Category Archives: Eczema

A recent research letter from the United Kingdom suggested that dietary exclusions for children with atopic dermatitis could have potential benefits, but that the evidence regarding these benefits was lacking.

Investigators cited limitations in their research, which included a narrow focus and a lack of eligible studies.

Despite this, a precedent with earlier studies that used food allergy tests to guide dietary exclusions for eczema symptoms. However, the literature surrounding exclusion diets for the treatment of atopic dermatitis was mixed.

Investigators led by Matthew J. Ridd, PhD, Population Health Sciences, University of Bristol, sought to provide an up-to-date review of any available literature to anser the research question, What is the value of test-guided dietary exclusions for treating established AD in children under 12 years of age?

From January 2006 to June 2021. Ridd and colleagues searched 2 databases, MEDLINE and EMBASE, for relevant data.

Eligibility criteria included randomized controlled trials, participants under 12 years old with established atopic dermatitis, intervention of dietary exclusions informed by allergen specific IgE blood or skin prick testing, eczema severity collected as the outcome, and comparator being children with atopic dermatitis with no test-guided dietary exclusions.

Initially, a total of 1416 records were identified for title and abstract screening. However, 1245 records were screened for eligibility after 171 duplicates were removed.

Eventually, 24 full-text papers were identified, with 2 studies meeting the inclusion criteria.

Both studies were based in the UK with the first being published in 1998. This study involved 62 participants aged 11 to 17 months, with the allocation group having underwent an egg exlusion diet for 4 weeks.

In short, investigators from the 1998 study suggested that children with atopic dermatitis and egg sensitivity would benefit from an egg exclusion diet.

The TEST study was conducted in 2019, with 84 children aged 2 months to 5 years.

Participants were randomized to either dietary advice based on allergy history and skin prick testing of 6 allergens including cows milk, hens eggs, peanut, cashew, codfish and wheat.

Eczema severity was measured at baseline and 24 weeks using Patient-Oriented Eczema Measure (POEM) and Eczema Area and Severity Index (EASI).

Investigators considered the effect of dietary exclusion in the TEST study to be attenuated, as most participants were not advised to make any dietary changes. This, along with the absence of validated outcome measures, made for complications regarding comparisons between studies.

In contrast, the 1998 study was prospectively registered, had published protocol, and was generally better reported. However, the findings were limited and the adherence to the exclusion diet was mixed.

As such, the team called for more appropriately documented trials.

Dietary exclusions informed by tests may benefit some children with AD but further adequately powered trials of test-guided dietary exclusions for established AD in children are needed to make robust conclusions, the team wrote.

The research letter, Test-guided dietary exclusions for treating established Atopic Dermatitis in children: A systematic Review, was published online in Clinical and Experimental Allergy.

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Data on Benefits of Dietary Exclusions for Children with AD Inconclusive - MD Magazine

Chidiebere Ibe, a medical illustrator and aspiring neurosurgeon, noticed that the patients in medical diagrams are always depicted as White. So, he decided to change that.

Ibe, who is from Nigeria, began drawing different medical illustrations such as a fetus in a womb, lung conditions, and eczema all of patients who are Black. Typically, medical illustrations in textbooks or doctor's offices are White, and Ibe said he wanted to use his passion for medicine and art to "fix that inequality."

"The underrepresentation of black skin medical illustration in medical textbooks and as tool of communication in the public health sector has brought a bridge in Doctor-Patient communication," Ibe writes on Instagram, where he shares his illustrations. "My goal is to create medical illustration of such."

Earlier this year, Ibe was raising money for his tuition at Kyiv Medical School in Ukraine. In 2020, he became creative director of several medical journals, including the Journal of Global Neurosurgery, according to a YouTube video, where he promotes his drawings as well as his fundraiser for med school.

Ibe says the lack of diversity in medical illustrations has implications for medical trainees because many conditions may look different based on people's skin color. He also says representation matters and that Black students are more engaged with illustrations that portray their skin color.

"I have decided to change the status quo by portraying anatomy, physiology and pathology on the Black skin," he writes in his YouTube video.

Ibe, now a first-year medical student in Ukraine, went viral for his drawings on social media this week. The illustrations even caught the eye of "CBS Mornings" anchor Nate Burleson. "You don't realize you haven't seen it until somebody shows you this," Burleson said Tuesday.

"I have never, ever seen that. I love how you set it up: 'Didn't realize how much I was missing until I saw it,'" said "CBS Mornings" anchor Gayle King. "Never saw a picture of a black baby, a fetus, inside the stomach, ever."

CBS News has reached out to Ibe and is awaiting response.

Caitlin O'Kane is a digital content producer covering trending stories for CBS News and its good news brand, The Uplift.

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A medical illustrator noticed patients are always depicted as White. So, he decided to draw diverse medical diagrams. - CBS News

FIRM GROUND RETINOL BODY LOTION

versedskin.com

Retinol is a universally acclaimed anti-aging ingredient featured in some of the most-popular skincare products. Generally, retinol application has been centered around the skin and face, with a focus on items that can target fine lines, wrinkles, and the under eye area. For its latest product launch, Versed Skincare is branching out, creating an all-over retinol lotion that has already "blown away" one shopper with its results.

The Firm Ground lotion from Versed combines retinol (a type of vitamin A) with moisturizing ingredients like squalene, vitamin E, and cocoa butter. Suggested for use on areas including the chest, knees, and elbows, Firm Ground addresses signs of aging that traditionally occur on drier areas of the skin.

FIRM GROUND RETINOL BODY LOTION

versedskin.com

To buy: $18; versedskin.com.

Skin irritation is often a common side effect of retinol use. While experts confirm that your skin will gradually adjust with continued use, Firm Ground aims to reduce that experience from the start, using an encapsulated version of retinol.

"Encapsulated retinol is a way to get the full benefits of retinol with less irritation. Encapsulation is also a way to formulate a product with a higher concentration of retinol, as the skin will tolerate it better, Dr. Luigi Polla, founder of Forever Institut and Alchimie Forever, told Real Simple.

In order to further reduce possible skin irritation, Tamerri Ater, senior director of product development at Versed, noted, "Like with all retinol based products, you should wear broad spectrum SPF 30 or higher and keep areas of application out of direct sunlight."

Firm Ground reviewers confirm their skin has acclimated to the lotion without any issue. "My skin usually reacts poorly to anything other than the most basic body lotion. However, that wasn't the case with Firm Ground," a reviewer shared. They added, "The retinol didn't cause any irritationit only made my skin soft! For the first time in as long as I can remember, I have soft elbows."

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It's recommended that you apply the lotion morning and night, but if this is your first time using retinol or you have sensitive skin, dermatologist Marnie Nussbaum suggests only using retinol twice a week. "After a few weeks, you can try increasing the frequency to four nights a week until you can use it nightly," she added.

Based on the experience of one first-time retinol user, Firm Ground is appropriate for most all skin types.

"This lotion worked far better than I had ever hoped. Having never used retinol, I didn't know what to expect. People, it helped my eczema," one reviewer shared. "I applied it to the keratosis pilaris (bumpy chicken skin) on the backs of my arms overnight. The next morning, it was darn near gone. Next, I tried it on my lower legs and feet, which is where my eczema flares worst. Overnight, [there was] soft, moisturized skin. My mind was blown. I plowed through the whole tube."

Ready to experience the lotion that left one shopper with "baby smooth skin?" Pick up a bottle of Firm Ground from Versed Skincare now.

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Shoppers Report Softer Skin and No Irritation With This Retinol-Based Body Lotion - Yahoo Lifestyle

You already know that keeping your hands clean is one of the best ways to keep yourself and others around you healthy.

Plain old handwashing with soap and water is most effective at fighting germs, as the Centers for Disease Control and Prevention (CDC) notes. When youre on the go, hand sanitizer made with at least 60 percent alcohol is a good stand-in.

Hand sanitizer remains important because it helps remove germs from your hands, so that they do not end up on your face, explains Jeffrey Cohen, MD, board-certified dermatologist and assistant professor at Yale School of Medicine in New Haven, Connecticut. These products can help reduce your risk of the common cold and in combination with vaccines COVID-19 and the flu, Dr. Cohen adds.

But if you regularly use hand sanitizer, you know that this hygiene product comes with an unpleasant side effect: dry, cracked skin. Thats why many people follow their hand sanitizer with a moisturizer. Now, though, thanks to a host of new products in drugstores, you may be able to take this hygiene routine from two steps to one, or at least use less moisturizer after sanitizing your hands.

RELATED: 10 Surprising Causes of Dry Skin

The alcohol in hand sanitizers can have a drying effect on the skin, says Joshua Zeichner, MD, associate professor of dermatology and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. With overuse, hand sanitizers can disrupt the skin barrier. For those witheczema and others with sensitive skin, the skin barrier is already compromised, increasing inflammation and causing or worsening symptoms including dryness, redness, flakiness, and irritation, notes the National Eczema Association. Therefore, using hand sanitizers without moisturizing the skin afterward can worsen symptoms of eczema on the hands.

RELATED: Alcohol in Skin Care: Is It Ever Okay?

The latest generation of hand sanitizers are truly a hybrid between skin care and disinfectants, Dr. Zeichner says. They contain the same types of hydrating ingredients found in traditional hand moisturizers, to protect the skin barrier from the ingredients that are necessary to kill microorganisms that spread infections.

While its less likely youll develop dryness and irritation when using moisturizing hand sanitizers, I still recommend exercising caution and using traditional hand moisturizers, he adds.

RELATED: The Top 10 Tips for Healthy Winter Skin

To pick a product that cleans and restores moisture to the skin, turn your attention to the ingredients list and follow these expert tips.

I always look for ethyl alcohol, which is more effective than isopropyl alcohol at killing microorganisms, says Karan Lal, MD, a board-certified dermatologist at Schweiger Dermatology Group in Hillsborough, New Jersey. While sanitizers with an alcohol concentration between 60 and 95 percent are more effective at killing germs than those with a lower alcohol concentration or a non-alcohol-based hand sanitizer, per theCDC, sticking to a sanitizer on the lower end of the scale is better for your skin. I would avoid very high concentrations (more than 85 percent) of alcohol because they are more drying, Dr. Lal says. All you need is 60 percent ethyl alcohol.

Separately, be wary of potentially hidden methanol content in certain sanitizers. In July 2020,the Food and Drug Administration (FDA) noted on its website that some products imported from Mexico were found to be contaminated with the ingredient, which was mislabeled as ethanol. Methanol is toxic, and its absorption can have serious health consequences including blindness and death, Lal says. The FDA urges consumers to pay attention to the ingredients labels on such products, and to avoid using any products specifically known to contain methanol, which the agency lists on its website.

If you have sensitive skin, consider a non-alcohol-based hand sanitizer. Benzalkonium chloride is one option, as its an antiseptic agent that has been found to deactivate COVID-19. Nonetheless, it doesnt kill as many infectious microorganisms as alcohol, Lal says. A study published in February 2021 in The Journal of Hospital Infectionfound that benzalkonium chloride deactivates COVID-19 on both hands and surfaces. Researchers noted several advantages of using it over alcohol for hand disinfection, including that it is less irritating to skin and nonflammable. They also pointed out that healthcare workers may be more likely to engage in better hand hygiene practices with benzalkonium chloride hand sanitizer because it has fewer side effects than alcohol-based sanitizers.

In terms of inactive ingredients, Lal looks for squalene, glycerin, and coconut oil all of which help attract water and maintain moisture, he says. Nazanin Saedi, MD, department co-chair of the Laser and Aesthetics Surgery Center at Dermatology Associates of Plymouth Meeting in Pennsylvania, agrees, noting that glycerin is the main ingredient she looks for in moisturizing hand sanitizers.

This tip is key for people with eczema and anyone managing sensitive skin, as fragrance can be irritating, says Dr. Saedi. It goes back to that compromised skin barrier that Zeichner mentioned earlier. Fragrances can be irritants, Saedi says, and with the compromised barrier, you can be prone to exacerbating eczema.

RELATED:The Skin-Care Glossary Every Woman Needs

Lal recommends this hand sanitizer because it boasts 70 percent ethyl alcohol, plus hydrating squalane and vegan glycerine. Its also fragrance-free, making it a great option for those with eczema or sensitive skin.

Buy it.

Another favorite of Lals, this hand sanitizer from baby brand Pipette is hypoallergenic and contains 65 percent ethyl alcohol. The fragrance-free hand sanitizer also boasts sugarcane-derived squalane for hydration.

Buy it.

This product is made with 61 percent naturally derived ethyl alcohol, in addition to moisturizers and emollients such as glycerin, butylene glycol, dimethicone, and glycine soja (soybean) oil. Both Lal and Zeichner are fans.

Buy it.

Both Saedi and Zeichner recommend this non-alcohol-based disinfectant. This hand sanitizer uses FDA-cleared benzalkonium chloride to keep the hands disinfected, but helps keep the skin hydrated and protected with glycerin and tapioca starch, forming a breathable seal over the skin, explains Zeichner.

Buy it.

RELATED: Should You DIY Hand Sanitizer? Experts Weigh In

See more here:
Do Hand Sanitizer Lotions Actually Work? - Everyday Health

The list of cures for eczema seems to now include milk baths, although there is still some debate on their suitability for the purpose. Essentially, a milk bath involves the addition of milk to the bathwater, per Healthline. Scientifically, uncertainty shrouds the efficacy of this particular cure, even though some studies have been made which suggest that milk baths can indeed help with skin ailments like eczema, as well as psoriasis (via Healthline.)

But even where milk baths have been successful, they have been found to be more suited to infants than adults. Infants suffer eczema at a mind-boggling rate; 20% of them are said to go through its discomfort, per Johns Hopkins Medicine.

While milk baths remain generally unproven as a cure for eczema in infants, their use for curing the condition in adults seem even more unconvincing. So it may be wise to speak with your doctor or dermatologist first before attempting this procedure.

Cures that have generally been used, and continued to be recommended as cure for eczema, include apple cider vinegar, coconut oil, and honey, among others, per Medical News Today.

Link:
Can Milk Baths Be Used To Treat Eczema? - The List

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Investigating genetically mimicked effects of statins via HMGCR inhibition on immune-related diseases in men and women using Mendelian randomization |...

Dr Manuraj Singh highlighted the risks associated with cranking up the central heating, layering up in woolly jumpers, and enjoying a steamy hot shower twice a day. "Showering once a day is enough for most people. Two showers is over the top," Dr Singh said. "Obviously if you get dirty or become particularly sweaty you should wash this off, but in general I advise sticking to once a day for most adults."

Another drying component is central heating, which "takes moisture away from the skin".

"People with pre-existing dry skin and inflammatory conditions, such as psoriasis and eczema, may find [their conditions] get worse during the winter," said Dr Singh.

"We also tend to go outside less during colder months so we dont get as many UV rays, which are naturally anti-inflammatory."

Dr Singh added: "Obviously, we dont want too many UV rays because they damage your DNA over a period of time which can lead to premature ageing and skin cancer.

DON'T MISS

"But sensible exposure to sunshine while wearing appropriate clothing and sun cream is okay."

Aside from spending some time outdoors while the sun is shining, Dr Singh advises to invest only in "good quality cotton".

Dr Singh elaborated: "Woolly jumpers can certainly irritate the skin so good quality cotton is always better.

"Wool can induce hives and cause itchy bumps, called contact urticaria."

If, however, you are suffering from itchy skin and it's not related to the clothes you wear, further investigation is warranted.

"It could be a sign of an internal problem," warned Dr Singh.

One common skin complaint in winter, aside from dry skin, is the development of chilblains.

Chilblains often appear a few hours after spending time outside in the cold, the NHS explained.

Dr Singh added: "These red skin lesions can be painful and itchy, but usually clear up on their own."

You can usually spot them on the fingers, toes, face, and legs.

"If they dont go away they will need to be investigated," said Dr Singh.

To help guard skin against winter temperatures, Dr Singh's advice is to "regularly moisturise".

Dr Manuraj Singh works on behalf of MyHealthcare Clinic, a doctor-led private healthcare business.

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Central heating, showering too much, and woolly jumpers could be bad for you, doctor warns - Daily Express

Eczema, asthma, and allergies sometimes occur together. Doctors call this the atopic triad. Eczema, common in babies and children, is a risk factor for later developing asthma and allergies.

All three conditions cause inflammation, which may help explain the link. Moreover, both eczema and allergies happen when the immune system secretes inflammatory chemicals.

In the case of allergies, the immune system overreacts to harmless substances, while eczema may cause a persons body to attack itself.

Doctors do not yet fully understand the atopic march, the tendency for eczema to develop into allergies and asthma. But the presence of one condition in the triad is a clear risk factor for another, which may help people with symptoms, their caregivers, and healthcare professionals anticipate symptoms and make treatment decisions.

In this article, we cover the link between eczema, asthma, and allergies and look at how to manage these conditions.

The atopic triad refers to the tendency of asthma, eczema, and allergies to occur together. The progression typically begins with eczema, followed by food allergies, and then the development of asthma and allergic rhinitis, which causes sneezing and a runny nose. Doctors also call this progression the atopic march.

Early research found that immunoglobulin E (IgE) plays a role in the triad. IgE is an antibody involved with the functions of the immune system, such as inflammation. While inflammation is important in these three conditions, we now know that IgE is not present in all cases of asthma, allergies, or eczema.

According to a 2018 paper, 20% of children with mild eczema develop asthma, while 60% with severe eczema develop asthma.

A 2021 study similarly linked eczema to the later development of peanut allergies, especially if the eczema is severe. The study included 321 babies. Peanut allergies developed in 18% of the babies with eczema, 19% with other food allergies, and 4% who had a relative with a peanut allergy. This suggests that eczema and other allergies better predict peanut allergies than genetics.

While people with one symptom in the triad are more likely to develop other symptoms, having one symptom does not guarantee the development of others. A 2014 cohort study of 9,801 children found that only about 7% of children with at least one symptom develop symptoms consistent with the atopic march.

Doctors do not fully understand the atopic march. Several underlying factors, such as genetic differences in immune response and inflammation, may help explain it.

Some evidence suggests that exposure to allergens through eczema-damaged skin may trigger immune system responses that lead to inflammation and allergies. Data from mice, for example, show that certain kinds of peanut exposure on the skin increase the risk of sensitivity to milk.

Environmental factors may also play a role. Children exposed to farm animals, for example, have a lower risk of atopic march, while antibiotics seem to increase the risk.

Because atopic march begins with eczema, doctors have focused on how eczema might influence the development of later symptoms. Some evidence suggests that early eczema treatment may help prevent subsequent allergies and asthma, perhaps by preventing exposure to allergens through a damaged skin barrier.

It is not possible to manage the three symptoms with a single treatment. Instead, treatment focuses on managing each symptom individually.

New research into biological therapies to treat these conditions is ongoing.

Keeping the skin well-moisturized is critical for people with eczema since the skins moisture barrier is damaged. This makes the skin dry out faster and more severely. Anti-inflammatory medication such as hydrocortisone can help. When itching is intense, a doctor may recommend antihistamines.

Identifying triggers can help reduce the frequency and severity of flares. This includes avoiding exposure to environmental allergens.

Learn more about treatment options for eczema here.

Avoiding allergens is critical for people with severe, life threatening allergies that cause anaphylaxis. For milder allergies, such as seasonal respiratory allergies, remaining indoors, using an air filter, and limiting contact with allergens may help.

Depending on the allergen, a person may undergo immunotherapy, or allergy shots, which helps desensitize the body. People with severe, life threatening allergies may need to carry an EpiPen for emergencies.

Learn more about allergy treatments here.

Treating asthma requires identifying and avoiding asthma triggers, which may include allergens. Some people have asthma attacks when they are stressed, so calming strategies like deep breathing and meditation can help.

During an asthma attack, a person may need to use an inhaler to take a corticosteroid. A person may need other medications for severe asthma. When an asthma attack does not relent, a person may need to go to the hospital.

Learn more about treatments for asthma here.

A different triad, Samters triad, suggests that people with asthma are more likely to develop nasal polyps and aspirin intolerance. Researchers do not know why this happens, but nonallergic hypersensitivity reactions may be to blame.

Samters triad involves inflammation like the atopic triad, but the inflammatory patterns are different. Samters triad does not involve IgE.

Aspirin and some other anti-inflammatory drugs inhibit the expression of the enzyme cyclooxygenase-1. People with Samters triad who take these drugs develop respiratory symptoms similar to an allergic reaction. Most also develop respiratory symptoms after drinking alcohol.

Although the triad of asthma, allergies, and eczema are distinct from Samters triad, people with asthma have a higher risk of this triad. And because people with allergies and eczema have a higher risk of asthma, they may also have an elevated risk for Samters triad.

A doctor can help with treating any of these conditions. People should speak with a doctor about symptoms of eczema, allergies, or asthma. It is especially important to seek help if symptoms are severe, such as if eczema cracks open and bleeds, allergies cause breathing difficulties, or asthma attacks are severe or frequent.

People undergoing treatment for these conditions should also contact a doctor if:

Asthma, allergies, and eczema all correlate with high levels of inflammation and disproportionate reactions to harmless substances. While most people who have one condition will not develop all three, they are much more likely to develop another triad disorder than those who do not have one.

Though these conditions tend to occur together, doctors cannot treat them as a single diagnosis. Instead, the presence of one component of the triad merely predicts that a person might develop another.

A knowledgeable doctor can help with properly diagnosing asthma, eczema, and allergies and appropriately treating them.

Excerpt from:
The triad of asthma, eczema, and allergies explained - Medical News Today

Older age, male sex, and other medical conditions not associated with heightened risk .Unlike Asian ethnicity, obesity, overcrowding, socializing, and people-facing roles.

People with allergic conditions such as hay fever, rhinitis, and atopic eczema, may have a lower risk of COVID-19 infection, especially if they also have asthma, finds a large, population-based study of UK adults, published online in the respiratory journalThorax.

And contrary to the findings of recent studies, older age, male sex, and other underlying conditions arent linked to a heightened risk of infection, the research indicates.

But Asian ethnicity, obesity, household overcrowding, socializing indoors with other households, and holding down a people-facing role other than in health and social care are all independently associated with a heightened risk of developing COVID-19, the findings show.

A growing body of evidence suggests that at least some risk factors for developing COVID-19 may differ from those which predispose to severe disease and the need for intensive care, say the researchers.

To explore this further and glean what contribution demographic, socioeconomic, lifestyle, diet, medical treatment and underlying conditions might make to the risk of developing COVID-19, the researchers captured detailed information on potential risk factors for the infection among UK adults between May 2020 and February 2021.

All participants were asked to provide information on their age, household circumstances, job, lifestyle, weight, height, long-standing medical conditions, medication use, vaccination status, diet, and supplement intake when they joined the study and then again in subsequent months.

Out of 16,081 eligible people, 15,227 completed at least one subsequent monthly follow-up questionnaire 30 days or more after joining the study; and 14,348 completed the final questionnaire on or before 5 February 2021.

The average age of the participants was 59; 70% were women; and 95% identified their ethnic origin as white.

In all, 446 participants (almost 3%) had at least one episode of confirmed COVID-19 infection, as determined by swab (PCR or lateral flow) test during the study period, and 32 were admitted to hospital.

The researchers accounted for an array of potentially influential factors: age: sex: length of participation in the study: ethnicity: testing frequency: ethnicity; education; deprivation; household income; housing type; number of people per bedroom; schoolchildren at home; ownership of a pet dog; shielding; socialising with other households; visits to shops and other indoor public places; travel to work or study; frontline worker status; physical activity; alcohol intake; weight (BMI); asthma; allergies; use of immune suppressant drugs, inhaled corticosteroids, and bronchodilators; BCG vaccination status; fruit, vegetable, and salad intake; and use of nutritional supplements.

Certain factors consequently emerged as being independently associated with increased odds of developing COVID-19.

People of Asian/Asian British ethnicity were more than twice as likely to become infected as their white counterparts.

Similarly, household overcrowding; socializing with other households in the preceding week; number of visits to indoor public places; a people-facing role other than in health and social care; and overweight/obesity were all associated with a heightened risk.

And the greater the number of people sharing a household and the higher the number of visits made to indoor public places, the higher were the odds of becoming infected, the findings showed.

But atopic (triggered by allergens) disease, which includes eczema/dermatitis and hay fever/allergic rhinitis, was independently associated with 23% lower odds of developing the infection than it was in those without atopic disease or asthma.

And among those who had atopic disease and asthma, the risk was even lower: 38%.This association held true even after factoring in the use of steroid inhalers.

Taking drugs to dampen down the immune system response (immunosuppressants) was also associated with 53% lower odds of COVID-19 infection, although this may reflect greater shielding from infection by these patients, say the researchers.

But age, sex, other medical conditions, diet, and supplement use werent associated with infection risk.

This is an observational study, and as such, cant establish cause. And the researchers acknowledge some limitations to their study.

These include no oversight of swab testing and reliance on the results of routine testing that will usually have been prompted by symptoms, so potentially missing those with symptomless infection.

Participants also volunteered themselves, so some ethnic minorities, particularly people of black, African, and Caribbean ethnicities, were underrepresented in the study.

Nevertheless, the researchers conclude: This large, population-based prospective study shows that there is limited overlap between risk factors for developing COVID-19 versus those for intensive care unit admission and death, as reported in hospitalized cohorts.

Reference: Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK) by Hayley Holt, Mohammad Talaei, Matthew Greenig, Dominik Zenner, Jane Symons, Clare Relton, Katherine S Young, Molly R Davies, Katherine N Thompson, Jed Ashman, Sultan Saeed Rajpoot, Ahmed Ali Kayyale, Sarah El Rifai, Philippa J Lloyd, David Jolliffe, Olivia Timmis, Sarah Finer, Stamatina Iliodromiti, Alec Miners, Nicholas S Hopkinson, Bodrul Alam, Graham Lloyd-Jones, Thomas Dietrich, Iain Chapple, Paul E Pfeffer, David McCoy, Gwyneth Davies, Ronan A Lyons, Christopher Griffiths, Frank Kee, Aziz Sheikh, Gerome Breen, Seif O Shaheen and Adrian R Martineau, 30 November 2021 2021, Thorax.DOI: 10.1136/thoraxjnl-2021-217487

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People With Allergic Conditions Such As Hay Fever and Eczema May Have a Lower Risk of COVID-19 Infection - SciTechDaily

Topical asivatrep, a transient receptor potential vanilloid subfamily V member 1 (TRPV1) antagonist, has been shown to be more effective than placebo in patients with mild to moderate atopic eczema. This was the finding from a Phase III trial by researchers from the Department of Dermatology, Hallym University, South Korea.

TRPVI is a non-selective cation channel which is expressed by keratinocytes, mast cells and sensory neurons related to itch, especially itch related to the release of histamine. Moreover, in vitro study data suggests that antagonism of TRPVI can suppress the atopic eczema-like symptoms by accelerating recovery of the skins barrier. More specifically, in animal models of atopic eczema-like dermatitis, topical asivatrep, has demonstrated improvements in eczema symptoms and the barrier function of the skin. In a dose ranging clinical study in adults with atopic eczema, topical asivatrep 1% was found to provide the greatest improvement in disease severity.

For the present study, the Korean team used a 1% formulation of asivatrep based on the results of the dose ranging study, for a Phase III, randomised, double-blind, placebo-controlled trial. Included patients were aged 12 years and older, with mild to moderate atopic eczema, defined by an investigators global assessment (IGA) score of 2 (mild) or 3 (moderate), and which affected between 5 and 30% of their body. The primary efficacy endpoint of the trial was the proportion of patients with an IGA score of 0 or 1 (i.e., clear or almost clear) after 8 weeks of treatment. Secondary endpoints included changes in EASI score, a pruritus visual analogue scale (VAS) score and a sleep disturbance score at several time points, including week 8.

Findings

A total of 240 patients with a mean age of 25.6 years (45.6% female) were included in the analysis with 157 assigned to topical asivatrep. Most (58.3%) had moderate severity atopic eczema. However, due to withdrawals and patient violations, the final analysis was based on a sample of 231 patients (153 asivatrep).

After 8 weeks of treatment, the proportion of patients achieving an IGA score of 0/1 was 36% in the asivatrep group and 12.8% in the placebo arm (p < 0.001). With respect to EASI scores, the greatest difference was observed at week 8 (44.3% vs 21.4%, asivatrep vs placebo, p < 0.001), with 9.8% of those receiving asivatrep achieving an EASI90 (i.e., 90% reduction in EASI score) compared to only 2.6% in the placebo group (p = 0.046).

There were also significant reductions in pruritus VAS scores and measures of sleep disturbance with asivatrep. In terms of safety, topical asivatrep was well tolerated and while the incidence of treatment-emergent adverse effects was slightly higher with asivatrep compared to placebo, the difference was non-significant.

The authors concluded that treatment with asivatrep cream, as a first-in-class topical agent, may be a novel treatment for patients with atopic eczema.

Citation

Park CW et al. Asivatrep, a TRPV1 antagonist, for the topical treatment of atopic dermatitis: Phase 3, randomized, vehicle-controlled study (CAPTAIN-AD). J. Allergy Clin Immunol 2021

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Topical asivatrep, a TRPVI antagonist, effective for adults with atopic eczema - Hospital Healthcare Europe