Impact of different treatments on skin barrier function in children with atopic dermatitis

DOI: https://doi.org/10.29296/25877305-2022-03-15
Issue: 
3
Year: 
2022

Associate Professor E. Dontsova(1), MD; Associate Professor I. Ivanova(2), MD; Professor L.
Novikova(1), MD; Professor V. Dontsov(1), MD; Associate Professor L. Borzunova(1), Candidate of Medical
Sciences; T. Koroleva(2) (1)N.N. Burdenko Voronezh State Medical University, Ministry of Health of Russia
(2)Central State Medical Academy, Presidential Administration of the Russian Federation, Moscow

Childhood atopic dermatitis (AD) is a common disease of unknown etiology and multifactorial pathogenesis, which is embodied in the inefficiency of existing therapies. Objective: to provide a rationale for the use of hydrotherapy (HT), non-selective chromotherapy (NCT), and low-intensity laser blood irradiation (NLBI) in the combination treatment of children with AD, taking into account skin barrier dysfunction. Subjects and methods. The investigation enrolled 164 children (mean age, 8.0±2.9 years) with AD and 30 healthy children of the same age (a control group). The patients with AD were divided into 5 treatment groups: 1) basic drug therapy (BDT); 2) HT + BDT; 3) NCT + BDT; 4) NLBI + BDT; 5) HT + NCT + NLBI + BDT. Skin barrier function was evaluated, by measuring the skin pH, skin moisture (corneometry), and transepidermal water loss (TEWL). Results. BDT had no corrective effect on the indicators of skin barrier function. HT, NCT, and NLBI significantly improved the studied parameters: skin pH, moisture, and TEWL. Conclusion. Combination treatment including HT, NCT, and NLBI during BDT more effectively corrects skin barrier dysfunction than each of the methods used alone, which is embodied in the restoration of skin pH, moisture, and TEWL to the level of healthy individuals.
Keywords: 
dermatology
pediatrics
atopic dermatitis
childhood
skin pH
skin moisture
transepidermal water loss
hydrotherapy
non-selective chromotherapy
low-intensity laser blood irradiation

References: 
  1. Pogorelova E.I., Pochivalov O.A., Panina O.A. i dr. Sovremennyj vzgljad na immunopatogenez atopicheskogo dermatita. Meditsina: teorija i praktika. 2019; 4 (1): 157–63.
  2. Balabolkin I.I., Grebenjuk V.N., Kapustina E.Ju. Naruzhnoe lechenie atopicheskogo dermatita u detej. Pediatrija. Zhurnal im. G.N. Speranskogo. 2007; 86 (2): 93–8.
  3. Boguniewicz M., Leung D. Y. Atopic Dermatitis: A Disease of Altered Skin Barrier and Immune Dysregulation. Immunol Rev. 2011; 242 (1): 233–46. DOI: 10.1111/j.1600-065X.2011.01027.x
  4. Weidinger S., Novak N. Atopic dermatitis. Lancet. 2016; 387 (10023): 1109–22. DOI: 10.1016/S0140-6736(15)00149-X
  5. Silverberg N.B., Silverberg J.I. Inside Out or Outside In: Does Atopic Dermatitis Disrupt Barrier Function or Does Disruption of Barrier Function Trigger Atopic Dermatitis? Cutis. 2015; 96 (6): 359–61.
  6. Atopicheskij dermatit u detej. Klinicheskie rekomendatsii. Ministerstvo zdravoohranenija Rossijskoj Federatsii. 2016 [Elektronnyj resurs]. URL: https://www.pediatr-russia.ru/information/klin-rek/deystvuyushchie-klinicheskie-rekomendatsii/AtD%20deti%20SPR.v2.pdf
  7. Kapasakalidi D., Koval'chuk V., Reut V. Atopicheskij dermatit: terapija i profilaktika. Osobennosti reabilitatsii v sanatorno-kurortnyh uslovijah. Vrach. 2015; 8: 51–5.
  8. Kruglova L.S., Abesadze G.A., Strelkovich T.I. Vlijanie uzkopolosnoj srednevolnovoj fototerapii na klinicheskie simptomy u bol'nyh prurigo. Vestnik novyh meditsinskih tehnologij. Elektronnoe izdanie. 2013; 1. URL: https://cyberleninka.ru/article/n/vliyanie-uzkopolosnoy-srednevolnovoy-fototerapii-na-klinicheskie-simptomy-u-bolnyh-prurigo
  9. Kruglova L.S., Kotenko K.V., Korchazhkina N.B. i dr. Metody fizioterapii v detskoj dermatologii. M.: GEOTAR-Media, 2017; 344 s.
  10. Beikert F.C., Langenbruch A.K., Radtke M.A. et al. Willingnes to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res. 2014; 306 (3): 279–86. DOI: 10.1007/s00403-013-1402-1
  11. Erina I.A. Opyt lechenija atopicheskogo dermatita. Tsentral'nyj nauchnyj vestnik. 2018; 3 (17): 9–10.
  12. Giam Y.C., Heber Y.C., Dizon M. V. A review on the role of moisturizers for atopic dermatitis. Asia Pacific Allergy. 2016; 6 (2): 120–8. DOI: 10.5415/apallergy.2016.6.2.120
  13. Wollenberg S., Barbarot S., Bieber T. et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018; 32 (5): 657–82. DOI: 10.1111/jdv.14891
  14. Kovaleva L.N., Slobodjanik Ja.I., Morja Ju.S. i dr. Obschaja ozdorovitel'naja terapija organizma u bol'nyh hronicheskimi dermatozami s pomosch'ju gidroterapii. Dermatovenerologija. Kosmetologija. Seksopatologija. 2015; 3 (4): 184–95.
  15. Karandashov V.I., Petuhov E.B., Zrodnikov V.S. Kvantovaja terapija: uchebnoe posobie. M., Meditsina: 2004; 336 c.
  16. Guljar S.A. Effektivnost' polihromaticheskogo poljarizovannogo sveta pri tonicheskoj boli v zavisimosti ot zony ego applikatsii. Ukrainskij zhurnal boli. 2012; 1 (2): 46–7.
  17. Rozhdestvenskij M.E., Konova O.M., Plotnikov N.V. Primenenie polihromaticheskogo nekogerentnogo poljarizovannogo sveta ot apparatov «Bioptron» pri bronhial'noj astme i atopicheskom dermatite u detej. Vestnik Roszdravnadzora. 2010; 5: 54–9.
  18. Solov'ev A.M., Ol'hovskaja K.B. Primenenie lazera v dermatologii i kosmetologii. Lechaschij vrach. 2005; 6: 73–8.
  19. Moskvin S.V., Kochetkov A.V. Effektivnye metodiki lazernoj terapii. Tver': Triada, 2016; 80 s.
  20. Pogorelova E.I., Pochivalov O.A., Panina O.A. et al. A modern view on immunopathogenesis of atopic dermatitis. Meditsina: teoriya i praktika. 2019; 4 (1): 157–63 (in Russ.).
  21. Balabolkin I.I., Grebenyuk V.N., Kapustina E.Yu. Naruzhnoe lechenie atopicheskogo dermatita u detej. Pediatrics named after G.N. Speransky. 2007; 86 (2): 93–8 (in Russ.).
  22. Boguniewicz M., Leung D. Y. Atopic Dermatitis: A Disease of Altered Skin Barrier and Immune Dysregulation. Immunol Rev. 2011; 242 (1): 233–46. DOI: 10.1111/j.1600-065X.2011.01027.x
  23. Weidinger S., Novak N. Atopic dermatitis. Lancet. 2016; 387 (10023): 1109–22. DOI: 10.1016/S0140-6736(15)00149-X
  24. Silverberg N.B., Silverberg J.I. Inside Out or Outside In: Does Atopic Dermatitis Disrupt Barrier Function or Does Disruption of Barrier Function Trigger Atopic Dermatitis? Cutis. 2015; 96 (6): 359–61.
  25. Atopicheskii dermatit u detei. Klinicheskie rekomendatsii. Ministerstvo zdravookhraneniya Rossiiskoi Federatsii. 2016 (in Russ.). URL: https://www.pediatr-russia.ru/information/klin-rek/deystvuyushchie-klinicheskie-rekomendatsii/AtD%20deti%20SPR.v2.pdf
  26. Kapasakalidi D., Koval’chuk V., Reut V. Atopic dermatitis: therapy, prophylaxis. rehabilitation at a sanatorium. Vrach. 2015; 8: 51–5 (in Russ.).
  27. Kruglova L.S., Abesadze G.A., Strelkovich T.I. Influence of narrow-band 311 nm phototherapy on clinical symptoms at patients pruritus. Vestnik novykh meditsinskikh tekhnologii. 2013; 1 (In Russ.). URL: https://cyberleninka.ru/article/n/vliyanie-uzkopolosnoy-srednevolnovoy-fototerapii-na-klinicheskie-simptomy-u-bolnyh-prurigo
  28. Kruglova L.S., Kotenko K.V., Korchazhkina N.B. et al. Metody fizioterapii v detskoi dermatologii. M.: GEOTAR-Media, 2017; 342 s. (in Russ.).
  29. Beikert F.C., Langenbruch A.K., Radtke M.A. et al. Willingnes to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res. 2014; 306 (3): 279–86. DOI: 10.1007/s00403-013-1402-1
  30. Erina I.A. Opyt lecheniya atopicheskogo dermatita. Tsentral’nyi nauchnyi vestnik. 2018; 3 (17): 9–10 (in Russ.).
  31. Giam Y.C., Heber Y.C., Dizon M. V. A review on the role of moisturizers for atopic dermatitis. Asia Pacific Allergy. 2016; 6 (2): 120–8. DOI: 10.5415/apallergy.2016.6.2.120
  32. Wollenberg S., Barbarot S., Bieber T. et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018; 32 (5): 657–82. DOI: 10.1111/jdv.14891
  33. Kovaleva L.N., Slobodyanyk Ya.I., Moria Yu.S. et al. The general health benefits by means of hydrotherapy for patients with chronic dermatoses. Dermatovenerologiya. Kosmetologiya. Seksopatologiya. 2015; 3 (4): 184–95 (in Russ.).
  34. Karandashov V.I., Petukhov E.B., Zrodnikov V.S. Kvantovaya terapiya: uchebnoe posobie. M., Meditsina: 2004; 336 s. (in Russ.).
  35. Gulyar S.A. Effektivnost’ polikhromaticheskogo polyarizovannogo sveta pri tonicheskoi boli v zavisimosti ot zony ego applikatsii. Ukrainskii zhurnal boli. 2012; 1 (2): 46–7 (in Russ.).
  36. Rozhdestvenskii M. E., Konova O.M., Plotnikov N.V. Primenenie polikhromaticheskogo nekogerentnogo polyarizovannogo sveta ot apparatov «Bioptron» pri bronkhial’noi astme i atopicheskom dermatite u detei. Vestnik Roszdravnadzora. 2010; 5: 54–9 (in Russ.).
  37. Solov’ev A. M., Ol’khovskaya K.B. Primenenie lazera v dermatologii i kosmetologii. Lechashchii vrach. 2005; 6: 73–8 (in Russ.).
  38. Moskvin S.V., Kochetkov A.V. Effektivnye metodiki lazernoi terapii. Tver: Triada, 2016; 80 s. (in Russ.).