Observational study of pimecrolimus 1% cream for prevention of transcutaneous sensitization in children with atopic dermatitis during their first year of life

IntroductionEpidermal barrier dysfunction in children with atopic dermatitis can cause transcutaneous sensitization to allergens and allergic diseases. We evaluated the effectiveness of an early-intervention algorithm for atopic dermatitis treatment, utilizing pimecrolimus for long-term maintenance therapy, in reducing transcutaneous sensitization in infants.MethodThis was a single-center cohort observational study that enrolled children aged 1-4 months with family history of allergic diseases, moderate-to-severe atopic dermatitis, and sensitization to ≥ 1 of the investigated allergens. Patients who sought medical attention at atopic dermatitis onset (within 10 days) were group 1 “baseline therapy with topical glucocorticoids with subsequent transition to pimecrolimus as maintenance therapy”; patients who sought medical attention later were group 2 “baseline and maintenance therapy with topical glucocorticoids, without subsequent use of pimecrolimus”. Sensitization class and level of allergen-specific immunoglobulin E were determined at baseline, and 6 and 12 months of age. Atopic dermatitis severity was evaluated using the Eczema Area and Severity Index score at baseline and 6, 9 and 12 months of age.ResultsFifty-six and 52 patients were enrolled in groups 1 and 2, respectively. Compared with group 2, group 1 demonstrated a lower level of sensitization to cow's milk protein, egg white and house dust mite allergen at 6 and 12 months of age, and a more pronounced decrease in atopic dermatitis severity at 6, 9 and 12 months of age. No adverse events occurred.DiscussionThe pimecrolimus-containing algorithm was effective in treating atopic dermatitis and prophylaxis of early forms of allergic diseases in infants.Trial registrationhttps://clinicaltrials.gov/NCT04900948, retrospectively registered, 25 May 2021

Penney, G., May 26, 1982, Part 2. David Taylor interviewing George Penney regarding boatbuilding.

Part 2 of David Taylor's May 26, 1982 interview with George Penney regarding boatbuilding. Mr. Penney discusses the future of boatbuilding in his area

Etiopathogenetic Similarities of Combined Forms of Localized Scleroderma and Vitiligo

Vitiligo is a common skin disease characterized by idiopathic progressive skin hypomelanosis. Vitiligo is associated with several comorbid autoimmune diseases such as localized scleroderma. This article demonstrates the general development mechanism of these pathologies, as well as the key aspect of cross-effect between autoimmune diseases on the molecular level. Recently, dermatologists have noted the increasing number of patients suffering from combined pathologies. Such patients (in pediatrics) have torpid course of disease and no pathognomonic symptoms. That exaggerates the diagnostics and adequate therapy prescription. This leads to increased awareness among physicians of different specialties on possible combinations, clinical presentation and pathogenesis aspects of such conditions

Role of Emollients in Prevention of the Comorbid Allergic Diseases Development in Children with Atopic Dermatitis

Atopic dermatitis (AD) is one of the common multifactorial inflammatory diseases manifesting predominantly in childhood. There is significant number of cases of self-regression of the disease with aging. On the other hand, there is also another scenario ending with AD persistent course and/or development of comorbid allergic pathologies that can significantly worsen patient’s quality of life and finally lead to social maladjustment. The pathogenesis of such way includes epidermal barrier disturbance, transcutaneous sensibilisation and aberrant allergic (Th2) immune systemic response development. Main role in preventing of this pathological pathway is lying on the new class of moisturizers containing active components "emollients plus". They are considered as foundation for the therapy and prevention of the development of AD and other allergic diseases. This literature review provides relevant data on AD pathogenesis and development of comorbid allergic pathologies. This paper also covers data on the effect of emollients in restoration of the epidermal barrier and their use as preventive measures

Sensitive Skin Syndrome in Children with Atopic Dermatitis: Pathogenesis and Management Features

The atopic dermatitis (AD) is common skin disease and has significant impact on patients and their families quality of life. In recent years the term “sensitive skin" has been used more frequently. It is separate syndrome with subjective perception (such as burning, itching, tingling, etc.) along with thickening and dryness of the skin in response to environmental factors (biotic, abiotic and anthropogenic) which normally do not cause such symptoms. This syndrome is often associated with AD. The AD and sensitive skin syndrome pathogenesis and their management are presented in the article. Efficiency and safety parameters of pimecrolimus 1% cream in children (including its appliance on sensitive skin areas) are analysed

Modern Outlooks on «Atopic March» Secondary Prevention Capabilities in Children with Atopic Dermatitis

Atopic dermatitis (AD) is one of the most common inflammatory diseases of childhood, and it is the first one in gradual development of allergic diseases, also known as «atopic march». Sensitization establishment during the AD uncontrolled course is associated with the high risk of developing of serious allergic pathologies, increase in the severity of the disease course, and patients’ quality of life reduction. Thereby, it is crucial to achieve quick jugulation of the inflammatory process in case of severe AD with early onset of disease. This article shows modern therapeutic approaches to disease control in children

Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study

Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants