Do early skin care practices alter the risk of atopic dermatitis? A case-control study

Pediatr Dermatol. Author manuscript; available in PMC 2012 July 15.

Published in final edited form as:

Pediatr Dermatol. 2011 Sep-Oct; 28(5): 593–595.

Published online 2011 September 5.doi:  10.1111/j.1525-1470.2011.01384.x

Marla E. Rendell, M.D Shahana F. Baig-Lewis, M.P.H., Trista M. Berry, B.S.,^** Melissa E. Denny, M.D.,^* Brenda M. Simpson, B.A.,^* Peter A. Brown, B.S.,and Eric L. Simpson, M.D., M.C.R.^**

^ABSTRACT

Background

The rise in atopic dermatitis prevalence seen in industrialized countries in unexplained. Some authors have suggested that the increase in the use of skin care products is partly responsible. There are few studies examining skin care practices commonly used in treatment of children. We hypothesized that the use of moisturizers early in life may alter the risk for developing atopic dermatitis.

Methods

A case-control study utilizing two control groups was performed. Cases were defined as children under six years of age who developed atopic dermatitis. A normal control and a high-risk control group were used for comparison. Parents or caregivers of children were questioned regarding skin care practices used in early life in an attempt to identify practices that increased the risk of developing atopic dermatitis.

Results

The regular use of a moisturizer on the child during the first six months of life was very common in all groups, 76%, 74.7%, and 78% in the atopic, non-atopic, and high-risk groups, respectively. Because of the high rate of moisturizer use in all groups, no significant differences were found between groups. Watery lotions were the most commonly used moisturizer.

Conclusions

Despite published guidelines advising to the contrary, the regular use of moisturizers was common in this population. Although no one specific skin care practice was associated with atopic dermatitis, the frequent use of products potentially detrimental to the skin barrier raises concern.

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PubMed - NIH

Risk of cardiovascular disorders in psoriasis patients : current and future.

Feb 2013

Many many of those with lymphedema, also have or had psoriasis, not to mention how many of us have some type of autoimmune problem as well..  I had it terribly on my left leg and ankle.  Thought this might be of interest.

Tablazon IL, Al-Dabagh A, Davis SA, Feldman SR.

Source

Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA.

Abstract

Psoriasis is an inflammatory autoimmune disease that affects the skin. Recently, psoriasis and its consequential lifestyle and dietary habits have been associated with increased risks for cardiovascular diseases. This article discusses the connection between cardiovascular disorders and psoriasis and the effects of available treatment options on cardiovascular risk. A PubMed search revealed 11 articles that were analyzed for information regarding this association, its effects, and potential courses of treatment. Both the presence and severity of psoriasis increases the risk for cardiovascular disorders and co-morbidities. Forty percent of psoriasis patients met metabolic syndrome criteria as compared with 23 % of non-psoriasis control subjects. Rate ratios for atrial fibrillation are correlated with the severity of psoriasis; patients with severe and mild psoriasis produced rate ratios of 1.63 and 1.31, respectively. Studies also show an increase in the risks for myocardial infarction, atherosclerosis, ischemic stroke, and other cardiovascular disorders. The exact mechanisms behind this affiliation are still uncertain; however, the psychological and physiological effects of psoriasis and the overlapping pathogenesis behind atherosclerosis and psoriasis may play a role. Since the risk for cardiovascular disorders increases with the presence and severity of psoriasis, psoriasis treatment should not only address the disease and its symptoms, but also its co-morbidities. Recent National Psoriasis Foundation (NPF) guidelines have provided recommendations for psoriasis patient care. Histories of co-morbidities, screenings for potential diseases, increased exercise, decreased alcohol consumption, and smoking cessation should be implemented. Unfortunately, while there are data for the increased risk for cardiovascular diseases within psoriasis patients, there are presently no data stating that increasing cardiovascular screening rates in patients produces a significant difference.

Adis

Skin pH: From basic science to basic skin care.

Jan 2013

Ali SM, Yosipovitch G.

Source

Department of Dermatology, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157 , USA.

Abstract

The "acid mantle" is a topic not only of historical interest, but also of clinical significance and has recently been linked to vital stratum corneum function. Despite compelling basic science evidence placing skin pH as a key factor in barrier homeostasis, stratum corneum integrity, and antimicrobial defense, application of the acid mantle concept in clinical care is lacking. We review recent basic science investigations into skin pH, discuss skin disorders characterized by aberrant pH, and finally discuss practical application for preservation of the acid mantle. Recognizing factors that alter skin pH and selecting products that preserve the acid mantle is of prime importance in treating dermatologic patients.

Medical Journals

Daily intake of Jeju groundwater improves the skin condition of the model mouse for human atopic dermatitis.

Jan 2013

Tanaka A, Jung K, Matsuda A, Jang H, Kajiwara N, Amagai Y, Oida K, Ahn G, Ohmori K, Kang KG, Matsuda H.

Source

Laboratories of Comparative Animal Medicine, Tokyo, Japan; Laboratory of Cooperative Major in Advanced Health Science, Graduate School of Bio-Applications and System Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan.

Abstract

Drinking water is an important nutrient for human health. The mineral ingredients included in drinking water may affect the physical condition of people. Various kinds of natural water are in circulation as bottled water in developed countries; however, its influence on clinical conditions of patients with certain diseases has not been fully evaluated. In this study, effects of the natural groundwater from Jeju Island on clinical symptoms and skin barrier function in atopic dermatitis (AD) were evaluated. NC/Tnd mice, a model for human AD, with moderate to severe dermatitis were used. Mice were given different natural groundwater or tap water for 8 weeks from 4 weeks of age. Clinical skin severity scores were recorded every week. Scratching analysis and measurement of transepidermal water loss were performed every other week. The pathological condition of the dorsal skin was evaluated histologically. Real-time polymerase chain reaction analysis was performed for cytokine expression in the affected skin. The epidermal hyperplasia and allergic inflammation were reduced in atopic mice supplied with Jeju groundwater when compared to those supplied with tap water or other kinds of natural groundwater. The increase in scratching behavior with the aggravation of clinical severity of dermatitis was favorably controlled. Moreover, transepidermal water loss that reflects skin barrier function was recovered. The early inflammation and hypersensitivity in the atopic skin was alleviated in mice supplied with Jeju groundwater, suggesting its profitable potential on the daily care of patients with skin troubles including AD.

Pub Med

Influence of age, gender, educational level and self-estimation of skin type on sun exposure habits and readiness to increase sun protection.

Jan 2013

Falk M, Anderson CD.

Source

Research and Development Unit for Local Health Care, County of Östergötland, 581 85 Linköping, Sweden; Department of Medical and Health Sciences, Division of Community Medicine, Primary Care, Linköping University, 581 85 Linköping, Sweden. Electronic address: magnus.falk@lio.se.

Abstract

Background: Sun exposure habits and the propensity to undertake sun protection differ between individuals. Not least in primary prevention of skin cancer, aiming at reducing ultraviolet (UV) exposure, knowledge about these factors may be of importance. The aim of the present study was to investigate, in a primary health care (PHC) population, the relationship between sun exposure habits/sun protection behaviour/readiness to increase sun protection and gender, age, educational level and skin UV-sensitivity. 

Methods: The baseline data from a previously performed RCT on skin cancer prevention was used. 415 patients, aged >18 years, visiting a PHC centre in southern Sweden, filled-out a questionnaire mapping sun exposure, readiness to increase sun protection according to the Transtheoretical Model of Behaviour Change (TTM), and the above mentioned factors. 

Results: Female gender was associated with more frequent suntanning (p<0.001) and sunbed use (p<0.05), but also with more extensive sunscreen use (p<0.001). High age was in general associated with low level of sun exposure and high level of protection. Subjects with low educational level reported less frequent sunscreen use than those with higher educational level, and also chose lower SPF (p<0.001). For almost all parameters, high skin UV-sensitivity was associated with markedly lower sun exposure (p<0.001) and more pronounced readiness to increase sun protection. Females and subjects with high educational level reported higher readiness to increase sunscreen use than males and subjects with lower educational level (p<0.001). 

Conclusions: Gender, age, educational level and skin type appear to be important factors affecting sun exposure habits and sun protection behaviour, which supports the idea of appropriate mapping of these factors in patients in order to individualise sun protection advice according to the individual patient situation and capabilities.

PubMed

Management of ulcers in lymphedematous limbs

Management of ulcers in lymphoedematous limbs.

2012

Karnasula VM.

Source

Department of Plastic Surgery, G.S.L. Medical College, Rajahmundry, Andhra Pradesh, India.

Abstract

Lymphedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care.

Full Text Article

NIH - Indian Journal of Plastic Surgery