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| Name | Class |
|---|---|
| Charite University, Berlin, Germany | OTHER |
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The primary objective of this study is to investigate the effectiveness of a standardized skin care regimen using a milk lotion once daily and a bathing addendum as needed during the first 52 weeks of life on the development of atopic Dermatitis (AD) compared to no structured skin care regimen in infants with atopic predisposition. Secondary objectives are to investigate the influence of a structured skin care regimen on the development of AD in the second year of life and the skin barrier function up to the infants' age of 2 years.
Atopic dermatitis is the most common cutaneous disease in childhood. First manifestations of AD usually appear early in life after the 3rd month of life and often precede other allergic diseases such as asthma or allergic rhinitis. AD affects over 15% of children up to school age in Germany and has a substantial impact on the lives and life quality of both the child and its family. Taking into account the burden on health-care resources, the impact on the quality of life of patients and their caregivers, together with increasing evidence that AD may progress to other allergic phenotypes, there is a clear need to improve disease prevention. Due to the childhood prevalence of the disease, prevention is focused on the postnatal period. It is recognized that prevention should start as soon as possible. Current studies suggest that epidermal barrier impairment is an important factor for the development of AD and other allergic diseases, with the gene encoding the filament-binding protein filaggrin (FLG) being the most widely replicated and most significant gene to influence atopic diseases. Currently, no standardized recommendations for preventive therapies exist for AD. Pilot studies have focused on interventions to enhance skin barrier function. Daily skin care with an emollient early after birth is considered to reduce the risk of atopic dermatitis in infants.
The study will be divided in 2 parts: The main study (Interventional period) lasts up to the child´s age of one year (52 weeks of life) and the follow-up period up to the second birthday.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention: standardized skin care regimen | Other | Intervention: The milk lotion will be applied once daily on the total body including the face by the parents or care givers at home. If bathing is needed, the bathing addendum is used in addition to water. |
|
| Control | No Intervention | In the control group no predetermined or standardized skin care regimen is prescribed. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| standardized skin care regimen | Other | Application of a standardized daily skin care regimen:
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| Measure | Description | Time Frame |
|---|---|---|
| Cumulative incidence of atopic dermatitis | Cumulative incidence of AD at week 52, with AD diagnosis based on the criteria by Simpson et al. 2012 | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Cumulative incidence of atopic dermatitis | 24 months | |
| AD incidence density | 12 months | |
| AD incidence density |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ulrike Blume-Peytavi, Prof. Dr. | Charite Universitätsmedizin Berlin | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Charite Universitätsmedizin Berlin | Berlin | 10117 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22424882 | Background | Simpson EL, Keck LE, Chalmers JR, Williams HC. How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies. J Allergy Clin Immunol. 2012 Jul;130(1):137-44. doi: 10.1016/j.jaci.2012.01.075. Epub 2012 Mar 15. |
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| ID | Term |
|---|---|
| D003876 | Dermatitis, Atopic |
| ID | Term |
|---|---|
| D012873 | Skin Diseases, Genetic |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003872 | Dermatitis |
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| 24 months |
| Eczema Area and Severity Index (EASI) | 12 months |
| Eczema Area and Severity Index (EASI) | 24 months |
| Infant Dermatitis Quality of Life (IDQoL) | 12 months |
| Infant Dermatitis Quality of Life (IDQoL) | 24 months |
| Transepidermal water loss (TEWL) on the midvolar forearm | at ages of 14 days, 1, 3, 6, 12 months and 2 years |
| Skin surface pH on the midvolar forearm | at ages of 14 days, 1, 3, 6, 12 months and 2 years |
| Stratum Corneum Hydration (SCH) on the forearm | at ages of 14 days, 1, 3, 6, 12 months and 2 years |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D017443 | Skin Diseases, Eczematous |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |