Effective treatment of atopic dermatitis in small children significantly improves the quality of life of patients and their families

Salava, Alexander; Perälä, Miia; Juppo, Mona; Pelkonen, Anna; Mäkelä, Mika J.; Remitz, Anita

doi:10.1684/ejd.2021.4169

Cited by 3 publications

(2 citation statements)

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“…Atopic dermatitis (AD) is the most frequent chronic skin disease in Finland and causes a significant burden 1,2 . Typically, the disease begins in early childhood, but in recent years, an increase in adult‐onset has been reported 3 .…”

Section: Introductionmentioning

confidence: 99%

“…Atopic dermatitis (AD) is the most frequent chronic skin disease in Finland and causes a significant burden. 1 , 2 Typically, the disease begins in early childhood, but in recent years, an increase in adult‐onset has been reported. 3 The multifactorial pathogenesis is based on environmental interactions, defects in skin barrier and immune dysregulation, resulting in both cutaneous and systemic inflammation.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with severity of atopic dermatitis – a Finnish cross‐sectional study

Salava

Salo

Leppänen

et al. 2022

Acad Dermatol Venereol

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Background Severity‐associated factors in atopic dermatitis (AD) have focussed on early onset, concomitant atopic diseases, markers of Th2‐shifted inflammation and filaggrin mutations. Objectives To investigate factors associated with severe AD in Finnish patients. Methods We conducted a single‐centre, cross‐sectional observational study with 502 AD patients aged 4.79 to 79.90 years (mean 32.08 years). Disease severity was assessed with the Rajka–Langeland severity score and EASI and associated clinical signs were evaluated. Data regarding onset, relatives, atopic and other comorbidities was gathered retrospectively. We investigated total serum IgE‐levels, a panel of filaggrin null mutations and functional variants of genes associated with skin barrier defects. Results Factors more frequent in severe AD included early onset (P = 0.004, 95%CI 0.000–0.024), male sex (P = 0.002, 95%CI 0.000–0.11), history of smoking (P = 0.012, 95%CI 0.000–0.024), concomitant asthma (P = 0.001, 95%CI 0.000–0.011), palmar hyperlinearity (P = 0.013, 95%CI 0.014–0.059), hand dermatitis (P = 0.020, 95%CI 0.000–0.029) and history of contact allergy (P = 0.042, 95%CI 0.037–0.096). Body mass indices (P < 0.000, 95%CI 0.000–0.011) and total serum IgE‐levels (P < 0.000, 95%CI 0.000–0.011) were higher in severe AD. No differences were observed for allergic rhinitis, allergic conjunctivitis, food allergy, peanut allergy, prick positivity, keratosis pilaris, history of herpes simplex infections, filaggrin null mutations and other gene variants. Conclusions Severity determinants in Finnish patients seem to be early‐onset, male sex, smoking, overweight, concomitant asthma, palmar hyperlinearity, hand dermatitis and high IgE‐levels. A sub‐typing of patients in relation to confirmed severity determinants may be useful for course prediction, prognosis and targeted AD management.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with severity of atopic dermatitis – a Finnish cross‐sectional study

Salava

Salo

Leppänen

et al. 2022

Acad Dermatol Venereol

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Long-Term Impact of Atopic Dermatitis on Quality of Life

Fitzmaurice,

Silverberg

2024

Dermatologic Clinics

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Topical tacrolimus versus corticosteroids in childhood moderate-to-severe atopic dermatitis and the impact on airway inflammation: a long-term randomized open-label study

Perälä

Salava

Malmberg

et al. 2023

Clinical and Experimental Dermatology

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Background Childhood atopic dermatitis (AD) is often followed by other atopic comorbidities like asthma. Objective To compare effectiveness of topical tacrolimus (TAC) and topical corticosteroids (TCSs) and their impact on airway inflammation and bronchial hyperresponsiveness in pediatric AD. Methods A three-year randomized open-label comparative follow-up study of 152 one- to three-year-old children with moderate-to-severe AD. Frequent study visits including clinical examinations, laboratory investigations (total IgE, specific IgEs, blood eosinophils), skin prick and respiratory function tests to assess airway inflammation and bronchial hyperresponsiveness (exhaled nitric oxide, airway responsiveness to exercise and methacholine), were performed. Results Changes in eczema parameters at 36 months were similar in the TCS and TAC groups for mean body surface area difference 1.4 (95% CI -1.48 to 4.19; P=.12), mean Eczema Area and Severity Index difference 0.2 (95% CI -1.38 to 1.82; P=.2), mean Investigator Global Assessment difference, 0.3 (95% CI -0.12 to 0.67; P=.12), and mean transepidermal water loss difference at eczema site, 0.3 (95% CI -4.93 to 4.30; P=.96), and at control site, 9.0 (95% CI 0.96 to 3.60, P=.19). Control TEWL increased more towards end in TCS vs TAC group (mean change difference 4.2; 95% CI -8.14 to -0.29; P=.0.04). No significant impact on development of airway inflammation or bronchial hyperresponsiveness occurred between early effective eczema-treatment responders vs others. Conclusion Children with moderate-to-severe AD benefit from long-term treatment with TCS or TAC. There were no significant differences in treatment efficacy. No differences on impact on airways occurred between early effective treatment responders vs others. (EudraCT2012-002412-95)

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Effective treatment of atopic dermatitis in small children significantly improves the quality of life of patients and their families

Cited by 3 publications

References 0 publications

Factors associated with severity of atopic dermatitis – a Finnish cross‐sectional study

Factors associated with severity of atopic dermatitis – a Finnish cross‐sectional study

Long-Term Impact of Atopic Dermatitis on Quality of Life

Topical tacrolimus versus corticosteroids in childhood moderate-to-severe atopic dermatitis and the impact on airway inflammation: a long-term randomized open-label study

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