Posts tagged "Children"

Spotlight on eczema in babies and children – Mirror.co.uk

Baby eczema, which is also called infantile eczema, is common and usually develops when a baby is about two to three months old.

Most children will eventually grow ­out of eczema by the age of three, if ­not, by seven.

Some important points:

• Baby eczema is less common in ­­babies who are breast-fed than in those who are fed formula.

• Baby eczema isn’t caused by ­an allergy and allergy tests sadly won’t help.

• Children with eczema won’t ­­get any benefit from a special diet.

What should you do?

• If your baby is scratching, look at his or her neck, scalp, face, hands and the creases of his or her elbows, knees and groin. These are all classic sites for ­baby dermatitis.

• Keep their fingernails short to minimise the possibility of breaking the skin. If the skin does happen to become broken, put mittens on him or her to prevent infection.

• If you’ve just started weaning your breast-fed baby, return to breast-feeds until you’ve seen your doctor. If you’ve been using formula, return to that.

• Apply an oily calamine lotion to ease irritation and soothe the skin.

• Soap and all detergents should be avoided as it ‘de-fats’ the skin and makes it drier, more scaly and irritable.

• Avoid woollen or hairy garments. Use cotton or linen instead.

What else can you do?

• Use an emollient cream whenever your child washes. This will keep the skin soft, prevent it from drying out and damp down the itchiness.

• Underplay the condition in front of your child. Your anxiety can make the condition worse.

• If the eczema is found to be made worse by pet fur, you may need to consider giving your family pet away.

• Use an aqueous cream, available from your pharmacist, as a soap substitute.

• Use a bath emollient (also available from your pharmacist) dissolved in bath water to create a protective layer for ­your child’s skin.

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Extremely Obese Children Have Higher Prevalence Of Psoriasis, Higher Heart Disease Risk – Electronic Health Records Used To Study 711,000 Children – Eczema.

Use Of Topical Corticosteroids In Children With Eczema Does Not Have Negative Side Effects

A new study published in the journal Pediatric Dermatology reveals that routine, long-term use of topical corticosteroids (TCS) for treating children with eczema does not cause any significant, negative side effects.

Parental phobia of TCS is widespread and leads to poorly managed eczema in children. The commonest fear is that TCS use will “thin the skin.” Parents fears are also shared by many health care providers, including pharmacists.

Led by Gayle Fischer, MBBS, FACD, of The University of Sydney, researchers studied 92 children, 70 of which were part of the study/dermatitis group while the other 22 were categorized in a control group. Researchers convinced the parents of these 70 children to use enough TCS to control their children’s eczema very well so that they were virtually free of eczema consistently. The 22 children in the control group were not using TCS.

Researchers then evaluated the children by examining them for any signs of skin thinning and by also examining their treated and untreated skin by dermoscopy, a technique which utilizes a mini-microscope to search for even the most subtle signs of TCS side effects.

They found that the children using TCS had no evidence of skin thinning even though they were using enough TCS to produce complete control of their eczema. These children were no different to the children who were not using TCS at all.

“Our results show that normal routine use of TCS does not cause skin thinning, and parents should be reassured. We hope that our work will give them the confidence to use TCS safely and effectively” Fischer notes.

Full citation:
“Evaluation of the Atrophogenic Potential of Topical Corticosteroids in Pediatric Dermatology Patients”
Hong, Smith, and Fischer
Pediatric Dermatology. URL upon Publication: http://doi.wiley.com/10.1111/j.1525-1470.2011.01445x

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

I used Synalar ointment for >10 years on a daily basis (since age of 11), Initially basically had eczema over my whole body and used Synalar and wrapped myself in saran wrap at night (per dermatologist instructions). Then just my arms and hands. Also used it on my face on an almost daily basis in my 20′s. I was never told, and had no idea that it would “think the skin. Pleased to report that at the age of 55 I do not have thin skin- in fact, my skin is much better than most people my age. What I can’t understand is why someone would take a p.o. med for eczema when cheap and effective topical meds exist.

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Eczema In Children Not Improved By Ion-Exchange Water Softeners

Eczema In Children Not Improved By Ion-Exchange Water Softeners

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Eczema In Children Not Improved By Ion-Exchange Water SoftenersRetweetMain Category: eczema / Psoriasis
Also Included In: Pediatrics / Children's Health
Article Date: 16 Feb 2011 - 3:00 PDT

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Water softeners provide no additional clinical benefit to usual care in children with eczema, so the use of ion-exchange water softeners for the treatment of moderate to severe eczema in children should not be recommended. However, it is up to each family to decide whether or not the wider benefits of installing a water softener in their home are sufficient to consider buying one. These are the findings of a study by Kim Thomas from the University of Nottingham, Nottingham, UK, and colleagues and published in this week's PLoS Medicine.

The authors conducted their randomised controlled trial among 336 children - who all lived in hard water areas in England - aged 6 months to 16 years with a diagnosis of eczema; they were randomised to receive either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone for 12 weeks. Research nurses measured each child's eczema severity score at baseline and at 6, 12, and 16 weeks to record changes in eczema severity. The authors also analysed any changes in eczema symptoms over the study period such as sleep loss, itchiness, and the amount of topical treatments used.

Although both treatment groups improved in disease severity during the course of the trial, there were no clinically important differences between the groups in any of the outcomes that were measured objectively (without knowledge of the treatment that the child received). However, parents in the trial did report small health benefits in some of the more subjective outcomes, such as sleep loss and itchiness, and just over 50% chose to buy the water softener at the end of the trial because of perceived improvements in the eczema and the wider benefits of water softeners.

The authors say: "The results of this study are clear, and as a result we cannot recommend the use of ion-exchange water softeners for the treatment of moderate to severe eczema in children."

They add, "Whether or not the wider benefits of installing a water softener in the home are sufficient to justify the purchase of a softener is something for individual householders to consider on a case by-case basis."

Notes:

Funding: This trial was funded by the National Institute for Health Research, Health Technology Assessment (NIHR HTA) Programme, project number HTA 05/16/01. The views and opinions expressed in this article are those of the authors and do not necessarily reflect those of the NIHR HTA Programme. A consortium of water industry representatives helped with this study: Aqua Belgica, Culligan International (UK) Ltd, Ecowater Systems Ltd, Harvey Softeners Ltd, Kennet Water Components Ltd, Kinetico UK Ltd, Monarch Water, Salt Manufacturers Association, and the Water Quality Association (USA). They provided technical advice, generic water softeners, fittings, salt, and analytical testing of the weekly water samples. This assistance was coordinated through the UK Water Treatment Association, which is an independent trade association for the industry. Funding for pilot work for this trial was provided by Kinetico UK Ltd. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: AF is Technical Director of the UK Water Treatment Association, which represents the interests of manufacturers of water treatment equipment used in private and public water supplies. The range of equipment covered includes water softeners. He is a consultant to the European Water Treatment Association with similar interests, and is International Director (unpaid) for the USA Water Quality Association.

Citation: Thomas KS, Dean T, O'Leary C, Sach TH, Koller K, et al. (2011) A Randomised Controlled Trial of Ion-Exchange Water Softeners for the Treatment of Eczema in Children. PLoS Med 8(2): e1000395. doi:10.1371/journal.pmed.1000395. Click here to access the freely available paper.

Source:
Katie Hickling
Public Library of Science

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  back to topVisitor Opinions In Chronological Order (1)Childhood Eczema, Why Nottingham experiment was flawedposted by Graeme Ward on 17 Feb 2011 at 9:17 pm

Dr Kim Thomas's experiment using water softeners to try to address childhood eczema, at Nottingham University, was flawed from the outset. I made several attempts to contact the study team both directly and by email to explain why but without response.

There was a germ of insight in their theory, that if you put the child in a salty environment this might impact the illness. In fact, if you could send the child to the Dead Sea for a fortnight, the combination of a salty atmosphere, sunshine and high pressure would undoubtedly help to clear the problem up. However, this environment cannot be replicated by using a water softener in the home.

To gain an insight into why it might have worked and to find an effective remedy, it is necessary to understand the aetiology of eczema in children. Eczema begins in the first few months of life in around 18% of babies. In most cases it will disappear in puberty but, in some cases, it can be lifelong if not effectively treated. The condition can be exacerbated by frequent use of prescribed or over-the-counter medications that expose the sufferers to many allergens and irritants and to thinning of the skin.

Eczema occurs when eccrine sweat ducts become blocked in the dermis. This has two effects. Firstly, sweat rising in the duct, under pressure, causes ruptures at the point of the blockage and spreads into the surrounding skin setting up inflammation and intense itching. Secondly, the absence of the undelivered insensible perspiration on the skin surface deprives it of essential peptide antibodies, the skin's natural antibiotic, and allows the ingress of microbes causing scabbing.

The sweat ducts get blocked because the glands are reabsorbing electrolytes at too fast a rate resulting in the electrolytes, particularly sodium, becoming crystalline The primary reason that salts crystallize, particularly within the skin, is because of a malfunction of the perspiration system caused by adverse habituation. The perspiration system is designed to work at two speeds. insensible, for normal irrigation and cleansing of the skin cells and copious for cooling at times of exertion. Copious is seven times the volume of insensible perspiration.

At the lower level, perspiration contains peptides and electrolytes at the same concentration as extracellular water. However, if this concentration was maintained for copious sweating then the loss of electrolytes to the body would be too great. To counter this, the eccrine sweat glands operate to reabsorb the electrolytes into the extracellular water before they are lost. Consequently, copious sweat is a dilute quite close to being just pure water. However, when the body is subject to adverse habituation, possibly passed on from mother or because of slightly out of balance development in baby, reabsorption takes place but the copious flow is not present. This now means that, within the sweat ducts, the extracellular water is too 'salty' compared with the intracellular water and as a result electrolytes are taken into cells where they overload the cell capacity and become crystalline.
It follows from this that the only effective treatment for childhood eczema is to restore normal habituation and clear the blockages, allowing perspiration to flow unhindered to the skin.

This can only be achieved if the sweat ducts can be unblocked and this means that the crystallized salts causing the blockages must be diluted. The only known therapy that can achieve this is Smart Cell Signal technology. In babies and younger children, this is administered with patches or biospheres worn close to the body (typically as a vest). Cell signals facilitate unblocking by stimulating ion channel gating. In this case, a package of electrolyte atoms surrounded by interstitial water are encapsulated in nodes on the patch that permit the water to pass through their surface in gas form but do not allow the release of the electrolyte atoms themselves.

The signalling nodes on the patches or within the biospheres use fuzzy logic to signal the presence of electrolytes and trigger ion gating. As the gates then operate, a one way traffic is stimulated because the cell will seek to exchange actual atoms with the phantom atoms that are not being released by the signal media. This will impact the balance within the cell with the consequence that, if there are crystallized salts within the cell, i.e. those that are causing the blockage, these will be diluted and resume electrolyte form.

Each pair of individual cells within the signal media will react millions of times each second with every cell that it passes. If there is no excess of trapped salts within the cell, homeostasis will be automatically restored by normal osmotic pressures. Thus, smart cell signal biology can only be beneficial and no side effects can arise as the body will only react to an apparent excess of electrolytes by initiating normal bodily reactions.
In trials, 90% of babies and young children using this therapy achieved significant reduction or elimination of eczema after a single course of treatment.

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European Survey Reveals Wide-Reaching Impact Of Eczema On Quality Of Life And Emotional Wellbeing Of Children And Their Families

Main Category: eczema / Psoriasis
Also Included In: Dermatology;  Pediatrics / Children’s Health
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New survey data released today demonstrate that childhood eczema can have a detrimental effect on quality of life not only for the children who live with the disease, but also for their families.[1a] The survey, which was carried out in eight countries across Europe, examines the impact of eczema on European children through the eyes of the parents who care for them.

The survey findings show that childhood eczema can negatively affect all aspects of life, from participation in education to self esteem, in particular for children with moderate or severe form of the disease.1a Children with moderate and severe eczema miss out on school or nursery as well as sport and play – over a quarter (27%) of children miss up to five days of school a year due to their disease.[1b] Furthermore, nearly one fifth (18%) miss out on sport and play due to their eczema.[1c] This has an impact on parents too: over a quarter (26%) of parents caring for a child with moderate and severe eczema have to miss time at work due to their child’s illness.[1d]

Worryingly, 50% of parents of children with moderate and severe eczema feel that the condition has a negative effect on their child’s self esteem.[1e] Almost one third of parents report that children living with moderate and severe eczema experience frustration (32%) and feeling different to other children (30%)[1f] and parents also believe that their child feels ‘self-conscious’ and ‘sad’ some of the time because of their condition.[1g] Significant pain and discomfort, sleeping problems and mood swings are all problems experienced by one in four children with moderate and severe eczema.[1h]

“While parents of children living with eczema know the impact that the disease can have on children and families, it isn’t always easy for other people to understand,” said Margaret Cox, Chief Executive, National Eczema Society (UK). “We welcome the findings of this survey in the hope that they will help everyone involved in the care of children with eczema to understand the challenges they face. Recognising the emotional toll that eczema can take is an important step towards helping to identify how we can better help these children to live and enjoy their childhoods to the full.”

Eczema (atopic dermatitis) is an incurable skin disease which affects between 5% and 20% of children in developed countries.[2] In children, 60% of eczema is diagnosed under the age of one year.[3] Once the disease has emerged, a child will usually experience a cycle of ‘flare ups’ followed by periods of remission when the disease will appear to have gone away and the skin looks as if it has returned to normal. Commonly, 2 out of 3 children with eczema ‘grow out of it’ by their mid-teens.[4]

Eczema can cause disruptions to family daily routine, a child suffering from moderate and severe eczema can be affected for a significant proportion of time each month and each year.

The survey revealed that flare prevention or reduction is a priority for parents. Parents of children with moderate and severe eczema feel that all aspects of family life would be improved and that their child’s quality of life would be improved if he or she experienced fewer flares.[1] Over one third believe that this would transform their child’s quality of life for the better.[1] Parents stated pain relief as the most important treatment outcome and approximately a quarter (24%) of parents of children with moderate and severe eczema identified failure to prevent flares as the biggest problem with their current treatment.[1]

“Eczema has a far more debilitating impact on a child’s life than most people understand. We manage my son’s itching by constantly moisturising his skin – which only serves to make him feel even more different from his friends.” said Suzanne Johns from Bradford, England, whose 7-year old son was diagnosed with eczema at birth.

“Eczema is far more than dry skin or a bit of an itch. Eczema can demand an all consuming lifestyle and coping techniques which need to be embraced by not only the sufferer, but their family as well. Only when people fully understand the far reaching impact of this relentlessly itchy, intolerable skin condition can we hope for better treatment and acceptance.”

Eczema is a complicated disease for which, at present, there is no cure. There are a range of treatments available to help to minimise the impact of eczema. Some patients may need treatments that are designed to be used regularly to prevent flare ups from happening. Other treatments are used for a shorter period of time to treat a flare up and help the skin to heal.[5]

About the survey

The Impact of Eczema on Children Survey was carried out by Opinion Health on behalf of Astellas Pharma Europe Ltd. The online survey involved 1,600 parents of children with eczema in total (754 of which were parents of children with moderate to severe eczema), comprising 200 from each of eight countries across Europe (Denmark, France, Germany, Netherlands, Poland, Spain, Sweden and the UK). The aim of the survey was to explore the impact of eczema and its management on the quality of life of children, their parents and families.

References

[1] APEL Quality of Life market research, 2010

[2] Leung DY, Boguniewicz M, Howell MD, et al. New insights into atopic dermatitis. J Clin Invest 2004; 113: 651-7.

[3] Kay J et al., J. Am. Acad. Derm 1994 ;30 ; 1 :35-39

[4] National Eczema Society, Atopic Eczema, Available here. Lasted accessed November2010

[5] National Collaborating Centre for Women’s and Children’s Health (2007) Atopic eczema in children: full guideline, National Institute for Clinical Excellence (NICE). Available here. Last accessed August 2010

Source:
Astellas Pharma Europe Ltd.

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Children With More Severe Eczema Less Likely To Outgrow Milk, Egg Allergy

Editor’s Choice
Main Category: Allergy
Also Included In: eczema / Psoriasis;  Pediatrics / Children’s Health;  Dermatology
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Unlike peanuts or seafood, allergies to egg and milk are often outgrown. But new research presented at the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) sheds even more light on food allergy outcomes, suggesting that children who have more severe atopic dermatitis, or eczema, are less likely to outgrow their milk or egg allergy.

“While our clinical impression has been that the natural course of food allergy might be related to co-existing atopic dermatitis, previous studies had not provided any clear answers to this important question,” explained study author Robert A. Wood, MD, FAAAAI.

Researchers from Duke, Johns Hopkins, Mount Sinai, National Jewish, the National Institute of Allergy and Infectious Diseases (NIAID) and the University of Arkansas enrolled over 500 children between the ages of 3 and 15 months. The participating children had either a convincing history of egg or milk allergy with a positive prick skin test to the trigger food and/or moderate-severe atopic dermatitis and a positive prick skin test to milk or egg.

Eczema severity was scored at baseline and 2 years and was analyzed categorically as none-mild or moderate-severe. Milk and egg allergy was based upon clinical history and food-specific IgE with resolution established by successful ingestion of the trigger food.

During 2 years of observation, 46% of children with none-mild eczema at enrollment outgrew their milk allergy versus only 25% of the children enrolled with moderate-severe eczema. Interestingly, improved eczema severity was not associated with food allergy resolution. Among those with moderate-severe eczema at enrollment who improved to none-mild, just 19% resolved their food allergy compared to 32% who remained moderate-severe.

When looking at egg allergy, 39% of children with none-mild eczema at enrollment outgrew their egg allergy versus 21% that were enrolled with moderate-severe eczema. Of those children who had moderate-severe eczema at enrollment who improved to none-mild over 2 years, 28% resolved their allergy compared with 22% who remained moderate-severe.

“These findings will help clinicians caring for infants with eczema and milk or egg allergy and provide more accurate advice to parents about the likely course of their child’s milk or egg allergy,” added Wood.

Source: American Academy of Allergy, Asthma & Immunology (AAAAI)

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