The role of modern emollients in prophylaxis of atopic dermatitis exacerbation during pollination season

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Abstract

BACKGROUND: Skin epidermal barrier impairment in patients with atopic dermatitis facilitates percutaneous penetration of allergens and leads to persistent skin inflammation in sensitized patients and even primary sensitization to the allergens. We hypothesized that the use of skincare products that restore the structure of the skin barrier may positively affect the disease course in patients with atopic dermatitis and pollen sensitization during the pollen season.

AIMS: This study aimed to investigate the clinical efficacy and safety of La Roche Posay formulas, i.e., Lipikar Syndet and Lipikar Baume AP+M, in the prevention of atopic dermatitis exacerbations in children and adults sensitized to different pollen allergens during the pollination season.

MATERIALS AND METHODS: Sixty patients aged 5–60 years with a clinical history of mild-to-moderate atopic dermatitis sensitized to different pollen allergens were enrolled in a single-center, simple, open, prospective comparative study, and they were divided into two groups. The main group used Lipikar Syndet and Baume AP+M daily together with standard atopic dermatitis treatment for 28 days during the pollen season of their clinically significant allergens. The control group received only standard therapy without any use of moisturizers. The study required three visits. At each visit, the severity of atopic dermatitis (SCORing atopic dermatitis [SCORAD] index), quality of life (Dermatology Life Quality Index/and Children’s Dermatology Life Quality Index), pruritus intensity (numerical rating scale), and corneometry were assessed. SCORAD changes were considered the primary endpoint of the study.

RESULTS: A significant decrease in SCORAD in the main group was registered by day 14 of the study (p <0.0001), whereas no significant changes in the SCORAD index were noted in the control group even by day 28. The SCORAD index in the main group was significantly lower than that in the control group (p=0.005) by day 28. For the secondary endpoints, the quality of life significantly improved by day 28 (p=0.0005), the intensity of pruritus significantly decreased (p <0.0001), and the level of skin hydration increased (p <0.0001) by day 14 in the main group compared with those in the control group. No adverse events were reported during the study.

CONCLUSIONS: Daily use of Lipikar Syndet and Lipikar Baume AP+M by patients with atopic dermatitis and pollen allergy during the pollen season significantly improved the atopic dermatitis course, reducing skin itching and improving skin hydration and patients’ quality of life. The use of these skincare products together with atopic dermatitis therapy helped reduce atopic dermatitis severity associated with direct skin contact with pollen allergens. This indicates a protective effect of Lipikar skincare products on the epidermal barrier function.

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About the authors

Alla O. Litovkina

National Research Center ― Institute of Immunology; Peoples’ Friendship University of Russia

Author for correspondence.
Email: dr.litovkina@gmail.com
ORCID iD: 0000-0002-5021-9276
SPIN-code: 2337-7930
Россия, Moscow; Moscow

Evgeniy V. Smolnikov

National Research Center ― Institute of Immunology; Peoples’ Friendship University of Russia; National Research Nuclear University MEPhI (Moscow Engineering Physics Institute)

Email: qwertil2010@yandex.ru
ORCID iD: 0000-0003-1302-4178
SPIN-code: 4874-8100
Россия, Moscow; Moscow; Moscow

Olga G. Elisyutina

National Research Center ― Institute of Immunology; Peoples’ Friendship University of Russia

Email: el-olga@yandex.ru
ORCID iD: 0000-0002-4609-2591
SPIN-code: 9567-1894

MD, Dr. Sci. (Med.)

Россия, Moscow; Moscow

Elena S. Fedenko

National Research Center ― Institute of Immunology

Email: efedks@gmail.com
ORCID iD: 0000-0003-3358-5087
SPIN-code: 5012-7242

MD, Dr. Sci. (Med.), Professor

Россия, Moscow

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Supplementary files

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2. Fig. 1. SCORAD dynamics at three timepoints: а ― in patients of Group 1; b ― in patients of Group 2; с ― comparison of indicators in groups 1 and 2. Д0, Д14, Д28 ― study days 0; 14th and 28th. a

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3. Fig. 2. DLQI dynamics at three timepoints: а ― in patients of Group 1; b ― in patients of Group 2; с ― comparison of indicators in groups 1 and 2. Д0, Д14, Д28 ― study days 0; 14th and 28th.

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4. Fig. 3. Comparison of skin itch intensity (NRS points) in Group 1 and Group 2 at three timepoints. Д0, Д14, Д28 ― study days 0; 14th and 28th.

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5. Fig. 4. Comparison of skin hydration levels (corneometry) in Group 1 and Group 2 at three timepoints. Д0, Д14, Д28 ― study days 0; 14th and 28th.

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