Birth of atopic dermatitis should be prevented in children – Children & # 39; s Health

Half of pediatricians in primary care wait for first outbreak to recommend preventative measures atopic dermatitis, according to the use of emollients, according to preliminary results of a survey conducted by the Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma (SEICAP). On the occasion of the Day of Atopic Dermatitis celebrated on November 27, SEICAP reminds the importance of preventing this pathology from birth in children with a genetic predisposition to suffer from allergic diseases. The work was done with 573 health professionals and it is also clear that 79% used an emollient cream before the diagnosis of atopic dermatitis. Different studies have shown that Proper hydration of babies' skin could prevent the entry of allergens into the dermis and, therefore, slow down the development of atopic dermatitis.

50% of cases of atopic dermatitis he is diagnosed during the first year of life, according to SEICAP data. "Therefore, we think that it is essential that, in babies with genetic predisposition to be allergic, it is recommended to use emollient creams to moisturize their skin and protect the skin barrier against possible allergens" says Dr. María Teresa Guerra, coordinator of the Atopic Dermatitis and Skin Allergy Working Group at SEICAP. Atopic dermatitis is a disease with high genetic load, modulated by climatic factors and involving immunological alterations. "This is why, in the newborn, atopy could become less progressive and become a chronic disease.For this, it is essential that health professionals and families are informed and well informed," he said. -he declares.

According to recent work published in The British Journal of Dermatology "Impairment of the epidermal barrier leads to increased permeability of the dermis, pathological inflammation of the skin and percutaneous sensitization to allergens". Thus, as specified in the text, several studies have shown that "how to prevent atopic dermatitis by rapidly using emollients in high-risk babies".

The primary prevention of atopic dermatitis in children with genetic predisposition "is to improve the cutaneous barrier from birth since it has been shown that, if the skin barrier is kept in balance, avoiding dryness and lymphadenopathy. inflammation, depending on the hydration, the development of atopic dermatitis, "says Dr. Guerra. A recent study conducted in the United Kingdom and published in BMC Dermatology concludes that prescribing emollients in primary care for the treatment of dry skin and atopic eczema is associated with a reduction in the number of visits to the consultation. In addition, children who do not use them are more likely to be prescribed topical or antimicrobial corticosteroids.

SEICAP insists that therapeutic patient education can help the child and their families better understand their disease and cope with treatment in order to maintain or improve quality of life and adherence to treatment . "Therefore, age-specific, multidisciplinary therapeutic education groups, so-called atopic schools, are the ones that have shown the greatest benefit, while improving adherence, improving knowledge of itching, and providing additional psychological benefit, "he said. Dr. Guerra "

Use of emollients in children with atopic dermatitis

The use of emollients is recommended for all patients with atopic dermatitis, regardless of the severity of the pathology. "This is an effective and safe method to improve the skin barrier through the intake of exogenous lipids," says Dr. Mercedes Escarrer, president of SEICAP. In addition, in patients with moderate to severe atopic dermatitis, it is advisable to combine them with a pro-active therapy of calcineurin inhibitors or topical corticosteroids.

In case of epidemic, it will be necessary that "to induce a rapid improvement of lesions and itching in the affected areas of active eczema, anti-inflammatory treatment be applied before the introduction of the disease." emollient, "says Dr. Escarrer. Moreover, between epidemics, although the skin may seem relieved, "subclinical inflammation is still present, accompanied by an overproduction of inflammatory stimuli and an increase in the number of cells in the inflammation ", he warns. In these cases, "it should be follow a proactive treatment based on minimal anti-inflammatory treatment and daily use of emollients"He adds.

In addition, it will be necessary to follow another series of care to protect the skin because the use of cotton or linen clothing and soaps without laundry detergent, using mild soaps, at acidic or neutral pH, for the bath, to keep the house clean of dust or to protect the skin from cold during winter.