What's New in Dermatology

<h2 id="genetic">Genetic Connections</h2><p>A national cohort study of over 499,000 children has revealed significant genetic links between atopic dermatitis (AD) and autoimmune diseases. Children with AD have a higher risk of developing six autoimmune conditions due to shared genetic traits.&nbsp;</p><p>This suggests that individuals with AD may be predisposed to autoimmune diseases, emphasizing the need for careful monitoring and early intervention.</p><h2 id="prevention">Prevention Strategies</h2><p>Preventive strategies for AD include, Enhancing the skin barrier, Using probiotics and prebiotics, Considering vitamin D supplementation, Encouraging breastfeeding, Exploring immunotherapy options. Global collaboration is crucial for developing conclusive evidence on these prevention methods, especially for high-risk infants.</p><h2 id="skin-microbiome">Skin Microbiome and AD</h2><p>The skin microbiome in AD patients is influenced by genetics and skin barrier integrity, leading to higher levels of Staphylococcus bacteria. These bacteria can disrupt the skin barrier, affect immune responses, and express virulence genes.&nbsp;</p><p>Early-life exposure and environmental factors shape the microbiome, with antibiotics potentially causing long-term changes. Treating AD flares can reduce S. aureus levels and improve microbiome diversity temporarily.&nbsp;</p><p>Fluctuations in the skin microbiome are linked to AD and food allergies, particularly in early life, where food allergies often arise from epicutaneous sensitization.</p><p><strong>AD has been associated with various other conditions:</strong></p><ul><li><strong>Food Sensitization and Allergies:</strong> AD patients often develop food sensitization before IgE-mediated food allergies.</li><li><strong>Eosinophilic Esophagitis (EoE):</strong> EoE frequently follows AD, food allergies, and asthma.</li><li><strong>Food Protein-Induced Enterocolitis Syndrome (FPIES):</strong> Non-IgE-triggered immune responses to foods, affecting toddlers.</li><li><strong>Inflammatory Bowel Diseases (IBD):</strong> Th2 responses in AD are linked to conditions like Crohn’s disease and ulcerative colitis, influenced by microbiota disruptions and short-chain fatty acid (SCFA) imbalances.</li></ul><h2 id="gerd">Gastroesophageal Reflux Disease (GERD)</h2><p>GERD, which is associated with asthma and AD, shares genetic ties with AD and may increase AD risk.</p><ul><li><strong>Impact of Antibiotics:</strong> Early-life antibiotics, particularly within the first year, have been shown to increase AD risk. This is due to alterations in the gut microbiome, with an increase in Tyzzerella nexilis and a decrease in Bifidobacterium linked to later AD development.</li><li><strong>Growth and Development:</strong> The 2024 AAD Annual Meeting's winning poster highlighted the impact of AD on children's growth. The PEDISTAD study compared growth metrics of children under 12 with AD to healthy peers.&nbsp;</li></ul><p><strong>Key findings include:</strong></p><ul><li>Lower height percentiles in children with AD, potentially due to itching and medication side effects.<br>Higher weight and BMI, which may be associated with growth limitations and sleep disturbances.</li></ul><p>The study underscores the importance of early intervention and tailored treatments to optimize growth outcomes for children with AD.</p>

DERMATOLOGY UPDATE ISSUE 1 2024

<ul><li><a href="#genetic">Genetic Connections</a></li><li><a href="#prevention">Prevention Strategies</a></li><li><a href="#skin-microbiome">Skin Microbiome and AD</a></li><li><a href="#gerd">Gastroesophageal Reflux Disease (GERD)</a></li></ul>