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Why you should read this article: • To improve your knowledge of atopic eczema and its prescribed treatment regimens • To enhance your awareness of the challenges encountered in the self-management of atopic eczema • To read about strategies nurses can use to support families to self-manage atopic eczema successfully. Atopic eczema is common in childhood and can continue into adulthood. Adherence to treatment is a significant factor in its effective management, but the complexity of treatment regimens can make adherence challenging. Additionally, living with the condition can have adverse psychosocial consequences for young people in particular. This article discusses treatment regimens for moderate-to-severe atopic eczema and some of the challenges encountered by children, young people and families in self-managing the condition. The authors discuss strategies that can support families to achieve optimal self-management, namely online support tools, written action plans and nurse-led eczema clinics. [ABSTRACT FROM AUTHOR]

The original article can be found online at https://doi.org/10.1007/s13555-023-01061-4.Publisher Correction to: Dermatol Ther (Heidelb) (2024) 14:261–270https://doi.org/10.1007/s13555-023-01061-4The infographic was missing from this article and should have appeared as below.InfographicGraphThe original article has been corrected.By Eric L. Simpson; Ben Lockshin; Lara Wine Lee; Zhen Chen; Moataz Daoud and Andrew KorotzerReported by Author; Author; Author; Author; Author; Author [Extracted from the article]

Emergency nurse practitioners are expected to assess and manage a variety of patients. These patients may present with urgent care-type complaints to severe life-threatening illnesses or injuries. For some, dermatological problems can sometimes be just as challenging as a critically ill patient. Atopic dermatitis (AD) is one, if not, the most common chronic inflammatory disease. Its presentation can vary depending on the age of the patient, the patient's skin tone, and other comorbidities. Patients often seek emergency care related to the condition itself or associated complications. This article includes a review of the pathophysiology, clinical manifestations, and standard management of AD. Finally, the potential complications of AD are discussed. A better understanding of AD will allow emergency nurse practitioners to properly identify and treat this chronic condition, as well as its complications. [ABSTRACT FROM AUTHOR]

Introduction: Keloids are a fibroproliferative, multifactorial, cutaneous disorder whose pathophysiology is not completely understood. Various factors such as high blood pressure, pregnancy, female gender, mechanical tension of local sites, and prolonged wound healing are known to worsen keloids. Childhood-onset keloids are keloids that form before 10 years of age, before various factors in adulthood come into play, and thus studying childhood-onset keloids may provide additional insight into the underlying mechanisms that lead to keloid formation. Methods: Retrospective chart review was performed on all patients with childhood-onset keloids who were evaluated at our plastic surgery clinic (one of the largest keloid referral centers in Japan) over a 1-year period. Results: Of the 1443 patients with diagnosis of keloids, 131 patients had childhood-onset keloids. Of these, 106 patients (80.9%) were female, 38.9% of patients had family history of keloids, and 48.9% of patients had allergies or allergy-related conditions (asthma, atopic dermatitis, or allergic rhinitis). Vaccination (47.5%) and chickenpox (19.9%) were the most common triggers. Of vaccinations, BCG was the most common trigger. The majority of keloids from BCG were in female patients (92.9%). The most common location was the chest in male patients (30.0%) and the arm in female patients (41.1%). Conclusion: To our knowledge, this is the largest report in the literature on childhood-onset keloids. There was overall female predominance in childhood-onset keloids, and even more significant female predominance in BCG-induced keloids. [ABSTRACT FROM AUTHOR]

Background Atopic eczema (AE) is a chronic relapsing, pruritic disease that greatly affects the child and family's quality of life (QoL). It is usually common and severe among children of Bangladeshi ethnicity. Objectives This is a cross-sectional quantitative study in patients with AE of Bangladeshi origin, which aims to analyse different components of the family, children and adult quality-of-life indices and their relationship to patient age, sex, eczema severity and distribution, other allergic associations, parental education and socioeconomic level. Methods Children and young adults of Bangladeshi origin aged 0–30 years, clinically diagnosed with AE were recruited as part of the Tower Hamlets Eczema Assessment project, a clinical phenotyping study of AE in the Bangladeshi population living in East London. Questionnaires completed by children/parents included the Family Dermatology Life Quality Index (FDLQI), Infant's Dermatology Quality of Life (IDQOL) and the Children's Dermatology Life Quality Index (CDLQI). Young adults completed the Dermatology Life Quality Index (DLQI). The disease severity was assessed objectively using the Eczema Area Severity Index (EASI). Patients and parents who did not read or speak English were aided by Bengali/Sylheti-speaking research assistants. Results Overall, 460 Bangladeshi children and 98 adults with AE were recruited. Burden of care, extra housework and emotional distress were the highest affected domains in parental QoL, while itching and sleep were the highest for children. Significant factors influencing FDLQI score were EASI [marginal effect (ME) 1.01, 95% confidence interval (CI) 1.00–1.03; P = 0.004], age (ME 0.98, 95% CI 0.97–0.99; P = 0.004), extensor eczema distribution (ME 1.25, 95% CI 1.03–1.52; P = 0.023), parental English fluency (ME 1.29, 95% CI 1.10–1.52; P = 0.002) and atopic comorbidities (ME 1.10, 95% CI 1.04–1.17; P = 0.001). Parental socioeconomic class was a nonsignificant factor. IDQOL/CDLQI was influenced significantly by the child's age (ME 0.99, 95% CI 0.97–1.00, P = 0.023), 'nonclear' eczema distribution clusters especially the 'severe extensive' cluster (ME 1.46, 95% CI 1.15–1.84; P = 0.002) and nonsignificantly by EASI and parental English literacy and socioeconomic levels. DLQI was affected significantly by nonclear eczema distribution groups especially 'severe extensive' (ME 2.49, 95% 1.76–3.53; P < 0.001) and nonsignificantly by patient age, and female sex. Conclusions AE is a chronic disease where many external factors other than disease severity affect QoL of patients and their families, -especially in under-represented minority groups who face different linguistic and cultural barriers. [ABSTRACT FROM AUTHOR]

Introduction: In pivotal phase 3 tralokinumab monotherapy (ECZTRA 1/2) and topical corticosteroid (TCS) combination (ECZTRA 3) trials in adults with moderate-to-severe atopic dermatitis (AD), tralokinumab significantly improved signs and symptoms of AD. Geographic region may impact treatment response due to potential differences in race and ethnicity, and based on findings in other therapy areas. Here, we evaluated the efficacy and safety of tralokinumab in the ECZTRA 1/2/3 North American population at week 16, as well as maintenance of responses over time, and compared these data side-by-side with those of the ECZTRA 1/2/3 non-North American population. Methods: Primary endpoints were Investigator's Global Assessment score of 0 or 1 (IGA 0/1; clear or almost clear) or at least 75% improvement in Eczema Area and Severity Index (EASI-75) at week 16. At week 16, tralokinumab-treated IGA 0/1 or EASI-75 responders were re-randomized 2:2:1 to tralokinumab 300 mg q2w, or q4w, or placebo (ECZTRA 1/2) and 1:1 to tralokinumab 300 mg q2w or q4w (ECZTRA 3). Results: Overall, 559/1596 (35%) and 160/380 (42.1%) patients randomized in ECZTRA 1/2 and ECZTRA 3 were from North America, respectively. At week 16, IGA 0/1 and EASI-75 response rates were greater with tralokinumab versus placebo in ECZTRA 1/2 (IGA 0/1: 25.3% vs 15.1%; 95% confidence interval [CI] 3.0, 17.3; p = 0.012; EASI-75, 40.1% vs 19.4%; 95% CI 12.6, 28.7; p < 0.001) and ECZTRA 3 (IGA 0/1, 40.0% vs 25.9%; 95% CI − 0.5, 28.3; p = 0.074; EASI-75: 58.1% vs 37.0%; 95% CI 4.9, 37.0; p = 0.012) and tralokinumab was well tolerated in the North American population. Patients with IGA 0/1 or EASI-75 response at week 16 demonstrated sustained responses at week 52 and week 32 in ECZTRA 1/2 and ECZTRA 3, respectively. Similar findings were observed in the non-North American trial populations. Conclusions: Tralokinumab, with or without TCS, displayed similar efficacy and safety in patients with moderate-to-severe AD across the North American population, and was comparable to the non-North American population. Clinical Trial Registration: NCT03131648 (registered 27-Apr-2017); NCT03160885 (registered 19-May-2017); NCT03363854 (registered 6-Dec-2017). [ABSTRACT FROM AUTHOR]

This study was aimed to find the most prevalent microbial isolates, as well as measurement of total serum IgE, LPS levels and their correlation with Atopic dermatitis occurrences. A 88 patients were collected randomly (47 females and 41 males), through a period Sep. 2019 to Feb. 2020 from Al Zafaraniyah General Hospital. Patients ages ranged between 10 months to 30 years. In addition, the control samples are collected randomly from 20 apparently healthy people. Microbial isolation results showed that the most prevalence microbial isolates in atopic skin patients were; Staphylococcus spp. 81 (30.10%), fungi 65 (24.20%), Bacillus spp. 53 (19.70%), Enterobacteriaceae spp. 32 (11.90%), Acinetobacter spp. 16 (5.90%), Corynobacterium spp. 10 (3.70%), Streptococcus spp. 8(3.00%) and Pseudomonas spp. 4 (1.50%) compared with control group. Antimicrobial susceptibility test was carried out for nine antimicrobial agents. The results showed that, most bacterial isolates are become a multidrug resistant especially Staphylococcus spp. and Enterobacteriaceae spp. whilst two other tests in a concern with the AD patients which are IgE and LPS, both parameters results show that, the age from 0 - 2 years, is recorded higher serum level than other age categories. [ABSTRACT FROM AUTHOR]

Introduction: The Biologics in Atopic Dermatitis: Experiences & Learnings (BADEL) project aims to improve real-life understanding of how, where, and when biologics can play a role in the treatment of atopic dermatitis (AD) from the perspective of healthcare professionals (HCPs) and patients. Methods: Individual experiences of 24 patients with moderate-to-severe AD and who had been treated with biologic therapy (dupilumab) for ≥ 3–6 months, and 20 HCPs with a sub-specialty interest in AD were collected by means of focus groups held in Canada, Germany, France, Italy and the United Kingdom. Dupilumab was the only biologic therapy available at the time of the study. Results: Most patients had suffered from AD for many years, particularly from itch and psychosocial issues, with AD negatively impacting all aspects of their life. They had experienced a long treatment journey and seen many dermatologists, enduring treatment delays and failures. They had been prescribed various therapies without long-term success. Biologics provided symptom improvement, offering many patients a near-normal quality of life. Side effects, especially conjunctivitis, were the greatest drawback, and there were a few issues with incomplete or unreliable efficacy. HCPs agreed that biologic therapy for AD in the majority of patients demonstrated rapid onset, good efficacy and tolerability, and are a viable option in patients who had exhausted all other treatment options. However, those patients who failed to sufficiently respond or developed intolerable adverse effects, particularly ocular symptoms, require alternative therapeutic options. Conclusion: Biologics can provide a near-normal quality of life for many patients with AD. Patients with AD who have failed conventional therapies should be offered all such novel therapies. Education and good patient–HCP communication will enable patients to manage their disease and treatment expectations. Patients and HCPs alike eagerly await alternative targeted therapies, which will offer greater choice and flexibility. [ABSTRACT FROM AUTHOR]

Objective. To investigate the correlation between serum immune factor levels and allergic constitution in children with infectious mononucleosis. Methods. A total of 120 children who visited our hospital from March, 2019, to December, 2020, were selected as the research objects, and 40 children who came to our hospital for physical examination were included in the control group (CG). 40 children with IM were classified into the IM group (IG), and 40 IM children with allergic rhinitis, allergic dermatitis, asthma, and other allergic diseases were classified into the IM allergy group (AG). On the second day of admission, 5 ml of fasting venous blood was collected from all children in the early morning to observe the serum IgE level, the level of lymphocyte subsets, and the level of immunoglobulin of the patient. Results. The serum CD3, CD4, and CD8 levels of children in AG were significantly higher than those in IG and CG (P < 0.05). The serum IgE, IgA, IgM, and IgG levels of children in AG were significantly higher than those of IG and CG (P < 0.05). The serum IgE levels of children in AG were positively correlated with the serum CD3, CD4, and CD8 levels (P < 0.05). There was a positive correlation between the serum IgE level and serum IgA, IgM, and IgG levels in children with AG (P < 0.05). Conclusion. The results of this study showed that there may be a certain relationship between allergic constitution and the incidence, clinical manifestations, and prognosis of infectious mononucleosis. IgE level can be used as a reference index for the early severity of IM clinical symptoms. [ABSTRACT FROM AUTHOR]

Introduction: In phase III trials in adolescents and children with atopic dermatitis (AD), dupilumab significantly decreased global disease severity. However, the effects of dupilumab on the extent and signs of AD across different anatomical regions were not reported. Here we characterize the efficacy of dupilumab in improving the extent and signs of AD across four different anatomical regions in children and adolescents. Methods: A post hoc subset analysis was performed using data from two randomized, double-blind, placebo-controlled, international multicenter, phase III trials of dupilumab therapy in adolescents aged ≥ 12 to < 18 years with moderate-to-severe AD and children aged ≥ 6 to < 12 years with severe AD. Endpoints included mean percentage change in Eczema Area and Severity Index (EASI) signs (erythema, edema/papulation, excoriation, lichenification) and extent of AD (measured by percentage of body surface area [% BSA] involvement) from baseline to week 16 across four anatomical regions (head and neck, trunk, upper extremities, lower extremities). Results: Dupilumab improved both the extent and severity of AD signs across the four anatomical regions. Improvements were shown to be similar across the four anatomical regions for % BSA involvement and for reduction in EASI signs. Improvements in all signs were seen early, within the first 4 weeks of treatment, and were sustained through week 16, across all regions. Conclusions: In pediatric patients 6 years of age and older, treatment with dupilumab resulted in rapid and consistent improvement in the extent and signs of AD across all anatomical regions. ClinicalTrials.gov Identifiers: LIBERTY AD ADOL (NCT03054428) and LIBERTY AD PEDS (NCT03345914). F7z4wqLwbkncM47ga-bUpB Does dupilumab provide improvement in atopic dermatitis across all anatomical regions in children and adolescents? (MP4 48,385 kb) [ABSTRACT FROM AUTHOR]

Patients' and caregivers' experiences with atopic dermatitis-related burden, medical care, and treatments in 8 countries. The Patient-Oriented Eczema Measure (POEM; patient-reported) and Eczema Area and Severity Index (EASI; physician-reported) were used to measure eczema severity. Association of inadequately controlled disease and disease severity with patient-reported disease burden in adults with atopic dermatitis. [Extracted from the article]

Correction to: Dermatol Ther (Heidelb) https://doi.org/10.1007/s13555-021-00584-y Authors would like to correct the error in their publication. The original article can be found online at https://doi.org/10.1007/s13555-021-00584-y. Correction to: Efficacy and Safety Trends with Continuous, Long-Term Crisaborole Use in Patients Aged >= 2 Years with Mild-to-Moderate Atopic Dermatitis. [Extracted from the article]