Early onset atopic dermatitis (AD) can result in significant protein loss in atopic dermatitis (SPLAD).

The goal of a new study published in Arerugi was to better understand the prognosis of SPLAD. This was a single-center, retrospective, observational study based on medical records of 2002-2017. During the study period, 61 children with SPLAD were hospitalized at the Allergy Center of the National Center for Child Health and Development. The study assessed patient characteristics, blood test results and prognoses for up to three years, as well as the frequency of topical corticosteroid (TCS) treatment and food intake status.

The results showed that AD therapy alone—without intravenous fluids—alleviated hypoproteinemia and electrolyte abnormalities in all individuals. Researchers employed a proactive therapy to keep patients in remission – by gradually reducing the frequency of TCS use. It was noted that after 1, 2 and 3 years, remission was maintained by taking TCS 2 days a week or less, in 77%, 92% and 95% of cases, respectively, although 39% did not require TCS after 3 years. Systemic therapy, such as systemic steroids, immunosuppressant’s or biologics, was not administered to any subject.

It was observed that after 3 years, 29% of infants younger than 1 year at admission had eliminated one or more egg, milk or wheat components. The study concluded that TCS use can be lowered to 2 days per week or less in individuals with SPLAD, the most severe form of AD, following 3 years with adequate skin therapy.

Source: Arerugi. 2021;70(10):1383-1390. doi: 10.15036/arerugi.70.1383.