[ACUTE TREATMENT AND LONG-TERM PROGNOSIS OF SEVERE PROTEIN-LOSS IN ATOPIC DERMATITIS (SPLAD)]

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Kenji Toyokuni1, Kiwako Yamamoto-Hanada1, Akio Yoshida1

  • 1Allergy Center, National Center for Child Health and Development.

Arerugi = [Allergy]
|December 16, 2021
PubMed

Insights

Severe protein-loss in atopic dermatitis (SPLAD) in infants can be managed effectively. Topical corticosteroid use can be significantly reduced within three years with appropriate skin treatment, improving prognosis.

Area of Science:

  • Pediatric Allergy and Immunology
  • Dermatology
  • Clinical Nutrition

Background:

  • Severe protein-loss in atopic dermatitis (SPLAD) is a serious complication in early infancy.
  • Understanding the long-term prognosis of SPLAD is crucial for effective management.

Purpose of the Study:

  • To investigate the prognosis of infants diagnosed with severe protein-loss in atopic dermatitis (SPLAD).
  • To evaluate the long-term outcomes of SPLAD management, including topical corticosteroid (TCS) use and dietary changes.

Main Methods:

  • A single-center, retrospective observational study involving 61 children with SPLAD.
  • Analysis of patient records from 2002 to 2017, focusing on clinical characteristics, laboratory results, and treatment outcomes up to three years.
  • Assessment of topical corticosteroid (TCS) frequency and food intake status.

Main Results:

  • All patients showed improvement in hypoproteinemia and electrolyte imbalances with AD treatment alone.
  • Proactive therapy led to sustained remission in 77% (1 year), 92% (2 years), and 95% (3 years) of patients using TCS twice weekly or less.
  • After three years, 39% of patients achieved remission without TCS, and 29% of those under one year at admission could tolerate egg, milk, or wheat.
  • No patients required systemic therapies.

Conclusions:

  • Appropriate skin treatment can significantly reduce topical corticosteroid (TCS) use in severe protein-loss in atopic dermatitis (SPLAD) cases.
  • SPLAD demonstrates a favorable prognosis with effective management, allowing for reduced medication dependence and potential tolerance of common allergens.
Abstract

Keywords:
atopic dermatitischildhypoproteinemiaproactive therapysevere protein-loss in atopic dermatitis

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