Children with Dry Skin and Atopic Predisposition: Outcome Measurement with Validated Scores for Atopic Dermatitis

Sawatzky, Sabine; Schario, Marianne; Stroux, Andrea; Lünnemann, Lena; Zuberbier, Torsten; Blume-Peytavi, Ulrike; Bartels, Natalie Garcia

doi:10.1159/000444590

Cited by 9 publications

(10 citation statements)

References 38 publications

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“…There is evidence that topical corticosteroids may further damage the skin barrier alongside of the beneficial suppression of inflammation in AD patients, and increases in TEWL in skin of patients have been observed under treatment with topical corticosteroids [25, 26]. Additionally, there is accumulating evidence that daily use of emollients may improve both TEWL and stratum corneum hydration measurements [19, 27], suggesting that topical application in our trial may have influenced the TEWL outcome in both groups. Indeed, the measurement of skin hydration in addition to TEWL and their correlation to AD severity scores [27] would have added valuable additional information.…”

Section: Discussion/conclusionmentioning

confidence: 88%

“…Interestingly, while symptoms decreased over time in both groups, possibly highlighting the natural improvement of the disease symptoms, the usage of topical fluticasone did not change over time, suggesting sustained need for topical treatment in this population. Other recent studies have shown the usefulness of different scoring systems such as the Patient-Oriented SCORAD (PO-SCORAD) to measure response to treatment [19]; such readout should be considered as an outcome in future trails.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Oral Administration of a Heat-Treated Lactobacillus paracasei Supplement in Infants with Atopic Dermatitis Receiving Topical Corticosteroid Therapy

Yan

Hung

et al. 2019

Skin Pharmacol Physiol

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Background/Aims: Atopic dermatitis (AD) is a common disease in infancy, for which topical steroids are the first-line therapy but have side effects. Innovative approaches are needed to reduce the burden of AD and corticosteroid usage in infants. Methods: The once-daily consumption of heat-treated probiotic Lactobacillus paracasei GM-080 or placebo for 16 weeks as supplementary approach to topical treatment with fluticasone propionate cream was compared in AD infants aged 4–30 months. Outcomes were SCORAD and its subscores, TEWL, Infants’ Dermatitis Quality of Life Index (IDQOL), corticoid “sparing effect,” CCL17/TARC, and IgE status. Results: SCORAD, objective SCORAD, itching, and IDQOL decreased significantly (p < 0.001) over the treatment period in both treatment groups. Slight decreases (ns) were noted in TEWL in lesional and unaffected skin and CCL17 levels. There were no differences between the treatment groups. Total IgE increased over the treatment period in both groups, with significantly higher increase in the heat-treated probiotic group (p = 0.038). There was no evidence of a corticoid “sparing effect” by the probiotic. Conclusions: In this design, the probiotic L. paracasei was not beneficial as a complementary approach to topical corticosteroids in infants with AD. However, slight beneficial effects may have been masked by the moderate potency corticoid.

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Section: Discussion/conclusionmentioning

confidence: 88%

Section: Discussion/conclusionmentioning

confidence: 99%

A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Oral Administration of a Heat-Treated Lactobacillus paracasei Supplement in Infants with Atopic Dermatitis Receiving Topical Corticosteroid Therapy

Yan

Hung

et al. 2019

Skin Pharmacol Physiol

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“…can dramatically impair quality of life of many patients. On the other hand, appropriate moisturization and emollient treatment of the skin can alleviate symptoms, and in some cases, they are even able to prevent the onset of AD (Hoppe et al, 2015;Sawatzky et al, 2016;Sugiura et al, 2014). Although inappropriate epidermal ceramide production is thought to be the most important player in these processes, a growing body of evidence now supports the concept that dysregulation of SG functions and the subsequent alterations in the SLP are also fundamental.…”

Section: Discussionmentioning

confidence: 99%

Endocannabinoid Tone Regulates Human Sebocyte Biology

Zákány

Oláh

Markovics

et al. 2018

Journal of Investigative Dermatology

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We have previously shown that endocannabinoids (eCBs) (e.g., anandamide) are involved in the maintenance of homeostatic sebaceous lipid production in human sebaceous glands and that eCB treatment dramatically increases sebaceous lipid production. Here, we aimed to investigate the expression of the major eCB synthesizing and degrading enzymes and to study the effects of eCB uptake inhibitors on human SZ95 sebocytes, thus exploring the role of the putative eCB membrane transporter, which has been hypothesized to facilitate the cellular uptake and subsequent degradation of eCBs. We found that the major eCB synthesizing (N-acyl phosphatidylethanolamine-specific phospholipase D, and diacylglycerol lipase-α and -β) and degrading (fatty acid amide hydrolase, monoacylglycerol lipase) enzymes are expressed in SZ95 sebocytes and also in sebaceous glands (except for diacylglycerol lipase-α, the staining of which was dubious in histological preparations). eCB uptake-inhibition with VDM11 induced a moderate increase in sebaceous lipid production and also elevated the levels of various eCBs and related acylethanolamides. Finally, we found that VDM11 was able to interfere with the proinflammatory action of the TLR4 activator lipopolysaccharide. Collectively, our data suggest that inhibition of eCB uptake exerts anti-inflammatory actions and elevates both sebaceous lipid production and eCB levels; thus, these inhibitors might be beneficial in cutaneous inflammatory conditions accompanied by dry skin.

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“…Similar to the previous studies, a control group without topical treatment was not feasible in our study population due to the patients’ dry skin and high risk of developing AD ( Williams et al, 2012 ). Moreover, a sufficient amount of data on untreated healthy infantile skin barrier parameters under comparable conditions is available ( Gao and Simpson, 2014 , Ludriksone et al, 2014 , Sawatzky et al, 2016 ). Therefore, two formulations on different body areas were chosen to identify their effect on the skin barrier function in this specific dermatological risk group.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive monitoring of plant-based formulations on skin barrier properties in infants with dry skin and risk for atopic dermatitis

Lünnemann

Ludriksone

Schario

et al. 2018

International Journal of Women's Dermatology

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BackgroundDry skin and the associated impaired epidermal barrier function are postulated to constitute a major element in the development of atopic dermatitis.ObjectiveThe aim of this study was to evaluate the effect of two plant-based formulations on the epidermal barrier function in a defined cohort of infants with a predisposition for atopic dermatitis.MethodsOver a period of 16 weeks, 25 infants who were ages 3 to 12 months and had an atopic predisposition and dry skin received two emollients that contained pressed juice of the ice plant. The infants received both cream and lotion on the forearm, only cream on the face, and only lotion on the leg. Stratum corneum hydration (SCH), transepidermal water loss (TEWL), skin surface pH, and sebum were assessed on the infants’ forehead, leg, and forearm. The Scoring Atopic Dermatitis (SCORAD) index was used for the clinical assessment.ResultsSCH significantly increased in all body regions that were assessed. The forearm and leg revealed stable levels of pH and TEWL, but a decline in pH (week 16) and TEWL (week 4) was noted on the forehead. At week 16, sebum levels were lower on the forehead compared with those at baseline. SCORAD scores improved significantly during the study.ConclusionA daily application of both emollients was associated with increased SCH levels and a stable course of TEWL, pH, and sebum on the forehead except for the forehead when compared with the forearm and leg. Clinically, improved SCORAD scores were noted.

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Children with Dry Skin and Atopic Predisposition: Outcome Measurement with Validated Scores for Atopic Dermatitis

Cited by 9 publications

References 38 publications

A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Oral Administration of a Heat-Treated <b><i>Lactobacillus paracasei </i></b>Supplement in Infants with Atopic Dermatitis Receiving Topical Corticosteroid Therapy

A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Oral Administration of a Heat-Treated <b><i>Lactobacillus paracasei </i></b>Supplement in Infants with Atopic Dermatitis Receiving Topical Corticosteroid Therapy

Endocannabinoid Tone Regulates Human Sebocyte Biology

Noninvasive monitoring of plant-based formulations on skin barrier properties in infants with dry skin and risk for atopic dermatitis

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