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Early intervention and active management of infant atopic eczema may play a crucial role in limiting eczema severity and preventing the onset of immediate‐type food allergy. Eczema management involves education, skincare and medications targeting skin inflammation and barrier repair. Topical corticosteroids are the mainstay of anti‐inflammatory therapy, with nonsteroidal options available for some infants. Proactive therapy, addressing subclinical inflammation, is useful for preventing eczema flares, especially in infants with recurrent eczema flares despite reactive therapy. In clinical practice, holistic consideration of overall infant and family health is essential. Providing advice on maternal stress management, nutritional guidance and recommendations for proper sleep and lifestyle is crucial for the well‐being of children and their families, not limited to eczema treatment alone. [ABSTRACT FROM AUTHOR]

Background: While treatment is a definitive therapeutic component in the management of inflammatory skin conditions, adjunctive skin care comprising of appropriate cleansing, moisturization, and photoprotection are just as important. Cleansing, treatment, moisturization, and photoprotection (CTMP) constitute the four major components of holistic skincare routine for dermatological conditions. However, inadequate patient understanding of the condition, limited resources for physicians, and insufficient time for patient education during busy dermatological consultations are the main obstacles to establishing a holistic skincare routine in the real world. Aims: This study aimed to identify key challenges in the implementation of a holistic skincare routine, and offer practical guidance to physicians to improve adoption in the management of acne, atopic dermatitis, rosacea, and sensitive skin syndrome. Methods: An expert panel comprising of nine dermatologists from Australia, China, Hong Kong, Taiwan, India, Philippines, Singapore, South Korea, and Thailand convened to develop consensus statements to stimulate real‐world adoption of holistic skincare routine in acne, rosacea, atopic dermatitis, and sensitive skin syndrome using the Delphi approach. Results: Consensus was defined as ≥80% of panel rating statement as ≥8 or median rating of ≥8. The final statements were collated to develop consensus recommendations to encourage adoption of holistic skincare routine. Conclusion: Promoting patient education on the skin condition, training support staff in patient counseling, and offering physician training opportunities are the key strategies to encourage real‐world adoption of CTMP as a holistic skincare routine. The consensus recommendations presented here should be considered in all dermatology patients to accomplish the ultimate goals of improved treatment outcomes and patient satisfaction. [ABSTRACT FROM AUTHOR]

Emollients plus are defined as topical formulations containing active ingredients with no pharmacological effect. They are designed to target multiple mechanisms in AD pathophysiology. The objective of the present study was to assess the efficacy of emollient plus medical device cream by performing a post-marketing surveillance study. It was carried out in cooperation with 88 members of the Polish Association for Atopic Diseases who were diagnosed with AD and voluntarily fulfilled the questionnaire after 14 days of product use. Additionally, the medical device underwent in vitro/ex vivo testing. Cytotoxicity was assessed by in vitro studies: direct MTT assay and indirect Agarose Overlay Assay. An ex vivo EpiDerm™ culture (EPI-200) was used to investigate the irritation potential, and culture medium was collected after 18 h of contact with the skin model to perform a flow cytometric for the analysis of inflammatory cytokines. A dermatological assessment with the local SCORAD was employed to confirm the efficacy of the cream. It was found that 86% of patients with AD observed an improvement in their skin condition during the two-week testing period. In vitro/ex vivo assays confirmed that the product is safe, non-irritant, and does not stimulate the production of proinflammatory cytokines. According to the local SCORAD, the symptoms of AD were alleviated. Moreover, preliminary studies indicated its efficacy in eliminating S. aureus on patients' skin. [ABSTRACT FROM AUTHOR]

Background: Washing with water is not inferior to washing with soaps and detergents in children with atopic dermatitis (AD) in remission during the fall-winter seasons. We investigated whether this finding varies during summer based on the type of cleanser (soaps and detergents). Methods: This evaluator-blinded, pragmatic, randomized, and non-inferiority study enrolled patients with AD whose eczema was controlled following regular steroid ointment application 2 days/week. For 8 ± 4 weeks, participants washed their upper and lower limbs with a cleanser on one side and with water alone on the other. Each participant chose either a weakly alkaline soap or an acidic detergent. The primary outcome was the Eczema Area and Severity Index (EASI) score at week 8 ± 4. Results: The data of 43 of the 47 registered participants were analyzed. The median patient age was 44 (23–99) months; 28 and 15 participants chose weakly alkaline and acidic cleansers, respectively. At week 8 ± 4, EASI scores of the water and cleanser sides were 0.00 (0.00–0.40) and 0.15 (0.00–0.40), respectively (p = 0.74). The difference between both sides was 0.00 (−0.07 to 0.14); the limits of the 95 % confidence interval did not reach the pre-specified non-inferiority margin. No difference was observed in the median Patient-Oriented Eczema Measure score, number of additional steroid ointment applications, and occurrences of skin infections. There were no differences between the cleanser types in any of the results. Conclusions: We demonstrated that washing with water was not inferior to that with a cleanser in patients with AD in the maintenance phase during summer, regardless of the type of cleanser.

Background: Pediatric patients with moderate-to-severe atopic dermatitis (AD) often experience a high disease burden and have a high risk of persistent disease. Standard-of-care immunosuppressive systemic treatments have been used off-label for AD in pediatric patients despite concerns for suboptimal safety with continuous use and risk of relapse upon discontinuation. The biologic agent dupilumab is the first systemic treatment approved for moderate-to-severe AD in children as young as 6 months. Long-term safety and efficacy data in this patient population are needed to inform continuous AD management. Objectives: The purpose of this work was to determine the long-term safety and efficacy of dupilumab treatment up to 1 year in an open-label extension (OLE) study [LIBERTY AD PED-OLE (NCT02612454)] in children aged 6 months to 5 years with moderate-to-severe AD who previously participated in the 16-week, double-blind, phase 3 LIBERTY AD PRESCHOOL trial (NCT03346434 part B; parent study) and were subsequently enrolled in PED-OLE. Methods: In PED-OLE, patients received dupilumab every 4 weeks according to a weight-tiered regimen (body weight ≥ 5 kg to < 15 kg: 200 mg; ≥ 15 kg to < 30 kg: 300 mg). Results: Data for 142 patients were analyzed, 60 of whom had completed the 52-week visit at time of database lock. Mean age at baseline was 4.1 y [SD, 1.13; range, 1.0–5.9 years]. A majority (78.2%) of patients reported ≥ 1 treatment-emergent adverse event (TEAE), most of which were mild or moderate and transient. The most frequently reported TEAEs were nasopharyngitis (19.7%), cough (15.5%), and pyrexia (14.1%). One TEAE led to treatment discontinuation (severe urticaria, which resolved in 1 day). By week 52, 36.2% of patients had achieved an Investigator's Global Assessment score of 0/1 (clear/almost clear skin), and 96.6%, 79.3%, and 58.6% had at least 50%, 75%, or 90% improvement, respectively, in Eczema Area and Severity Index scores. Conclusions: Consistent with results seen in adults, adolescents, and older children (aged 6–11 years), treatment with dupilumab for up to 1 year in children aged 6 months to 5 years with inadequately controlled moderate-to-severe AD demonstrated an acceptable long-term safety profile and sustained efficacy. These results support the long-term continuous use of dupilumab in this patient population. Trial Registration: ClinicalTrials.gov Identifiers: NCT02612454 and NCT03346434 (part B). Plain Language Summary: Atopic dermatitis (AD) is a chronic inflammatory skin disease that often results in a high disease burden in young children and their families. Patients often need long-term treatment to control their disease symptoms, including itch and rash. Dupilumab treatment for 16 weeks has shown benefits in children aged 6 months to 5 years with moderate-to-severe AD, with an acceptable safety profile. As AD is likely to continue from childhood into adolescence and adulthood, there is a need for data supporting long-term use of dupilumab in young children. In this study, children who completed the 16-week study continued dupilumab treatment for up to 1 year, receiving 200 mg or 300 mg of dupilumab (depending on the child's bodyweight) every 4 weeks. Through the year of treatment, 78.2% of patients reported at least one side effect, most of which were mild or moderate. Only one patient interrupted treatment because of severe skin rash (hives), which was resolved in 1 day. At the end of the year, 36.2% of patients had clear or almost clear skin, and almost all (96.6%) achieved at least 50% improvement in their extent and severity of disease. Additionally, 79.3%, and 58.6% had at least 75% or 90% improvement in their extent and severity of disease. In summary, consistent with results seen in adults, adolescents, and older children, this study showed that 1-year dupilumab treatment provides continued benefits with an acceptable safety profile. These results support long-term continuous use of dupilumab in children aged 6 months to 5 years with moderate-to-severe AD. 5SqqskjZPmoHiNU8WnfbXp What is the long-term safety and efficacy profile in young children with moderate-to-severeatopic dermatitis treated with dupilumab? [ABSTRACT FROM AUTHOR]

Microemulsions (MEs) and nanoemulsions (NEs) are dispersions of two immiscible liquids which are usually transparent/translucent. Several reports are available on uses of MEs/NEs to increase efficacy of the loaded active ingredient(s) in topical dosage forms. This review aims to describe brief applications of MEs/NEs in common skin diseases as well as skincare products. Advantages of MEs/NEs in comparison with the traditional bulk form, including their improved efficacy and safety, have been discussed to highlight the importance of use of such delivery systems. The review briefs mechanism of action of MEs/NEs in enhancing delivery of the cargo. Furthermore, applications of MEs/NEs in common skin diseases including infectious rashes, pigmentation disorders (hyperpigmentaion and hypopigmentation), wound healing, skin cancers and scaling patches and plaques/papulosquamous disorders (psoriasis, atopic dermatitis and acne) have been discussed. MEs/NEs in skin care products have also been reviewed here. [ABSTRACT FROM AUTHOR]

Washing with water is not inferior to washing with soaps and detergents in children with atopic dermatitis (AD) in remission during the fall-winter seasons. We investigated whether this finding varies during summer based on the type of cleanser (soaps and detergents). This evaluator-blinded, pragmatic, randomized, and non-inferiority study enrolled patients with AD whose eczema was controlled following regular steroid ointment application 2 days/week. For 8 ± 4 weeks, participants washed their upper and lower limbs with a cleanser on one side and with water alone on the other. Each participant chose either a weakly alkaline soap or an acidic detergent. The primary outcome was the Eczema Area and Severity Index (EASI) score at week 8 ± 4. The data of 43 of the 47 registered participants were analyzed. The median patient age was 44 (23–99) months; 28 and 15 participants chose weakly alkaline and acidic cleansers, respectively. At week 8 ± 4, EASI scores of the water and cleanser sides were 0.00 (0.00–0.40) and 0.15 (0.00–0.40), respectively (p = 0.74). The difference between both sides was 0.00 (−0.07 to 0.14); the limits of the 95 % confidence interval did not reach the pre-specified non-inferiority margin. No difference was observed in the median Patient-Oriented Eczema Measure score, number of additional steroid ointment applications, and occurrences of skin infections. There were no differences between the cleanser types in any of the results. We demonstrated that washing with water was not inferior to that with a cleanser in patients with AD in the maintenance phase during summer, regardless of the type of cleanser. [ABSTRACT FROM AUTHOR]

This article discusses the relationship between neonatal skin dysbiosis and the development of infantile atopic dermatitis (AD). The study found that infants who developed AD at one year of age exhibited skin dysbiosis as early as the third day of life. The use of moisturizer was associated with a lower risk of AD and food allergy (FA) during infancy. However, the study had limitations, and further research is needed to validate the efficacy of moisturizer-based interventions in preventing AD and FA. [Extracted from the article]

Pediatric dermatitis seborrhoica (DS) is a common inflammatory disorder of infancy and adolescence distinct from atopic dermatitis. We performed a narrative review on clinical and therapeutic aspects of the disease. The prevalence varies geographically and can reach up to 10%. There is a slight male predominance. Although etiopathology is not well known, both endogenous and exogenous factors contribute. Skin microbiome and its interaction with sebaceous gland function is crucial. The inflammatory pathways include innate immune function and skin barrier disturbances. Malassezia spp. and certain bacteria are increased in lesional skin. DS develops in different clinical subtypes, from localized cephalic to disseminated disease with a risk of erythroderma and eczema herpeticatum. Treatment consists of skin care and topical and rarely systemic medical therapy. Cornerstones of treatment are antifungals and mild corticosteroids. Targeted treatment is on the horizon. Pediatric DS is a common disorder important in the differential diagnosis of skin problems in infants and and children. Due to better understanding of its pathogenesis, new treatment options are developed. [ABSTRACT FROM AUTHOR]

Skin conditions are numerous and often have a major impact on patients' quality of life, and effective and safe treatment is very important. The conventional drugs used for skin diseases are usually corticosteroids and antimicrobial products that can induce various side effects, especially with long-term use, which is why researchers are studying alternatives, especially biologically active natural products. Three products caught our attention: bee venom (BV), due to reported experimental results showing anti-inflammatory, antibacterial, antiviral, antioxidant, antimycotic, and anticancer effects, Ficus carica (FC) due to its demonstrated antioxidant, antibacterial, and anti-inflammatory action, and finally Geranium essential oil (GEO), with proven antifungal, antibacterial, anti-inflammatory, and antioxidant effects. Following a review of the literature, we produced this paper, which presents a review of the potential therapeutic applications of the three products in combating various skin conditions and for skin care, because BV, FC, and GEO have common pharmacological actions (anti-inflammatory, antibacterial, and antioxidant). We also focused on studying the safety of the topical use of BV, FC, and GEO, and new approaches to this. This paper presents the use of these natural therapeutic agents to treat patients with conditions such as vitiligo, melasma, and melanoma, as well as their use in treating dermatological conditions in patients with diabetes. [ABSTRACT FROM AUTHOR]

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Background: Daily skin care is important for treatment of skin diseases, but few studies have reported on appropriate washing methods. Aim: This study aimed to provide guidance on washing techniques and examine changes in skin condition after using the recommended washing technique and foaming‐type skin cleanser in patients with atopic or asteatotic dermatitis. Methods: An internet‐based questionnaire survey on skin symptoms and cleaning methods was conducted. Further, a left–right comparative, nonrandomized trial was performed in 19 patients with asteatotic or atopic dermatitis and xerosis. Participants were instructed to wash with a cotton towel and their normal cleanser during Weeks 1–4 and with bare hands or a cotton towel and the recommended foaming‐type cleanser during Weeks 5–8. Results: The survey revealed that the degree of lathering differed depending on the cleaning tool. In the trial, scores for erythema, desquamation, and xerosis in the lower legs were significantly reduced after 4 weeks compared with scores at the start. Between Weeks 4 and 8, scores for erythema, xerosis, and pruritus in the inner forearm on the side washed with bare hands and scores for xerosis, pruritus, and excoriation on the side washed with a cotton towel were significantly reduced. A significant increase was noted in stratum corneum ceramide content on both left and right inner forearms, whereas a significant decrease was noted in stratum corneum thymus and activation‐regulated chemokine level ratios in the lower legs on both sides. Conclusions: Xerotic skin disease symptoms can be improved using appropriate body washing methods. [ABSTRACT FROM AUTHOR]

Background: New‐onset allergic diseases, such as food allergy or atopic dermatitis, can develop after allogeneic transplantation. There are limited reports of new‐onset atopic dermatitis after allogeneic hematopoietic stem cell transplantation in children and adolescents, and its treatment is yet to be established. The pathogenesis may differ from typical atopic dermatitis in terms of alloimmunity including graft‐versus‐host disease. Methods: We present five children and adolescents with new‐onset atopic dermatitis after allogeneic hematopoietic stem cell transplantation. The characteristics and clinical profiles of skin treatment after hematopoietic stem cell transplantation are summarized. Results: Graft‐versus‐host disease prophylaxis included systemic tacrolimus for all patients. After hematopoietic stem cell transplantation, all patients achieved complete donor chimerism of the bone marrow and had acute graft‐versus‐host disease of the skin. After engraftment, all patients had skin lesions that met the international consensus diagnostic criteria for atopic dermatitis. None of the patients met the diagnostic criteria for chronic graft‐versus‐host disease. Topical therapy and skin care based on atopic dermatitis guidelines improved skin condition and atopic dermatitis severity scores in all patients. In addition, type 2 inflammatory markers improved accordingly. Conclusion: Topical therapy and skin care may be effective for transplant‐related atopic dermatitis after hematopoietic stem cell transplantation. When extensive dermatitis is observed after hematopoietic stem cell transplantation, this treatment may avoid excessive immunosuppressive therapy if it meets the diagnostic criteria for atopic dermatitis. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Atopic dermatitis (AD) is chronic inflammatory skin disorder. It typically begins in infancy or childhood and might persist into adulthood. AD is characterized by dry, itchy, eczematous skin. The lesions can vary in intensification from mild to severe according to patient age or body region. AD requires ongoing management to control the symptoms. Skin manifestations along with the demand of treatment and care regimens significantly impact quality of life (QOL) in patients with AD. Individuals suffering from this condition are more prone to developing mental health disorders, which are often linked to emotional stress they experience. Exposure to stress exacerbates AD and stimulates skin changes, which in turn leads to intensification of treatment regimens. This cause-and-effect chain can be considered as a vicious circle mechanism. The aim of the review is to highlight the phenomenon by examining current literature on this topic in order to raise the awareness of healthcare professionals regarding this subject as well as implement appropriate and complete support for patients struggling with AD. A brief description of the state of knowledge: The pathophysiology of AD is multifactorial. Numerous studies explore the impact of stress on the deterioration of AD symptoms and delve into its pathogenic concepts. Simultaneously, researchers highlight increased psychological distress in AD patients, which surpass that observed in many other chronic conditions. Psychological factors play a significant role in AD. It demands considering mental health screening and support as a part of clinical practice, treating AD patients. Further research is necessary to provide efficient and comprehensive interventions. [ABSTRACT FROM AUTHOR]

This article discusses the efficacy of skin care interventions in preventing eczema and food allergy in infants. The study found that emollients, such as moisturizers, during infancy do not significantly impact the risk of developing eczema. However, they may increase the chance of developing mild local skin infections. The study also highlights a lack of trials studying other approaches to infant skincare for preventing eczema. Further research is needed to understand whether different approaches to infant skin care might prevent eczema or food allergy. [Extracted from the article]

Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While clinical monitoring is the standard of care, many caregivers are interested in its removal to prevent psychosocial burden or to decrease risk. Although melanoma can occur regardless of CMN removal, there are a variety of treatments that may offer improved cosmesis or local symptom control, including surgical excision, laser therapy, and other superficially destructive techniques. Regardless of the selected management, these patients are monitored for ongoing melanoma risk. An extensive discussion with families regarding the risks and benefits of observation versus active intervention is essential. To facilitate these discussions, we herein summarize current CMN management strategies and considerations. [ABSTRACT FROM AUTHOR]

Background. Little is known about parents' experience of using water softeners to potentially prevent and alleviate infants' eczema. We used the context of a randomised controlled pilot trial to examine parents' experiences. Aims. This study explored and compared the experiences of parents of infants at risk of eczema either using a water softener or not, their infant's related skin care and participation in the SOFtened waTER for eczema prevention pilot trial (SOFTER NCT03270566). Methods. Qualitative method, Framework Analysis. Semi-structured interviews were conducted with trial participants, 21 families of infants. Thematic analysis utilised NVivo software. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting standard.1 Results. Three key themes emerged related to parents' lived experience of using a water softener (birth to six months of age): 1. Using and applying less skin product 2. Using 'unscented', 'natural', 'allergy friendly' (parental terms) products 3. Bathing frequency. Conclusions. Using a water softener may reduce the frequency of and influence the choice of skin care products used. It may also impact bathing frequency by parents of high-risk infants. [ABSTRACT FROM AUTHOR]

Purpose: Environmental factors such as bathing may play a role in atopic dermatitis (AD) development. This analysis utilized data from the Community Assessment of Skin Care, Allergies, and Eczema (CASCADE) Trial (NCT03409367), a randomized controlled trial of emollient therapy for AD prevention in the general population, to estimate bathing frequency and associated factors within the first 9 weeks of life. Methods: Data were collected from 909 parent/newborn dyads recruited from 25 pediatric and family medicine clinics from the Meta‐network Learning and Research Center (Meta‐LARC) practice‐based research network (PBRN) consortium in Oregon, North Carolina, Colorado, and Wisconsin for the CASCADE trial. Ordinal logistic regression was used to conduct a cross‐sectional analysis of the association between bathing frequency (measured in baths per week) and demographic, medical, and lifestyle information about the infant, their family, and their household. Variables were selected using a backwards‐stepwise method and estimates from the reduced model are reported in the text. Results: Moisturizer use (OR = 2.03, 95% CI: 1.54–2.68), Hispanic or Latino ethnicity (OR = 1.97, 95% CI: 1.42–2.72), a parental education level lower than a 4‐year college degree (OR = 2.48, 95% CI: 1.70–3.62), living in North Carolina or Wisconsin (compared to Oregon; OR = 2.12 and 1.47, 95% CI: 1.53–2.93 and 1.04–2.08, respectively), and increasing child age (in days; OR = 1.02, 95% CI: 1.01–1.02) were significantly associated with more frequent bathing, while pet ownership (OR = 0.67, 95% CI: 0.52–0.87) was significantly associated with less frequent bathing. Conclusions: We found significant ethnic, geographic, and socioeconomic variation in bathing frequency before 9 weeks of age that may be of relevance to AD prevention studies. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a common skin condition and is undertreated in children under 2 years, whom there are no specific guidelines for. We sought to understand barriers to AD treatment and primary care pediatricians' (PCPs) suggested solutions. We conducted semi-structured focus groups (n = 5) with PCPs (n = 17) on how the undertreatment of AD can be addressed. Data were analyzed using an inductive qualitative approach. Participants noted that the perceived undertreatment of AD in children under 2 years could be explained by topical corticosteroid (TCS) use hesitancy, lack of caregiver adherence to PCP recommendations, and under-documentation of AD in the electronic medical record (EMR). Proposed suggestions for improving AD management included caregiver and PCP education on TCS safety; stepwise management guidelines for this age group; and EMR aids to help document and manage AD. Research is warranted to create and disseminate clinician-friendly AD management guidelines for this age group. [ABSTRACT FROM AUTHOR]

Importance: Preserving skin health is crucial for atopic dermatitis control as well as for the thriving of children. However, a well‐developed and validated tool that measures the knowledge, attitude, and practice of skin care is lacking. Objective: To develop and validate the atopic dermatitis and infant skincare knowledge, attitude, and practice (ADISKAP 1.0) scale that measures parental health literacy on atopic dermatitis and skin care. Methods: We conducted a review of the literature, a focus group (two dermatologists and 12 parents), and a panel discussion in order to generate the ADISKAP prototype. Two samples of parents with knowingly superior (dermatologists, n = 59) and inferior (general population, n = 395) knowledge traits participated in the validation of ADISKAP. Cronbach's alpha was reported as a measure of internal consistency, and the intraclass correlation coefficient (ICC) was calculated to assess the test‐retest validity. The known‐groups technique was used to evaluate construct validity. Results: The ADISKAP scale contained 17 items after content and face validity validation. After removing items that displayed poor test‐retest reliability (n = 4) and construct validity (n = 3), 12 items were retained in the ADISKAP 1.0. Interpretation: ADISKAP 1.0 is a reliable and valid tool for assessing parental knowledge, attitude, and practice on infantile atopic dermatitis and skin care. [ABSTRACT FROM AUTHOR]

Over the course of the last 20 years, numerous studies have identified the benefits of thermal waters on different skin conditions. Consequently, several investigations have been carried out on their effects on the skin, which are linked to their chemical composition, and, recently, scientists have turned their attention to the role of the thermal spring's microbiota, named "hydrobiome", regarding these therapeutic effects. At the same time, the development of cosmetics based on pre, pro, and postbiotics has reached great relevance and research is increasing every day. This review gathers information on the biological diversity of thermal spring waters and their potential use in obtaining biological compounds, metabolites, or bacterial extracts for use in dermocosmetics as active ingredients. These bioactive compounds are able to improve dermatological diseases such as atopic dermatitis or rosacea and ameliorate pruritus and xerosis; moreover, they can increase protection against UV exposure, strengthen barrier function, maintain good homeostasis of skin defenses, repair damaged skin, promote wound healing, improve skin condition, reduce uneven skin pigmentation, and prevent skin aging. From a future perspective, fruitful cooperation among researchers, hydrologists, thermal spa centers, and cosmetic industries will drive this sector toward a better understanding of the role of the hydrobiome of thermal spring waters on healthy skin and dermatological diseases and consider the inclusion of derivatives of this hydrobiome (in the form of fermenters, lysates, extracts, etc.) in dermocosmetic formulations. Therefore, and being aware of the potential of the hydrobiome in dermatological and skin care applications, the future prospects for the use of bioactive substances derived from it in dermocosmetic formulations are promising. [ABSTRACT FROM AUTHOR]

From dry skin in the newborn to atopic eczema in the infant and child, health professionals in primary care play a crucial role in supporting families in the care of skin, and the treatment and management of skin conditions in children. The evidence base can be conflicting and guidance changes frequently. With so much information to share with new parents, baby skincare is often seen as a lower priority when imparting health promotion advice than other areas such as safe sleep or infant feeding. It has been argued that, with the rising prevalence of atopic eczema in the UK population, advice to parents about what to be concerned about and when to seek medical advice is imperative. This article explores the evidence on general skincare from the newborn period to the treatment and management of common skin conditions, including atopic eczema and seborrheic dermatitis. [ABSTRACT FROM AUTHOR]

Background: Moderate to severe AD can be successfully managed by systemic treatments. Current guidelines also recommend emollients or emollients 'plus' and eudermic cleansers for all AD patients to improve the skin barrier and provide anti‐irritant and anti‐pruritic effects. Objectives: To investigate the efficacy of skin care (in addition to systemic treatment) with an Emollient 'plus' balm designed to improve the skin barrier and skin microbiome plus a corresponding syndet compared to usual commercial emollients and cleansers. Methods: In a randomized controlled multicenter study, patients with moderate to severe AD (Severity scoring of atopic dermatitis [SCORAD] score ≥ 40) receiving systemic treatment (cyclosporin A, dupilumab or a Janus kinase inhibitor) were randomized 1:1 to apply twice daily for 10 weeks Emollient 'plus' after pre‐cleaning with the syndet (Emollient 'plus' group) or to continue with their usual emollient and cleanser (Control group). Assessments included SCORAD, pruritus on a Visual Analog Scale, Dermatology quality of life questionnaire (DLQI), efficacy and tolerance questionnaires. Results: Included were 57 patients with mean age of 38 years (range 19–70 years). The mean amount of emollient used after 10 weeks was 447.3 g (range 29–1099 g) and 613.2 g (range 97–2565 g) for the Emollient 'plus' versus the Control, respectively (p = 0.0277). After 10 weeks, subjects in the Emollient 'plus' had a significantly greater reduction in current pruritus (p = 0.0277) and a greater reduction in some DLQI items compared to the Control group. Conclusions: In patients with moderate to severe AD receiving systemic treatment, the Emollient 'plus' regimen significantly improved pruritus and quality of life items compared to the control, while using 23% less product over a 10‐week period. These results stress the importance of daily use of emollients, especially emollients 'plus' to improve signs, symptoms and quality of life in patients with AD. [ABSTRACT FROM AUTHOR]

Prurigo nodularis (PN) is a chronic neural- and immune-mediated disease that is characterized by intense itch, history of skin scratching, and development of papulonodular lesions. These lesions can develop consequent to a cycle of itching and scratching associated with inflammation and changes in skin cells and nerve fibers (eg, pathogenic skin fibrosis, tissue remodeling, and chronic neuronal sensitization). Diagnosis of PN involves individual evaluation of clinical characteristics to identify disease and symptom severity. In the United States, adult patients with PN (estimated, < 90,000) are more likely to be older (age, 50-60 years); in addition, this disease is detected at higher rates in women and Black individuals relative to other demographic subgroups. Still, the small population of patients with PN exhibits considerably high use of health care resources and experiences considerable symptom burden and negatively impacted quality of life. Further, PN is associated with increased rates of a range of comorbid diseases compared with other inflammatory dermatoses (eg, atopic dermatitis, psoriasis). Adequate treatment must address both the neural and immunological component of the disease; there remains a great unmet need for safe and effective therapies that can reduce the burden of disease. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disease caused predominantly by immune dysregulation. The global impact of AD continues to increase, making it not only a significant public health issue but also a risk factor for progression into other allergic phenotype disorders. Treatment of moderate-to-severe symptomatic AD involves general skin care, restoration of the skin barrier function, and local anti-inflammatory drug combinations, and may also require systemic therapy, which is often associated with severe adverse effects and is occasionally unsuitable for long-term use. The main objective of this study was to develop a new delivery system for AD treatment based on dissolvable microneedles containing dexamethasone incorporated in a dissolvable polyvinyl alcohol/polyvinylpyrrolidone matrix. SEM imaging of the microneedles showed well-structured arrays comprising pyramidal needles, fast drug release in vitro in Franz diffusion cells, an appropriate mechanical strength recorded with a texture analyzer, and low cytotoxicity. Significant clinical improvements, including in the dermatitis score, spleen weights, and clinical scores, were observed in an AD in vivo model using BALB/c nude mice. Taken together, our results support the hypothesis that microneedle devices loaded with dexamethasone have great potential as a treatment for AD and possibly for other skin conditions as well. [ABSTRACT FROM AUTHOR]

Background: Protecting the skin barrier in early infancy may prevent atopic dermatitis (AD). We investigated if daily emollient use from birth to 2 months reduced AD incidence in high‐risk infants at 12 months. Methods: This was a single‐center, two‐armed, investigator‐blinded, randomized controlled clinical trial (NCT03871998). Term infants identified as high risk for AD (parental history of AD, asthma or allergic rhinitis) were recruited within 4 days of birth and randomised 1:1 to either twice‐daily emollient application for the first 8 weeks of life (intervention group), using an emollient specifically formulated for very dry, AD‐prone skin, or to standard routine skin care (control group). The primary outcome was cumulative AD incidence at 12 months. AD <6 months was diagnosed based on clinical presence of AD. The UK Working Party Diagnostic Criteria were applied when diagnosing AD between 6 and 12 months. Results: Three hundred twenty‐one were randomised (161 intervention and 160 control), with 61 withdrawals (41 intervention, 20 control). The cumulative incidence of AD at 12 months was 32.8% in the intervention group vs. 46.4% in the control group, p = 0.036 [Relative risk (95%CI): 0.707 (0.516, 0.965)]. One infant in the intervention group was withdrawn from the study following development of a rash that had a potential relationship with the emollient. There was no significant difference in the incidence of skin infections between the intervention and control groups during the intervention period (5.0% vs. 5.7%, p > 0.05). Conclusions: This study has demonstrated that early initiation of daily specialized emollient use until 2 months reduces the incidence of AD in the first year of life in high‐risk infants. [ABSTRACT FROM AUTHOR]

Background: It has been proposed that regular emollient application in early life could enhance skin barrier function and prevent atopic dermatitis (AD) especially in predisposed infants. This hypothesis was supported by evidence from exploratory and pilot trials showing protective effects in terms of reduced cumulative atopic dermatitis incidence with the use of daily emollient therapy starting immediately after birth. Objectives: To investigate the effectiveness of a standardized skin care regimen for infants on the development of AD compared to not structured skin care regimen in infants with atopic predisposition. Methods: Prospective, parallel group, randomized, pragmatic, investigator‐blinded intervention trial including 160 infants with 52 weeks intervention and 52 weeks follow up phase up to the age of two years. Infants were randomly assigned to receive a standardized skin care regimen including once daily leave‐on product application (lipid content 21%) or skin care as preferred by the parents. Results: Using the intention to treat approach, the cumulative AD incidence was 10.6% after one year, and 19.5% after two years in the total sample. There were no statistical significant differences between intervention and control groups. Skin barrier parameters between the intervention and control groups were comparable. AD severity was higher and quality of life was more affected in the control group. Conclusions: Regular emollient application during the first year of life does not prevent the development of atopic dermatitis. A standardized skin care regimen does not delay skin barrier development or causes side effects. [ABSTRACT FROM AUTHOR]

The skin microbiome is composed of a complex association of bacteria, fungi, and viruses. The maintenance of skin commensal microbes is essential for preventing the overgrowth of pathogenic microorganisms or already present opportunistic pathogens. Thus, the development of bioactive compounds capable of modulating skin microbiome has become an important topic for both researchers and the cosmetic industry. Increasingly, scientific evidence highlights that metabolites derived from probiotics have a great potential to prevent diseases affecting the skin. These compounds have recently been called postbiotics and are defined as a "preparation of inanimate microorganisms and/or their components that confers a health benefit on the host". Postbiotics are obtained from fermentations performed almost exclusively by lactic acid bacteria and yeast. Short-chain fatty acids, bacteriocins, and organic acids are some examples of postbiotics. These compounds exhibit antimicrobial, immunomodulatory, antioxidant, and anti-inflammatory activities. In addition, postbiotic production possesses technological advantages, including high stability and increased safety, compared to viable probiotics. In this article, a model for the large-scale production of postbiotics and their uses in cosmetic formulations are reviewed. In addition, results obtained from in vivo tests for the treatment of alopecia, acne, atopic dermatitis, and wound healing are discussed. Finally, technological advances are shown based on a survey of the main patents filed in the area of postbiotics. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD), sometimes referred to as eczema, is the most common chronic skin condition in children. Children of color have a higher reported prevalence of AD compared with their White counterparts. The purpose of this article is to discuss the differences of AD in skin of color (SOC), including clinical findings and management, with an emphasis on early recognition to avoid more severe, persistent disease. School nurses are on the frontline for these students with their ability to guide families and help support students with AD in the school setting. [ABSTRACT FROM AUTHOR]

Background: Treatment, cleansing, moisturizing, and photoprotection are four major components of holistic skin care for dermatological conditions. While treatment (T) is recognized as a key component in the management of dermatological conditions, there is a lack of practical guidance on the adjunctive role of cleansing, moisturizing, and photoprotection ("CMP"). Limited patient knowledge, confusion over product selection, and lack of guidance on how to choose and use CMP skin care products (in conjunction with pharmacological therapy) are the main barriers to establishing a holistic skin care routine for dermatological conditions. Aims: This study aimed to review current clinical evidence, identify gaps, and provide practical guidance on conceptualization and implementation of CMP routine in the management of sensitive skin due to underlying acne, atopic dermatitis, or rosacea, including conditions with idiopathic causes referred to as idiopathic sensitive skin syndrome. Methods: An expert panel comprising of 10 dermatologists from Australia, China, Hong Kong, Taiwan, India, Indonesia, Philippines, Singapore, South Korea, and Thailand convened to develop consensus statements on holistic skin care in acne, rosacea, atopic dermatitis, and idiopathic sensitive skin syndrome using the Delphi approach. Results: Consensus was defined as ≥80% of panel rating statement as ≥8 or median rating of ≥8. The final statements were collated to develop consensus recommendations on holistic skin care. Conclusion: A dermatologist‐guided holistic skin care routine is essential to improve patient confidence and reduce confusion over product selection. The consensus recommendations presented here highlight the importance of cleansing, moisturization, and photoprotection in holistic skin care and how it can be utilized as a communication tool for physicians and patients to achieve overall better patient compliance, satisfaction, and treatment outcomes. [ABSTRACT FROM AUTHOR]

Emollients are used as soap substitutes, bath additives, and leave-on treatments for dry skin conditions like eczema. However, there are many different types of emollients available. This article reviews what guidelines and formularies advise and what the research evidence is regarding their effectiveness and acceptability. It also summarises the findings from the recently published Best Emollients for Eczema (BEE) study, which was the first head-to-head comparison of commonly used lotions, creams, gels and ointments for childhood eczema in the world, and which recommends a decision aid to help parents and older children find a product that suits them. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin disease experienced mostly in childhood. Chronicity of the disease, relapses, constant need of regular skin care causes seeking for alternative treatments. The aim of this study is to evaluate the complementary and alternative treatments (CAT) used by parents' caregivers in pediatric patients diagnosed with AD, and the association between CAT use and patient characteristics. A questionnaire questioning the sociocultural and demographic characteristics of the family, the clinical findings of the patients, their treatments and CAT applications was recorded. Eighty-three patients were included in the study. 68.7% of the patients used at least one type of CAT. Vitamins and oils were the most commonly used CAT (48.8% and 47%, respectively) and 73.3% of the patients using CAT continued normal AD treatment while using CAT. The biggest factor affecting CAT choice was the advice of the immediate circle (75%), and 40.6% of the patients stated that they benefited from the complementary therapy. CAT are widely used in AD. Physicians should know the socio-cultural structure of the region they are in, the CAT used and their side effects, and inform the families. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD), the most common inflammatory skin disorder, is a multifactorial disease characterized by a genetic predisposition, epidermal barrier disruption, a strong T helper (Th) type 2 immune reaction to environmental antigens and an altered cutaneous microbiome. Microbial dysbiosis characterized by the prevalence of Staphylococcus aureus (S. aureus) has been shown to exacerbate AD. In recent years, in vitro models of AD have been developed, but none of them reproduce all of the pathophysiological features. To better mimic AD, we developed reconstructed human epidermis (RHE) exposed to a Th2 pro-inflammatory cytokine cocktail and S. aureus. This model well reproduced some of the vicious loops involved in AD, with alterations at the physical, microbial and immune levels. Our results strongly suggest that S. aureus acquired a higher virulence potential when the epidermis was challenged with inflammatory cytokines, thus later contributing to the chronic inflammatory status. Furthermore, a topical application of a Castanea sativa extract was shown to prevent the apparition of the AD-like phenotype. It increased filaggrin, claudin-1 and loricrin expressions and controlled S. aureus by impairing its biofilm formation, enzymatic activities and inflammatory potential. [ABSTRACT FROM AUTHOR]

Background: Rice has been used for cosmetic purposes for centuries and its benefits have been translated into modern‐day skin careproducts. Methods: Pubmed and google were searched with the terms "skin care" and "cosmetics" in conjunction with the words "rice", "rice bran", and "fermented rice bran". Resulting articles were analysed for potential benefits of ingredients contained within rice for skin care and summarised. Results: Individual components of rice have been identified including phenolic compounds, betaine, squalene, tricin, and rice bran. These rice‐derived ingredients have been found to be antiaging, anti‐inflammatory, whitening, photoprotective, and moisturizing. Moreover, rice‐derived ingredients have demonstrated benefits for dermatological conditions. Rice bran ash extract increases melanin synthesis and offers protection from radiation and skin injury. Fermented rice bran extract and rice bran broth baths have shown utility in atopic dermatitis treatments. Literature suggests that rice‐derived ingredients are also safe, non‐irritating, and hypoallergenic. Conclusion: Ingredients isolated from rice and its components have wide potential for use in skin care and cosmetic products. [ABSTRACT FROM AUTHOR]

As the potential applications of electrospinning in healthcare continue to be explored, along with advancements in industrial-scale solutions and the emergence of portable electrospinning devices, some researchers have explored electrospinning technology in topical products, including its application in skincare, such as facial masks, beauty patches, sunscreen, and dermatological treatments for conditions like atopic dermatitis, psoriasis, acne, skin cancer, etc. In this review, we first outline the fundamental principles of electrospinning and provide an overview of existing solutions for large-scale production and the components and functionalities of portable spinning devices. Based on the essential functionalities required for skincare products and the mechanisms and treatment methods for the aforementioned dermatological diseases, we summarize the potential advantages of electrospinning technology in these areas, including encapsulation, sustained release, large surface area, and biocompatibility, among others. Furthermore, considering the further commercialization and clinical development of electrospinning technology, we offer our insights on current challenges and future perspectives in these areas, including issues such as ingredients, functionality, residue concerns, environmental impact, and efficiency issues. [Display omitted] • The new functions of electrospun topical products are introduced. • The recent advancements in electrospun topical products are summarised. • The challenge and future perspectives of electrospun topical products are discussed. [ABSTRACT FROM AUTHOR]

A significant increase in the severity of clinical manifestations of various dermatoses accompanied by dry skin often increases the feeling of discomfort and itching of the skin, significantly reducing the patient's quality of life. This leads to the search for effective ways to correct the dryness of the skin and maintain the proper functioning of the epidermal barrier of the skin in various dermatoses. The aim of the study was to study the effect of using a combined emollient, which includes components of a classic emollient (with the inclusion of ceramides and substances with moisturizing and softening effects), as well as substances with antiseptic and fungistatic effects. The results of treatment of 100 patients with skin diseases and conditions accompanied by dry skin and itching were analyzed. The study group included patients with acne undergoing treatment with retinoids and external preparations with an irritating effect, patients with atopic dermatitis in remission, patients with seborrheic dermatitis, rosacea, follicular hyperkeratosis, and skin xerosis. Using the method of corneometry, the dynamics of changes in skin hydration during the use of a combined moisturizer and changes in the indicators of the dermatological index of the quality of life of patients were studied. The data obtained showed a pronounced increase in skin hydration in terms of corneometry after 2 weeks of using an emollient (by an average of 31.6 units or 160%), and after a month of observation, the changes amounted to 36.7 conv. units, i.e. increased by 185%, which proves the effectiveness of using Blue cap® foam to normalize skin hydration. The level of the dermatological index of quality of life during this period decreased from 9.9±0.2 to 7.2±0.2 points, i.e. by 2.7 points or 27%,what also indicates an improvement in the subjective attitude of patients and promotion quality of life of patients. In the course of the study, a significant improvement in skin hydration when using the combined Blue cap® foam to correct signs of skin xerosis was proven. In the case of dermatoses accompanied by itching associated with dry skin, a marked reduction in itching was noticed, as well as a significant improvement in the quality of life of the patient after a month of using the combined moisturizer. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis, a chronic inflammatory skin disease can significantly reduce patients' quality of life. It is commonly observed in infants or young children but can also occur in adults. Patients with atopic dermatitis are at risk of developing food allergies, allergic rhinitis, and asthma. Current Concepts: Treatment of atopic dermatitis should commence with moisturization of epidermal skin and avoidance of environmental factors that may trigger exacerbation of atopic dermatitis. Topical corticosteroid application remains the gold standard for medical management of atopic dermatitis; however, topical corticosteroids are often avoided owing to concerns regarding the adverse effects of these drugs. Recently, several systemic immunosuppressants and biological agents have been introduced for the treatment of atopic dermatitis. These medications are associated with fewer adverse effects than those observed with previous treatments and have therefore shown positive results for successful management of atopic dermatitis. Discussion and Conclusion: It is expected that new drugs tailored to the disease level of each patient will revolutionize the treatment of atopic dermatitis more effectively in future. [ABSTRACT FROM AUTHOR]

Introduction: Basic therapy is of central importance in the treatment of atopic eczema. Using electron microscopic images, the morphology of epidermal skin barrier and its lipids was investigated after application of a lipid foam cream and basic cream. Methods: Patients with two contralateral comparable atopic eczema (local SCORAD 1–10) on the forearms were tested. Eczema was treated with a lipid foam cream or basic cream twice daily for 28 days. At the beginning, after 14 days, and at the end of application, the local SCORAD, trans-epidermal water loss (TEWL), skin hydration, intercellular lipid length in the intercellular space of the stratum corneum (SC), and skin lipids were determined. Results: After application of the foam cream, the epidermal skin barrier could be completely restored and corresponded to healthy skin, while the epidermal skin barrier could not reach this state after care with the basic cream. The content of lipids in the SC increases significantly by 31% after basic cream treatment, whereas they are significantly increased by 85% after application of the lipid foam cream. The local SCORAD improved for both treatments to about the same extent, and no significant results could be shown for TEWL and skin hydration. Conclusion: In subjects with mild atopic eczema, the lipid foam cream leads to a measurable recovery of the skin barrier which is much more pronounced in comparison to the basic cream. [ABSTRACT FROM AUTHOR]

Xerosis cutis is recognized as a burdensome and stressful condition of the skin, resulting in impaired health-related quality of life (HRQoL). Therefore, it should be treated as a relevant skin disease with detailed care and treatment recommendations. This cross-sectional, exploratory study aimed to examine xerosis cutis-related burden from patient's perspective and compare it with individuals without xerosis cutis. Within-group comparisons were also performed among patients with xerosis cutis associated with atopic dermatitis (AD) or not. The second aim was to assess the effect of a routinely applied basic skin care therapy in terms of burden release. Overall, 127 participants were included in the study. Patients with xerosis cutis reported a lower quality of life (p =.041), more dysmorphic concerns (p <.001), and higher general anxiety (p =.029) than individuals without xerosis cutis. The presence of AD was associated with lower HRQoL (p =.023), more depression (p =.008) and anxiety symptoms (p =.003), and more stigmatization experiences at baseline (p <.001). Patients with xerosis cutis showed higher psychosocial burden than participants without xerosis cutis. Additionally, patients with xerosis and AD had more psychosocial impairments than patients with xerosis without AD. [ABSTRACT FROM AUTHOR]

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Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune dysregulation, microbiome dysbiosis, genetic and environmental factors. All these interactions are shaping the landscape of AD endotypes and phenotypes. In the "era of allergy epidemic", the role of food allergy (FA) in the prevention and management of AD is a recently explored "era". Increasing evidence supports that AD predisposes to FA and not vice versa, while food allergens are presumed as one of the triggers of AD exacerbations. AD management should focus on skin care combined with topical and/or systemic treatments; however, in the presence of suspected food allergy, a thorough allergy evaluation should be performed. Food-elimination diets in food-allergic cases may have a beneficial effect on AD morbidity; however, prolonged, unnecessary diets are highly discouraged since they can lead to loss of tolerance and potentially increase the risk of IgE-mediated food allergy. Preventive AD strategies with the use of topical emollients and anti-inflammatory agents as well as early introduction of food allergens in high-risk infants seem promising in managing and preventing food allergy in AD patients. The current review aims to overview data on the complex AD/FA relationship and provide the most recent developments on whether food allergy interventions change the AD course and vice versa. [ABSTRACT FROM AUTHOR]

Dr Emma Craythorne (London)Dochart 117:15-17:35UK TrendPodoconiosis - maintaining skin healthDr Paul Matts (London)Dochart 117:20-17:40Invited LecturePhotosensitivity and photodiagnosisProfessor Sally Ibbotson (Dundee)Lomond17:35-17:55UK TrendWhat help can skin biologists offer dermatologists in terms of improving skin health? HT