Abstract：
BACKGROUND: Atopic dermatitis (AD) typically starts in infancy and early childhood. The chronic skin disorder is associated with recurrent flares, pruritus, and genetic predisposition. Daily use of moisturizers that contain lipids, such as ceramides, reduces the rate of AD flares and the need for topical steroid treatment. We aimed to provide insights on AD attenuation to tailor AD prescription therapy, skin care, and maintenance treatment to improve pediatric patients with AD and families.
METHODS: A panel of 6 pediatric dermatologists and dermatologists who treat neonates, infants, and children developed a consensus paper on AD attenuation for pediatric patients. The modified Delphi process comprised a face-to-face panel meeting and online follow-up to discuss the systematic literature search results and draw from clinical experience and opinion of the panel to adopt and agree on 5 statements. Results: Understanding the functional properties of newborn and infant skin, discussing skincare product use with parents, and recommending tailored prescription and skincare routines can improve newborn, infant, and children’s skin health. Studies on the prophylactic application of moisturizers initiated in early infancy suggest moisturizers may delay rather than prevent AD, especially in high-risk populations and when used continuously. Increasingly there is evidence that moisturizer application reduces the severity of AD and extends the time to flares, which may help attenuate the atopic march. The protective effect of skin care for AD has been observed in studies where its daily use is ongoing; these beneficial effects may be lost in less than 1year after cessation. It is therefore important to emphasize that skin care should be routinely used when counseling patients and caregivers. Conclusion: Healthcare providers can improve patient outcomes in atopic-prone infants and children by providing instructions regarding the daily benefits of applying skin care with gentle cleansers and moisturizers. Using gentle cleansers and moisturizers containing barrier lipids from birth onward may delay AD occurrence and mitigate severity in predisposed infants.J Drugs Dermatol. 2024;23(3): doi:10.36849/JDD.7894.
METHODS: A panel of 6 pediatric dermatologists and dermatologists who treat neonates, infants, and children developed a consensus paper on AD attenuation for pediatric patients. The modified Delphi process comprised a face-to-face panel meeting and online follow-up to discuss the systematic literature search results and draw from clinical experience and opinion of the panel to adopt and agree on 5 statements. Results: Understanding the functional properties of newborn and infant skin, discussing skincare product use with parents, and recommending tailored prescription and skincare routines can improve newborn, infant, and children’s skin health. Studies on the prophylactic application of moisturizers initiated in early infancy suggest moisturizers may delay rather than prevent AD, especially in high-risk populations and when used continuously. Increasingly there is evidence that moisturizer application reduces the severity of AD and extends the time to flares, which may help attenuate the atopic march. The protective effect of skin care for AD has been observed in studies where its daily use is ongoing; these beneficial effects may be lost in less than 1year after cessation. It is therefore important to emphasize that skin care should be routinely used when counseling patients and caregivers. Conclusion: Healthcare providers can improve patient outcomes in atopic-prone infants and children by providing instructions regarding the daily benefits of applying skin care with gentle cleansers and moisturizers. Using gentle cleansers and moisturizers containing barrier lipids from birth onward may delay AD occurrence and mitigate severity in predisposed infants.J Drugs Dermatol. 2024;23(3): doi:10.36849/JDD.7894.
摘要：
背景：特应性皮炎（AD）通常在婴儿期和儿童早期开始。慢性皮肤病与复发性耀斑有关，瘙痒,和遗传倾向。每日使用含有脂质的保湿剂，如神经酰胺，降低AD耀斑的发生率和局部类固醇治疗的需要。我们旨在提供有关AD衰减的见解，以定制AD处方治疗，护肤,和维持治疗，以改善小儿AD患者和家庭。
方法：由6名儿科皮肤科医生和治疗新生儿的皮肤科医生组成的小组，婴儿,儿童发表了一篇关于儿科患者AD衰减的共识论文。修改后的Delphi流程包括面对面的小组会议和在线随访，以讨论系统的文献检索结果，并借鉴临床经验和小组意见，通过并同意5项声明。结果:了解新生儿和婴儿皮肤的功能特性,与父母讨论护肤品的使用，推荐量身定制的处方和护肤程序可以改善新生儿，婴儿,和儿童’的皮肤健康。对婴儿早期开始的保湿剂预防性应用的研究表明，保湿剂可能会延迟而不是预防AD。特别是在高危人群和连续使用时。越来越多的证据表明，保湿剂的应用降低了AD的严重程度，并延长了耀斑的时间，这可能有助于减弱特应性行军。在每天使用AD的研究中已经观察到皮肤护理对AD的保护作用;这些有益作用可能在停止后不到1年内消失。因此，重要的是要强调，在为患者和护理人员提供咨询时，应常规使用皮肤护理。结论：医疗保健提供者可以通过提供有关使用温和的清洁剂和保湿剂进行皮肤护理的日常益处的说明，来改善易发生特应性的婴儿和儿童的患者预后。从出生开始使用含有屏障脂质的温和清洁剂和保湿剂可以延迟AD的发生并减轻易感婴儿的严重程度。J药物Dermatol.2024；23（3）：doi：10.36849/JD.7894。
方法：由6名儿科皮肤科医生和治疗新生儿的皮肤科医生组成的小组，婴儿,儿童发表了一篇关于儿科患者AD衰减的共识论文。修改后的Delphi流程包括面对面的小组会议和在线随访，以讨论系统的文献检索结果，并借鉴临床经验和小组意见，通过并同意5项声明。结果:了解新生儿和婴儿皮肤的功能特性,与父母讨论护肤品的使用，推荐量身定制的处方和护肤程序可以改善新生儿，婴儿,和儿童’的皮肤健康。对婴儿早期开始的保湿剂预防性应用的研究表明，保湿剂可能会延迟而不是预防AD。特别是在高危人群和连续使用时。越来越多的证据表明，保湿剂的应用降低了AD的严重程度，并延长了耀斑的时间，这可能有助于减弱特应性行军。在每天使用AD的研究中已经观察到皮肤护理对AD的保护作用;这些有益作用可能在停止后不到1年内消失。因此，重要的是要强调，在为患者和护理人员提供咨询时，应常规使用皮肤护理。结论：医疗保健提供者可以通过提供有关使用温和的清洁剂和保湿剂进行皮肤护理的日常益处的说明，来改善易发生特应性的婴儿和儿童的患者预后。从出生开始使用含有屏障脂质的温和清洁剂和保湿剂可以延迟AD的发生并减轻易感婴儿的严重程度。J药物Dermatol.2024；23（3）：doi：10.36849/JD.7894。
