Published Online: October, 2014
Recent studies have suggested that skin barrier dysfunction contributes to the development of atopic dermatitis, and the presence of atopic dermatitis during infancy is critically involved in the subsequent development of other allergic diseases. Now, in a study recently published in The Journal of Allergy and Clinical Immunology, K. Horimukai and colleagues present the results of a randomized controlled trial to determine whether protecting the skin barrier with a moisturizer during the neonatal period prevents development of atopic dermatitis and allergic sensitization.
An emulsion-type moisturizer was applied daily during the first 32 weeks of life to neonates at high risk for atopic dermatitis (based on having a parent or sibling with atopic dermatitis). The primary outcome was the cumulative incidence of atopic dermatitis at week 32 of life. A secondary outcome, allergic sensitization, was evaluated based on serum levels of allergen-specific IgE, determined using a high-sensitivity allergen microarray of diamond-like carbon-coated chip.
Approximately 32% fewer neonates who received the moisturizer developed atopic dermatitis by week 32 than controls (P=.012 in log-rank test). A statistically significant effect of emollient was not found regarding allergic sensitization based on the serum level of IgE antibody against egg white. However, the sensitization rate was significantly higher in infants who developed atopic dermatitis than in those who did not (odds ratio, 2.86; 95% confidence interval, 1.22–6.73).
Thus, daily application of emollient reduces risk for development of atopic dermatitis by 32 weeks. We might be able to reduce the prevalence of allergic sensitization by preventing development of atopic dermatitis.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.