Saturday , October 1 2022

Atopic dermatitis in children should be prevented from birth – Children's health


Half of primary care pediatricians expect the first outbreak to recommend preventive measures atopic dermatitis, as a result of the use of emollients, according to preliminary results of a survey by the Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma (SEICAP). On the occasion of the Atopic Dermatitis Day, which is celebrated on November 27, SEICAP recalls the importance of preventing this pathology from birth in children with genetic predisposition to suffering from allergic diseases. The work was carried out by 573 healthcare professionals, and it is also clear that 79% used an emollient cream before diagnosing atopic dermatitis. Different studies have demonstrated this proper hydration of the baby's skin could prevent allergens from entering the dermis and therefore slowing the development of atopic dermatitis.

50% of cases of atopic dermatitis is diagnosed in the first year of life, according to SEICAP data. Therefore, we believe it is essential for children with a genetic predisposition to be allergic, it is recommended to use emollient creams to hydrate the skin and to protect the skin's barrier against potential allergens, "says Dr. María Teresa Guerra, Group Coordinator work atopic dermatitis and skin allergy of SEICAP Atopic dermatitis is a disease with a high genetic burden, modulated by climatic factors and involving immunological alteration.Therefore, in newborn babies, the atopy development of a chronic disease may be slowed down "It is essential for both health professionals and their families to be aware and well informed," he says.

According to a recent paper published in British Journal of Dermatology "Changing the epidermal barrier leads to greater permeability of the dermis, pathological inflammation of the skin, and percutaneous sensitization of allergens." Thus, as stated in the text, several studies have shown that "how to prevent atopic dermatitis with early use of emollients in high risk children".

Primary prevention of atopic dermatitis in children with genetic predisposition "is to improve the skin barrier at birth because it has been shown that if the skin barrier is kept in balance, avoiding dryness and inflammation, hydration can avoid the development of atopic dermatitis, Guerra. A recent study in the UK and published in the UK BMC Dermatology concludes that prescribing emollients in primary care to treat dry skin and atopic eczema is associated with fewer consultation visits. In addition, children who do not use them are more likely to receive topical corticosteroids or antimicrobials.

From SEICAP, it is insisted that the patient's therapeutic education can help the child and his / her families better understand the illness and cope with treatment to maintain or even improve quality of life and adherence to treatment. "Therefore, age-related multidisciplinary therapeutic educational groups, the so-called atopic schools, are the ones that have shown the greatest benefit, as well as improving adherence, improving the knowledge of the itching, and providing additional psychological benefit," he says. Dr. Guerra "

Use of emollients in children with atopic dermatitis

The use of emollients is recommended for all patients with atopic dermatitis irrespective of the severity of the pathology. This is an effective and safe method of improving the skin barrier due to the contribution of exogenous lipids, says Dr. Mercedes Escarrer, president of SEICAP. In addition, in patients with moderate to severe atopic dermatitis, it is recommended to combine them with proactive therapy of calcineurin inhibitors or topical corticosteroids.

When there is an outbreak, it will be necessary that "in order to induce a rapid improvement of injuries and itching in areas affected by active eczema, anti-inflammatory therapy is applied before introducing the emollient," says Dr. Escarrer. On the other hand, between outbreaks, although the skin may seem relieved, "subclinical inflammation is always present, accompanied by an overproduction of inflammatory stimuli and an increase in the number of inflammatory cells," he warns. In these cases, "it should be follow proactive treatment based on minimal anti-inflammatory therapy and daily use of emollients"He adds.

In addition, it will be necessary to follow another series of care designed to protect the skin as the use of cotton or lingerie clothes and non-detergent soap for washing, the use of soft, acidic or neutral pH soaps for the bath to keep the house clean of dust or to protect the skin from cold in the winter.

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