A pilot study of emollient therapy for the primary prevention of atopic dermatitis.
BACKGROUND
Prevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of AD and possibly food allergy and asthma. Correcting skin barrier defects from birth may prevent AD onset or moderate disease severity.


OBJECTIVE
We sought to determine the feasibility of skin barrier protection as a novel AD prevention strategy.


METHODS
We enrolled 22 neonates at high risk for developing AD in a feasibility pilot study using emollient therapy from birth.


RESULTS
No intervention-related adverse events occurred in our cohort followed up for a mean time of 547 days. Of the 20 subjects who remained in the study, 3 (15.0%) developed AD, suggesting a protective effect when compared with historical controls. Skin barrier measurements remained within ranges seen in normal-appearing skin.


CONCLUSIONS
No conclusions regarding efficacy can be made without a control group.


CONCLUSIONS
Skin barrier repair from birth represents a novel and feasible approach to AD prevention. Further studies are warranted to determine the efficacy of this approach.
Simpson
Eric L
EL
Department of Dermatology, Oregon Health and Science University, Portland, Oregon 97239-4501, USA. simpsone@ohsu.edu
Berry
Trista M
TM
Brown
Peter A
PA
Hanifin
Jon M
JM
D001249:Asthma / Q000517:prevention & control; D003876:Dermatitis, Atopic / Q000151:congenital / Q000188:drug therapy / Q000517:prevention & control*; D004338:Drug Combinations; D004643:Emollients / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D011322:Primary Prevention / Q000379:methods*; D011409:Propylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D018570:Risk Assessment; D012869:Skin Absorption / Q000187:drug effects*; D012967:Sodium Dodecyl Sulfate / Q000627:therapeutic use*; D016896:Treatment Outcome
D004338:Drug Combinations; D004643:Emollients; D011409:Propylene Glycols; C011189:cetyl alcohol, propylene glycol, sodium lauryl sulfate non-lipid cleansing lotion; D012967:Sodium Dodecyl Sulfate