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International Archives of Allergy and... 2024This scoping review aims to critically assess gaps in the current literature on atopic dermatitis (AD) by evaluating the overall effectiveness of dietary interventions.... (Review)
Review
BACKGROUND
This scoping review aims to critically assess gaps in the current literature on atopic dermatitis (AD) by evaluating the overall effectiveness of dietary interventions. Through a comprehensive analysis that follows the Preferred Reporting Item for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a thorough search on the Web of Science database in May 2023 using specific search strategies to identify all relevant studies on the research topic.
SUMMARY
A total of 104 full-text articles were included for review. Our synthesis identified seven notable categories of dietary interventions for AD, showcasing the diversity of interventions utilized. This includes vitamin supplementation, probiotic and prebiotic supplementation, dietary fat, biological compounds, foods from natural sources, major nutrients, and diet-related approaches. Further analyses stratified by targeted populations revealed a predominant focus on pediatrics, particularly in probiotic supplementation, and on adults, with an emphasis on vitamin D and E supplementation.
KEY MESSAGES
Despite most dietary interventions demonstrating overall effectiveness in improving AD severity and its subjective symptoms, several significant gaps were identified. There was a scarcity of studies on adults and whole-diet interventions, a prevalence of short-term interventions, heterogeneity in study outcomes, designs, and population, occasional disparity between statistical significance and clinical relevance, and a lack of a comprehensive multidisciplinary approach. Nonetheless, these findings offer valuable insights for future AD research, guiding additional evidence-driven dietary interventions and informing healthcare professionals, researchers, and individuals, advancing both understanding and management of AD.
Topics: Dermatitis, Atopic; Humans; Dietary Supplements; Probiotics; Diet; Prebiotics
PubMed: 38442688
DOI: 10.1159/000535903 -
Expert Opinion on Investigational Drugs Apr 2024Atopic dermatitis (AD) is a common inflammatory cutaneous disease that arises due to dysregulation of the Th2 immune response, impaired skin barrier integrity, and... (Review)
Review
INTRODUCTION
Atopic dermatitis (AD) is a common inflammatory cutaneous disease that arises due to dysregulation of the Th2 immune response, impaired skin barrier integrity, and dysbiosis of the skin and gut microbiota. An abundance of biofilms in AD lesions increases the Th2 immune response, and gut bacteria release breakdown products such as Short Chain Fatty Acids that regulate the systemic immune response.
AREAS COVERED
We aim to evaluate therapies that modulate the microbiome in humans and discuss the clinical implications of these treatments. We performed a review of the literature in which 2,673 records were screened, and describe the findings of 108 studies that were included after full-text review. All included studies discussed the effects of therapies on the human microbiome and AD severity. Oral probiotics, topical probiotics, biologics, and investigational therapies were included in our analysis.
EXPERT OPINION
Oral probiotics demonstrate mixed efficacy at relieving AD symptoms. Topical probiotics reduce S. aureus abundance in AD lesional skin, yet for moderate-severe disease, these therapies may not reduce AD severity scores to the standard of biologics. Dupilumab and tralokinumab target key inflammatory pathways in AD and modulate the skin microbiome, further improving disease severity.
Topics: Humans; Dermatitis, Atopic; Staphylococcus aureus; Skin; Microbiota; Biological Products
PubMed: 38441984
DOI: 10.1080/13543784.2024.2326625 -
The Australasian Journal of Dermatology Jun 2024
Topics: Humans; Dermatitis, Atopic; Biological Products; Health Services Accessibility; Adult; Severity of Illness Index
PubMed: 38439194
DOI: 10.1111/ajd.14243 -
Contact Dermatitis Jun 2024The Global Guidelines in Dermatology Mapping Project (GUIDEMAP) assesses the methodological quality of clinical practice guidelines (CPGs) for high-burden skin diseases....
The Global Guidelines in Dermatology Mapping Project (GUIDEMAP) assesses the methodological quality of clinical practice guidelines (CPGs) for high-burden skin diseases. This review focuses on contact dermatitis. We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library, Emcare, Epistemonikos, PsycINFO and Academic Search Premier for CPGs published between 1 November 2018 and 1 November 2023. Prespecified guideline resources were hand searched. Two authors independently undertook screening, data extraction and quality assessments. Instruments used were the Appraisal of Guidelines for Research and Evaluation (AGREE) II Reporting Checklist, the U.S. Institute of Medicine's (IOM) criteria of trustworthiness, The Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent Adherence to Trustworthy Standards (NEATS) Instrument and Lenzer's Red Flags. Twenty five CPGs were included, exhibiting heterogeneity in both the topics they addressed and their methodological quality. Whereas the CPGs on management of hand eczema from Denmark, Europe and the Netherlands scored best, most CPGs fell short of being clear, unbiased, trustworthy and evidence-based. Disclosure of conflicts of interest scored well, and areas needing improvement include 'strength and wording of recommendations', 'applicability', 'updating' and 'external review'. Adhering to AGREE II and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) enhances methodological quality.
Topics: Humans; Dermatitis, Contact; Dermatology; Practice Guidelines as Topic
PubMed: 38403277
DOI: 10.1111/cod.14530 -
Pediatric Dermatology 2024Pediatric dermatitis and nonaccidental trauma (NAT) may have overlapping cutaneous presentations, posing a risk of misdiagnosis and subsequent emotional distress and...
BACKGROUND/OBJECTIVES
Pediatric dermatitis and nonaccidental trauma (NAT) may have overlapping cutaneous presentations, posing a risk of misdiagnosis and subsequent emotional distress and further harm. Through a systematic literature review, we reviewed pediatric (<18 years old) patients investigated for both dermatitis and NAT.
METHODS
EMBASE and MEDLINE databases were searched. English publications with original data involving pediatric patients investigated for both dermatitis and NAT were included. Nonhuman studies and incomplete articles/conference abstracts were excluded. Data extracted included the first author, year of publication, study design, participant count, sex of the population, age of the population, cutaneous presentation, timing of presentation, Child Protective Services involvement, and case relation to dermatitis and NAT.
RESULTS
This review included 21 case reports or series encompassing 29 patients. Among 26 patients initially investigated as NAT (26.9% involving Child Protective Services), final diagnoses included irritant contact dermatitis (53.8%), phytophotodermatitis (30.8%), allergic contact dermatitis (7.7%), perianal infectious dermatitis (3.8%), and atopic dermatitis (3.8%). Three patients initially diagnosed with nontraumatic dermatitis were later found to be victims of physical (2/3; 66.7%) or sexual abuse (1/3; 33.3%).
CONCLUSIONS
Effective history-taking and physical examinations should encompass a history of laxative use, contact with furocoumarin-containing plants/fruit, parallel family/peer cutaneous presentations, caregiver involvement, financial burden, patient discomfort, birthmark assessment, and lesions aligning with diaper borders or toilet seats. Limitations of this review include potential underreporting and the inclusion of low-quality study designs and evidence.
Topics: Child; Humans; Adolescent; Child Abuse; Laxatives; Dermatitis, Phototoxic; Dermatitis, Atopic; Diagnostic Errors
PubMed: 38400817
DOI: 10.1111/pde.15556 -
Medicine Feb 2024Atopic dermatitis (AD) is a common and recurrent inflammatory disease with strong genetic susceptibility. The abnormal production of chemokines plays an important role... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Atopic dermatitis (AD) is a common and recurrent inflammatory disease with strong genetic susceptibility. The abnormal production of chemokines plays an important role in the occurrence and development of AD.
METHODS
A comprehensive online literature search was performed in databases of China National Knowledge Infrastructure, Wanfang, VIP China Science and Technology Journal Database, China Biomedical Literature Database, PubMed, Embase and Cochrane Library to retrieve relevant articles published from January 2000 to October 2022. The odds ratio (OR) with its 95% confidence interval (CI) was employed to calculate this relationship.
RESULTS
A total of 7 studies were finally screened out, including 1316 AD patients and 1099 controls. There were 3 studies for CC chemokine ligand 5 (CCL5) polymorphisms, 2 for CCL11 polymorphisms, and 2 for CCL17 polymorphisms, respectively. The meta-analysis revealed a significant association between the CCL5 - 403G/A polymorphism and AD under the allelic model (A vs G: OR = 1.25, 95% CI = 1.02-1.52, P = .03), heterozygous model (AG vs GG: OR = 1.40, 95% CI = 1.08-1.80, P = .01) and dominant model (AA + AG vs GG: OR = 1.38, 95% CI = 1.08-1.76, P = .01) in a fixed-effect model. The allelic model (G vs C: OR = 1.46, 95% CI = 1.07-1.98, P < .01) and dominant model (GG + GC vs CC: OR = 1.74, 95% CI = 1.23-2.47, P < .001) of the CCL5 - 28C/G polymorphism were also associated with an increased risk of AD. However, this significant association was not found in other alleles and genotypes (P > .05).
CONCLUSION
Our results show that the A allele, AG and AA + AG genotypes of the CCL5 - 403G/A polymorphism, the G allele and GG + GC genotype of the CCL5 - 28C/G polymorphism are risk factors for AD. Future studies with large population are still needed to further explore those correlations.
Topics: Humans; Chemokine CCL11; Chemokine CCL17; Chemokine CCL5; Dermatitis, Atopic; Genetic Predisposition to Disease; Genotype; Ligands; Polymorphism, Single Nucleotide; Risk Factors
PubMed: 38394497
DOI: 10.1097/MD.0000000000036897 -
Allergy Feb 2024We performed a systematic review to investigate the current evidence on the association between allergic diseases and short chain fatty acids (SCFAs), which are... (Review)
Review
We performed a systematic review to investigate the current evidence on the association between allergic diseases and short chain fatty acids (SCFAs), which are microbially produced and suggested as one mechanism on how gut microbiome affects the risk of allergic diseases. Medline, Embase and Web of Science were searched from data inception until September 2022. We identified 37 papers, of which 17 investigated prenatal or early childhood SCFAs and the development of allergic diseases in childhood, and 20 assessed SCFAs in patients with pre-existing allergic diseases. Study design, study populations, outcome definition, analysis method and reporting of the results varied between papers. Overall, there was some evidence showing that the three main SCFAs (acetate, propionate and butyrate) in the first few years of life had a protective effect against allergic diseases, especially for atopic dermatitis, wheeze or asthma and IgE-mediated food allergy in childhood. The association between each SCFA and allergic disease appeared to be different by disease and the age of assessment. Further research that can determine the potentially timing specific effect of each SCFA will be useful to investigate how SCFAs can be used in treatment or in prevention against allergic diseases.
PubMed: 38391245
DOI: 10.1111/all.16065 -
Dermatitis : Contact, Atopic,... Feb 2024(Review)
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JAAD International Jun 2024Atopic dermatitis (AD) is an inflammatory skin condition, often multifactorial in origin, and most commonly manifests during childhood. Although there remains a deficit... (Review)
Review
BACKGROUND
Atopic dermatitis (AD) is an inflammatory skin condition, often multifactorial in origin, and most commonly manifests during childhood. Although there remains a deficit in literature, current data suggest Honduras may have the highest prevalence and severity of AD among all Latin American countries.
OBJECTIVE
To assess the current prevalence of pediatric AD in Honduras and evaluate existing gaps in available literature to monitor disease burden.
METHODS
A comprehensive literature search was performed in March 2023. Articles were removed if they were published before 2007, were of the incorrect study design, or were focused on countries outside of Honduras. The articles were independently reviewed by 2 authors.
RESULTS
The initial literature search yielded 174 studies, of which 7 met inclusion criteria. AD prevalence rates in children in Honduras ranged from 0.7% to 40.0%.
LIMITATIONS
Limitations include elements of study design, analytic methods, study populations, and limited articles.
CONCLUSION
There appears to be a disproportionately higher prevalence and disease burden of pediatric AD in Honduras. Future research should acquire accurate data to further understand the prevalence, incidence, and severity of AD in Honduras.
PubMed: 38371663
DOI: 10.1016/j.jdin.2023.12.009 -
Indian Journal of Dermatology 2023Atopic dermatitis is a chronic inflammatory skin condition common in early childhood. Acute exacerbation is frequently associated with colonization.
BACKGROUND
Atopic dermatitis is a chronic inflammatory skin condition common in early childhood. Acute exacerbation is frequently associated with colonization.
AIMS AND OBJECTIVES
This study aims to explore the relationship between skin and nasal colonization with pediatric atopic dermatitis.
METHODS
A systematic review and meta-analysis were conducted by comparing atopic dermatitis patients aged ≤18 years and nondiseased controls. A random-effects model was used to obtain the pooled prevalence and odds ratio of colonization at eczematous skin, nonlesional skin, and nasal cavity. Subgroup analyses for colonization with methicillin-resistant were also evaluated.
RESULTS
A total of 2,670 cases and 1,224 controls from 26 studies were included in the meta-analysis. colonization at eczematous skin and nasal cavity is significantly higher in atopic dermatitis compared to control with odds ratios of 10.55 (95% confidence interval [CI]; 4.85-22.92, < .001) and 2.38 (nasal cavity; 95% CI; 1.46-3.90, < .001), respectively. The pooled prevalence of skin and nasal colonization were 55.0% (eczematous skin; 95% CI; 38.3-71.7), 23.3% (nonlesional skin; 95% CI; 12.6-33.9), and 56.3% (95% CI; 43.2-69.4), respectively. Methicillin-resistant strain was obtained from the nares and eczematous skin with rates of 11.6% (95% CI; 6.5-16.7) and 8.5% (95% CI; 4.3-12.8), respectively.
CONCLUSION
Children with atopic dermatitis are more prone to skin and nasal colonization by compared to nondiseased individuals.
PubMed: 38371569
DOI: 10.4103/ijd.ijd_453_22