Category Archives: Eczema

They analysed patch-test data dating from 1993 to 2017 from two tertiary referral patch-testing centres including the results of 511 children who presented with suspected skin allergies.

Of those, more than half had a positive patch-test, and 65.8 per cent of those (38 per cent of the total) had a positive patch-test deemed relevant as an allergic reaction to a substance they had been exposed to.

The five most common relevant patch-test reactions were to fragrance mix (a mixture of eight individual fragrances commonly found in perfumes, cosmetics, laundry products and toothpaste), a group of preservatives (MCI/MI and MI) commonly used in wet wipes, liquid soaps, shampoos, cosmetics and toy 'slime', the plant resin colophonium (which commonly causes reactions to adhesive dressings), another fragrance (myroxylon pereriae) found in cosmetics and food, and nickel sulphate.

The study's lead author Claire Felmingham said MI and MCI/MI are particularly "potent allergens" that have been described as causing an "epidemic" of allergic contact dermatitis in adults and should be generally avoided even without a diagnosed allergy.

Dr Felmingham said the preservatives are being gradually removed from a lot of products, but that given their presence in baby wipes and 'slime', "its not surprising that theyve also affected the paediatric population".

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While the study found very few children under five had been patch-tested, among the 6-10 age group, fragrance and colophonium were the most common allergens. Fragrance and nickel sulphate were the most common allergens in the 1117 age group.

Nickel sulphate allergies were more common among girls, which the authors said is consistent with existing literature and likely due to the "increased use of jewellery in females", particularly ear piercings.

Armed with evidence of the most common allergens affecting children, the researchers have proposed the first Australian Paediatric Baseline Series comprising 30 common allergens and potential allergens for patch-testing.

While patch-testing is "the gold standard" for diagnosing allergic contact dermatitis (ACD), it "appears to be performed infrequently in children, and consequently, ACD is likely underdiagnosed," the authors said.

"This is unfortunate because ACD can have a significant impact on a childs quality of life, andearly, correct, identification of allergens and subsequent avoidance can lead to substantial improvement in symptoms, preventing progression to a chronic disease state," the study found.

Dr Felmingham said parents should consider patch-testing their children if they have persistent eczema that isn't responding to treatment, as well as keeping an eye on product labels for ingredients that commonly cause allergies.

Jenny Noyes is a journalist at the Sydney Morning Herald. She was previously a writer and editor at Daily Life.

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Fragrances found in baby wipes and 'slime' among most common causes of skin allergies - Sydney Morning Herald

When the patient was dressed, Iammatteo returned to the examination room. She didnt think this was an allergy, she told him. But it could be a parasite. She thought it was more likely toxocara, given his recent exposures to dogs and cats. Toxocara is a type of parasite called a nematode or roundworm. It lives in the gastrointestinal tract of dogs and cats. Until the end of the 20th century, visceral toxocariasis could be diagnosed only by the symptoms it caused when it invaded the organs of the body the liver, the lungs, the brain or the eyes. These were serious infections causing everything from wheezing and shortness of breath to blindness or, rarely, death. It wasnt until a diagnostic blood test was developed that other manifestations of the disease were identified. In whats called common toxocariasis, patients have gastrointestinal symptoms as well as an itchy rash. In covert toxocariasis, the only symptom is an itchy rash. These infections often resolve on their own over time, but they can also be treated with a medicine. This patient could have covert toxocariasis.

Iammatteo said she would test for both toxocariasis and strongyloidiasis. She would also refer him to a hematologist to look for a malignancy or other trigger that might have caused his overproliferation of white blood cells. There were other causes of his rash and eosinophilia, but these were the most likely and a good place to start.

A few days later, she got a possible answer and called the patient. You probably have toxocariasis, she told him. The blood test came back positive, but she explained there was a caveat. The test measures whether the immune system has responded to this particular parasite ever. The fact that it was positive meant that the patient had been exposed to the parasite, but it couldnt determine when the exposure occurred. Toxocara infections are most common in children. But the test will still be positive even if the infection is long gone. The only way to know for certain that the toxocara was causing the itch, she told him, was to treat him and see how he responded. She referred him to an infectious-disease doctor who prescribed the recommended five days of Albendazole.

Because he couldnt know for sure if this was the right diagnosis, the patient kept his appointment with the hematologist. That doctor sent off more blood to look for signs that the overabundance of these cells could be caused by an eosinophil gone wild.

But well before those tests results came back negative, the patient felt that he had his answer. Within days of completing his treatment with Albendazole, the itching resolved. And by the time he went back to see Iammatteo two weeks later, even the rash had mostly disappeared.

Why had Iammatteo been able to figure this out when other doctors couldnt? the patient asked when he saw her for a follow-up visit. She explained that shed gone to Albert Einstein College of Medicine in the Bronx, and one professor there was an expert in parasitology. She took her class, and what she learned stuck with her. Different medical schools have different strengths, she told me later. Parasites were one of theirs.

And, she added, doctors are taught that toxocara infection is rare. But now shes not so sure. Since making this patients diagnosis last spring, she told me she has diagnosed nearly a dozen cases of toxocariasis in patients whom she might not have thought to test for the parasite if not for this older man and his rash. I know Ive been successfully diagnosing more of it because its on my mind.

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He Was Unbearably Itchy, but the Problem Wasnt in His Skin - The New York Times

Eczema can be painful and debilitating. Leona ONeill meets three NI families who have learnt how to live with the condition.

Eczema also known as dermatitis is a dry skin condition that can come in many different forms. In mild cases, the skin is dry, scaly, red and itchy while in more severe cases, there may be weeping, crusting and bleeding.

Constant scratching causes the skin to split and bleed and also leaves it open to infection. At its worst, the condition can be very painful.

Dermatitis affects people of all ages but is primarily seen in children one in five children and one in 12 adults live with eczema.

Three Northern Ireland women tell us about their familys experiences and how theyve learned to cope with the condition

Myrtle Johnston, from Belfast, represents the NI Support Network for the National Eczema Society. She joined the society after her son and daughter were both diagnosed with the condition. She says:

I got involved in the National Eczema Society 40 years ago when both my son and daughter had the condition.

My son had it when he was a baby and throughout his school years. My daughter developed it a bit later.

There are people who have experiences that are a lot worse than ours, and I just hope they know they can talk to people about it.

What people dont realise is how eczema can affect a whole family. Children do suffer badly, meaning their parents do, too.

Some children have it really quite bad on their face and I know another mother who was taking off her sons socks and the skin just came off with it.

There are some really heart-breaking stories where people have had to think about giving up their career and lots of other things.

Eczema wont kill you, but it is very disabling.

East Belfast mum Michelle Laverty (48) says her son Henrys eczema left him feeling itchy and uncomfortable and was starting to impact on his confidence, before she found something that worked for him. She says:

My son Henry has eczema on his upper arms. He has had it from he was a little baby and it really came out as he started getting older.

It seems that it had something to do with him getting ready in the morning. The stuff I was using on his hair was coming down over his upper arms and that was causing his eczema.

It had never even occurred to me that could happen. He had raised red spots and it was so itchy and uncomfortable for him.

He would have scratched himself and it looked so red and awful.

Eczema does not have a nice appearance and it really affected his confidence. He was lucky in a way because it was on his upper arms, so it was quite covered most of the time.

I mentioned it to one of the girls in my office and she suggested Elave cream, which she said worked for her child.

Obviously eczema is a huge thing for children and it affects so many.

So, I got the shampoo and the shower gel and within about 10 days it was significantly better. It worked really well.

I nipped it in the bud before it got any worse, because I know how bad some children can suffer with eczema.

Mum-of-three Angela Morgan (42), from Belfast says her daughter Evies (5) eczema was so bad there would be blood on her bed clothes. The Four Winds beauty salon owner says she felt helpless about the condition until she found something that worked for her little girl. She says:

My youngest daughter Evie has eczema, asthma and allergies.

She has had all of those from birth. Since she was very small her skin would be itchy and red, particularly in between the creases of her arms and legs. Then it spread. Her face would be totally broken out. Around her cheeks, the skin was raw and would get quite infected, particularly when she was teething.

It was really hard to manage. She was on all types of creams and antibiotics and steroids. We tried everything but nothing worked.

They thought initially that it was baby eczema, but as she started getting older, nearing a year old, we realised that the likes of strawberries, bananas and tomatoes would have set her skin off.

So by the time she got that little bit older, it was very much tied to food as well.

At its worst, during a really bad flare-up, it would appear all over her.

I remember one day when she was very young, taking her into a cafe before a doctors appointment and people were staring at her because her face was so raw.

She would have just scratched herself until she bled.

Angela says that she tried every cream on the market as well as everything the doctor prescribed, to no avail.

Any time her skin looked in any way dry at all, we plastered her in cream, she says.

She would have scratched herself in the middle of the night, so there would be blood on the bed clothes in the morning. And I felt terrible because there was nothing I could do about it.

The doctors were giving me cream after cream, hoping that something was going to work. And with Evie being so young, I didnt want to resort to antibiotics all the time.

It was a constant battle trying to get to it before it got to the stage where she needed antibiotics.

Evie also lives with asthma and severe allergies, associated with her eczema.

Evie would take an anaphylactic reaction to nuts, pulses, legumes, kiwi and eggs, says Angela.

We knew that she was sensitive to certain things. But at that stage, she hadnt been tested for anything. I just didnt give her any nuts, because I assumed that it probably wouldnt be a good idea.

But I came home one day, and Evie was coughing while sitting on the sofa. I asked my husband how long she had been doing that and he said around half an hour.

I could see her skin also starting to break out, so I picked her up and took her around to the chemist.

They gave her some Periton and told me to take her to the hospital.

She had eaten a peanut M&M and that was the start of it. She had an overnight stay there.

Then, a few weeks later, she had a mouthful of vegetable soup which had lentils in it. And it was the same again her face and lips swelled, and we had to go straight to the hospital where she got adrenaline and all sorts of things.

We have had a few dramas.

We had an issue where someone gave her peanut butter recently and I had to give her the EpiPen and take her to the hospital.

Because Evie is that little bit older, she is more aware of it and has become more vigilant about what she eats now. We dont have anything that could harm her at home and her school were very good they are nut-free. But we have to be very careful and carry an EpiPen and Periton around with us everywhere, just in case.

When she was three years old, we discovered that she was asthmatic as well. She takes inhalers now also.

Angela says that she finally found her miracle cream in the form of Elave skincare.

All the stuff that we got from the doctor just didnt work, she says.

And then I heard about the Elave products and started using them on Evies skin. Her skin has been amazing since.

For the majority of the year as the change in the weather can flare her up she has been really good.

We just keep the cream on the spots that are more likely to flare up.

I use the whole range; the bath wash, the shampoo and the cream with Evie. Using all three works a treat.

I love it because it is a totally natural product, there is nothing harsh in it that can harm her skin. The condition is so easily triggered.

For something as simple as this product is, to be so effective, has been amazing and is working really well for her.

The National Eczema Society confidential telephone and email Helpline provides information, support and reassurance to people struggling to cope with eczema. You can contact the helpline on 0800 089 1122. Myrtle Johnston is also available through the helpline if you want to make contact with support from Northern Ireland

The Gardiner family history of creating skin care products goes back to 1934 when Joseph Gardiner created the first Family Apothecary in Ireland.

Their expertise in making traditional Ovelle apothecary products like Silcocks Base, Aqueous Cream and Emulsifying Ointment allowed them to draw on dermatological advances in skincare to create the now multi-award winning Elave skincare headed up by Josephs granddaughter Joanna which helps prevent flare up of sensitive including eczema, dermatitis and rosacea prone skin.

Their promise of absolute purity means no sulfates SLES/SLS, no parabens, no perfume, no formaldehyde, no methylisothiazolinone (MI), no alcohol, no soap, no colours and more. Elave sensitive skincare has been awarded cruelty-free status by PETA and is also vegan friendly.

Their products are available in most pharmacies and online at http://www.elave.myshopify.com/

Belfast Telegraph

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Meet the Northern Ireland people battling eczema who are finally comfortable in their own skin - Belfast Telegraph

Ann & Robert H. Lurie Children's Hospital of Chicago issued the following announcement on Oct. 16.

In a study using non-invasive tape strips in young children with eczema (or atopic dermatitis), researchers found many molecular signs of immune dysfunction and skin changes that relate to disease activity. These signs (or biomarkers) were present even before eczema was visible and can be used to track disease activity over time. With more research, these biomarkers also may help predict response to medicine and development of conditions associated with eczema, such as asthma, other allergies, infections and even attention deficit hyperactivity disorder (ADHD). Findings were published in JAMA Dermatology

Our study was the most comprehensive to date to demonstrate that tape strips can be used in infants and young children instead of painful biopsies to assess early-onset atopic dermatitis on the molecular level, says senior author Amy Paller, MD, from Ann & Robert H. Lurie Childrens Hospital of Chicago, who also is Chair of Dermatology and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. We found the highest number of atopic dermatitis biomarkers, including new ones, that might be predictors of treatment response, disease progression, and development of comorbid conditions.

Atopic dermatitis is a long-lasting, inflammatory, extremely itchy skin disorder that affects 10-20 percent of children in the United States. Currently, molecular profiling of skin biopsies is the gold standard for evaluating atopic dermatitis.

In young children, skin biopsies are virtually impossible to perform, even in research, since they are painful and leave scars, says Dr. Paller. This reinforced our desire to find a way to evaluate these kids that did not hurt at all.

The study included 51 children younger than 5 years, with 21 children who had moderate to severe atopic dermatitis that had its onset less than six months previously. Tape strips were collected from the skin with and without lesions in the children who had atopic dermatitis, as well as from the normal skin of children who did not have the condition. Researchers evaluated gene expression of 77 biomarkers of immune dysfunction and skin barrier changes (97 percent of biomarkers assessed) in children with atopic dermatitis.

Our findings pave the way for more routine use of tape strips in pediatric longitudinal research and clinical trials for atopic dermatitis, says Dr. Paller. Eventually, we hope this technology will become commercially available for use in the clinic.

Original source can be found here.

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ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO: Painless Tape Strips Used to Detect Molecular Changes in Skin of Children with Eczema -...

On Wednesday night, Dr Mackay was named Australia's Life Scientist of the Year. She was among seven scientists, school teachers and research teams from across Australia recognised with a Prime Minister's Science Prize the nation's top science awards. This year five of the seven prizes were awarded to women. All winners will share in $750,000 in prize money.

"This new field really is going to change the way we make new vaccines," Dr Mackay told The Age.

Her work focuses on the role of the body's T cells, referred to as the "foot soldiers" of the immune system.

Previously, scientists imagined these cells patrolling around our body through our blood stream, always watching for new infections. But they aren't just in our blood they are also in our skin, lungs, gut and brain.

"What was overlooked for a long time purely from not looking in the right place was if you go into the skin or the lung, we found healthy T cells in there too, and we found they were different," says Dr Mackay, who is based at Melbourne's Peter Doherty Institute for Infection and Immunity.

Rather than patrolling, the cells have dug trenches and set up a permanent fortress against attack. They are able to attack a virus as soon as it enters the skin or lungs an immediate, powerful form of immunity.

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"They are ready to go. They are frontline troops," says Professor Turner. "What Laura has been able to do is really nut out how these cells are generated in the first place. How are they made, and how they stay in the tissue."

Dr Mackay's discovery has scientists working to determine if this new-found layer of defence can be used to create better vaccines.

The vaccines we use today are designed to train patrolling T cells to catch and kill invaders. A vaccine that trained both patrolling and fortified cells could be much more powerful. Two new vaccines incorporating the technology, for malaria and HIV, are now in the early stages of testing.

Immunotherapy, a cutting-edge new anti-cancer weapon, is able to train immune cells to attack cancer. Scientists are now working to see if we can train the frontline cells living in our skin to attack tumours.

The work also has implications for allergy treatments. Skin-based immune cells could be behind allergic reactions like the red rashes that break out on the skin of people with eczema.

Emeritus Professor Cheryl Praeger from the University of Western Australia took out the top prize for her work on mathematical theory.

Emeritus Professor Cheryl Praeger, winner of the Prime Minister's Prize for Science.Credit:Alex Ellinghausen

Professor Praeger specialises in group theory, a type of mathematics important in cryptography the art of writing or solving codes. Her work has also contributed to search engine design, and she mentored Akshay Venkatesh, the Australian winner of the 2018 Fields Medal mathematics equivalent of a Nobel prize.

She was only the second woman ever appointed a mathematics professor at an Australian university, and now has more than 410 publications to her name.

"What I love about mathematics is the way that it explains the world. It makes sense of the world," she said.

The University of Sydneys Associate Professor Elizabeth New was named Physical Scientist of the Year for developing new tools to watch what happens inside cells in real time.

Liam is The Age and Sydney Morning Herald's science reporter

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Our top scientists and the discovery that could revolutionise cancer, eczema treatment - The Age

Atopic eczema is a skin condition that manifests itself in the form of dry, red, itchy patches and is common in small children. For many children, the symptoms go away as they get older but some continue to have eczema throughout their lives. Psoriasis on the other hand is a chronic disease that usually develops when people are in their 20s and causes raised, red, scaly patches. Both conditions can lead to a deteriorating quality of life, with both physical and psychological effects.

What causes atopic eczema and psoriasis arent entirely known, but researchers think both genetics and environment can play a role as well as the abundance of microorganisms that populate the skin. Healthy skin is usually colonized by millions of bacteria that can both protect against pathogens and help the skin heal faster. However, disruption in the bacterial balance can trigger inflammation. Prior studies have shown that S. aureus can induce skin inflammation similar to atopic eczema and that its presence increases as the symptoms worsen.

In this study, the researchers examined bacteria in skin samples collected from the back and thighs of some 350 people, of whom nearly two-thirds had either atopic eczema or psoriasis and the rest had healthy skin. The result showed an abundance of S. aureus in atopic eczema coupled with a significant reduction in potentially health-promoting bacteria such as Lactobacillus, Cutibacterium and Finegoldia. In psoriasis, the microbial composition changed but was not dominated by a single organism like in atopic eczema.

The researchers also discovered that S. aureus produced certain toxins that directly influenced the skins barrier and defense mechanisms by altering the expression of certain genes. The significant abundance of S. aureus fueled the skins metabolism by increasing the breakdown of sugar. The researchers observed the same physiological reaction that earlier this month was acknowledged with the Nobel prize, namely the HIF transcription factor, in skin attacked by S. aureus bacteria. They also noted signs of an expediated breakdown of vital amino acids in the skin-a possible attempt by the skin to eliminate the unwelcomed guest. In psoriasis, the correlation between bacteria and gene expression in the skin was less pronounced, which gives reason to focus on viruses and fungus in future studies.

The researchers hope the findings could eventually pave the way for new treatment methods for these skin diseases. One possible way forward may be to transplant microorganisms from the skin in healthy people to ill individuals, a method that is currently used to treat people with inflammatory bowel disease.

To facilitate conditions on the skin that benefit the growth of certain bacteria over others could be a natural way to keep the pathogens at bay, says Nanna Fyhrquist, researcher at the Institute of Environmental Medicine at Karolinska Institutet and lead author.

The study was financed with the help of the Knut and Alice Wallenberg Foundation, the National Institute for Health Research, Dunhill Medical Trust, Association pour la Recherche contre le Cancer (ARC), European Research Council, Institute National de la Sant et de la Recherche Mdicale, INCA, Fondation ARSEP, ANR och BIOMAP IMI2.

Microbe-host interplay in atopic dermatitis and psoriasis, Nanna Fyhrquist, Bjrn Andersson, Harri Alenuis et al., Nature Communications, October 16, 2019, DOI: 10.1038/s41467-019-12253-y

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People with atopic eczema have more S. aureus bacteria in their skin - Mirage News

Dr. Amit X. Garg, a professor of medicine at Western University in London, Ontario, knew about turmerics medicinal use because of his Indian heritage. He knew firsthand of its rich cultural significance too: On his wedding day, his relatives rubbed the spice all over him because it is believed to be cleansing.

After seeing the effectiveness of curcumin, in smaller studies, Dr. Garg and his colleagues decided to test it on a larger scale in hopes it would make elective aortic surgery safer by reducing the risk of complications, which include heart attacks, kidney injury and death. In the randomized clinical trial that followed, about half of the 606 patients were administered 2,000 milligrams of curcumin eight times over for four days, while the others were given a placebo. It was a bit disappointing, but we couldnt demonstrate any benefit used in this setting, Dr. Garg said of the study, published last year in the Canadian Medical Association Journal.

In fact, there is not enough reliable evidence in humans to recommend turmeric or curcumin for any condition, according to the National Center for Complementary and Integrative Health. Turmeric became a nutritional golden child partly because of its promise in laboratory studies cellular and animal. Some research indicates that both turmeric and curcumin, the active ingredient in turmeric supplements, have anti-inflammatory, antioxidant, antibacterial, antiviral and antiparasitic activity. But this has mostly been demonstrated in laboratory studies, and, in many cases, the benefits of preclinical research isnt observed in clinical trials.

According to Natural Medicines, a database that provides monographs for dietary supplements, herbal medicines, and complementary and integrative therapies, while some clinical evidence shows that curcumin might be beneficial for depression, hay fever, hyperlipidemia, ulcerative colitis, osteoarthritis and nonalcoholic fatty liver disease, its still too early to recommend the compound for any of these conditions.

And Natural Medicines has found there isnt enough good scientific evidence to rate turmeric or curcumins use for memory, diabetes, fatigue, rheumatoid arthritis, gingivitis, joint pain, PMS, eczema or hangovers.

Physicians say more research is needed. Dr. Gary W. Small, a professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles, who studies curcumins effect on memory, sees a lot of therapeutic potential. He also states that existing research demonstrates curcumins biological effects.

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What Are the Benefits of Turmeric? - The New York Times

If youre living with eczema or atopic dermatitis, you know targeting your triggers and keeping your skin moisturized are two essentials for happy, healthy skin. When it comes to eczema triggers, there are some known culprits think fragrance, laundry detergent, hot or cold weather, and even stress notes the National Eczema Association.

Yet what you put at the end of your fork may also play a role in your risk for flare-ups.

Typically, after eating a triggering food, your skin will get itchy or red. You may also notice swollen, hive-like patches or a flare of preexisting lesions, past research suggests. The symptoms may not be immediate they could take a few hours or up to two days to appear.

To identify those triggers in yourself or your infant, maybe youve considering trying an elimination diet. This involves avoiding specific foods that you think are responsible for your symptoms, according to the University of Wisconsin in Madison School of Medicine and Public Health. These diets are used mainly to identify triggers for health conditions such as irritable bowel syndrome, autoimmune disorders such as rheumatoid arthritis or multiple sclerosis, and migraines. Sometimes, people with eczema try them, too, if they suspect food is triggering their symptoms.

Indeed, according to the aforementioned research, infants with moderate to severe eczema are more likely to have food allergies, so identifying the foods that trigger their allergy symptoms may also help control eczema.

RELATED: Researchers Identify Subtype of Eczema Tied to Food Allergies

Everyone responds to foods differently not everyone with eczema will have the same reaction to milk, for instance so an elimination diet may not be the right tool to add to your arsenal against eczema.

The University of Wisconsin in Madison outlines these general steps for following an elimination diet:

RELATED: 7 Types of Eczema and What They Look Like

It can be but not always, says Susan Bard, MD, a board-certified dermatologist with Vive Dermatology Surgery & Aesthetics in Brooklyn, New York. According to the American Academy of Allergy, Asthma & Immunology, foods are a trigger in 20 to 30 percent of moderate to severe eczema cases.

Dr. Bard says an elimination diet for eczema is worth trying only if it seems clear that a food is to blame for an outbreak. I tell patients that if they see an obvious association between a certain food and eczema flares to avoid that food, she says.

Alice Hoyt, MD, an allergist and clinical immunologist with Cleveland Clinic in Ohio, also doubts food is always to blame. The reason we don't recommend elimination diets to modify atopic dermatitis is because there's no evidence that it will actually change the disease process because foods are not causing atopic dermatitis, she says. She says it might seem like theres a link because eczema patients are at increased risk of developing other allergies, including food allergies, but says its much more beneficial to look at what people are putting on their skin rather than what theyre eating.

RELATED: The Connection Between Eczema and Diet

The downside of elimination diets is they can lead to unbalanced eating because you may rule out entire food groups in an effort to find your trigger, Bard says. This excessive restriction can lead to nutritional deficiencies, according to a past study. Thats why Dr. Hoyt pairs patients who are trying an elimination diet with a registered dietitian, who can advise them on how to source necessary nutrients. For instance, if you eliminate dairy, youll need to find other ways to meet your calcium needs. The point is to optimize good nutrition, she says.

Another major downside is that elimination diets could lead to increased intolerance and more immediate sensitivity to the food in the future. A study published in the March-April 2016 issue of The Journal of Allergy and Clinical Immunology: In Practice found that after confirming food-triggered eczema, about 19 percent of participants had an immediate negative reaction when they were next exposed to the ingredient, which had never happened before. Rather than eliminating the food completely, the researchers suggest a better approach would be to determine how much of the ingredient your body can handle and incorporate that amount into your diet.

RELATED: A Detailed Guide to Treating Eczema

According to The Journal of Allergy and Clinical Immunology: In Practice study, the most common triggers for 183 study participants were milk (57.5 percent), eggs(30.6 percent), and soy (21 percent). Daniel P. Friedmann, MD, a board-certified dermatologist with Westlake Dermatology in Austin, adds wheat and peanuts to the list of common allergens for people with eczema, anda past article notes fish is another usual suspect.

RELATED: How to Target Eczema Triggers

Though youre likely used to visiting your dermatologist for eczema, if a food allergy could be in play, its best to see an allergist as well.

Dr. Friedmann says your dermatologist will likely recommend you visit a board-certified allergy specialist to determine what food allergies you have and to advise on whether an elimination diet will be right for you.

Excerpt from:
Should You Try an Elimination Diet to Determine the Root Cause of Eczema? - Everyday Health

Study: Long-Term Dupilumab Safe and Effective in Adolescents with Atopic Dermatitis

The results reinforced findings from an earlier short-term study that showed dupilumab can significantly improve AD in adolescents. The study, published in the British Journal of Dermatology, examined the long-term efficacy and safety profile of dupilumab in adolescents with inadequately controlled, moderate-to-severe AD.

Up until recently, there was a high unmet medical need for adolescents with AD, for which treatments typically included topical therapies that did not have long-term applicability. AD can have substantial detrimental effects on health-related quality of life (QoL) in adolescents, often linked with depression, anxiety, and attention deficit-hyperactivity disorder as well as a greater risk of asthma, allergic rhinitis, and food allergy.

Dupilumab, a monoclonal antibody that blocks the shared receptor component for interleukin (IL)-4 and IL13, has demonstrated a favorable benefit-to-risk safety profile, improved disease severity and symptoms, and improved scores for anxiety, depression, and QoL in adults with AD.

For this phase 2a study, 40 adolescents received 1 dupilumab dose and 8 weeks of pharmacokinetic sampling. Patients then received the same dose weekly for 4 weeks, with 8-week safety follow-up. Thereafter, 36 patients were enrolled in the ongoing phase 3 open-label extension (OLE) study.

Overall, mean SD trough dupilumab concentrations in serum at week 48 in the OLE trial were 74 19 mg L-1 and 161 60 mg L-1 for 2 mg kg-1 and 4 mg kg-1, respectively. Additionally, dupilumab was well tolerated over 52 weeks, with the most common treatment-emergent adverse effects being nasopharyngitis (week 52: 41% [2 mg kg-1], 47% [4 mg kg-1]) and AD exacerbation (29%, 42%). No new safety signals were observed and the safety profile was comparable with the known safety profile of dupilumab in adults.

The study also showed that, with continuing treatment, Eczema Area and Severity Index (EASI) scores improved [week 52: -85% 12% (2 mg k-1) and -84% 20% (4mg kg-1)].

Adolescents with moderate-to-severe atopic dermatitis have a high disease burden that negatively affects quality of life, and patients are in need of therapies that can be used long-term, senior author Ashish Bansal, MD, of Regeneron Pharmaceuticals, said in a statement. Results from these trials show that dupilumab provides substantial and sustained clinical benefit to these patients with an acceptable safety profile.

According to the study authors, in addition to the studies demonstrating the long-term efficacy and safety of dupilumab in adolescents for up to 52 weeks of treatment, the data also support the use of dupilumab in combination with topical corticosteroids.

These 52-week safety and efficacy data support long-term use of dupilumab in this patient population, the authors concluded.

References

Cork MJ, Thaci D, Eichenfield LF, et al. Dupilumab in adolescents with uncontrolled moderate-to-severe atopic dermatitis: results from a phase 2a open-label trial and subsequent phase 3 open-label extension. British Journal of Dermatology. 2019. https://doi.org/10.1111/bjd.18476

Long-Term Dupilumab Benefits Adolescents with Eczema [news release]. Wiley. https://newsroom.wiley.com/press-release/british-journal-dermatology/long-term-dupilumab-benefits-adolescents-eczema. Accessed October 9, 2019.

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Long-Term Dupilumab Safe, Effective in Adolescents with Atopic Dermatitis - Pharmacy Times

NEW YORK--(BUSINESS WIRE)--Pfizer Inc. (NYSE: PFE) announced today complete results from a Phase 3, 12-week, pivotal study (JADE MONO-1) in patients aged 12 and older with moderate to severe atopic dermatitis (AD). Abrocitinib, an investigational oral Janus kinase 1 (JAK1) inhibitor, met all the co-primary and key secondary endpoints, which were related to skin clearance and itch relief compared to placebo. Safety data showed that both evaluated doses of abrocitinib (200mg and 100mg) were well tolerated and were consistent with a companion study (JADE MONO-2) from the JAK1 Atopic Dermatitis Efficacy and Safety (JADE) global development program. The results were shared as a Late-Breaking presentation at the 28th Congress of the European Academy of Dermatology and Venereology (EADV) taking place October 9-13, 2019 in Madrid, Spain.

The co-primary study endpoints in JADE MONO-1 were the proportion of patients who achieved an Investigator Global Assessment (IGA) score of clear (0) or almost clear (1) skin and two-point or greater improvement relative to baseline; and the proportion of patients who achieved at least a 75% or greater change from baseline in their Eczema Area and Severity Index (EASI) score. The key secondary endpoints were the proportion of patients achieving a four-point or larger reduction in itch severity measured with the pruritus numerical rating scale (NRS), and the magnitude of decrease in the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD), a patient-reported measurement scale developed by Pfizer. Other secondary endpoints included the proportion of patients who achieved a 90% or greater change in EASI score, and the percentage change from baseline in their SCORing Atopic Dermatitis (SCORAD) response at all scheduled time points.

There is a critical need for additional treatment options for patients living with moderate to severe atopic dermatitis, said Michael Corbo, PhD, Chief Development Officer, Inflammation & Immunology, Pfizer Global Product Development. We are pleased by these findings, which together with the recently reported positive top-line results from our second Phase 3 trial, encourage us that, if approved, abrocitinib may provide the first oral, once-daily treatment option for these patients.

JADE MONO-1 Study Efficacy Results1

Both doses of abrocitinib significantly improved the IGA and EASI-75 dose response outcomes compared to placebo. By week 12, the following co-primary efficacy and secondary endpoint results were seen:

Abrocitinib200mg (N=154)

Abrocitinib100mg (N=156)

Placebo (N=77)

IGA Response Rate

43.8%

23.7%

7.9%

EASI-75 Response Rate

62.7%

39.7%

11.8%

NRS 4-Point Improvement Response Rate

57.2%

37.7%

15.3%

EASI-90 Response Rate

38.6%

18.6%

5.3%

The percentage changes in SCORAD were significantly greater at all time points in the 200mg and 100mg treatment arms compared to placebo.

JADE MONO-1 Safety Results1

The most frequently reported treatment-emergent adverse events in abrocitinib-treated patients (200mg, 100mg) were short-lasting nausea (20.1%, 9.0%), headache (9.7%, 7.7%), and nasopharyngitis (11.7%, 14.7%), while for placebo, it was dermatitis (16.9%). Observed serious adverse events (SAEs) for abrocitinib 200mg were inflammatory bowel disease, peritonsillitis, dehydration, and asthma (2 cases). SAEs seen for the 100mg dose included retinal detachment, acute pancreatitis, appendicitis, dizziness, and seizures. In the placebo arm, SAEs were condition aggravated, appendicitis, meniscal degeneration, and atopic dermatitis. Other safety findings included:

Abrocitinib200mg (N=154)

Abrocitinib100mg (N=156)

Placebo (N=77)

Rate of Serious Adverse Events

3.2%

3.2%

1.9%

Rate of Discontinuation due to an Adverse Event

5.8%

5.8%

9.1%

Additional Details About the JADE MONO-1 Study

The double-blind, parallel group study randomized a total of 387 subjects to abrocitinib 200mg, abrocitinib 100mg, or placebo. Randomization was stratified by baseline disease severity (moderate [IGA=3] and severe [IGA=4] AD) and age (age <18 and 18 years). Eligible subjects completing the 12-week treatment period of the study had the option to enter a long-term extension (LTE) study, B7451015. Subjects discontinuing early from treatment, or who were otherwise ineligible for the LTE study, entered a 4-week follow up period in this study.

For additional information about the JADE MONO-1 study, please visit https://www.clinicaltrials.gov.

Pfizer recently announced positive top-line results from the companion Phase 3 study from the JADE program (JADE MONO-2), suggesting similar positive safety and efficacy results. Additional data for abrocitinib and new findings from the JADE program will be shared in early 2020.

Phase 2b data for abrocitinib were recently published in JAMA Dermatology.

About Abrocitinib

Abrocitinib is an oral small molecule that selectively inhibits Janus kinase (JAK) 1. Inhibition of JAK1 is thought to modulate multiple cytokines involved in pathophysiology of AD, including interleukin (IL)-4, IL-13, IL-31, and interferon gamma.

Abrocitinib received Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA) for the treatment of patients with moderate to severe AD in February 2018. Breakthrough Therapy designation was initiated as part of the Food and Drug Administration Safety and Innovation Act (FDASIA) signed in 2012. As defined by the FDA, a breakthrough therapy is a drug intended to be used alone or in combination with one or more other drugs to treat a serious or life-threatening disease or condition, and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. If a drug is designated as a Breakthrough Therapy, the FDA will expedite the development and review of such drug.2

About Atopic Dermatitis

AD is a chronic skin disease characterized by inflammation of the skin and skin barrier defects.3,4 Lesions of AD are characterized by erythema (redness), itching, induration (hardening)/papulation (formulation of papules), and oozing/crusting.3,4

AD is one of the most common, chronic, relapsing childhood dermatoses, affecting up to 10% of adults and up to 20% of children worldwide.5,6

About Pfizers Immunokinase Inhibitor Leadership

The JAK pathways are believed to play an important role in inflammatory processes as they are involved in signaling for over 50 cytokines and growth factors, many of which drive immune-mediated conditions.7 JAK inhibition may offer patients with these conditions a potential new advanced treatment option.8

Pfizers leading JAK biology and chemistry expertise from years of JAK research experience, has enabled the company to take a different R&D approach, resulting in the broadest immunokinase inhibitor pipeline. Instead of studying a single molecule for all its potential uses, where it may not be optimal for some, Pfizers candidates are purposefully matched to the conditions where we believe they have the greatest potential to, if approved, address unmet need. Pfizer has five unique immunokinase inhibitors in late-stage clinical trials for the potential treatment of nine immune-mediated diseases:

Pfizer Inc.: Breakthroughs that Change Patients Lives

At Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products, including innovative medicines and vaccines. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world's premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, we have worked to make a difference for all who rely on us. We routinely post information that may be important to investors on our website at http://www.pfizer.com. In addition, to learn more, please visit us on http://www.pfizer.com and follow us on Twitter at @Pfizer and @Pfizer_News, LinkedIn, YouTube and like us on Facebook at Facebook.com/Pfizer.

DISCLOSURE NOTICE: The information contained in this release is as of October 12, 2019. Pfizer assumes no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments.

This release contains forward-looking information about a product candidate, abrocitinib, and Pfizers ongoing investigational programs in kinase inhibitor therapies, including their potential benefits, that involves substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risks and uncertainties include, among other things, the uncertainties inherent in research and development, including the ability to meet anticipated clinical endpoints, commencement and/or completion dates for our clinical trials, regulatory submission dates, regulatory approval dates and/or launch dates, as well as the possibility of unfavorable new clinical data and further analyses of existing clinical data; the risk that clinical trial data are subject to differing interpretations and assessments by regulatory authorities; whether regulatory authorities will be satisfied with the design of and results from our clinical studies; whether and when drug applications may be filed in any jurisdictions for any potential indication for abrocitinib or any other investigational kinase inhibitor therapies; whether and when any such applications may be approved by regulatory authorities, which will depend on myriad factors, including making a determination as to whether the product's benefits outweigh its known risks and determination of the product's efficacy and, if approved, whether abrocitinib or any such other investigational kinase inhibitor therapies will be commercially successful; decisions by regulatory authorities impacting labeling, manufacturing processes, safety and/or other matters that could affect the availability or commercial potential of abrocitinib or any other investigational kinase inhibitor therapies; and competitive developments.

A further description of risks and uncertainties can be found in Pfizers Annual Report on Form 10-K for the fiscal year ended December 31, 2018 and in its subsequent reports on Form 10-Q, including in the sections thereof captioned Risk Factors and Forward-Looking Information and Factors That May Affect Future Results, as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available at http://www.sec.gov and http://www.pfizer.com.

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1 Simpson E, Sinclair R, Forman S et al. Efficacy and Safety of Abrocitinib in Patients With Moderate-to-Severe Atopic Dermatitis: Results From the Phase 3, JADE MONO-1 Study. Oral presentation at the 28th Congress of the European Academy of Dermatology and Venereology (EADV), October 9-13, 2019, Madrid, Spain2 U.S. Food and Drug Administration. Fact Sheet: Breakthrough Therapies at https://www.fda.gov/RegulatoryInformation/LawsEnforcedbyFDA/SignificantA... (link is external) accessed on August 16, 2019.3 Hanifin JM, Reed ML. A population-based survey of eczema in the United States. Dermatitis. 2007;18(2):82-91.4 Bieber T. Atopic dermatitis. Dermatology. 2012;1(3):203-217.5 Oszukowska M, Michalak I, Gutfreund K, et al. Role of primary and secondary prevention in atopic dermatitis. Postep Derm Alergol. 2015:32(6):409-420.6 Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(suppl 1):8-16.7 Banerjee, S, Biehl, A, Gadina, M et al. JAKSTAT Signaling as a Target for Inflammatory and Autoimmune Diseases: Current and Future Prospects. Drugs. 2017;77: 521. https://doi.org/10.1007/s40265-017-0701-9.8 Telliez JB, Dowty ME, Wang L, Jussif J, Lin T, Li L, et al. Discovery of a JAK3-selective inhibitor: functional differentiation of JAK3-selective inhibition over pan-JAK or JAK1-selective inhibition. ACS Chem Biol. 2016;11(12):344251. doi:10.1021/acschembio.6b00677.

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Pfizer Presents Positive Phase 3 Data at the 28th Congress of the European Academy of Dermatology and Venereology for Abrocitinib in Moderate to...