employing bispecific Ab targeting IL4Rα and IL31Rα with potent efficacy.
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Affiliation(s)
- Feiyan Deng
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Yuxin Qiu
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Xiangling Zhang
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Nining Guo
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Junhong Hu
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Wenjie Yang
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Wei Shang
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
| | - Bicheng Liu
- Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing 999077, China
| | - Suofu Qin
- Drug Discovery, Center for Research and Development, Kexing BioPharma Co., Ltd, Shenzhen 518057, China
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Shih PY, Li CJ, Yong SB. Emerging trends in clinical research on Janus kinase inhibitors for atopic dermatitis treatment. Int Immunopharmacol 2023; 124:111029. [PMID: 37820425 DOI: 10.1016/j.intimp.2023.111029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/26/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects millions of people worldwide, characterized by immune function imbalance and impaired epidermal barrier function. It is a complex disorder that involves multiple pathogenic pathways, including the JAK/STAT signaling pathway, which plays a critical role in regulating immune and inflammatory responses. The therapeutic potential of Janus kinase inhibitors (JAKi) in the management of atopic dermatitis (AD) has garnered significant interest in recent years. AD is a chronic inflammatory skin condition characterized by impaired epidermal barrier function and immune function imbalance, and its pathogenesis is closely associated with dysregulated JAK/signal transducer and activator of transcription (STAT) signaling pathways. JAKi offer a novel therapeutic approach by selectively inhibiting JAK enzymes, thereby blocking downstream STAT signaling and preventing the expression of cytokines involved in AD pathogenesis. This review will focus on several JAKi including tofacitinib, baricitinib, ruxolitinib and upadacitinib, and provide a comprehensive overview of the latest research on the application of JAKi in AD treatment, including its mechanism of action, clinical trial results and safety profile.
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Affiliation(s)
- Pei-Yun Shih
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chia-Jung Li
- Department of Obstetrics and Gynaecology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan; Institute of Biopharmaceutical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan.
| | - Su-Boon Yong
- Department of Allergy and Immunology, China Medical University Children's Hospital, Taichung, Taiwan; Department of Medicine, College of Medicine, China Medical University, Taiwan.
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Olejnik A, Gornowicz-Porowska J, Jenerowicz D, Polańska A, Dobrzyńska M, Przysławski J, Sansone A, Ferreri C. Fatty Acids Profile and the Relevance of Membranes as the Target of Nutrition-Based Strategies in Atopic Dermatitis: A Narrative Review. Nutrients 2023; 15:3857. [PMID: 37686888 PMCID: PMC10489657 DOI: 10.3390/nu15173857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/26/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Recently, the prevalence of atopic dermatitis has increased drastically, especially in urban populations. This multifactorial skin disease is caused by complex interactions between various factors including genetics, environment, lifestyle, and diet. In eczema, apart from using an elimination diet, the adequate content of fatty acids from foods (saturated, monounsaturated, and polyunsaturated fatty acids) plays an important role as an immunomodulatory agent. Different aspects regarding atopic dermatitis include connections between lipid metabolism in atopic dermatitis, with the importance of the MUFA levels, as well as of the omega-6/omega-3 balance that affects the formation of long-chain (C20 eicosanoic and C22 docosaenoic) fatty acids and bioactive lipids from them (such as prostaglandins). Impair/repair of the functioning of epidermal barrier is influenced by these fatty acid levels. The purpose of this review is to drive attention to membrane fatty acid composition and its involvement as the target of fatty acid supplementation. The membrane-targeted strategy indicates the future direction for dermatological research regarding the use of nutritional synergies, in particular using red blood cell fatty acid profiles as a tool for checking the effects of supplementations to reach the target and influence the inflammatory/anti-inflammatory balance of lipid mediators. This knowledge gives the opportunity to develop personalized strategies to create a healthy balance by nutrition with an anti-inflammatory outcome in skin disorders.
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Affiliation(s)
- Anna Olejnik
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland;
- Centre for Advanced Technology, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 10, 61-614 Poznań, Poland
| | - Justyna Gornowicz-Porowska
- Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medicinal Sciences, Rokietnicka 3, 60-806 Poznań, Poland
| | - Dorota Jenerowicz
- Department of Dermatology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-356 Poznań, Poland; (D.J.); (A.P.)
| | - Adriana Polańska
- Department of Dermatology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-356 Poznań, Poland; (D.J.); (A.P.)
| | - Małgorzata Dobrzyńska
- Department of Bromatology, Poznan University of Medical Sciences, Rokietnica 3, 60-806 Poznań, Poland; (M.D.); (J.P.)
| | - Juliusz Przysławski
- Department of Bromatology, Poznan University of Medical Sciences, Rokietnica 3, 60-806 Poznań, Poland; (M.D.); (J.P.)
| | - Anna Sansone
- Istituto per la Sintesi Organica e la Fotoreattività, Consiglio Nazionale Delle Ricerche, Via Piero Gobetti 101, 40129 Bologna, Italy;
| | - Carla Ferreri
- Istituto per la Sintesi Organica e la Fotoreattività, Consiglio Nazionale Delle Ricerche, Via Piero Gobetti 101, 40129 Bologna, Italy;
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Ilic I, Stojkovic A, Velickovic V, Zivanovic Macuzic I, Ilic M. Atopic Dermatitis in Children Under 5: Prevalence Trends in Central, Eastern, and Western Europe. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1275. [PMID: 37628274 PMCID: PMC10453452 DOI: 10.3390/children10081275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Atopic dermatitis is a major public health issue worldwide, but data on trends in prevalence in children in European countries are sparse. The aim of this study was to assess the trends in the prevalence of atopic dermatitis in children under 5 in the Central, Eastern, and Western European sub-regions from 1990 to 2019. METHODS In this study, a descriptive, observational epidemiological method was applied. In addition, an ecological study design was used. Joinpoint regression analysis was used to assess trends. RESULTS A total of 118 million (54 million males and 64 million females) prevalent cases of atopic dermatitis in children under 5 were reported in European countries in 1990-2019. More than half of all cases of atopic dermatitis in children under 5 in Europe were recorded in the Western European sub-region. The highest prevalence rates of atopic dermatitis in children under 5 were observed in the Eastern European sub-region, with the highest rates in both males and females recorded in Estonia (equally at about 15,000 per 100,000), followed by the Russian Federation (equally at about 12,000 per 100,000). Moreover, the lowest prevalence rates were reported in the Eastern European sub-region (equally at about 5000 per 100,000 in Romania and Latvia). A sex disparity in the prevalence and trends of atopic dermatitis in children under 5 was observed. A significantly increased trend in atopic dermatitis prevalence in children under 5 was recorded in the Eastern European sub-region from 1990 to 2019 (by +0.3% per year in males and by +0.1% per year in females). Conversely, in the Western and Central European sub-regions, trends in the prevalence of atopic dermatitis in children under 5 slightly decreased (about -0.1% per year). The Pearson coefficient showed a significant negative correlation between the prevalence of atopic dermatitis in children under 5 and the Human Development Index in most countries in the Eastern European sub-region, while a significant positive correlation was reported between the prevalence and HDI in high-income countries in the Western European sub-region. CONCLUSIONS High prevalence rates and mostly stable trends during the last three decades make atopic dermatitis still a major health issue in children under 5 in European countries.
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Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Andjelka Stojkovic
- Department of Pediatrics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
- Clinic of Pediatrics, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia;
| | - Vesna Velickovic
- Clinic of Pediatrics, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia;
| | - Ivana Zivanovic Macuzic
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
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12
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Al Khalifa N, Alsabbagh M, Raees M, Aljufairi E. Misdiagnosed Pityriasis Rubra Pilaris Successfully Managed With Isotretinoin: A Case Series. Cureus 2023; 15:e38657. [PMID: 37168410 PMCID: PMC10166574 DOI: 10.7759/cureus.38657] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 05/13/2023] Open
Abstract
Being a rare inflammatory, hyperproliferative dermatosis, diagnosing pityriasis rubra pilaris (PRP) can be a challenge to many clinicians. Our case reports aim to demonstrate that PRP is frequently diagnosed and managed as atopic dermatitis (AD) and that distinguishing features on dermoscopy, and biopsy can help diagnose this rare disease. The study also aims to show that PRP can be successfully treated with Isotretinoin. Our case series aims to describe two cases of PRP, initially diagnosed as AD and managed with topical corticosteroids. Being the first case series in the literature to describe the incidences of diagnosing PRP as AD portrays the significance of utilizing dermoscopy and biopsy as tools to confirm this diagnosis for appropriate management. Although PRP is a rare diagnosis, dermoscopy and biopsy can help confirm the disease. Management with isotretinoin will most likely have successful outcomes in those patients.
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Affiliation(s)
| | | | - Mazen Raees
- Dermatology, King Hamad University Hospital, Busaiteen, BHR
| | - Eman Aljufairi
- Pathology, King Hamad University Hospital, Busaiteen, BHR
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13
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Bae S, Jeong NH, Choi YA, Lee B, Jang YH, Lee S, Kim SH. Lupeol alleviates atopic dermatitis-like skin inflammation in 2,4-dinitrochlorobenzene/Dermatophagoides farinae extract-induced mice. BMC Pharmacol Toxicol 2023; 24:27. [PMID: 37098554 PMCID: PMC10131421 DOI: 10.1186/s40360-023-00668-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 04/04/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects from children to adults widely, presenting symptoms such as pruritus, erythema, scaling, and dryness. Lupeol, a pentacyclic triterpenoid, has anti-inflammatory and antimicrobial activities. Based on these properties, the therapeutic effects of lupeol on skin disorders have been actively studied. In the present study, we aimed to determine the effectiveness of lupeol on AD. METHODS We utilized tumor necrosis factor (TNF)-α/interferon (IFN)-γ-stimulated keratinocytes and 2, 4-dinitrochlorobenzene/Dermatophagoides farinae extract (DFE)-induced AD mice to confirm the action. RESULTS Lupeol inhibited TNF-α/IFN-γ-stimulated keratinocytes activation by reducing the expressions of pro-inflammatory cytokines and chemokines which are mediated by the activation of signaling molecules such as signal transducer and activator of transcription 1, mitogen-activated protein kinases (p38 and ERK), and nuclear factor-κB. Oral administration of lupeol suppressed epidermal and dermal thickening and immune cell infiltration in ear tissue. Immunoglobulin (Ig) E (total and DFE-specific) and IgG2a levels in serum were also reduced by lupeol. The gene expression and protein secretion of T helper (Th) 2 cytokines, Th1 cytokines, and pro-inflammatory cytokine in ear tissue were decreased by lupeol. CONCLUSIONS These results suggest that lupeol has inhibitory effects on AD-related responses. Therefore, lupeol could be a promising therapeutic agent for AD.
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Affiliation(s)
- Sojung Bae
- CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Na-Hee Jeong
- CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Young-Ae Choi
- CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Byungheon Lee
- Department of Biochemistry and Cell Biology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea
| | - Yong Hyun Jang
- Department of Dermatology, School of Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Republic of Korea.
| | - Soyoung Lee
- Immunoregulatory Materials Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 181 Ipsin-gil, Jeongeup, 56212, Republic of Korea.
| | - Sang-Hyun Kim
- CMRI, Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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Fijan S, Kolč N, Hrašovec M, Jamtvedt G, Pogačar MŠ, Mičetić Turk D, Maver U. Single-Strain Probiotic Lactobacilli for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis. Pharmaceutics 2023; 15:pharmaceutics15041256. [PMID: 37111741 PMCID: PMC10146705 DOI: 10.3390/pharmaceutics15041256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/09/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Probiotics are known for their positive effects on the gut microbiota. There is growing evidence that the infant gut and skin colonization have a role in the development of the immune system, which may be helpful in the prevention and treatment of atopic dermatitis. This systematic review focused on evaluating the effect of single-strain probiotic lactobacilli consumption on treating children's atopic dermatitis. Seventeen randomized placebo-controlled trials with the primary outcome of the Scoring Atopic Dermatitis (SCORAD) index were included in the systematic review. Clinical trials using single-strain lactobacilli were included. The search was conducted until October 2022 using PubMed, ScienceDirect, Web of Science, Cochrane library and manual searches. The Joanna Briggs Institute appraisal tool was used to assess the quality of the included studies. Meta-analyses and sub meta-analyses were performed using Cochrane Collaboration methodology. Due to different methods of reporting the SCORAD index, only 14 clinical trials with 1124 children were included in the meta-analysis (574 in the single-strain probiotic lactobacilli group and 550 in the placebo group) and showed that single-strain probiotic lactobacilli statistically significantly reduced the SCORAD index compared to the placebo in children with atopic dermatitis (mean difference [MD]: -4.50; 95% confidence interval [CI]: -7.50 to -1.49; Z = 2.93; p = 0.003; heterogeneity I2 = 90%). The subgroup meta-analysis showed that strains of Limosilactobacillus fermentum were significantly more effective than strains of Lactiplantibacillus plantarum, Lacticaseibacillus paracasei or Lacticaseibacillus rhamnosus. A longer treatment time and younger treatment age statistically significantly reduced symptoms of atopic dermatitis. The result of this systematic review and meta-analysis shows that certain single-strain probiotic lactobacilli are more successful than others in reducing atopic dermatitis severity in children. Therefore, careful consideration to strain selection, treatment time and the age of the treated patients are important factors in enhancing the effectiveness of reducing atopic dermatitis in children when choosing probiotic single-strain lactobacilli.
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Affiliation(s)
- Sabina Fijan
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
| | - Nina Kolč
- Department of Pediatrics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Metka Hrašovec
- Department of Pediatrics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Gro Jamtvedt
- Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Maja Šikić Pogačar
- Department of Pediatrics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
- Institute of Biomedical Sciences, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Dušanka Mičetić Turk
- Department of Pediatrics, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Uroš Maver
- Institute of Biomedical Sciences, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
- Department of Pharmacology, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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15
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Zhang X, Ding C, Zhao Z. Identification of diagnostic molecules and potential therapeutic agents for atopic dermatitis by single-cell RNA sequencing combined with a systematic computing framework that integrates network pharmacology. Funct Integr Genomics 2023; 23:95. [PMID: 36944896 DOI: 10.1007/s10142-023-01005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
Atopic dermatitis (AD) is composed of highly flexible cellular participants. To better understand its pathobiology and molecular regulation mechanisms, it is necessary to combine single-cell RNA sequencing (scRNA-seq) with new computing frameworks or specific technologies, which may contribute to the development of better treatments for AD. The scRNA-seq data of GSE180885 and bulk RNA-seq data of GSE193309 were obtained from Gene Expression Omnibus (GEO) database, and the scRNA-seq data was analyzed by Seurat package to identify the cell types in AD. The genes related to the activity of AD topical drugs were obtained from the ChEMBL database, which provided a variety of bioactivity data such as multiple drugs and targets. AD-related genes were obtained from DisGeNET and CTD databases synthesizing human disease-related genes; the intersection of AD-related genes from these three sources with differentially expressed genes (DEGs) between non-diseased AD and normal human skin (NHS) samples and differential cell type marker genes was taken. The proximity analysis of drug gene network was performed based on the gene with the largest area of receiver operating characteristic (ROC) curve. Ten distinct cell types of AD and NHS were identified, except for phagocytes cells. Three hub genes, F10 and CALCRL and CTSB, were obtained. The area under the curve of ROC based on CTSB expression was the largest, which was 60.15%. By binding drug CTSB-related gene interaction network, we identified 145 potential drugs. Among them, the score of DB07045 and CTSB docking was the lowest, and molecular docking and molecular dynamics (MD) simulation confirmed the close and stable binding of DB07045 and cathepsin B. This work identified diagnostic molecules and potential therapeutic drugs of AD by scRNA-seq combined with a systematic computing framework of network pharmacology, which may provide valuable clues for drug design.
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Affiliation(s)
- Xin Zhang
- Department of Dermatology, The First Medical Center of PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 110000, China
| | - Changrui Ding
- Department of Dermatology, The First Affiliated Hospital of Qiqihar Medical College, Qiqihar, 230200, China
| | - Zigang Zhao
- Department of Dermatology, The First Medical Center of PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 110000, China.
- Department of Dermatology, Hainan Hospital of PLA General Hospital, Sanya, 460200, China.
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16
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Multimorbidity of Allergic Conditions in Urban Citizens of Southern China: A Real-World Cross-Sectional Study. J Clin Med 2023; 12:jcm12062226. [PMID: 36983228 PMCID: PMC10059830 DOI: 10.3390/jcm12062226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/15/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023] Open
Abstract
Background: Extensive knowledge of allergic multimorbidities is required to improve the management of allergic diseases with the industrialization of China. However, the demography and allergen distribution patterns of allergic multimorbidities in China remain unclear, despite the increasing prevalence of allergies. Methods: This was a real-world, cross-sectional study of 1273 outpatients diagnosed with one or more allergic diseases in Guangzhou, the most populated city of southern China, with leading industrial and commercial centers, between April 2021 and March 2022. Seven allergic diseases (allergic rhinitis (AR), asthma (AS)/cough variant asthma (CVA), atopic dermatitis (AD)/eczema, food allergy (FA), allergic conjunctivitis (AC), drug allergy (DA), and anaphylaxis) were assessed. Positive rates of sensitization to different allergens were measured using an allergen detection system of the UniCAP (Pharmacia Diagnostics, Sweden) instrument platform to compare the groups of allergic multimorbidities against a single entity. Results: There were 659 (51.8%) males and 614 (48.2%) females aged from 4 months to 74 years included in the analysis. The study participants who were diagnosed with allergic diseases had an average of 1.6 diagnoses. Overall, 46.5% (592 of 1273) of the patients had more than one allergic condition, and allergic rhinitis was the most common type of multimorbidity. Women were more likely to suffer from an allergic disease alone, whereas allergic multimorbidities were more likely to be diagnosed in men (p = 0.005). In addition, allergic multimorbidities were common in all age groups, with an incidence ranging from 37.1% to 57.4%, in which children and adolescents were more frequently diagnosed with allergic multimorbidities than adults (18–60 years old) (all p < 0.05). Allergic multimorbidity was observed throughout the year. A difference in the positive rate of allergens sensitization and total immunoglobulin E (tIgE) levels between different allergic multimorbidities was observed. Conclusions: Allergic multimorbidities were very commonly found in nearly half of all patients with allergies. The proportion of allergic multimorbidities varied with the type of disease, sex, age, and allergen distribution pattern. These findings may help clinicians to develop “One health” strategies for the clinical management of allergic diseases.
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17
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Chuah LH, Loo HL, Goh CF, Fu JY, Ng SF. Chitosan-based drug delivery systems for skin atopic dermatitis: recent advancements and patent trends. Drug Deliv Transl Res 2023; 13:1436-1455. [PMID: 36808298 PMCID: PMC9937521 DOI: 10.1007/s13346-023-01307-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
Atopic dermatitis (AD) is a complex, relapsing inflammatory skin disease with a considerable social and economic burden globally. AD is primarily characterized by its chronic pattern and it can have important modifications in the quality of life of the patients and caretakers. One of the fastest-growing topics in translational medicine today is the exploration of new or repurposed functional biomaterials into drug delivery therapeutic applications. This area has gained a considerable amount of research which produced many innovative drug delivery systems for inflammatory skin diseases like AD. Chitosan, a polysaccharide, has attracted attention as a functional biopolymer for diverse applications, especially in pharmaceutics and medicine, and has been considered a promising candidate for AD treatment due to its antimicrobial, antioxidative, and inflammatory response modulation properties. The current pharmacological treatment for AD involves prescribing topical corticosteroid and calcineurin inhibitors. However, the adverse reactions associated with the long-term usage of these drugs such as itching, burning, or stinging sensation are also well documented. Innovative formulation strategies, including the use of micro- and nanoparticulate systems, biopolymer hydrogel composites, nanofibers, and textile fabrication are being extensively researched with an aim to produce a safe and effective delivery system for AD treatment with minimal side effects. This review outlines the recent development of various chitosan-based drug delivery systems for the treatment of AD published in the past 10 years (2012-2022). These chitosan-based delivery systems include hydrogels, films, micro-, and nanoparticulate systems as well as chitosan textile. The global patent trends on chitosan-based formulations for the AD are also discussed.
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Affiliation(s)
- Lay-Hong Chuah
- grid.440425.30000 0004 1798 0746School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Malaysia
| | - Hooi-Leong Loo
- grid.440425.30000 0004 1798 0746School of Pharmacy, Monash University Malaysia, Bandar Sunway, 47500 Subang Jaya, Malaysia
| | - Choon Fu Goh
- grid.11875.3a0000 0001 2294 3534Discipline of Pharmaceutical Technology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia
| | - Ju-Yen Fu
- grid.410876.c0000 0001 2170 0530Malaysian Palm Oil Board, Bandar Baru Bangi, 43000 Kajang, Selangor, Malaysia
| | - Shiow-Fern Ng
- Centre for Drug Delivery Technology, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia.
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18
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Guarneri F, Belloni Fortina A, Corazza M, Cristaudo A, Foti C, Parodi A, Pigatto P, Stingeni L, DE Pità O. Topical non-pharmacological treatment of eczema: an Italian consensus. Ital J Dermatol Venerol 2022; 157:402-413. [PMID: 36213968 DOI: 10.23736/s2784-8671.22.07283-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Eczematous diseases (contact dermatitis, atopic dermatitis, hand eczema) are among the most frequent findings in dermatological clinical practice. A large body of evidence exists on structural and functional skin barrier damage in eczematous diseases, and on the importance of interventions aimed to repair such damage. While there is substantial agreement on pharmacological treatment, more sparse data are available on role, indications and usefulness of topical non-pharmacological treatments, despite significant research and progress in the composition and technology of emollients, cleansers and barrier creams significantly changed and expanded the functional activities of these products. This often leads to inadequate prescription and/or use, which increase individual and social costs of the disease and make the products useless or, in some cases, even counterproductive. This consensus document, discussed and compiled in a series of meetings by a group of Italian dermatologists experienced in the field of eczematous diseases, summarizes epidemiology and clinical features of the nosological entities of the "eczema family", illustrates the chemical/biochemical structure of emollients, cleansers and barrier creams, and aims to help physicians to exploit the full potential of available products, by providing a detailed but practical guide on characteristics, indications and correct use of non-pharmacological treatments currently available for eczematous diseases.
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Affiliation(s)
- Fabrizio Guarneri
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Caterina Foti
- Department of Biomedical Sciences and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Paolo Pigatto
- Unit of Dermatology, Department of Surgical and Odontoiatric Biomedical Sciences, Galeazzi IRCCS Orthopedic Institute, Milan, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ornella DE Pità
- Unit of Clinical Pathology, Inflammatory and Autoimmune Skin Diseases, Cristo Re Hospital, Rome, Italy
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19
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Peng Z, Braig S, Kurz D, Weiss JM, Weidinger S, Brenner H, Rothenbacher D, Genuneit J. Trajectory and determinants of agreement between parental and physicians' reports of childhood atopic dermatitis. Pediatr Allergy Immunol 2022; 33:e13855. [PMID: 36156820 DOI: 10.1111/pai.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parent self-administered reports are commonly used in studies on childhood atopic dermatitis (AD) but data on its validity are sparse. We aimed to examine the agreement between parent- and physician-reported measures of childhood AD throughout early life and identify the determinants. METHODS In this prospective cohort study, we used data of 449 infants and their mothers recruited in the Ulm SPATZ Health Study in Germany. Longitudinal data of parental and children's caring physicians' reports were used to assess the point and cumulative agreement of parent- and physician-reported AD diagnoses, AD onset age, and trend of agreement at child ages between 1 and 6 years overall and by child and parent demographics and health conditions. A Generalized Estimating Equation model was fitted to identify factors associated with the sensitivity of parent reports. RESULTS The point agreement between parent- and physician-reported AD was substantial at the age of 1 (kappa = 0.63, 95% CI: 0.51-0.75) but declined with age and became fair after the age of 3 (kappa < 0.40). The cumulative agreement remained moderate at the age of 6 (kappa = 0.51, 95% CI: 0.43-0.60). Parents had a bias towards delayed reporting of the AD onset age. The AD severity was the only strong determinant for the agreement of AD diagnoses and largely explained the variance of the sensitivity of parent reports. CONCLUSION The disagreement between parent- and physician-reported AD increases with child age, likely due to the change of AD severity. Using parent-reported data might miss a substantial portion of mild childhood AD cases.
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Affiliation(s)
- Zhuoxin Peng
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Stefanie Braig
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Deborah Kurz
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Johannes M Weiss
- Department of Dermatology and Allergology, University Medical Center Ulm, Ulm, Germany
| | - Stephan Weidinger
- Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Dietrich Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.,German Center of Child and Youth Health (DZKJ), Leipzig, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.,German Center of Child and Youth Health (DZKJ), Leipzig, Germany
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