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J Allergy Clin Immunol. 2014 Oct;134(4):824-830.e6. doi: 10.1016/j.jaci.2014.07.060.

Application of moisturizer to neonates prevents development of atopic dermatitis.

Author information

1
Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
2
Division of Dermatology, Department of Surgical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
3
Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
4
Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan.
5
Division of Enzyme Chemistry, Institute for Enzyme Research, Tokushima University, Tokushima, Japan.
6
Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
7
Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
8
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
9
Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
10
Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. Electronic address: saito-hr@ncchd.go.jp.
11
Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan. Electronic address: ohya-y@ncchd.go.jp.

Abstract

BACKGROUND:

Recent studies have suggested that epidermal barrier dysfunction contributes to the development of atopic dermatitis (AD) and other allergic diseases.

OBJECTIVE:

We performed a prospective, randomized controlled trial to investigate whether protecting the skin barrier with a moisturizer during the neonatal period prevents development of AD and allergic sensitization.

METHODS:

An emulsion-type moisturizer was applied daily during the first 32 weeks of life to 59 of 118 neonates at high risk for AD (based on having a parent or sibling with AD) who were enrolled in this study. The onset of AD (eczematous symptoms lasting >4 weeks) and eczema (lasting >2 weeks) was assessed by a dermatology specialist on the basis of the modified Hanifin and Rajka criteria. The primary outcome was the cumulative incidence of AD plus eczema (AD/eczema) at week 32 of life. A secondary outcome, allergic sensitization, was evaluated based on serum levels of allergen-specific IgE determined by using a high-sensitivity allergen microarray of diamond-like carbon-coated chips.

RESULTS:

Approximately 32% fewer neonates who received the moisturizer had AD/eczema by week 32 than control subjects (P = .012, log-rank test). We did not show a statistically significant effect of emollient on allergic sensitization based on the level of IgE antibody against egg white at 0.34 kUA/L CAP-FEIA equivalents. However, the sensitization rate was significantly higher in infants who had AD/eczema than in those who did not (odds ratio, 2.86; 95% CI, 1.22-6.73).

CONCLUSION:

Daily application of moisturizer during the first 32 weeks of life reduces the risk of AD/eczema in infants. Allergic sensitization during this time period is associated with the presence of eczematous skin but not with moisturizer use.

KEYWORDS:

Atopic dermatitis; IgE; allergic sensitization; atopy; food allergy; randomized controlled trial

PMID:
25282564
DOI:
10.1016/j.jaci.2014.07.060
[Indexed for MEDLINE]
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