A new study published in The Lancet stated that atopic dermatitis (AD), eczema or atopic eczema, is the most common chronic inflammatory disorder of the skin and affects around a quarter of children. Its worldwide, its prevalence is increasing and persistence into adulthood is has become common.

The authors reported that the first manifestations of AD usually appear in early life with dry, cracked, scaly and erythematous skin, along with intractable pruritus at all ages. AD can result in impaired quality of life for patients and their families, alongside considerable social and financial burden. However, there is no known cure or established strategies for prevention.

This article elaborated that early onset AD is often the hallmark of an atopic diathesis. Mutations in the filaggrin gene (FLG)—which encodes a protein crucial to epidermal function and skin barrier integrity—is associated with atopic dermatitis, food sensitization and allergy. Thus, the skin barrier might play a key role in the development of atopic dermatitis and subsequently, via epicutaneous sensitization through damaged skin, in food allergies.

Skin barrier dysfunction can be apparent in the first weeks of life, before the development of atopic dermatitis and FLG mutations are associated with food allergy even in the absence of atopic dermatitis—suggesting that interventions to improve skin barrier function from infancy have the potential to prevent the skin condition and development of food allergy independently.

Hence, emollients are the primary management strategy of AD and include leave-on creams or ointments, as well as bath additives. Regular, liberal use of emollients aims to maintain skin moisture, repair or enhance the skin barrier and reduce the need for anti-inflammatory measures.

It was reported that evidence from concept pilot studies provides strong efficacy signals that daily emollient use could prevent AD.

Source: The Lancet. 2020:95:10228:P923-924. DOI: 1016/S0140-6736(19)33174-5