Improvement of therapy efficacy in children with atopic dermatitis due to emollient complex

Active studies of atopic dermatitis (AtD) have revealed new disease pathways and confirmed the complex treatment approach need, including different forms of emollients (creams and bath treatments). Study aim: to show effectiveness of locally produced moisturizing cream and bathing oil combination (Lipobase baby trademark) in the complex treatment of babies and toddlers with AtD.

Patients and methods. Thirty children (60% boys) aged from 6 to 36 months with mild/moderate AtD were included in open prospective non-comparative study 30 days long. Initial and after each 2 weeks SCORAD and dairies for 10 points skin itch and sleep disturbance scores, moisturizers consumption and adverse events were evaluated. Global evaluation of treatment effectiveness score were performed by patient’s doctor.

Results. Medium compliance for moisturizers consumption was 89.2% days. Medium SCORAD results decreased from visit 1 to 3: from 23.5±7.3 points to 18.7±4.9 points and to 14.6±3.1 points. After 2 weeks complex therapy including investigated moisturizers, medium day skin itch score was reduced from 6.4 to 3.6 points, also as sleep disturbance score from 2.6 to 1.2 points. Direct moderate correlation (r=0.64, p=0.012) was revealed between number of days without skin itch or sleep disturbance and compliance to moisturizers consumption. No any adverse event caused by investigated products was registered.

Conclusion. Inclusion of locally produced moisturizing cream and bathing oil (Lipobase baby trademark) in the complex AtD therapy improve the treatment efficacy.

Conflict of interest: Products of medical cosmetics for use in this Protocol are provided by the Pharmatek Company LLC. Representatives of the Company did not participate in the statistical processing, interpretation of the results and preparation of this publication.

1. Смирнова Г.И. Актуальный атопический дерматит: проблемы и перспективы. Российский аллергологический журнал 2017; 14: 4–5: 30–39. [Smirnova G.I. Actual atopic dermatitis: problemsand perspectives. Rossiiskii allergologicheskii zhurnal 2017; 14: 4–5: 30–39. (in Russ)]

2. Mortz C.G., Andersen K.E., Dellgren C., Barington T., BindslevJensen C. Atopic dermatitis from adolescence to adulthood in the TOACS cohort: prevalence, persistence and comorbidities. Allergy 2015; 70(7): 836–845. DOI: 10.1111/all.12619

3. Al-naqeeb J., Danner S., Fagnan L.J., Ramsey K., Michaels L.A., Mitchell J. et al. The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium. J Am Board Fam Med 2019; 32(2): 191–200. DOI: 10.3122/jabfm.2019.02.180225

4. Mallol J., Crane J., von Mutius E., Odhiambo J., Keil U., Stewart A.; ISAAC Phase Three Study Group. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three: a global synthesis. Allergol Immunopathol (Madr) 2013; 41(2): 73–85. DOI: 10.1016/j.aller.2012.03.001

5. Батожаргалова Б.Ц., Мизерницкий Ю.Л., Подольная М.А. Метаанализ распространенности астмоподобных симптомов и бронхиальной астмы в России (по результатам программы ISAAC). Российский вестник перинатологии и педиатрии 2016; 61(4): 59–69. [Batozhargalova B.C., Mizernickij Yu.L., Podol’naja M.A. Metanalysis of the prevalence of asthma-like symptoms and bronchial asthma in Russia (ISAAC program results). Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2016; 61(4): 59–69. (in Russ)]. DOI: 10.21508/1027-4065- 2016-61-4-59-69

6. Simpson E.L., Chalmers J.R., Hanifin J.M., Thomas K.S., Cork M.J., McLean W.H. et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014; 134: 818–823. DOI: 10.1016/j.jaci.2014.08.005

7. Атопический дерматит у детей. Федеральные клинические рекомендации. М., 2016; 60. [Atopic dermatitis in children. Federal clinical recommendations. Moscow, 2016; 60. (in Russ)]

8. Werfel T., Heratizadeh A., Aberer W., Ahrens F., Augustin M., Biedermann T. et al. S2k guideline on diagnosis and treatment of atopic dermatitis – short version. Allergo J Int 2016; 25: 82–95. DOI: 10.1007/s40629-016-0110-8

9. Скрипкин Ю. К., Зверькова Ф.А., Шарапова Г.Я., Студницын А.А. Руководство по детской дерматовенерологии. Ленинград: Медицина, 1983; 477. [Skripkin Yu. K., Zver’kova F.A., Sharapova G.Ja., Studnicyn A.A. Pediatric dermatovenerology guideline. Lenigrad: Meditsina, 1983; 477. (in Russ)]

10. Зайцева С.В., Застрожина А.К., Муртазаева О.А. Наружная терапия атопического дерматита у детей. Медицинский совет 2017; 19: 149–152. [Zajceva S.V., Zastrozhina A.K., Murtazaeva O.A. Topical therapy of atopic dermatitis in children. Medicinskii sovet 2017; 19: 149–152. (in Russ)]

11. Смирнова Г.И. Атопический дерматит у детей: новое в патогенезе, диагностике и лечении. Лечащий врач 2017; 4: 12–18. [Smirnova G.I. Atopic dermatitis in children: news in pathogenesis, diagnostics and treatment. Lechashchii vrach 2017; 4: 12–18. (in Russ)]

12. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatol 1993; 186(1): 23–31.

13. Weidinger S., Novak N. Atopic dermatitis. Lancet 2016; 387:1109.

14. Балаболкин И.И., Булгакова В.А., Елисеева Т.И. Нарушение кожного барьера и продукты лечебной косметики для ухода за кожей при атопическом дерматите у детей. Фарматека 2018; S1: 64–71. [Balabolkin I.I., Bulgakova V.A., Eliseeva T.I. Skin barrier impairment and medical cosmetic skin care products for atopic dermatitis in children. Pharmateca 2018; S1: 64–71. (in Russ)]

15. Камаев А.В., Трусова О.В., Ляшенко Н.Л., Макарова И.В. Эмоленты в терапии атопического дерматита у детей: анализ клинической и фармакоэкономической эффективности. Российский аллергологический журнал 2017; 14(4–5): 98–107. [Kamaev A.V., Trusova O.V., Ljashenko N.L., Makarova I.V. Emolients in atopic dermatitis treatment in children: analysis of clinical and pharmacoeco nomical efficacy. Rossiiskii allergologicheskii zhurnal 2017; 14(4–5): 98–107. (in Russ)]

16. Cabanillas B., Brehler A.C., Novak N. Atopic dermatitis phenotypes and the needfor personalized medicine. Curr Opin Allergy Clin Immunol 2017; 17: 309–315. DOI: 10.1097/ ACI.0000000000000376

17. Roduit C., Frei R., Depner M., Karvonen A.M., Renz H., Braun-Fahrländer C. et al. Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr 2017; 171(7): 655–662. DOI: 10.1001/ jamapediatrics.2017.0556

18. Макарова И.В. Уход за кожей больных атопическим дерматитом. Аллергология 2005; 1: 47–52. [Makarova I.V. Skin care for atopic dermatitis patients. Аllergologiya 2005; 1: 47–52. (in Russ)]

19. Макарова И.В. Комплексный подход к наружной терапии детей с атопическим дерматитом с использованием средств ухода за кожей серии Бальнеум. Вопросы практической педиатрии 2007; 2(6): 60–64. [Makarova I.V. Complex approach to the topic therapy in children with atopic dermatitis: Balneum skin care products usage. Voprosy prakticheskoi pediatrii 2007; 2(6): 60–64. (in Russ)]