Novel Sodium Hypochlorite Cleanser Shows Clinical Response and Excellent Acceptability in the Treatment of Atopic Dermatitis

Abstract Background Several studies have investigated the efficacy of balneotherapy in atopic dermatitis (AD), including a pediatric open randomized clinical trial conducted at the Comano thermal spring water center, which showed a significant reduction in AD severity and an improvement of the quality of life. However, so far many studies on balneotherapy in pediatric AD have included relatively small populations without identifying patients’ characteristics associated with their response. The aim of the present study was to identify any features associated with the clinical response to the Comano thermal spring water balneotherapy in a large cohort of pediatric AD patients. Methods An observational study was conducted on 867 children aged ≤16 years (females 50.5%, mean patient’s age 5.9 years, standard deviation ±3.6 years) with mild to severe AD who underwent balneotherapy at the Comano thermal spring water center (Comano, Trentino, Italy) from April to October 2014. Patients were stratified according to their disease severity, which was evaluated using five SCORing Atopic Dermatitis (SCORAD) categories before and immediately after a thermal spring water balneotherapy course. Potential characteristics associated with the patients’ clinical response to Comano thermal spring water balneotherapy were investigated. Results A statistically significant improvement in AD severity was observed after Comano thermal spring water balneotherapy (p < 0.0001). A significantly higher percentage of patients achieving improvement in AD severity was reported among children ≤4 years old (p < 0.0001) with early-onset AD (p < 0.0001), severe AD (p < 0.0001) or coexistent reported food allergies (p < 0.01). The therapy was well tolerated, and no relevant adverse effects were reported during the treatment course. Conclusions Comano thermal spring water balneotherapy is a safe complementary treatment for pediatric patients with AD, as it was able to reduce the disease severity, especially in children ≤4 years old, with early onset AD, severe AD or concomitant food allergies.

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Identification of atopic dermatitis phenotypes with good responses to probiotics (Lactobacillus plantarum CJLP133) in children

Beneficial Microbes ◽

10.3920/bm2017.0034 ◽

2017 ◽

Vol 8 (5) ◽

pp. 755-761 ◽

Cited By ~ 6

Author(s):

J. Kim ◽

B.S. Lee ◽

B. Kim ◽

I. Na ◽

J. Lee ◽

...

Keyword(s):

T Cells ◽

Atopic Dermatitis ◽

Clinical Response ◽

Lactobacillus Plantarum ◽

Transforming Growth Factor ◽

Immunoglobulin E ◽

Treg Cells ◽

Good Clinical Response ◽

Total Ige ◽

Probiotic Treatment

The therapeutic effect of probiotics in atopic dermatitis (AD) remains controversial and varies according to the individual patient. We aimed to identify a population of AD patients with a good clinical response to probiotic treatment. We recruited 76 children with a median age of 7.1 years who suffered from moderate to severe AD. After a 2-week washout period, all patients were given Lactobacillus plantarum CJLP133 at a dosage of 1×1010 colony-forming units once a day for 12 weeks. We measured eosinophil counts in the peripheral blood, the proportion of CD4+CD25+Foxp3+ regulatory T (Treg) cells in CD4+ T cells, serum total immunoglobulin E (IgE) levels, and specific IgE against common allergens before the start of the treatment (T1) and at discontinuation (T2). Responders were defined as patients with at least a 30% reduction in the SCORing of AD (SCORAD) index after treatment. There were 36 responders and 40 non-responders after probiotic treatment. The median SCORAD was reduced from 29.5 (range 20.6-46.3) at T1 to 16.4 (range 6.3-30.8) at T2 in the responder group (P<0.001). In multivariable logistic regression analysis, a good clinical response was significantly associated with high total IgE levels (aOR 5.1, 95% CI 1.1-23.6), increased expression of transforming growth factor (TGF)-β (aOR 4.6, 95% CI 1.3-15.9), and a high proportion of Treg cells in CD4+ T cells (aOR 3.7, 95% CI 1.1-12.7) at T1. In the responder group, the proportion of Treg cells was significantly increased after 12 weeks of treatment (P=0.004), while TGF-β mRNA expression was decreased (P=0.017). Our results suggest that a subgroup of patients with a specific AD phenotype showing an immunologically active state (high total IgE, increased expression of TGF-β, high numbers of Treg cells) may benefit from probiotic treatment with L. plantarum CJLP133.

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Efficacy and safety of sodium hypochlorite (bleach) baths in patients with moderate to severe atopic dermatitis in Malaysia

The Journal of Dermatology ◽

10.1111/1346-8138.12265 ◽

2013 ◽

Vol 40 (11) ◽

pp. 874-880 ◽

Cited By ~ 48

Author(s):

Su-ming Wong ◽

Ting Guan Ng ◽

Roshidah Baba

Keyword(s):

Atopic Dermatitis ◽

Sodium Hypochlorite ◽

Severe Atopic Dermatitis ◽

Efficacy And Safety

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1066 Biomarkers CCL17/TARC and total IgE do not predict clinical response to dupilumab in atopic dermatitis (AD): A post hoc analysis of pooled phase 3 data (SOLO 1 & 2)

Journal of Investigative Dermatology ◽

10.1016/j.jid.2018.03.1079 ◽

2018 ◽

Vol 138 (5) ◽

pp. S181

Author(s):

J.D. Hamilton ◽

Z. Chen ◽

L.A. Beck ◽

E.L. Simpson ◽

T. Hultsch ◽

...

Keyword(s):

Atopic Dermatitis ◽

Clinical Response ◽

Phase 3 ◽

Total Ige ◽

Post Hoc Analysis ◽

Post Hoc

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Cyclosporine shows benefit as compared to methotrexate for treatment of pediatric atopic dermatitis refractory to topical medications when rapidity of clinical response is of key importance to the patient

Clinical Research in Practice The Journal of Team Hippocrates ◽

10.22237/crp/1593562680 ◽

2020 ◽

Vol 6 (2) ◽

Author(s):

Connor R. Buechler ◽

Steven Daveluy

Keyword(s):

Atopic Dermatitis ◽

Clinical Response ◽

Pediatric Patient ◽

Clinical Decision ◽

Severe Atopic Dermatitis ◽

Topical Medications

A clinical decision report appraising El-Khalawany MA, Hassan H, Shaaban D, Ghonaim N, Eassa B. Methotrexate versus cyclosporine in the treatment of severe atopic dermatitis in children: a multicenter experience from Egypt. European Journal of Pediatrics. 2012;172(3):351-356. https://doi.org10.1007/s00431-012-1893-3 for a pediatric patient with severe atopic dermatitis.

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