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Randomized Controlled Trial
. 2016 Mar-Apr;33(2):165-71.
doi: 10.1111/pde.12786.

Effects of a New Emollient-Based Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis

Pascale Bianchi  1 , Jennifer Theunis  1 , Christiane Casas  1 , Cecile Villeneuve  1 , Annalisa Patrizi  2 , Chloe Phulpin  1 , Adeline Bacquey  1 , Daniel Redoulès  1 , Valerie Mengeaud  1 , Anne-Marie Schmitt  1
Affiliations
Randomized Controlled Trial

Effects of a New Emollient-Based Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis

Pascale Bianchi et al. Pediatr Dermatol. 2016 Mar-Apr.

Abstract

Background/objectives: The use of emollients is widely recommended for the management of atopic dermatitis (AD), especially between flares. An imbalance of skin microflora is suspected of playing a key role in exacerbations of AD. Our aim was to evaluate the effect of a new emollient balm on clinical parameters (SCORing Atopic Dermatitis [SCORAD], xerosis, pruritus), skin barrier function (transepidermal water loss and loricrin, filaggrin, corneodesmosin, and involucrin expression], skin microflora biodiversity, and Staphylococcus aureus and Staphylococcus epidermidis balance in children with mild AD.

Methods: Fifty-four children (1-4 yrs old) were enrolled in this randomized, controlled study. Subjects applied a hygiene product and the emollient balm (emollient group, n = 28) or the hygiene product only (control group, n = 26) twice a day for 28 days.

Results: We found improvement in favor of the emollient group in SCORAD (p < 0.001), pruritus (p = 0.06), and xerosis (p = 0.06) after 28 days of application. Moreover, transepidermal water loss decreased in the emollient group by 34% (p = 0.06) and involucrin expression by 37% (p = 0.001) at day 28 from baseline in association with improvement in barrier function, whereas other barrier-specific proteins did not vary. S. aureus increased significantly in the control group only (6.5 times, p = 0.01), whereas S. epidermidis remained stable in both groups. The Shannon index (H' = 2.3) did not vary with treatment in either group.

Conclusion: Twice-daily application of a new emollient balm in children with mild AD protected the skin from S. aureus proliferation and preserved microflora biodiversity.

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Figures

Figure 1
Figure 1
Effect of emollient on xerosis. Clinical assessment of xerosis at baseline and after 15 (D15) and 28 (D28) days of treatment. Data are expressed as the percentage of subjects with different degrees of severity of xerosis (*p < 0.05).
Figure 2
Figure 2
Involucrin gene expression analysis after application of hygiene product and emollient for 28 days. Values are expressed as fold change from baseline (D0). Data are mean ± standard error of the mean (**p < 0.01 vs baseline).
Figure 3
Figure 3
Effect of emollient on the balance between Staphylococcus aureus and Staphylococcus epidermidis. Quantification of (A) S. epidermidis and (B) S. aureus using quantitative polymerase chain reaction and absolute quantification. Data are expressed as sodA gene copy number ± standard error of the mean. S. aureus copy values for inflammatory and xerotic areas are given as references for AD subjects with a SCORing Atopic Dermatitis score of 20 (*p < 0.05 vs baseline).
Figure 4
Figure 4
Effect of treatments on skin microflora diversity. Genus proportion calculated from 16S ribosomal RNA pyrosequencing data associated with the Shannon index (diversity index) at baseline (D0) and after application of emollient or hygiene product for 28 days (D28).
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References

    1. Cork MJ, Danby SG, Vasilopoulos Y et al. Epidermal barrier dysfunction in atopic dermatitis. J Invest Dermatol 2009;129:1892–1908. - PubMed
    1. Leung DY, Guttman‐Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol 2014;134:769–779. - PMC - PubMed
    1. Kong HH, Oh J, Deming C et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res 2012;22:850–859. - PMC - PubMed
    1. Zollner TM, Wichelhaus TA, Hartung A et al. Colonization with superantigen‐producing Staphylococcus aureus is associated with increased severity of atopic dermatitis. Clin Exp Allergy 2000;30:994–1000. - PubMed
    1. Casas C, Ginisty H, Alvarez‐Georges S et al. Molecular characterization of inflammation and Staphylococcus aureus colonization of involved skin of atopic dermatitis patients. A non‐invasive approach. Skin Pharmacol Physiol 2008;21:260–268. - PubMed

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