Predicting skin barrier dysfunction and atopic dermatitis in early infancy. |
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Predicting skin barrier dysfunction and atopic dermatitis in early infancy.

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The purpose of a new study published in The Journal of Allergy and Clinical Immunology was to identify parental, prenatal and perinatal predictive factors of dry skin, high transepidermal water loss (TEWL) and atopic dermatitis (AD) at 3 months of age, and to determine whether dry skin or high TEWL at 3 months can predict AD at 6 months.This study included 1150 mother-child pairs from the Preventing Atopic Dermatitis and Allergies in children (Prevent ADALL) prospective birth cohort study. Dry skin, TEWL and eczema were assessed at 3 and 6 months investigations. Eczema, used as a proxy for AD, was defined as the presence of eczematous lesions, excluding differential diagnoses to AD. High TEWL was defined as TEWL > 90th percentile, equaling 11.3 g/m2/h. Potential predictive factors were recorded from electronic questionnaires at 18- and 34-week pregnancy and obstetric charts.It was found that significant predictive factors for dry skin at 3 months were delivery > 38 gestational weeks and paternal age > 37 years; for high TEWL – male sex, birth during winter season and maternal allergic disease; and for eczema – elective caesarean section, multiparity and maternal allergic diseases. Moreover, dry skin without eczema at 3 months was predictive for eczema at 6 monthswhile high TEWL at 3 months was not. Thus, it was concluded that in early infancy, distinct parental and pregnancy-related factors were predictive of dry skin, high TEWL and AD. While dry skin at 3 months of age was predictive of AD, three months later.

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