Monthly Archives: April 2017

Eczema affects a large proportion of children and adolescents in the United States. New research investigates whether silk clothing improves health outcomes for children with eczema.

Eczema - also known as atopic dermatitis - is a chronic dermatological disease that causes the skin to itch and become very dry. Although the condition is not contagious, people with eczema may be vulnerable to other viral and bacterial skin diseases.

Atopic dermatitis affects approximately 30 percent of the U.S. population, according to the National Institutes of Health (NIH). Children and adolescents seem to be particularly at risk of eczema, the NIH report.

Clothing seems to play an important role in the management of the disease. Patients are routinely advised to wear cotton or smooth fabrics and avoid materials such as wool, which may worsen the itching.

Furthermore, in countries such as the United Kingdom, specialist silk clothing is available on prescription for people with eczema.

As a result, a team of researchers from the University of Nottingham in the U.K. - led by Kim Thomas and colleagues - set out to investigate the benefits of wearing silk garments for children with eczema. The study was published in the journal PLOS Medicine.

Thomas and team conducted a randomized, controlled, and observer-blind trial - that is, the nurses who evaluated the patients were unaware of the treatment that the participants were undergoing - and called it the "CLOTHES Trial."

The team recruited 300 children aged between 1 and 15 who received community and secondary care for moderate to severe eczema across five medical centers in the U.K.

Participants were randomized into two groups: one group received standard care for eczema and wore silk clothing, while the other group received standard care alone.

In the first group, the children wore the silk clothing - which was made of 100 percent sericin-free silk - for 6 months. Using the Eczema Area and Severity Index (EASI), the researchers evaluated the severity of eczema at the beginning of the study, and then at 2, 4, and 6 months, respectively.

The researchers adjusted for the children's age and the medical center from which they were recruited.

Thomas and colleagues averaged the EASI score for the two groups and found no significant difference between them.

Specifically, 25 percent of the children in the silk garments plus standard care group developed skin infections, compared with 28 percent in the group that received only standard care. The small treatment effect was considered insignificant from a statistical and clinical standpoint, as the 95 percent confidence interval varied from 1.5 points in favor of silk garments to 0.5 in favor of standard care alone - a difference too small to be considered relevant.

Additionally, the study found no difference in the quality of life between the two groups.

Furthermore, the researchers calculated the cost of using silk therapeutically per quality-adjusted life year, and they concluded that silk garments are not cost-effective. The computed yearly cost amounted to 56,881, which corresponds to around $70,550.

The researchers explain the significance of the findings:

"The CLOTHES Trial is the first large, independent [randomized, controlled trial] to have evaluated silk garments for the management of eczema. The results of this trial suggest that silk garments are unlikely to provide additional clinical or economic benefits over standard care for children with moderate to severe eczema."

However, the authors also admit a limitation of the study: although using an objective primary outcome measure - namely, the EASI score, assessed by nurses who were blinded to the treatment - minimized detection bias, it may have also ignored changes in symptoms and underestimated the beneficial effects of the treatment.

Learn how an arthritis drug successfully treated eczema.

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Clinical trial finds no benefits of wearing silk for children with eczema - Medical News Today

No significant differences were observed in eczema severity for children with moderate to severe eczema who wore silk garments compared with those who wore their usual clothing, according to a randomized controlled study published in PLOS Medicine by Kim Thomas from University of Nottingham, UK, and colleagues.

Clothing may play a role in either exacerbating or soothing eczema, and patients often avoid wool garments and turn to cotton and other fine weave fabrics, including silk. In the new study, 300 children age 1 to 15 years with moderate to severe eczema were recruited from five UK centers covering a range of rural and urban settings. The participants were randomly divided into two groups: half the children received the standard of care and the other half received the standard of care plus silk garments that are claimed to be beneficial for eczema.

After 6 months, there was no significant difference in eczema severity -- based on the Eczema Area and Severity Index -- and no difference in quality of life or medication use between the groups. The researchers report that the garments are unlikely to be cost-effective even if the small differences between groups were genuine, with a computed cost per quality adjusted life year of silk garments to be GBP 56,811.

A limitation of the study is that the use of an objective outcome measure (an eczema severity score assessed by research nurses) may underestimate changes in symptoms.

The authors say: "The results of this trial suggest that silk garments are unlikely to provide additional clinical or economic benefits over standard care for children with moderate to severe eczema."

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Link:
Silk clothing did not improve eczema in children - Science Daily

FDA approved a new ointment for eczema that can help manage symptoms Miami Herald Eucrista, also called crisaborole, is an FDA-approved ointment used to treat mild to moderate eczema in adults and children ages 2 and older. It is not a steroid and does not cause skin thinning and other side effects that occur with prolonged steroid use.

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FDA approved a new ointment for eczema that can help manage symptoms - Miami Herald

Diversity is required to create a healthy body politic and a healthy body, inside and out.

You've heard a lot about the various "good" and "bad" bacteria that make up your gut biome. But you may not know that your skin is also home to a wildly rich and, when healthy, very diverse bacterial soup.

Scientists have discovered that on healthy skin, harmful Staphylococcus aureus is kept in check by its friendlier cousin, Staphylococcus epidermidis.

But on people with eczema specifically atopic dermatitis (AD), the most common type of eczema there is an overgrowth of S. aureus compared to S. epidermidis.

When researchers check the biome in the inner elbow or the back of the knee on folks with AD, they find an imbalance of those microbes. And the less diversity there is the less healthy the skin.

But a skin biome transplant may be possible: When gram-negative bacteria is collected from healthy human skin and cultured in the lab, it can be put into a treatment (maybe a cream) that can knock out AD.

This breakthrough in understanding of the skin biome means that there's good news on the horizon for the 17.8 million Americans with AD.

So stay tuned for the next round of research and, in the meantime, try taking a probiotic capsule regularly. That can add healthful diversity to your skin biome, as well as your gut.

And if you have AD, avoid antibacterial soaps and household products that can further upset your skin biome.

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New Ways to Control Eczema - Newsmax

13 April 2017 by Katy Morton

Researchers found that use of silk clothing does not improve children's eczema

Findings from the trial, which involved 300 children aged one to 15 years of age with moderate to severe eczema, suggest that wearing specialist silk garments does not reduce the severity of the skin condition, nor does it lessen the amount of cream and ointment needed to treat eczema.

Results of the CLOTHing for the relief of Eczema Symptoms trial (CLOTHES trial) are published in the journal PLOS Medicine.

According to researchers from the University of Nottingham, who led the trial, clothing has been thought to play a role in either soothing or making eczema symptoms worse, and specialist clothing is now available on prescription in the UK in a variety of forms, including silk.

The aim of the clinical trial was to determine whether adding silk garments to standard eczema care could reduce the severity of eczema in children with the condition.

Those who took part were split into two groups. One group continued with just their normal eczema treatments, while the other group used their normal eczema treatment and wore silk garments - long-sleeved silk vests and leggings, during the day and night. At the time of the trial, the same silk garments were available on prescription.

All the children continued regularly using emollient creams and topical steroids for controlling inflammation, and were asked not to change their standard treatment for the duration of the trial if possible.

Throughout the trial, their skin was assessed by nurses every two months using the Eczema Area and Severity Index (EASI), which measures how bad eczema is, for example how red and inflamed the skin looks, evidence of scratch marks and skin swelling. Researchers also assessed the childrens eczema symptoms, use of creams and steroids, quality of life and the number of skin infections and hospital admissions.

In terms of severity of eczema, quality of life and use of eczema medications, the researchers found no difference between the children in the two groups. The number of skin infections and hospitalisations due to eczema were also similar.

However, children who used the silk clothing did report small improvements in their eczema, but the differences were minimal.

Professor Kim Thomas from the Centre for Evidence-based Dermatology in the University of Nottinghams School of Medicine, who led the trial, said, The silk garments that we looked at as part of this trial did not appear to provide additional clinical or economic benefits over standard care for the management of children with eczema.

While some may find these results disappointing, we hope that patients and doctors will find the CLOTHES study useful in helping them to make informed decisions about how best to help children with eczema. Unfortunately, this trial suggests that silk clothing probably does not provide value for money for patients or for the NHS.

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Silk clothing not effective in reducing children's eczema - Nursery World (subscription)