Prevalence of major food allergens in skincare products for atopic dermatitis.

Introduction: Food allergy is a common concomitant disease in patients with atopic dermatitis. Sensitisation and subsequent development of food allergy might result from the application of skincare products containing food allergens, particularly when the skin barrier is impaired and inflamed. Emollients are the mainstay of the management of atopic dermatitis; however, the prevalence of food allergens in skincare products used for atopic dermatitis is unknown. Aim: To analyse the prevalence of major food allergens in skincare products for atopic dermatitis. Material and methods: Three major online cosmetic retailers in Poland were screened for atopic skincare products. The major food allergens under the mandatory allergen labelling regulation of the European Union were searched for using the INCI nomenclature of cosmetics ingredients. Results: We screened 396 skincare products, out of which 127 (32.1%) products contained at least one derivative of a major food allergen. The most common allergens were almonds, macadamia nuts, soya and cereals, followed by sesame and milk. There was no significant difference in the presence of food derivatives between leave-on and rinse-off skincare products, as well as between those intended for use by infants and children, and adults only. Conclusions: Our analysis revealed that major food allergens are prevalent in skincare products for eczema. Applying skincare products containing food derivatives on affected and inflamed skin can promote percutaneous sensitisation. Therefore, clinicians and patients with atopic dermatitis must be careful of products used for treating eczema that may contain derivatives of a major food allergen.

Contact allergens in moisturizers in preventative emollient therapy - A systematic review.

Background: Results of preventative emollient therapy on atopic dermatitis and food allergy trials are inconsistent. In addition to the ingredients considered beneficial, the moisturizers may contain potentially harmful haptens. This study aimed to assess the prevalence of haptens in moisturizers used in studies to prevent atopic dermatitis or food allergy and assess their correlations to the trial results. Methods: A systematic search of studies investigating the role of emollient usage in preventing atopic dermatitis or food allergy in infants was performed from inception to December 2020. Haptens were identified based on the nine common patch test series (European, American, and Australian). Results: 12 clinical trial studies were included in the review. In total, 16 different emollients were applied as an intervention. The vast majority (75%) of preparations contained at least one hapten from which several substances pose high allergic or irritant potential. Quantitative data synthesis of the findings regarding food allergy and atopic dermatitis prevention was not possible due to the significant heterogeneity of preparations used. Conclusions: Careful selection of emollient should consider the absence of potentially harmful ingredients, particularly when used in youngest children. Chronic skin exposure to haptens promotes the development of allergic contact dermatitis and moreover, via deterioration of the skin barrier and subclinical inflammation, may facilitate epicutaneous sensitization and promote atopic dermatitis; however further research is needed to validate our suppositions.

Milk Fat Globule Membrane Supplementation in Children: Systematic Review with Meta-Analysis.

(1) Background: Milk fat globule membrane (MFGM), composing fat droplets responsible for lipid transport in breast milk, has been shown to possess immunological and antimicrobial effects. Standard formulas (SF) are devoid of MFGMs during the production process. The study's aim was to evaluate the safety and benefits of MFGMs supplementation in children. (2) Methods: We searched four databases for randomized controlled trials evaluating the supplementation of MFGMs in children. Growth parameters were chosen as the primary outcome. (3) Results: Twenty-four publications of seventeen studies were included. Meta-analyses assessing the primary outcomes at the age of 4 months included four studies (814 children) comparing the MFGM-supplemented formulas and SF, and two trials (549 children) comparing the MFGM-supplemented formulas and breastfeeding. The primary outcomes were non-inferior in all the experimental MFGM formulas compared to SF, or even represented more similar results to breastfed infants. The promising effects, including a lower incidence of acute otitis media and improved cognitive development, cannot be firmly confirmed due to the small amount of existing evidence. No significant adverse effects were reported in any of the assessed products. (4) Conclusions: The available data signaled beneficial effects and a good safety profile, requiring future research with well-designed trials.

Cosmetics for neonates and infants: haptens in products' composition.

Cosmetics and skin care products for neonates and infants are considered as ''hypoallergenic'', "tested" or ''safe''. Nevertheless, the prevalence of haptens in these products is a matter of concern, since allergic contact dermatitis in children is gaining an importance. We aimed to assess the prevalence of haptens in cosmetics designed for children younger than 1 year. To identify haptens, the components of the cosmetics listed on packaging were compared with substances from European baseline series, Cosmetics series and Fragrance series. Survey comprised 212 cosmetics among which 186 (87.7%) contained at least one hapten from reference lists. Altogether there were 41 different haptens found in cosmetics. Number of sensitizers per product ranged between 1-12 and, each product contained 2.51 haptens on average. The most abundant sensitizers were cocamidopropyl betaine, tocopherol, propylene glycol, fragrances, lanolin. Majority of products for children were labeled as hypoallergenic/dermatologically tested/safe for children etc. from which 85% contained haptens. This survey highlights the extent of presence of haptens in cosmetics for children under the first year of age.

Novel Therapeutic Approaches to Atopic Dermatitis.

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases. The number of people affected by AD is relatively high and seems to be rising. Although mild and moderate forms of the disease can be well controlled by the use of emollients, topical corticosteroids, and topical calcineurin inhibitors, treatment of severe is still a huge challenge. The new hope is biologic drugs, magic bullets in allergy, targeted at different points of the complex pathomechanism of inflammation in AD. In this review, novel biologic therapies are discussed, including recombinant monoclonal antibodies directed against various interleukin pathways (such as IL-4, IL-13, TSLP, IL-31, and IL-12/23), on immunoglobulin E, molecules acting as T cells, B cells, etc. Of biological drugs, the most promising seems to be anti-IL-4/IL-13 therapy (dupilumab-the biological agent) and phosphodiesterase-4 inhibitor (crisaborole-a small molecule). A deep understanding of the AD pathomechanism provides a new perspective for tailor-made treatment of severe atopic dermatitis.