A Global Review on the Risk Factors and Management of Early Atopic Dermatitis in Children Ages 0 to 2 Years Old
October 2019 | Volume 18 | Issue 10 | Original Article | 1020 | Copyright © October 2019
Lawrence A. Schachner MD FAAD FAAP,a Adelaide A. Hebert MD FAAD,B Anneke Andriessen PhD,c Latanya T. Benjamin MD FAAD FAAP,D Ana M. Duarte MD FAAD FAAP,e Norman Goldberg MD FAAP,f Pearl C. Kwong MD FAAD,g Tace Steele Rico MD FAAD,h Lawrence F. Eichenfield MD FAAD FAAPi
ªThe Phillip Frost Department of Dermatology & Cutaneous Surgery, Pediatrics;Leonard M. Miller School of Medicine, University of Miami, FL
BPediatric Dermatology, McGovern School of Medicine, Children’s Memorial Hermann Hospital, Houston, TX; UT Physicians Dermatology–Texas Medical Center, Houston, TX
cRadboud UMC Nijmegen, Andriessen Consultants, Malden, The Netherlands
eChildren’s Skin Center, Miami, FL
hFlorida Hospital for Children, University of Miami School of Medicine, AdventHealth Medical Group, Orlando, FL
iDepartments of Dermatology and Pediatrics, University of California, San Diego and Rady Children's Hospital, San Diego, CA
Methods: A working group of experienced clinicians managing pediatric populations with atopic dermatitis (AD) convened for a meeting. The panel reviewed the literature surrounding early intervention in infants and young children with AD and developed and discussed clinical questions aimed at optimizing clinical outcomes.
Results: Complex gene/immune system/environment interactions are involved in AD development. Epidermal barrier defects play a central role in the condition, with various studies showing impairment of skin barrier function at birth may precede clinical AD. Dynamic changes take place in the amounts of skin lipids during infancy. Studies confirm that daily use of a moisturizer from birth onwards may offer benefits in improving skin barrier function and possibly prevention of AD, especially in high-risk, atopic prone newborns. Plant-based moisturizers were shown to be safe and effective when applied in pediatric patients with AD and may provide a TCS-sparing effect while improving skin condition.
Conclusion: Dry skin conditions during infancy may predict the subsequent development of AD. Consequently, emollient therapy from birth represents a feasible, safe, and effective approach for AD prevention. Therefore, parental education and the application of moisturizers are recommended as an integral part of AD prevention, treatment, and maintenance.
J Drugs Dermatol. 2019;18(10):1020-1027.
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