Practical issues of emollient use in winter for patients with atopic dermatitis: expert resolution

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

In September 2024, a meeting of the Expert Council took place, featuring leading specialists in the fields of allergology, pediatrics, and dermatology. The main focus was on the issue of seasonal exacerbations of atopic dermatitis, including their manifestations during the winter period. Experts discussed the leading trigger factors that contribute to the deterioration of patients’ conditions, as well as the criteria that modern emollients for the skincare of patients with atopic dermatitis should meet.

During the discussion, the importance of emollients plus in preventing seasonal exacerbations was emphasized, based on the data from previously conducted studies. The participants concluded that further informational and organizational activities are necessary to raise awareness among both patients and physicians about seasonal environmental factors, such as temperature and humidity, atmospheric pressure, as well as contact with allergens and air pollutants that affect the condition of the epidermal barrier and contribute to the development of exacerbations of atopic dermatitis. Strategies for preventing these exacerbations using modern emollients plus were also proposed.

The results of the meeting underscore the importance of a comprehensive approach to managing atopic dermatitis, highlighting the role of lifestyle and environmental factors in controlling the disease. These results could serve as a foundation for further research and practical guidelines in the fields of allergology, pediatrics, and dermatology.

About the authors

Elena S. Fedenko

National Research Center Institute of Immunology

Author for correspondence.
Email: efedks@gmail.com
ORCID iD: 0000-0003-3358-5087
SPIN-code: 5012-7242

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Irina N. Zakharova

Russian Medical Academy of Continuing Professional Education

Email: kafedra25@yandex.ru
ORCID iD: 0000-0003-4200-4598
SPIN-code: 4357-3897

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Olga V. Zaytseva

Russian University of Medicine

Email: olga6505963@yandex.ru
ORCID iD: 0000-0003-3426-3426
SPIN-code: 3090-4876

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Alexander N. Pampura

Russian Medical Academy of Continuing Professional Education; N.I. Pirogov Russian National Research Medical University

Email: apampura@pedklin.ru
ORCID iD: 0000-0001-5039-8473
SPIN-code: 9722-7961

Scientific Research Clinical Institute of Pediatrics and Pediatric Surgery named after acad. Yu.E. Veltishchev, MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Nikolay N. Murashkin

National Medical Research Center for Children’s Health; Central State Medical Academy; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: m_nn2001@mail.ru
ORCID iD: 0000-0003-2252-8570
SPIN-code: 5906-9724

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow; Moscow

Alla O. Litovkina

National Research Center Institute of Immunology; People’s Friendship University of Russia named after Patrice Lumumba

Email: dr.litovkina@gmail.com
ORCID iD: 0000-0002-5021-9276
SPIN-code: 2337-7930

Department of Clinical Immunology, MD

Russian Federation, Moscow; Moscow

References

  1. Federal clinical guidelines for the management of patients with atopic dermatitis [electronic resource]. Moscow: Russian Society of Dermatovenerologists and Cosmetologists; Russian Association of Allergologist and Clinical Immunologist; Union of Pediatricians of Russia; National Alliance of Dermatovenerologists and Cosmetologists; 2024. Available from: https://cr.minzdrav.gov.ru/recomend/265_3. Accessed: 08.11.2024.
  2. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(Suppl 1):8–16. doi: 10.1159/000370220
  3. Lewis-Jones S. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract. 2006;60(8):984–992. doi: 10.1111/j.1742-1241.2006.01047.x
  4. Elisyutina OG, Litovkina AO, Smolnikov EV, et al. Clinical features of various phenotypes of atopic dermatitis. Russian Journal of Allergy. 2019;16(4):30–41. doi: 10.36691/RAJ.2020.16.4.004
  5. Liang Y, Chang C, Lu Q. The genetics and epigenetics of atopic dermatitis-filaggrin and other polymorphisms. Clin Rev Allergy Immunol. 2016;51(3):315–328. doi: 10.1007/s12016-015-8508-5
  6. Egawa G, Kabashima K. Barrier dysfunction in the skin allergy. Allergol Int. 2018;67(1):3–11. doi: 10.1016/j.alit.2017.10.002
  7. Ständer S. Atopic Dermatitis. N Engl J Med. 2021;384(12):1136–1143. doi: 10.1056/NEJMra2023911
  8. Li H, Zhang Z, Zhang H, et al. Update on the pathogenesis and therapy of atopic dermatitis. Clin Rev Allergy Immunol. 2021;61(3):324–338. doi: 10.1007/s12016-021-08880-3
  9. Williams JR, Burr ML, Williams HC. Factors influencing atopic dermatitis – a questionnaire survey of schoolchildren’s perceptions. Br J Dermatol. 2004;150(6):1154–1161. doi: 10.1111/j.1365-2133.2004.05869.x
  10. Silverberg JI, Lei D, Yousaf M, et al. Association of itch triggers with atopic dermatitis severity and course in adults. Ann Allergy Asthma Immunol. 2020;125(5):552–559.e2. doi: 10.1016/j.anai.2020.06.014
  11. Werfel T, Heratizadeh A, Niebuhr M, et al. Exacerbation of atopic dermatitis on grass pollen exposure in an environmental challenge chamber. J Allergy Clin Immunol. 2015;136(1):96–103.e9. doi: 10.1016/j.jaci.2015.04.015
  12. Fölster-Holst R, Galecka J, Weißmantel S, et al. Birch pollen influence the severity of atopic eczema – prospective clinical cohort pilot study and ex vivo penetration study. Clin Cosmet Investig Dermatol. 2015;8:539–548. doi: 10.2147/CCID.S81700
  13. Krämer U, Weidinger S, Darsow U, et al. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005;124(3):514–523. doi: 10.1111/j.0022-202X.2005.23625.x
  14. Gaul LE, Underwood GB. Relation of dew point and barometric pressure to chapping of normal skin. J Invest Dermatol. 1952;19(1):9–19. doi: 10.1038/jid.1952.61
  15. Engebretsen KA, Johansen JD, Kezic S, et al. The effect of environmental humidity and temperature on skin barrier function and dermatitis. J Eur Acad Dermatol Venereol. 2016;30(2):223–249. doi: 10.1111/jdv.13301
  16. Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol. 2013;133(7):1752–1759. doi: 10.1038/jid.2013.19
  17. Weiland SK, Hüsing A, Strachan DP, et al. Climate and the prevalence of symptoms of asthma, allergic rhinitis, and atopic eczema in children. Occup Environ Med. 2004;61(7):609–615. doi: 10.1136/oem.2002.006809
  18. Furue M, Yamazaki S, Jimbow K, et al. Prevalence of dermatological disorders in Japan: a nationwide, cross-sectional, seasonal, multicenter, hospital-based study. J Dermatol. 2011;38(4):310–320. doi: 10.1111/j.1346-8138.2011.01209.x
  19. Sasaki T, Furusyo N, Shiohama A, et al. Filaggrin loss-of-function mutations are not a predisposing factor for atopic dermatitis in an Ishigaki Island under subtropical climate. J Dermatol Sci. 2014;76(1):10–15. doi: 10.1016/j.jdermsci.2014.06.004
  20. Nemoto-Hasebe I, Akiyama M, Nomura T, et al. Clinical severity correlates with impaired barrier in filaggrin-related eczema. J Invest Dermatol. 2009;129(3):682–689. doi: 10.1038/jid.2008.280
  21. Wang SP, Stefanovic N, Orfali RL, et al. Impact of climate change on atopic dermatitis: a review by the International Eczema Council. Allergy. 2024;79(6):1455–1469. doi: 10.1111/all.16007
  22. Uter W, Geier J, Land M, et al. Another look at seasonal variation in patch test results. A multifactorial analysis of surveillance data of the IVDK. Information Network of Departments of Dermatology. Contact Dermatitis. 2001;44(3):146–152. doi: 10.1034/j.1600-0536.2001.044003146.x
  23. Egawa M, Oguri M, Kuwahara T, Takahashi M. Effect of exposure of human skin to a dry environment. Skin Res Technol. 2002;8(4):212–218. doi: 10.1034/j.1600-0846.2002.00351.x
  24. Sunwoo Y, Chou C, Takeshita J, et al. Physiological and subjective responses to low relative humidity. J Physiol Anthropol. 2006;25(1):7–14. doi: 10.2114/jpa2.25.7
  25. Vyumvuhore R, Tfayli A, Duplan H, et al. Effects of atmospheric relative humidity on Stratum Corneum structure at the molecular level: ex vivo Raman spectroscopy analysis. Analyst. 2013;138(14):4103–4111. doi: 10.1039/c3an00716b
  26. Kita H. How are airborne allergens remembered by the immune system? J Allergy Clin Immunol. 2022;149(6):1940–1942. doi: 10.1016/j.jaci.2022.02.014
  27. Chevigné A, Jacquet A. Emerging roles of the protease allergen Der p 1 in house dust mite-induced airway inflammation. J Allergy Clin Immunol. 2018;142(2):398–400. doi: 10.1016/j.jaci.2018.05.027
  28. Serhan N, Basso L, Sibilano R, et al. House dust mites activate nociceptor-mast cell clusters to drive type 2 skin inflammation. Nat Immunol. 2019;20(11):1435–1443. doi: 10.1038/s41590-019-0493-z
  29. Nakamura Y, Miyata M, Shimokawa N, et al. House dust mite allergen Der f 1 can induce the activation of latent TGF-beta via its protease activity. FEBS Lett. 2009;583(12):2088–2092. doi: 10.1016/j.febslet.2009.05
  30. Nygaard U, Hvid M, Johansen C, et al. TSLP, IL-31, IL-33 and sST2 are new biomarkers in endophenotypic profiling of adult and childhood atopic dermatitis. J Eur Acad Dermatol Venereol. 2016;30(11):1930–1938. doi: 10.1111/jdv.13679
  31. Endo K, Hizawa T, Fukuzumi T, Kataoka Y. [Keeping dogs indoor aggravates infantile atopic dermatitis]. Arerugi. 1999;48(12):1309–1315. [In Japanese].
  32. Jaworek AK, Szafraniec K, Jaworek M, et al. Cat Allergy as a source intensification of atopic dermatitis in adult patients. Adv Exp Med Biol. 2020;1251:39–47. doi: 10.1007/5584_2019_451
  33. Pónyai G, Hidvégi B, Németh I, et al. Contact and aeroallergens in adulthood atopic dermatitis. J Eur Acad Dermatol Venereol. 2008;22(11):1346–1355. doi: 10.1111/j.1468-3083.2008.02886.x
  34. Nankervis H, Pynn EV, Boyle RJ, et al. House dust mite reduction and avoidance measures for treating eczema. Cochrane Database Syst Rev. 2015;1(1):CD008426. doi: 10.1002/14651858.CD008426.pub2
  35. Meyer-Hoffert U. Reddish, scaly, and itchy: how proteases and their inhibitors contribute to inflammatory skin diseases. Arch Immunol Ther Exp (Warsz). 2009;57(5):345–354. doi: 10.1007/s00005-009-0045-6
  36. Gilles S, Mariani V, Bryce M, et al. Pollen allergens do not come alone: pollen associated lipid mediators (PALMS) shift the human immune systems towards a T(H)2-dominated response. Allergy Asthma Clin Immunol. 2009;5(1):3. doi: 10.1186/1710-1492-5-3
  37. Pan Z, Dai Y, Akar-Ghibril N, et al. Impact of air pollution on atopic dermatitis: a comprehensive review. Clin Rev Allergy Immunol. 2023;65(2):121–135. doi: 10.1007/s12016-022-08957-7
  38. Tang KT, Ku KC, Chen DY, et al. Adult atopic dermatitis and exposure to air pollutants – a nationwide population-based study. Ann Allergy Asthma Immunol. 2017;118(3):351–355. doi: 10.1016/j.anai.2016.12.005
  39. Kim J, Kim H, Lim D, et al. Effects of indoor air pollutants on atopic dermatitis. Int J Environ Res Public Health. 2016;13(12):1220. doi: 10.3390/ijerph13121220
  40. Lu C, Deng L, Ou C, et al. Preconceptional and perinatal exposure to traffic-related air pollution and eczema in preschool children. J Dermatol Sci. 2017;85(2):85–95. doi: 10.1016/j.jdermsci.2016.11.004
  41. Wollenberg A, Kinberger M, Arents B, et al. European guideline (EuroGuiDerm) on atopic eczema – part II: non-systemic treatments and treatment recommendations for special AE patient populations. J Eur Acad Dermatol Venereol. 2022;36(11):1904–1926. doi: 10.1111/jdv.18429
  42. Giménez-Arnau A. Standards for the protection of skin barrier function. Curr Probl Dermatol. 2016;49:123–134. doi: 10.1159/000441588
  43. Shen J, Liu Y, Wang X, et al. A comprehensive review of health-benefiting components in rapeseed oil. Nutrients. 2023;15(4):999. doi: 10.3390/nu15040999
  44. Zhu JR, Wang J, Wang SS. A single-center, randomized, controlled study on the efficacy of niacinamide-containing body emollients combined with cleansing gel in the treatment of mild atopic dermatitis. Skin Res Technol. 2023;29(9):e13475. doi: 10.1111/srt.13475
  45. Tan CYR, Tan CL, Chin T, et al. Nicotinamide prevents UVB- and oxidative stress-induced photoaging in human primary keratinocytes. J Invest Dermatol. 2022;142(6):1670–1681.e12. doi: 10.1016/j.jid.2021.10.021
  46. Kim HW, Ryoo GH, Jang HY, et al. NAD+-boosting molecules suppress mast cell degranulation and anaphylactic responses in mice. Theranostics. 2022;12(7):3316–3328. doi: 10.7150/thno.69684
  47. Namazi MR, Fallahzadeh MK, Roozbeh J. Nicotinamide as a potential novel addition to the anti-uremic pruritus weaponry. Saudi J Kidney Dis Transpl. 2009;20(2):291–292.
  48. Bains P, Kaur M, Kaur J, Sharma S. Nicotinamide: mechanism of action and indications in dermatology. Indian J Dermatol Venereol Leprol. 2018;84(2):234–237. doi: 10.4103/ijdvl.IJDVL_286_17
  49. Guéniche A, Dahel K, Bastien P, et al. Vitreoscilla filiformis bacterial extract to improve the efficacy of emollient used in atopic dermatitis symptoms. J Eur Acad Dermatol Venereol. 2008;22(6):746–747. doi: 10.1111/j.1468-3083.2007.02428.x
  50. Gueniche A, Knaudt B, Schuck E, et al. Effects of nonpathogenic gram-negative bacterium Vitreoscilla filiformis lysate on atopic dermatitis: a prospective, randomized, double-blind, placebo-controlled clinical study. Br J Dermatol. 2008;159(6):1357–1363. doi: 10.1111/j.1365-2133.2008.08836.x
  51. Mainzer C, Le Guillou M, Vyumvuhore R, et al. Clinical efficacy of oligofructans from Ophiopogon japonicus in reducing atopic dermatitis flare-ups in Caucasian patients. Acta Derm Venereol. 2019;99(10):858–864. doi: 10.2340/00015555-3224
  52. Braun C, Coutier L, Bégin P, Nosbaum A. Skin-centered strategies in food allergy prevention. Pediatr Allergy Immunol. 2024;35(5):e14130. doi: 10.1111/pai.14130
  53. Bradshaw LE, Wyatt LA, Brown SJ, et al. Emollient application from birth to prevent eczema in high-risk children: the BEEP RCT. Health Technol Assess. 2024;28(29):1–116. doi: 10.3310/RHDN9613
  54. Bzioueche H, Tamelghaghet M, Chignon-Sicard B, et al. Ceramide AD™ restores skin integrity and function following exposure to house dust mite. Int J Mol Sci. 2023;24(11):9234. doi: 10.3390/ijms24119234
  55. Billmann-Eberwein C, Rippke F, Ruzicka T, et al. Modulation of atopy patch test reactions by topical treatment of human skin with a fatty acid-rich emollient. Skin Pharmacol Appl Skin Physiol. 2002;15(2):100–104. doi: 10.1159/000049396
  56. Litovkina AO, Smolnikov EV, Elisyutina OG, Fedenko ES. The role of modern emollients in prophylaxis of atopic dermatitis exacerbation during pollination season. Russian Journal of Allergy. 2023;20(1):41–51. doi: 10.36691/RJA4136

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2024 Pharmarus Print Media

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

1. Я (далее – «Пользователь» или «Субъект персональных данных»), осуществляя использование сайта https://journals.rcsi.science/ (далее – «Сайт»), подтверждая свою полную дееспособность даю согласие на обработку персональных данных с использованием средств автоматизации Оператору - федеральному государственному бюджетному учреждению «Российский центр научной информации» (РЦНИ), далее – «Оператор», расположенному по адресу: 119991, г. Москва, Ленинский просп., д.32А, со следующими условиями.

2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».