Eczema

WEDNESDAY, May 10, 2023 (HealthDay News) -- A mindfulness and self-compassion training intervention is effective for improving quality of life (QOL) among adults with atopic dermatitis, according to a study published online May 10 in JAMA Dermatology.Sanae Kishimoto, M.P.H., from Kyoto University in Japan, and colleagues examined the efficacy of mindfulness and self-compassion training in improving QOL for adults with atopic dermatitis in a randomized clinical trial. A total of 107 adults were randomly assigned to receive eight 90-minute weekly group sessions of online mindfulness and self-compassion training or to a waiting list (56 and 51 patients, respectively).The researchers observed a greater improvement in the Dermatology Life Quality Index score at 13 weeks in the intervention group (between-group difference estimate, −6.34). At 13 weeks, the standardized effect size (Cohen d) was −1.06. Greater improvements were seen in the intervention versus the waiting-list group for all secondary outcomes, including eczema severity, itch- and scratching-related visual analog scales, self-compassion and all of its subscales, mindfulness, psychological symptoms, and participants' adherence to dermatologist-advised treatments."The present study is the first, to our knowledge, to show that group-format mindfulness and self-compassion enhances the QOL for adults with atopic dermatitis," the authors write.Several authors disclosed financial ties to the biopharmaceutical industry.<a target="_blank" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jamadermatology/article-abstract/2804875">Abstract/Full Text (subscription or payment may be required)</a>

Intervention group showed greater improvement in Dermatology Life Quality Index score at 13 weeks and in secondary end points

Mindfulness, Self-Compassion Training Improves QOL in Eczema

WEDNESDAY, May 3, 2023 (HealthDay News) -- Greenness around the home during early childhood does not seem to protect against eczema, according to a study published online April 7 in Pediatric Allergy and Immunology.Minna Lukkarinen, from University of Turku in Finland, and colleagues evaluated the impact of 12 land cover classes and two greenness indices around homes at birth on the development of doctor-diagnosed eczema by the age of 2 years among 5,085 children.The researchers found that neither greenness indices nor residential or industrial/commercial areas were associated with eczema by age 2 years. There was an association observed for coniferous forests (adjusted odds ratios [aORs], 1.19 [95 percent confidence interval (CI), 1.01 to 1.39] for the middle and 1.16 [95 percent CI, 0.98 to 1.28] for the highest versus lowest tertile) and mixed forests (aOR, 1.21 [95 percent CI, 1.02 to 1.42] for the middle versus lowest tertile) with elevated eczema risk. There was also a trend seen toward higher coverage with agricultural areas and elevated eczema risk (aOR, 1.20 [95 percent CI, 0.98 to 1.48] versus none). Transport infrastructure was inversely associated with eczema (aOR, 0.77 [95 percent CI, 0.65 to 0.91] for the highest versus lowest tertile)."Our results do not support the hypothesis that greenness and nature-related exposures around home would prevent [eczema] and the urban-related exposures increase the risk of allergic diseases in small children," the authors write.

Exposure to coniferous, mixed forests and agriculture areas associated with elevated eczema risk

Nearby Nature Does Not Protect Against Early Childhood Eczema

WEDNESDAY, April 26, 2023 &nbsp;-- For patients with chronic hand eczema (CHE), rapid improvement is seen with gusacitinib 80 mg treatment, according to a study published online April 22 in the Journal of the American Academy of Dermatology.Pablo A. Jimenez, M.D., from Asana BioSciences in Lawrenceville, New Jersey, and colleagues examined the efficacy and safety of gusacitinib in a double-blind phase 2 study in 97 patients with CHE. Participants were randomly assigned to placebo or gusacitinib (40 or 80 mg) for 12 weeks (part A) and then received gusacitinib through week 32 in part B.The researchers found a 69.5, 49.0, and 33.5 percent decrease in the modified Total Lesion Symptom Score (mTLSS) for patients receiving 80 mg gusacitinib, 40 mg gusacitinib, and placebo, respectively. Significant improvement in the Physician's Global Assessment (PGA) was seen in 31.3 and 6.3 percent of patients receiving 80 mg gusacitinib and placebo, respectively. A 73.3 versus 21.7 percent decrease in the hand eczema severity index (HECSI) was observed for patients receiving 80 mg gusacitinib versus placebo. A significant decrease in hand pain was noted for patients receiving 80 mg gusacitinib. Significant reductions over placebo were seen for 80 mg gusacitinib in mTLSS, PGA, and HECSI as early as week 2. Upper respiratory infection, headache, nausea, and nasopharyngitis were reported as adverse events."In this double-blind, placebo-controlled study in 97 moderate-to-severe steroid refractive CHE patients, gusacitinib was well tolerated and showed significant efficacy with a fast onset of action," the authors write.The study was funded by Asana BioSciences, the manufacturer of gusacitinib.Abstract/Full Text (subscription or payment may be required)

Significant reductions seen over placebo for 80 mg gusacitinib in mTLSS, PGA, HECSI as early as week 2

Chronic Hand Eczema Rapidly Improves With Gusacitinib

In two January data briefs published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics, data are presented regarding the prevalence of seasonal allergy, eczema, and food allergy among children and adults in 2021.

 Benjamin Zablotsky, Ph.D., from the National Center for Health Statistics in Hyattsville, Maryland, and colleagues used data from the 2021 National Health Interview Survey (NHIS) to describe the percentage of children who had diagnosed seasonal allergy, eczema, or food allergy. The researchers found that 18.9, 10.8 and 5.8 percent had a seasonal allergy, eczema, and a food allergy, respectively, in 2021. The likelihood of having a seasonal allergy was higher for boys than girls (20.0 versus 17.7 percent). There was variation observed by age in the percentage of children with eczema (10.4, 12.1, and 9.8 percent in children aged 0 to 5, 6 to 11, and 12 to 17 years, respectively). The likelihood of having a food allergy was increased for non-Hispanic Black versus non-Hispanic White and Hispanic children.

 Amanda E. Ng, M.P.H., and Peter Boersma, M.P.H., both from the National Center for Health Statistics, used 2021 NHIS data to describe the prevalence of seasonal allergy, eczema, or food allergy among adults. The researchers found that 25.7, 7.3, and 6.2 percent of adults had a seasonal allergy, eczema, and a food allergy, respectively, in 2021. Compared with Hispanic, non-Hispanic Black, and non-Hispanic Asian adults, the percentage of adults with a seasonal allergy was higher in non-Hispanic White adults. Women were more likely than men to have eczema (8.9 versus 5.7 percent). With increasing age, the prevalence of food allergy decreased. 

 "For all three allergies, women were more likely than men to have a diagnosed allergy," Ng and Boersma write.
<a href="https://www.cdc.gov/nchs/products/databriefs.htm" class="rm-stats-tracked" target="_blank">Data Brief - Children</a><a href="https://www.cdc.gov/nchs/products/databriefs.htm" class="rm-stats-tracked" target="_blank">Data Brief - Adults</a>

18.9 percent of children and 25.7 percent of adults had seasonal allergy; 10.8 and 7.3 percent had eczema in 2021

CDC Reports on Prevalence of Seasonal and Food Allergies, Eczema

Immediate and delayed patch test reactions to individual fragrances have been identified in the Thai population, according to a study published online June 8 in the
 
 Journal of the American Academy of Dermatology.
 




 Nutchaya Amornruk, M.D., from Chulalongkorn University in Bangkok, and colleagues examined the prevalence of an immediate patch test reaction to fragrance in patients with fragrance allergic contact dermatitis in a prospective study. A total of 291 patients were given standard patch tests for allergic contact dermatitis, and those with positive reactions were asked to undergo additional patch tests to 28 different fragrance substances for immediate and delayed reactions.




 The researchers found that the most frequently encountered substances in positive immediate reactions and standard (delayed) patched tests were cinnamic aldehyde and cinnamic alcohol. Reactions to benzyl alcohol, sorbic acid, and coumarin were observed more frequently in immediate patch tests than standard patch tests.




 "Cinnamic aldehyde and cinnamic alcohol were found to be the most common fragrance allergens eliciting immediate reactions in the Thai population in our current study," the authors write. "Given that both fragrance substances were major components of spices and essential oils that were frequently used in a variety of Asian foods, beverages, and personal care products such as mouthwash, it was expected that a high prevalence of immediate allergic reaction to these substances would exist in the Thai population."




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Cinnamic aldehyde and cinnamic alcohol were most frequently encountered substances in immediate, delayed reactions

Immediate, Delayed Reactions to Fragrances ID'd in Thai Population

There are no differences in effectiveness between the four main types of moisturizers for childhood eczema, according to a study published online May 23 in
 
 The Lancet Child &amp; Adolescent Health
 
 .




 Matthew J. Ridd, Ph.D., from the University of Bristol in the United Kingdom, and colleagues compared the clinical effectiveness and safety of the four main emollient types. Children (aged 6 months to 12 years) with eczema were randomly assigned to lotions (137 children), creams (140 children), gels (135 children), and ointments (138 children).




 The researchers observed no difference in eczema severity between emollient types over 16 weeks. Results remained unchanged even with multiple imputation, sensitivity, and subgroup analyses. There were also no differences seen in total number of adverse events between the treatment groups (36, 39, 40, and 35 percent for lotions, creams, gels, and ointments, respectively). However, stinging was less common with ointments (9 percent) compared with lotions (20 percent), creams (17 percent), and gels (19 percent).




 "A study of this type has been long overdue. It has not been in the interest of the manufacturers to directly compare types of moisturizer in the way we have done in this trial," Ridd said in a statement. "Our findings challenge conventions about how often moisturizers need to be applied, which types are less likely to cause problems and which patients should be recommended certain types."




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Patient choice and personal preferences should guide selection decisions

Lotion, Cream, Gel, and Ointment Similarly Effective for Childhood Eczema

Wildfire air pollution in San Francisco was associated with increased public interest in specific skin symptoms and diseases, according to a study presented at the annual meeting of the Society for Investigative Dermatology, held from May 18 to 21 in Portland, Oregon.




 Noting that wildfire smoke has been shown to exacerbate atopic dermatitis and itch for patients at one tertiary care medical center, Raj Fadadu, a medical student at the University of California in San Francisco, and colleagues examined the effects of wildfire air pollution on the skin based on trends in online searches. Daily environmental data, including fine particulate matter (PM
 
 2.5
 
 ) concentration and smoke plume density score, were obtained for San Francisco during the wildfire season from June through November 2020 and were compared to the same months in 2016. Search data for common skin symptoms and conditions were collected from Google Trends, which provides a daily Search Volume Index (SVI) ranging from 0 to 100 for each term.




 The researchers found that a 10-µg/m
 
 3
 
 increase in mean weekly PM
 
 2.5
 
 was associated with an increased mean weekly SVI for eczema, acne, itchy, itchy skin, and red skin. In models for psoriasis, there were no statistically significant results observed.




 "These results can inform skin health counseling and education that clinicians and public health practitioners provide during wildfires as well as suggest avenues for further study," the authors write.




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 More Information
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Searches for eczema, acne, itchy, itchy skin, red skin increased with a 10 µg/m

Google Searches for Skin Conditions Increase During Wildfires

Elimination diets may be associated with modest improvement in eczema severity but with some potential risks, according to a review published online July 18 in the
 
 Journal of Allergy and Clinical Immunology: In Practice
 
 .




 Paul Oykhman, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a systematic literature review to identify the benefits and harms of dietary elimination for the treatment of atopic dermatitis.




 Based on 10 randomized controlled trials (599 participants), the researchers found that dietary elimination may slightly improve eczema severity (50 percent with versus 41 percent without dietary elimination improved SCORAD [SCOring Atopic Dermatitis] by a minimally important difference of 8.7 points), pruritus (daytime itch score mean difference [MD]: −0.21), and sleeplessness (sleeplessness score MD, −0.47) with low certainty evidence. Elimination strategy (empiric versus guided by testing) and food-specific sensitization were not associated with subgroup differences. There were insufficient data examining harms of elimination diets, but there was indirect evidence suggesting elimination diets may increase the risk for developing immunoglobulin E-mediated food allergy.




 "My advice to anyone with atopic dermatitis-type eczema is that if you're going to pursue this dietary option, make sure you keep using your usual medicated creams, moisturizers, and talk to your doctor first," a coauthor said in a statement.




 Several authors disclosed financial ties to the pharmaceutical industry.




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Authors warn of some potential downsides to inform decision-making

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