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Background and objective Probiotics, defined as live microbial dietary supplements that provide health benefits for the host, have been suggested as a treatment for atopic dermatitis based on a variety of proposed mechanisms of action. We analyzed evidence for the efficacy of probiotics to attenuate the severity of atopic dermatitis in pediatric patients younger than the age of 18 years. Material and methods Systematic review of trials of probiotics that included patients under the age of 18 years with a confirmed diagnosis of atopic dermatitis scored for severity using the Scoring Atopic Dermatitis SCORAD) tool. We performed a meta-analysis of the randomized placebo controlled trials. The following databases were searched: MEDLINE, Web of Science, Scopus, ClinicalTrials.gov, Epistemonikos, Trip Medical Database, and the Spanish Virtual Health Library. Results Twenty trials were retrieved and included in the systematic review. Sixteen supported the use of probiotics to attenuate SCORAD-evaluated severity. Meta-analysis found an overall mean difference in effect between probiotics and placebo of −0.38 (95% CI, −0.63 to −0.14) in favor of probiotics. However, trial heterogeneity was high (I2 statistic, 76%) due to clinical and methodological variability. Conclusion In spite of clinical heterogeneity in trials attributable to different types of probiotic products and doses, and to the subjective variability of the SCORAD scale, we conclude that probiotics are beneficial for reducing the severity of atopic dermatitis as reflected by the SCORAD index.

Case report: The case report regards a 33-year-old male patient living in a big city. The patient has been suffering from atopic dermatitis since infancy. Results: SCORAD index evaluating the AD intensity level changed after 15 whole-body cryotherapy sessions. Before the treatments, the patient achieved 42.9 points on the above-mentioned scale. After the 15th treatment the sum of points amounted to 36.8, and after 3 weeks since the therapy was discontinued — 33.9 points. Changes in the level of hydration of both healthy skin and skin with AD symptoms were also observed. Conclusion: Due to these properties, the hypothesis has been put forward that systemic cryotherapy can be a complementary method in the treatment of AD.

Objectives: To determine topical tacrolimus ointment’s efficacy in atopic dermatitis. Study Design: Descriptive case series study. Setting: Outpatient Department of Dermatology, Liaquat University of Medical and Health Sciences (LUMHS), Civil Hospital, Hyderabad. Period: 12 October 2017 to 12 April 2018. Material & Methods: Consisted of 106 patients. Detailed History was taken from patients and systemic review was also done to assessed any co-morbidity. Data was analyzed through SPSS version 23.0. Results: In this study 71 (66.98%) patients were men and 35 (33.01%) were female; with male to female ratio 2:1. The mean age was 6.1+1.8 years. Clinical signs of patients were erythema 88(83.01%), edema 76(71.69%), Oozing/ crusting 45(42.45%), excoriation 59(55.66%) and lichenification 64(60.37%). Before treatment start the SCORAD index (SCORAD I) mean was 61.8 ± 11.12 (range 7–103): moderate cases were observed in 87(82.07%) patients (SCORAD I 30 – 49) and 19(17.92%) patients had severe AD (SCORAD I ≥50). After treatment, the SCORAD index mean was 35.8 ± 13.15 (range 7–103): 57(53.77%) patients had SCORAD index values ≤30; moderate cases (SCORAD I 30-49) were observed in 42(39.62%) patients and 7(6.60%) patients had severe AD (SCORAD I >50). In 57(53.77%) cases topical tacrolimus ointment (0.1%) showed positive efficacy in atopic dermatitis, while in 49(46.22%) cases observed negative. Conclusion: The application of topical tacrolimus ointment (0.1%) is effective in the treatment of atopic dermatitis in children.

Itchy skin, a symptom of various diseases, present in 54.4 % of patients with skin pathologies, is a rather difficult task when choosing a therapy.Material and methods. Under observation were 45 patients (27 women and 18 men) with various dermatoses, accompanied by itching. All patients received Neotanin therapy (cream and spray) with standard topical therapy. Efficiency assessment was carried out taking into account the indices Prurindex, BRS, dermatological status indices for each nosology (SCORAD, EASI, PASI), and DIC.Results. In patients with idiopathic skin itching, Prurindex decreased by 100 % by the end of 3rd weeks, BRS – by 96.8 %. In atopic dermatitis, the SCORAD index decreased by 78.3 %, BRS index reduced by 91.9 %, Prurindex index decreased by 95.4 %. With eczema, the EASI index decreased by 96.1 %, the BRS and Prurindex index were reduced by 100 %. In psoriasis, the PASI index decreased by 86.5 %, BRS index – by 90.8 %, Prurindex index – by 94.2 %.Conclusions. The use of the topical Neotanin as monotherapy for idiopathic pruritus, as a part of comprehensive treatment for atopic dermatitis, eczema, psoriasis, significantly improves the quality of life of patients.

Introduction Atopic dermatitis (AD) is featured by pruritus, which causes diminished quality of life. Little clinical data exists concerning the use, efficacy and side effects of UVA1 phototherapy in AD patients. Aim To determine the effectiveness of medium-dose UVA1 phototherapy in AD treatment. Material and methods Thirty-six patients with AD were irradiated with medium-dose UVA1 (45 J/cm2) as monotherapy for 4 weeks for a total of 20 sessions (daily irradiations during weekdays only). Clinical status was evaluated with the visual analogue scale for pruritus, Dermatology Life Quality Index (DLQI) for evaluating general well-being and the SCORAD index. All parameters were measured twice: before and after phototherapy. Results UVA1 phototherapy resulted in a significant (p < 0.001) decrease in pruritus, improvement in DLQI (p < 0.001) and SCORAD (p < 0.001). Before phototherapy, the intensity of pruritus and SCORAD index correlated with DLQI (r = 0.34, p < 0.05 and r = 0.61, p < 0.05, respectively). Similarly, after irradiation, pruritus correlated with DLQI, and SCORAD index correlated with DLQI (r = 0.51, p < 0.05 and r = 0.55, p < 0.05, respectively). No severe adverse effects were noted during the study. Conclusions Phototherapy with medium-dose UVA1 irradiation exerts a significant antipruritic effect, decreases the severity of the disease and improves the quality of life of AD patients. This technique can therefore be used as a safe and effective treatment method.

Background Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue. Objective To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China. Methods This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history-taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy. Results A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis. Conclusions In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity.

Background: Behçet's disease (BD) is a chronic inflammatory systemic disease that affects multiple organs. The causes of BD are still unknown, but it is primarily characterized by autoimmune reaction in the blood vessels. Current research focuses on treatments that can reduce the non-typical inflammatory responses of BD. Nevertheless, studies on improving the inflammatory effect of BD using inflammation mechanisms are still insufficient. Therefore, we conducted the integrated treatments related to inflammation modulation and achieved alleviation of symptoms in BD mice. Methods: To understand the complex etiology of BD and compare its management, the herpes simplex virus (HSV)-induced BD mouse model was used. In order to alleviate the inflammatory response in BD mice, Taraxaci Herba (TH, herbal medicine), R7050-a TNFα inhibitor, and a mixture of TH and R7050 were injected for 2 weeks repetitively. The SCORAD index was examined to evaluate the cutaneous inflammations. In addition, histological changes and inflammatory factors were analyzed. Results: Repetitive injection of TH and/or R7050 reduced the symptoms of BD and significantly decreased IL-6, IL-1β, and TNFα in blood sera. Moreover, this treatment reduced the ulcers and the deterioration of skin. Conclusions: The results of our study showed that the down-regulation of inflammatory factors is related to the control of immune responses in BD models, suggesting that a mixed drug treatment may be more effective in improving the condition of BD.

Background. One of the most important tasks in the treatment of atopic dermatitis (AD) is alleviation of racking skin dryness and persistent pruritus, because these factors exert a significant influence on worsening patients’ quality of life. Cryotherapy being a new form of rehabilitation in AD may supplement and support a long-term process of AD treatment, because it has anti-inflammatory and antipruritic effects and exerts a positive influence on the nervous system. Methods. 14 adults (mean age 32±10.8) with mild to moderate AD were enrolled. WBC (15 treatments in total) took place in winter 2018/2019. Patient skin parameters (hydration of the epidermis, sebum level, and skin pH level) were measured with probes produced by Courage + Khazaka Electronic GmbH. Results. Changes were observed in the hydration level of the epidermis. The SCORAD index evaluating the AD intensity level also changed (decreased). Conclusion. Due to these properties, hypothesis has been put forward that WBC can be an effective, supporting method in the treatment of AD.

Atopic dermatitis (AtD) is a chronic inflammatory skin disease with complex etiopathogenesis, which begins in childhood. Purpose of the study: To evaluate the clinical efficacy and safety of Skin-cap cream as a topical background therapy in children with diabetes. Materials and methods: The study included 77 children aged 1 to 11 years with moderately severe AtD with a widespread lesion of the skin (33,5%), skin itching, inflammatory skin reaction and exacerbations occurring 3 to 4 times a year. During the study, two arms of children were formed: the treatment arm - 39 children with an average course of the disease (SCORAD index = 33,9 ± 2,2 points), who received the background therapy with the prescription of Skin-cap cream. Comparison arm: 38 children (SCORAD index = 34,2 ± 2,1 points), who received Afloderm cream as a background therapy. Results: Patients of the treatment arm showed a significant dynamics of relief of AtD symptoms as compared with the comparison arm. the differences in the duration of dermal manifestations were as follows: in the treatment arm, the time of reducing hyperaemia was 4,4 ± 1,2 days, in the comparison arm, hyperaemia was reduced at 5,7 ± 1,5 days (p< 0.05), the mean duration of alleviation of the skin itching was 3,0 ± 0,9 days and 5,8 ± 1,4 days (p< 0,05) at 6,8 and 7,3 days in the treatment arm and the comparison arm, respectively. Conclusions: The conducted study confirmed the high efficacy of the use of Skin-cap cream as a topical agent for background therapy of AtD, as compared to topical glucocorticosteroids.

Objective — to study of therapeutic efficacy of acute period of atopic dermatitis with inclusion of probiotic strain Lactobacillus rhamnosus GG (LGG® in microencapsulated form) into the complex treatment.Materials and methods. A total of 36 children with moderate-to-severe atopic dermatitis (SCORAD more than 20 points) in the exacerbation phase were examened. All patients were divided into 2 groups: the main group consisted of 26 children (average age 8.6±1.3 years old) and were administrated Preema® in complex therapy, the comparison group comprised 10 children (aged 9.1±2.0 years) treated with standard remedies.Results. After 2-week treatment in the main group SCORAD index reduced to 18.52±3.9 points, which was significantly lower than in the comparison group that made up 24.3±4.8 points (р

WOS: 000484626500003, PubMed: 31543528, Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder affecting a large number of people in the world. Atopic dermatitis (AD) is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It was first described in 1933 but exists since antiquity. Aim and Objectives: To determine the relationship between AD and IBS. Materials and Methods: A total of 109 patients with AD and 100 healthy controls were included in the study. They were defined for diagnosis of IBS according to ROME-III diagnostic criteria. Supporting findings, Bristol stool scale, frequency of defecation and history of AD and IBS were also evaluated. AD severity was assessed using Severity Scoring of Atopic Dermatitis index. Results: A total of 62 patients (56.9%) in the AD group and 28 patients (28%) in the control group were diagnosed with IBS (P

The aim of this study is the evaluation, if the level of total IgE, onset of atopic dermatitis (AD) and the family history are in the significant dependence to the severity of AD. The statistical evaluation of the dependence between the severity of AD and the the level of total IgE, family history and onset of AD was performed. 296 patients were examined. The level of total IgE above 200 IU/ml is recorded in 93 % of patients suffering from severe form and the positive data about atopy in family history are recorded in 66 % of patients with severe form of AD. The significant dependence was recorded between the severity of AD and parameters such as the level of total IgE, and family history about atopy. No dependence was recorded between the severity of AD and the onset of AD.

Goal of the research: to determine the efficacy of a new line of Atopic cosmetic products for skin care in children suffering from atopic dermatitis. Materials and methods: The study involved three groups of 15 children aged 3-12 suffering from atopic dermatitis in each group. Subjects from Group 1 were treated with Atopic Soothing Cream, from Group 2 with Atopic Soothing Stick Cream and from Group 3 with Atopic Everyday Care Cream. Different inclusion and exclusion criteria were developed for each group, and the algorithm for the product application and efficacy criteria were determined. According to recommendations, Atopic Soothing Cream and Atopic Soothing Stick Cream were applied to clean and dry skin in the morning and in the evening for the study period of 14 days. The patients’ skin condition was assessed prior to the study and on Day 14 of the therapy; the assessment covered parameters necessary for calculating the SCORAD Index. Atopic Everyday Care Cream was applied to clean and dry skin in the morning and in the evening for 28 days. The patients’ skin condition was assessed prior to the study and on Days 14 and 28 of the therapy including the SCORAD Index and assessments of the skin hydration level of the epidermal corneous layer and transepidermal waster loss (TEWL) using the DermaLabCombo CORTEX device. According to the study results, the line of Atopic cosmetic products fully complies with the properties specified by the manufacturer, reliably improves the skin condition in children suffering from atopic dermatitis, has no irritant or sensitizing effect, and can be recommended for the complex treatment and rehabilitation of patients suffering from the pathology.

Background: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in infancy with a complex pathology. In adults, the clinical severity of AD has been associated with increases in T helper cell type (Th) 2, Th22, and Th17 serum markers, including high levels of CC chemokine ligand (CCL) 17 and CCL22 chemokines.Objective: To explore the possible association between serum chemokine levels and AD severity in infants with moderate-to-severe AD and elevated immunoglobulin E (IgE).Subjects and methods: Serum samples (n = 41) obtained from a randomized, double-blind, and clinical dietary intervention study were used to study biomarkers in infants with AD. Baseline- and post-intervention samples (4 months) were used, six chemokines and nine ratios thereof were analyzed using Luminex and correlated to AD severity. In the initial study, the infants were randomized to receive extensively hydrolyzed whey-based formula without (control) or with short-chain galacto-oligosaccharides/long-chain fructo-oligosaccharides (9:1) and Bifidobacterium breve M-16V (active).Results: 31 Infants up to 11 months of age, with an objective-SCORAD score (oSCORAD) ≥ 20 and elevated total-IgE and/or specific-IgE levels were included. In time, the median oSCORAD decreased in both groups by -8 (control, p Conclusion: While this study is small and exploratory in nature, these data contribute to immune biomarker profiling and understanding of AD in infants.

Objectives This study investigated the effect of camping style Hospitalization program for atopic dermatitis female adolescent patients. 6 patients, 12-14 year old female adolescent, admitted for camping style hospitalization program.Methods 6 patients were admitted for camping style hospitalization program (2014.08.13~2014.08.16). The program included acupuncture, herbal medicine, examination, education, psychotherapy, dressing, exercise. The patients were analyzed by Severity Scoring Atopic Dermatitis(SCORAD) index and measured skin pH value(pH). Also, patients evaluated themselves by writing an atopic dermatitis diary which consists of diet, emotion, severity of pruritus, and sleep loss, and checked questionnaires which consist of atopic dermatitis, self treatment methods and degree of satisfaction of each program.Results Most of subjective symptoms which patients complained were improved and also SCORAD index total scores were decreased by sasang constitutional medication.Conclusions We expect that the camping style hospitalization program based on sasang constitutional medicine could be helpful for female adolescent patient of atopic dermatitis.

Objectives : This study is clinical report of one atopic dermatitis patient with exudate.Methods : We treated a 16-year old woman patient with acupuncture, pharmacopuncture, herbal medicine, herbal bath, aroma cream therapy and western medicine. The improvement of the patient was evaluated by SCORAD INDEX and photography.Results : The SCORAD Index score of admission day at hospital was 73.5, and the SCORAD INDEX score of discharge day was 11.4. Amount of exudate and the score of oozing were decreased.Consults : The complex treatments of korean medicine and western medicine was effective to improve of atopic dermatitis patient with exudate. And the influence of weather condition to prognosis of atopic dermatitis with exudate was observated. It is necessary to have more observations and case reports.

Dermaveel cream, which has been registered for the use in atopic dermatitis (AD), consists of, among others, ectoine and hazel bark extract. To evaluate safety, efficacy and tolerance of the preparation, 242 subjects with AD were included in open-label studies in 64 research sites in Poland. Dermaveel cream was applied to affected skin 2× daily for 4 weeks. Patients came for follow-up visits three times – at the beginning of the study and then once every two weeks. Intensity of skin changes was evaluated with the use of SCORAD index and intensity of pruritus and sleep disorders were assessed with the use of analogue scale of 1–10. Reduction of the mean SCORAD index from 42 at visit I to 25 at visit II and to 15 at visit III was observed. Statistically significant reduction of intensity of pruritus and sleep disorders at follow-up visits has also been shown. During the study, patients also evaluated usable properties of the study cream considering ease of spreading, absorption rate, consistency, and smell. Almost all patients assessed these properties as very good or good. On the basis of the conducted study, it has been concluded that Dermaveel cream is a safe and efficient preparation. It can be recommended for use on all parts of the body both in children and adults. Its regular use may reduce the need for topical glucocorticosteroids but it requires further studies.

Aim of this study is to evaluate the dependence between the occurrence of food hypersensitivity reactions and the severity of atopic dermatitis. The detailed personal history about the food hypersensitivity reactions was recorded and the severity of atopic dermatitis was evaluated with SCORAD index. The statistical evaluation of the dependence between the occurrence of food hypersensitivity reactions and the severity of atopic dermatitis was performed. Two hundred and eighty-five patients were examined – 90 men and 195 women, average age 26.2 (s.d. = 9.5). The significant dependence between the severity of atopic dermatitis and the occurrence of food hypersensitivity reactions was confirmed; 96% of patients with severe form of atopic dermatitis suffer from food reactions. In evaluating the single foods, the significant dependence was found between the severity of atopic dermatitis and the reactions to nuts, apples, and fishes.

Purpose Atopic dermatitis (AD) is a chronic inflammatory relapsing skin disorder. Vitamin D plays a pivotal role in the development of AD, and interleukin (IL) 31 is known to be related to pruritus in AD. The aim of our study was to determine whether 25-hydroxyvitamin D (25(OH)D) levels are related to IL-31 levels or to the severity of AD. Methods We enrolled 91 children with AD and 32 control subjects without history or symptoms of allergic diseases. Blood was drawn to evaluate complete blood cell count, total eosinophil count (TEC), and total IgE, specific IgE to common allergens, 25(OH)D, and IL-31 levels. Serum 25(OH)D and IL-31 levels were measured using high-performance liquid chromatography and enzyme-linked immunosorbent assay, respectively. The scoring atopic dermatitis (SCORAD) index was used to evaluate the severity of AD. Results The mean 25(OH)D level was significantly lower in the AD group than in the control group; 25(OH)D decreased greatly in the moderate and severe AD groups compared with the mild AD group. Children with atopic sensitization showed significantly lower 25(OH)D levels than nonatopic children. However, serum IL-31 levels were not related to AD group, SCORAD index, or 25(OH)D levels. The SCORAD index was inversely correlated with serum 25(OH)D level and positively correlated with TECs and total IgE levels. Children with moderate and severe AD had significantly higher TECs than children with mild AD. Conclusion Vitamin D is related to the severity of AD independently of IL-31.

The present study was undertaken to evaluate effects of eco-friendly underwears(three kinds of natural dying underwears) in patients with atopic dermatitis. We recruited 45 patients with atopic dermatitis admitted to Dongshin Oriental Hospital from August to September 2013. These patients were divided into three groups (A, B and C). Each group include 15 patients and three kinds of natural underwears dyed with polygonum tinctorium, loess, and non-dyed general cotton were given, respectively. We also used SCORAD index and digital infrared thermal imaging to investigate the effects of each eco-friendly underwear in patients with atopic dermatitis. In SCORAD index, Group A after wearing loess-dyed underwears for 4 weeks showed statistically significant reduction to 27.96 (P

Objective : The purpose of this study is to report the effectiveness of a long-term Korean Medicine Treatment on 1035 atopic dermatitis patients Methods : Objective SCORAD Index(OSI) is used for measuring the degree of atopic dermatitis with photos of total 1035 atopic dermatitis patients who has visited oriental clinic from January 9, 2011 to October 31, 2013. Then, OSI was estimated according to gender, age, period of treatment and intensity. Results:1.The ratio of male to female was 44.4 : 55.6. All patients were constituted with 26.5% of 0~11 year-old group, 15.7% of 12~18 year-old and 57.9% of 19 and more year-old. 2.The ratio of OSI improvement was significantly higher in women than in men after 3 month treatment, but there was no significant difference after 6, 9 and 12 months. 3.The OSI improvement of 0~11 year-old group was significantly higher than the other groups after 3 month treatment. But at the other periods of treatment, there was no significantly difference of the improvement among 3 different groups of age. 4.After 3, 6, 9 and 12 month treatment, the score of OSI was significantly lower than before treatment. After 12 month treatment, the score of OSI was lowest compared to the other periods of treatment. 5. The final OSI score of 87.7% patients was decreased compared to the initial.

The aim of the present study was to provide evidence for the application of probiotics in the prevention and treatment of infantile eczema by exploring changes in the intestinal Bifidobacteria levels and the Scoring Atopic Dermatitis (SCORAD) index prior and subsequent to treatment with probiotics in infants with eczema. A total of 40 infants with eczema were randomly divided into treatment and control groups. Prior and subsequent to the treatment, the SCORAD index was evaluated and the content of Bifidobacterium bifidum in the stool of each infant in the two groups was quantified using 16S rRNA/DNA quantitative polymerase chain reaction analysis. After four weeks of treatment with B. bifidum triple viable capsules, the levels of B. bifidum increased sharply (P0.05). Following treatment, the levels of B. bifidum in the stools of the treatment group were significantly higher than those in the stools of the control group (P

Background: The pathogenesis of atopic dermatitis (AD) remains to be determined; recently a possible change in the immune system with production of immunoglobulins is proposed. As vitamin E is a potent antioxidant, with the ability to decrease the serum levels of immunoglobulin E (IgE) in atopic patients, we aimed to evaluate the effect of oral vitamin E on treatment of AD. Materials and Methods: This randomized, double-blind, placebo-controlled trial comprised seventy participants with mild-to-moderate AD, based on the Hanifin and Rajka diagnostic criteria. The patients were randomly selected from teaching skin clinics in Isfahan, Iran. They were randomly assigned to two groups of equal number, receiving vitamin E (400 IU/day) and placebo for four 4 months. Each month, the extent, severity, and subjective symptoms including itch and sleeplessness were measured by SCORAD index. Three months after the end of intervention, the recurrence rate was assessed. Results: The improvement in all symptoms, except sleeplessness, was significantly higher in the group receiving vitamin E than in controls (-1.5 vs. 0.218 in itching, -10.85 vs. -3.54 in extent of lesion, and -11.12 vs. -3.89 in SCORAD index, respectively, P < 0.05). Three months after the end of intervention, the recurrence rate of AD was evaluated. Recurrence rate between all 42 individuals, who remained in the study, was 18.6%. Recurrence ratio of the group receiving vitamin E compared to the placebo group was 1.17, without significant differences between the two groups (P > 0.05). Conclusion: This study suggests that vitamin E can improve the symptoms and the quality of life in patients with AD. As vitamin E has no side effects with a dosage of 400 IU/day, it can be recommended for the treatment of AD.

Introduction: Atopic Dermatitis (AD) is a common chronic inflammatory condition characterized clinically by pruritus and eczematous lesions. An inverse relationship has been suggested between serum 25-hydroxyvitamin D concentration and severity of atopic dermatitis. Aim: We carried out this controlled cross- sectional study to evaluate the association between the serum vitamin D3 levels and SCORAD index. Materials and Methods: For this study, 40 patients with clinical diagnosis of AD based on UK diagnostic criteria were enrolled and 40 patients with minor ailments like superficial bacterial, fungal or viral infections and not suffering from atopic dermatitis were taken as controls. Salient presentations were recorded in a preset proforma. Serum 25-hydroxyvitamin D levels were determined through Sandwich-ELISA technique. SCORAD (Scoring AD) index was used to evaluate the severity of the disease. Results: Mean value of serum 25-hydroxyvitamin D levels in cases was 30.38 nmol/l whereas in controls, it was 53.46 nmol/l. The decrease in serum levels in cases was statistically highly significant (p-value

Atopic dermatitis (AD) can significantly compromise the quality of life (QoL). The aim of our investigation was to evaluate whether QoL correlates with AD severity, evaluated through the physician and the patient perspective, in a sample of Italian children.Forty children with AD were evaluated. Disease severity was assessed by the physician and the patients (or their parents) using the SCORAD and the patient-oriented SCORAD (PO-SCORAD) tools, respectively. Patients or their parents completed specific QoL questionnaires (IDQOL/CDLQI). Spearman's correlation coefficient and non-parametric analysis of covariance were used to analyze the data.SCORAD e PO-SCORAD were moderately but significantly correlated (ρ Spearman=0.55, P0.01). QoL scores ranged from 1 to 23, with a median score of 4.0 (higher scores represent more impaired QoL). After adjustment for age and sex, children with SCORAD40 had significantly higher QoL scores (more impaired QoL) than those with SCORAD≤40 (median QoL of 5 and 4, respectively, P=0.048). Even higher differences emerged when AD severity was self-assessed (median QoL of 6 and 3.5 for children with PO-SCORAD40 and PO-SCORAD≤40, respectively, P=0.01). AD children with concomitant food allergy had a significantly more impaired QoL than those with AD only (P=0.040). No significant difference in QoL was observed according to sex or age.In our sample of AD children, QoL appeared slightly-moderately altered, and increasing disease severity was associated with greater impairment in QoL. SCORAD and PO-SCORAD were fairly correlated and the association of QoL was somewhat stronger with the PO-SCORAD than the SCORAD Index. This supports the usefulness of PO-SCORAD for the self-assessment of AD in children, and suggests the importance to integrate physician and patient perspectives in the management of AD.

Background The efficacy of low-dose medicine (LDM) in childhood mild/moderate eczema is not known. We conducted a double-blind, two-stage, randomized, placebo-controlled clinical trial, lasting 23 months, to address this issue. Method Eighty children with chronic mild/moderate eczema were randomly allocated to Group A (placebo) or Group B (treatment group; Galium-Heel®, a low-dose multicomponent medicine based upon natural substances; Guna-Interleukin 12 and Guna-Interferon-γ administered twice a day for six non-consecutive months for each stage). LDM is characterized by the use of biological molecules, such as cytokines, neuropeptides, growth factors, hormones at very low concentrations, which correspond to physiological levels within the human body. The dosage of the cytokines used in this trial (IFN-γ and IL-12) is 10 fg/ml. The SCORAD index was evaluated by the same operator: subjects with a SCORAD index below 20 were considered to have mild eczema (61/80; mean: 10.79), whereas a SCORAD index between 20–50 indicated moderate eczema (19/80; mean: 26.84). The data of 66/80 children were analyzed in stage 1 and those of 62/66 children in stage 2. The primary outcome measure was reduction of eczema severity assessed by the SCORAD index. Secondary outcomes were disease-free interval, and treatment safety and tolerability. Results The decrease in disease severity was greater in Group B than in Group A already in stage 1 (a decrease 63.9% versus 53.2%), but the difference was not significant (p = 0.16). Moreover, subjective symptoms (itching and sleep disturbances) initially decreased and then worsened in Group A, whereas itching decreased linearly and sleep disturbances decreased significantly (p=0.049) in Group B. Conclusions Preliminary evidence suggests potential benefit, but further work is needed to validate this approach. Trial registration The trial was registered with EudraCT number 2010–018640-13 through the database of the National Clinical Trials Monitoring Centre Database (Osservatorio delle Sperimentazioni Cliniche, OsSC) of the Italian Medicines Agency.

Background: Treatment of Atopic Dermatitis (AD) is still a challenge, with Narrow band (NB-UVB) considered to be a corner stone. Calcidiol deficiency is one of the factors in the pathogenesis of AD, thus supplementation with oral calcidiol is assumed to offer additional therapeutic option for such patients. Aim of study: Was to assess the possible role of calcidiol in the treatment of AD whether it is induced by phototherapy or given as an oral supplementation. Patients and methods: 30 pediatric patients with AD were enrolled in this study and divided into 2 equal groups. Group Ι patients received 24 sessions of NB- UVB and group ΙΙ patients received oral calcidiol (600 IU/day orally) for 2 months. A blood sample was taken and SCORAD index was assessed before and after treatment for all patients. 20 controls were also included. Results: At baseline, the mean level of calcidiol was significantly lower in AD patients (92.53 ± 22.42 ng/ml) in comparison to controls (132.18 ± 48.27 ng/ml) (P=0.005). Two months after therapy, both groups showed elevation of calcidiol level with no statistical difference between them (P=0.66), and also improvement of SCORAD index with no statistical difference between both groups (P=0.172). Conclusion: The current study proves the suggested role of calcidiol deficiency in AD especially in the pediatric group. In addition, it demonstrated the high efficacy of oral supplementation of calcidiol in the management of AD children that was comparable to documented results of NB-UVB.

A clinical trial was carried out in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka to evaluate the efficacy of Mometasone Furoate 0.1% cream in atopic dermatitis. Forty patients of atopic dermatitis were selected and randomized into two groups. In Group I, study patients were applied Mometasone Furoate 0.1% cream to the affected skin and in Group II, control patients were allowed to apply white vaseline to the affected skin. SCORAD index was assessed fortnightly at 2 nd and 3 rd visit and final SCORAD index were calculated at the end of 4 week (3 rd visit). In the study, at base line SCORAD index in case group was 49.76 ± 17.25 and in control group was 55.25 ± 13.94 (p>0.05). At 2 nd visit that is at the end of 2 (two) weeks of medication SCORAD in case group was 27.39 ± 11.16 and in control group was 50.05 ± 14.69 (p=0.001) and at 3 rd visit that is at the end of 4 (four) weeks of medication in case group SCORAD was 12.08 ± 6.87 and in control group was 46.70 ± 14.80 (p=0.001). Percent of reduction of SCORAD from 1 st visit to 3 rd visit in case group was 76.70 ± 8.10 and in control group was 16.88 ± 8.70 (p=0.001) which indicates satisfactory improvement and statistically significant. It can be concluded that once daily application of mometasone furoate 0.1% cream is effective in atopic dermatitis. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21311 Medicine Today 2014 Vol.26(1): 36-40

Objectives : The purpose of this study is to confirm the effects of external applications(CLANCHE SM A Clinic) containing herbal extracts on patient with atopic dermatitis. Methods : A total of 24 patients who visited Semyung Oriental Medical Center from January 15th, 2014 to February 20th, 2014 were included in the study. In this study, the patients were treated with external applications(CLANCHE SM A Clinic) containing herbal extracts. For 4 weeks of gross examination and instrumental assesment were made before and after the study. Results : 1. In the primary endpoint, SCORAD index showed a statistically significant decline. 2. In the secondary endpoint, index of skin hydration and index of TEWL showed statistical significance. 3. In the secondary endpoint, index of skin pH showed no statistically significant result. c 2014 the Society of Korean Medicine Ophthalmology & Otolaryngology & Dermatology This is an Open Access journal distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/license/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 강민서 외 2인 : 경증의 아토피 환자에서 한약 추출물 함유 외용제에 대한 임상 연구 41 4. To evaluate the safety of the products for the human body, vital sign check were conducted and showed no statistically significant result. And There were no severe adverse events during this study. Therefore, it is suggested that the safety of the products, if used for certain period, should be safe for the human body. 5. In global assesment of efficacy, both experimenter and subjects evaluated external applications were effective. Conclusions : According to the above experiments, it is suggested that external applications(CLANCHE SM A Clinic) containing herbal extracts should be effective for the atopic dermatitis. Key word : Atopic dermatitis; External application; Herbal cosmetics; CLANCHE SM A Clinic; SCORAD index 교신저자 : 김희택, 충북 제천시 세명로 66 세명대학교부속한방병원 한방안이비인후피부과학교실 (Tel:043-649-1817, E-mail:kht8725c@naver.com) ∙접수 2014/7/8 ∙수정 2014/8/7 ∙채택 2014/8/14 I. 서 론 아토피 피부염은 만성의 재발성 습진성 피부염으로 심한 소양감을 특징으로 하며 주로 유아와 소아기에 발생하는 면역성 질환으로 대개 생후 2개월 전후에 시작되며, 약 50%가 생후 1세 이내에, 약 90%가 5세 이내에 발병한다. 국민건강보험공단 통계에 의하면 2008년부터 2012년까지 아토피 피부염으로 진료 받 은 인원은 연평균 104만명이었으며, 2012년도에는 9 세 이하의 진료 인원이 47만 4천명으로 전체 진료인 원의 절반에 육박하고 특히 4세 이하의 영유아는 32 만 1천명이, 즉 100명당 15명이 진료를 받아 전체 환 자의 35%를 차지하여 국가적인 문제로 대두되고 있 다. 아토피 피부염의 발생 원인 및 발생 기전에 대해 서는 아직 명확하게 밝혀지지 않았으나 유전적 요인 과 함께 자동차 매연 분진, 미세먼지, 휘발성 유기화 합물 등의 새로운 알레르기 항원의 등장 및 주거환경 변화로 인한 항원에 대한 노출 증가 등 다양한 환경 적 요인, 면역학적 요인들이 제시되고 있다. 아토피 피부염의 증상으로는 급성기의 심한 가려움 증과 홍반성 구진, 수포, 긁으며 발생한 삼출성 병변, 아급성기의 긁은 상처, 홍반, 인설이 덮인 구진, 판과 만성기의 반복적인 소파로 인한 태선화 등이 있으며, 이와 같은 다양한 시기의 병변들이 한 환자에게서 동 시에 관찰된다. 서양의학에서는 대증요법과 함께 스테로이드제, 면 역조절제, 항생제 등의 국소도포와 더불어 외용제에 반응하지 않는 병변에는 항히스타민제, 스테로이드제, 항생제 등의 경구치료와 면역글로불린의 정맥주사, 자외선 조사나 레이저 조사를 통한 광치료 등의 다양 한 치료법을 사용하고 있다. 한의학적으로도 아토피 피부염에 대해 한약제재를 이용한 다양한 치료법의 제시 및 임상연구가 진행되 고 있는데 최근에는 내복약뿐만이 아니라 외용제에 대한 관심이 높아져 오 등의 탁리소독음 함유 외용 제, 주 등의 삼황세제가미방 함유 화장품, 홍 등의 樺皮. 蔓荊子. 仙鶴草 함유 외용제와 같이 한방 추출 물을 포함한 보습제를 이용하여 아토피 피부염이 호 전되는 증례를 보고한 바 있으나 이에 대한 표준이 되는 기준이 마련되어 있지 않으며, 또한 한방 처방을 이용한 치료제 개발의 어려움으로 치료제 보다는 보 습제, 에센스, 로션, 크림 등에 한약 성분이 포함된 기 능성 화장품제품 차원에서 개발되고 있는 실정이다 . 이에 아토피 피부염 환자의 손상된 피부를 효과 적으로 관리하기 위하여 한방 소재를 이용하여 개발 한 ‘클란체 SM A Clinic 제품’을 경증의 아토피 피부 염 환자를 대상으로 사용하여 유의한 결과를 얻었기 에 보고하고자 한다. 한방안이비인후피부과학회지 제27권 제3호(2014년 8월)

Objectives This study investigated the effect of camping style Hospitalization program for atopic dermatitis children patients. Methods 6 patients were admitted for camping style hospitalization program. The program includes acupuncture, herbal medicine, examination, education, psychotherapy, dressing, exercise. The patients were analyzed by Severity Scoring Atopic Dermatitis (SCORAD) index and measured skin pH value (pH). Also, patients evaluated themselves by writing an atopic dermatitis diary which consists of diet, emotion, severity of pruritus, and sleep loss. Checked questionnaires which consists of atopic dermatitis, self treatment methods and each program satisfaction. Results After 7 days of hospitalization program, the patient`s SCORAD index scores were decreased and most of the patient`s symptoms were improved. Conclusions The hospitalization program could be helpful for atopic dermatitis children patients.

Objectives : The purpose of this study is to investigate the efficacy of external preparation containing herbal extract(Sophorae Radix, Aurantii Immaturus Fructus, Schizonepetae Spica, Forsythia fructus and Portulacea Herba) on atopic dermatitis patients. Methods : A total of 33 patients who visited the Dept. of Ophthalmology, Otolaryngology & Dermatology of Korean Medicine of Korean Medical hospital of Daejeon university from February 2012 to February 2013 were engaged in this study. Patients who corresponded the requirements were enrolled in the study. This study shows symptom comparisons before and after the use of this product. Effectiveness was evaluated through SCORAD(SCORing Atopic Dermatitis) Index, and the quality of life scale was conducted through Skindex-29. Results : 1. Comparison of the general changes through SCORAD Index indicated that the experimental group showed more statistically significant declines than the placebo group after the two-week use. 2. Comparison of changes in intensity criteria(Erythema, Edema, Oozing, Excoriation) through SCORAD Index indicated that the experimental group showed more statistically significant declines than the placebo group after the two-week use. c 2014 the Society of Korean Medical Ophthalmology & Otolaryngology & Dermatology This is an Open Access journal distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/license/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 한방안이비인후피부과학회지 제27권 제1호(2014년 2월) 18 3. Comparison of changes in subjective symptoms through SCORAD Index indicated that the experimental group showed no statistically remarkable changes. 4. Comparison of changes in the body parts(Upperlimb) through SCORAD Index indicated the experimental group showed statistically significant changes after the two-week use. 5. Comparison of the general changes in quality of life through Skindex-29 indicated that the total score from experimental group showed statistically significant changes after the four-week use. Conclusions: This study, evaluated through SCORAD Index, indicated that the treatment with the external preparation containing herbal extract has a statistically marginal significance of efficacy on atopic dermatitis patients in the short term.

Objectives : The aim of this study is to examine the effect of external application containing herbal extracts (Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba) to patients with atopic dermatitis. Methods : Twenty patients (experiment group) were treated with the external application containing herbal extracts (Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba) and other twenty patients (control group) were treated with normal external application that doesn’t contain herbal extracts for 2weeks. We observed comparisons between experiment and control group after 1week, 2weeks. Degrees of severity of atopic dermatitis were measured by SCORAD index (Scoring of Atopic Dermatitis Index). Statistical significance was achieved if the probability was less than 5% (p

Purpose: Wet wrap therapy is a well-known treatment for severe atopic dermatitis (AD). However, wet wrap therapy with usual ban dage was a troublesome and time-consuming process of application. The aim of this study was to evaluate the efficacy, safety and convenience of wet wrap therapy with new garments in children with moderate-to-severe AD. Methods: We compared 56 AD children treated with wet wrap therapy and 14 AD children treated with only conventional therapy. We retrospectively reviewed the clinical features, change of SCORing Atopic Dermatitis (SCORAD) index, adverse effects and par ent’s reports. Results: The initial mean SCORAD index was 60.3±15.3 points. No significant differences in sex, age, initial SCORAD index, total eo sinophil count, total IgE level, food allergen sensitization, inhalant allergen sensitization or associated allergic diseases were found between the wet wrap and conventional groups. The pharmacological and nonpharmacological interventions except wet wrap therapy were same in the 2 groups. Wet wrap therapy with garments or tubular bandage was easily done one time per day over night in 10.6±3.5 days by parents. Improvement in total SCORAD index, intensity, subjective symptoms and pruritus were signifi cantly higher in the wet wrap group than in the conventional group (36.2 vs. 26.9, 6.0 vs. 4.0, 9.9 vs. 7.4, and 4.8 vs. 3.6 points). No fol liculitis and serious adverse effects were reported. Conclusion: Wet wrap therapy with new garments could be easily done by parents. Wet wrap therapy may be effective and safe in controlling moderate-to-severe AD in children. (Allergy Asthma Respir Dis 2019;7:13-21)

A Case Study of a Patient with Atopic Dermatitis improved by Yangdokbaekho-tang Ji-Hwan Kim, Min-Ji Kim, Han-Beom Son, Hyo-Sang Bae, and Seong-Sik Park Dept. of Sasang Constitutional Medicine, College of Korean Medicine, Dongguk Univ.ObjectivesThe purpose of this case study was to report the main effect of Yangdokbaekho-tang to a Soyangin atopic dermatitispatient. MethodsThis patient was treated by Yangdokbaekho-tang, topical herbal extract, moxa and acupuncture according to theresult of Sasang constitutional diagnosis.Results and ConclusionsThe patient's subjective symptoms of atopic dermatitis and general condition were improved after using Yangdokbaekho-tang in spite of patient's loose stool. The SCORAD index (Scoring Atopic Dermatitis Severity Index) which was used to evaluate the therapeutic effect of Sasang constitutional treatment on atopic dermatitis was also decreased from 86.3 to 42.8 without using anti-histamine or steroid medications.Key Words: Atopic dermatitis, Soyangin, Yangdokbackho-tang

Background Atopic dermatitis (AD) is a chronic inflammatory skin disorder with an immunologic basis. It may have negative medical and social impacts on a patient and his family. Objectives To assess serum level of vitamin D among children with AD and determine its association with AD severity using the AD Scoring System Index. Study design A case-control study. Patients and methods Twenty-nine patients with AD in the age group between 2 and 12 years were enrolled in the study. The severity of the disease was determined by the AD scoring system. Thirty controls were recruited. Serum levels of 25-hydroxyvitamin D3 [25(OH)D3] were tested using commercial automated chemiluminescent microparticle immunoassay. Results The mean value of vitamin D in children with AD was much lower than normal value, and there was a significant difference in the mean values of vitamin D between children with AD (5.4±1.9 ng/mL) and the controls (28.9±2.4 ng/mL). Serum 25(OH)D levels were found to be significantly higher in mild AD (14.6±3.5 ng/mL) compared with moderate (5.5±3.1 ng/mL) or severe AD (0.3±0.1 ng/mL); P Conclusion Patients with AD have lower serum vitamin D levels than normal. Vitamin D deficiency might be related to the severity of AD.

A Case Report of Soeumin Adult Atopic Dermatitis Improved with Sipyimigwanjung-tang. Seong-Tae Kim, Ae-Ryun Choi, Deok-Mo KooDept. of Sasang Constitutional Medicine, college of Korean Medicine, Daegu Haany Univ.ObjectivesThe purpose of this case study is to report that a Soeumin patient diagnosed as adult atopic dermatitis was treatedwith Sipyimigwanjung-tang and then his symptoms improved.MethodsWe diagnosed the patient as Soeumin Greater Yin Pattern based on his nature & emotion, physical characteristics,symptoms. So we treated him with Sipyimigwanjung-tang and used Visual Analogue Scale(VAS), SCORAD(Scoring of Atopic Dermatitis) index and pictures of the affected part for the assessment.Results & ConclusionsAfter treatment, his SCORAD index results significantly decreased from 76.3 to 41.8, VAS of itching decreased from 10 to 4 and the patient's subjective symptom and general condition considerably improved. This case studydescribe the effectiveness of Sipyimigwanjung-tang on Soeumin adult atopic dermatitis symptoms.Key Words: Adult Atopic Dermatitis, Sipyimigwanjung-tang, Soeumin, Sasang Constitutional Medicine

Atopic dermatitis (AD) is a disease with multifactorial etiology. Staphylococcus aureus is one of the predominant environmental factors acting on the course and intensity of the disease.The aims of the study were to evaluate the efficacy and safety of clothing made of cellulose fibers with seaweed enriched with silver ions in the treatment of children with AD.A prospective, randomized and double-blinded controlled selection was done to recruit 19 children with diagnosis of AD. This sample was divided in two groups with similar demographic and clinical characteristics (the "control" group of seven children who wore placebo clothing and the "trial textile" group of 12 children who wore clothing with the new textile). The severity of AD and clinical response were assessed by the SCORAD index, the intensity of pruritus and the changes in sleep characteristics, at the start of the study and after 7 and 90 d.The SCORAD index improvement in the group with the fiber under study was statistically significant after the first 7 d of treatment (p 0.001) and was reduced by about 45% after 90 d. There was also a statistically relevant reduction of the intensity of pruritus and an improvement in the sleep quality after the initial 7 d and at day 90.The results showed that the textile clothing with seaweed enriched with silver ions brings a quicker improvement of the patients in the first days in opposition to the use of standard all-cotton clothes. The results also reinforce the importance of non-pharmacological measures, like clothing, in the management of patients with a diagnosis of AD.

BACKGROUND: Atopic dermatitis (AD) and food allergy frequently coexist in children.OBJECTIVE: To examine the association between food allergy and AD.METHODS: Between 2001 and 2011, children referred to our tertiary care center underwent double-blind, placebo-controlled food challenges (DBPCFCs) for one or more suspected food allergies as part of regular care. Immediate reactions were observed and recorded by allergy nursing staff, whereas late reactions were ascertained by semistructured telephone interview 48 hours after challenge. To test to which degree specific IgE results were predictive in the outcome of DBPCFCs in children with and without (previous and current) AD, logistic regression analysis was performed.RESULTS: A total of 1186 DBPCFCs were studied. Sensitization to foods occurred significantly more often in children with previous AD. The association between specific IgE results and the outcome of DBPCFCs was significant for children with and without (previous and current) AD but stronger for children without current AD. The positivity rate of DBPCFCs in children with mild, moderate, and severe AD was 53.3%, 51.7%, and 100%, respectively. Children with AD and a history of worsening AD as their only symptom reacted as often to placebo as to challenge food.CONCLUSION: Children with current AD are more frequently asymptomatically sensitized to the foods in question than those without AD. In addition, children suspected of food allergy should be considered for testing, regardless of the severity of their AD. Our results suggest that children with exacerbation of AD in the absence of other allergic symptoms are unlikely to be food allergic.

Clothing, or “the second skin,” not only provides an additional shield for most parts of the body, but also creates a portable living microclimate that improves human survival. A growing interest in the use of antimicrobial active textiles/clothing has being developed as a desirable goal of prevention and nonpharmacological treatment for the management of atopic dermatitis and skin infective diseases. This review focuses on new development of antimicrobial active textiles using appropriate natural or special-treated fabrics coated with antimicrobial agents or using nanotechnology and nanomaterial in the care of atopic dermatitis or other skin diseases. Clinical evaluations of current available antimicrobial active textiles were summarized according to the aim, design, human subjects, intervention/control, duration, and SCORAD index and other outcomes. Lastly, evaluation of the safety of antimicrobial textiles for humans and the environment is also discussed.

Several studies on the pathogenesis of allergy both in man and experimental animals continue to show the importance of commensal bacteria in the gastrointestinal tract in stimulating and directing the immune system. The interest in modulating commensal bacteria flora with pre- and probiotics to prevent and treat food allergy has multiplied in recent years. We recently studied 230 infants with atopic dermatitis and suspected cow’s milk allergy. The infants were randomly allocated to groups which received Lactobacillus GG (LGG), a mixture of four probiotic strains (MIX) or placebo for 4 weeks. We inferred that probiotics induce systemically detectable low-grade inflammation, which may explain the clinical effects and the secretion pattern of cytokines induced by PBMC. To study the ability of probiotics to prevent allergy in children, we recruited 1223 pregnant women carrying fetuses at increased risk of allergy for a double-blind placebo-controlled trial. Mothers used a mixture of four probiotic bacteria or a placebo from the 36th week of gestation. Their infants received the same probiotics plus prebiotic galacto-oligosaccharides for 6 months. At the 2-year follow-up, a total of 925 infants participated. The cumulative incidence of allergic disease did not differ significantly between the synbiotic and the placebo group. However, synbiotics significantly reduced eczema. The preventive effect of synbiotics was more pronounced against IgE-associated diseases. At the 5 year follow-up, 891(88%) of the 1018 intention-to-treat infants attended. In the probiotic and placebo groups, frequencies of allergic symptoms and IgE-associated allergic disease and sensitization were similar, and the frequencies of eczema did not differ between the groups. Atopic eczema, allergic rhinitis and asthma appeared equal frequency in the groups. However, less IgE-associated allergic disease occurred in the cesarean-delivered infants given probiotics. In cesarean-delivered childen, we noticed a delayed rise in bifidobacteria recovery in placebo-treated children which was corrected by pro- and prebiotic supplementation. Indications from studies of feces and blood at the age 6 months suggest that probiotics may enhance both inflammation and immune defence of the gut. The probiotic treatment further stimulated maturation of the immune system since the infants given probiotics showed increased resistance to respiratory infections and improved vaccine antibody responses.

This study aimed to investigate the skin irritancy with unripe Citrus grandis Osbeck extract and to determine the effect of cotton underclothes dyed with the citrus extract on the severity of atopic dermatitis by in-vivo methodology. The skin irritancy from the extract was assessed by Kawai’s method and the severity of atopic dermatitis was evaluated by measuring the quantitative index of SCORAD for human subjects wearing the citrus-dyed underclothes. Skin reactions were not found by Kawai’s method, which suggests that the citrus extract does not cause irritancy on human skin. In a wear test, a marked clinical improvement of atopic dermatitis indicated by a decrease of SCORAD index value was observed in human subjects wearing the dyed underclothes compared to the values for subjects with undyed clothes. These results imply that Citrus grandis Osbeck could be utilized as a bioactive natural material for dermal healthcare-related textiles.

BACKGROUND: The aim of the controlled double-blind trial in patients with atopic dermatitis was the evaluatuion of efficacy of the combination of levomenol and heparin compared to the two single active substances alone and the cream base. PATIENTS AND METHODS: 278 patients were randomized to four groups: 79 patients were treated with a combination preparation from levomenol and heparin, 80 with levomenol alone, 78 with heparin alone, and 41 with the cream base without active substances. The cream was applied twice daily for 8 weeks. Efficacy criteria were the severity of pruritus (visual analogue scale) and the SCORAD index as well as the overall assessment of efficacy and tolerance by the physician and patient. RESULTS: The improvement of pruritus and SCORAD values in the combination preparation group was significantly superior compared to all other groups (ANCOVA, p < 7 × 10 - 8 ). The improvement of pruritus under treatment with the combination approximately corresponded to the cumulative effect of the two single active substances. CONCLUSION: The combination of levomenol and heparin proved to be significantly more efficacious against pruritus and inflamed skin than preparations of the single components.

Background Vitamin D plays an important role in the immune system. It inhibits B-lymphocyte proliferation and modulates the humoral response to suppress IgE production. Studies on the relationship between serum 25-hydroxyvitamin-D level and the severity of atopic dermatitis in several countries have had varying results. Objective To assess for a possible correlation between serum 25-hydroxyvitamin-D level and atopic dermatitis severity in children. Me thods A cross-sectional study was conducted in 26 children with atopic dermatitis from September to December 2015. We evaluated the severity of disease using the Scoring of Atopic Dermatitis (SCORAD) index and measured serum 25-hydroxyvitamin-D levels. Spearman’s test was used to analyze for a correlation between serum 25-hydroxyvitamin-D level and the atopic dermatitis score in children with atopic dermatitis. Results Mean SCORAD index was 32.0 (SD 14.99) , with a range of 10.9 to 71.4. Mean serum 25-hydroxyvitamin-D level was 41.1 (SD 24.81) ng/mL, with a range of 10-137 ng/mL. There was a moderate correlation between serum 25-hydroxyvitamin-D level and the SCORAD index (r=-0.591), with higher SCORAD index associated with lower serum 25-hydroxyvitamin-D level (P=0.01). Conclusion There is a moderate correlation between serum 25-hydroxyvitamin-D level and the SCORAD index in children with atopic dermatitis.

In a double-blind, placebo-controlled crossover trial, 23 patients consumed 250 ml mare's milk or placebo for 16 weeks. The aim was to examine the effects of mare's milk on the characteristics of atopic dermatitis (AD), on faecal microbiota and on clinical and immunological parameters. The intensity of AD was examined using the Severity Scoring of Atopic Dermatitis (SCORAD) index. During the mare's milk period, the mean SCORAD value of patients (n=23; 17 females, 6 males) decreased from 30.1 to 25.3 after 12 weeks (P

Background: Atopic dermatitis (AD) is a chronic inflammatory pruritic skin heterogeneous disease, which does not have an objective tool able to permit comparison between patients and to monitor changes due to a specific treatment. Several assessment methods have been developed to evaluate the AD. Objectives: The aim of this study was to investigate the agreement between two observers in the assessment of the severity of AD applying SCORAD index and EASI in infants and young children with AD. The variations of parameters that compose each score, as well as the inter-observer variation for both scores, were also studied. Methods: We evaluated 42 infants and young children admitted and followed in a paediatric allergy centre (UNIFESP-EPM). All children met the diagnostic criteria for clinical AD established by Hanifin and Rajka. Two investigators graded the severity of AD, applying the SCORAD index and EASI. The two scoring systems assessed the variation between baseline evaluation and one month after treatment. Results: Significant correlations were observed comparing both scores for each physician and each evaluation. There were no differences between the mean SCORAD and EASI scores for each physician, in the two evaluations. There was a significant decrease in the mean total SCORAD and EASI score and its components, except for the item Upper Extremities EASI Conclusion: Both scoring systems for AD are valid, reproducible and responsive in monitoring AD patients. Further studies will be necessary to investigate the development of AD and the best evaluation. SCORAD showed itself to be an excellent score to detect the development of AD, whereas the EASI are suitable to follow up in drug-effect studies of AD for research purposes.

Background. Аn estimation of a family method efficiency of children rehabilitation with atopic dermatitis. Materials and methods. There were 88 families under medical survey where children with atopic dermatitis lived. These families were divided into two groups: the first group (basic) - 68 children who passed rehabilitation according to a family principle at the consulting center of family rehabilitation; the second group (control group) - 20 children, who improved their health with a traditional method. Catamnesis data was used as the methods of rehabilitation control of efficiency with an estimation of frequency and recurrences severity of the basic disease of SCORAD index change, numbers of references to the doctor in occasion of concomitant diseases were used. Results. The positive effect in dermatitis treatment was achieved at 66 among 68 patients (97,1%). 2-3 fold decrease of frequency of the recurrences was observed at 56 children (82,4%), decrease in the defeated area - at 53 children (77,9%). The positive effect was observed in 6 out of 20 children (30%) (p

Irritation of the skin of patients with atopic dermatitis by contact with rough fibres of synthetic or woollen clothes is well known. Therefore, it has been recommended that patients should wear cotton clothes. However, cotton also consists of rough fibres able to irritate the skin, whereas silk is characterized by smooth fibres without irritating potential. The aim of our study was to evaluate the clinical effect of Dermasilk- a special silk fabric (sericin-free silk treated with AEGIS AEM5772/5 which has antibacterial properties) - in children with atopic dermatitis. A total of 22 children with mild-to-moderate atopic dermatitis were recruited for a study period of 3 months. All of them received three different tube-fabrics - Dermasilk, sericin-free silk fabric without AEGIS AEM 5772/5 and cotton, covering the cubital region. Patients were advised to wear the Dermasilk fabric all day long during the whole study period on one arm, whereas the sericin-free AEGIS-free silk tube had to be used during the first 2 wk only on the other arm followed by the use of the cotton tube for the rest of the study period. Evaluation of the local SCORAD score was carried out at the beginning of the study, after 2, 4, 8 and 12 wk. A significant reduction of the local SCORAD index of the Dermasilk covered arm was observed after 4, 8 and 12 wk in comparison with the cotton-covered arm score [median (quartile 1-quartile 3)] 6.5 (5-8) vs. 8 (7-9), p < 0.002; 6 (5.25-7.75) vs. 8 (7-9), p < 0.0001; and 6 (5-6) vs. 8 (7.25-10), p < 0.0001. The use of Dermasilk has a significant beneficial effect in atopic dermatitis because of the non-irritating properties of silk as well as the antibacterial capacity of AEGIS AEM 5772/5.