9-1OAS Transepidermal Water Loss Measurement during Infancy Can Predict the Subsequent Development of Atopic Dermatitis

Friday, 16 October 2015: 15:30 - 15:45
Room R2 ABC (Floor 3) (Coex Convention Center)

Kenta Horimukai, MD , Department of Pediatrics, Jikei University Katsushika Medical Center, Tokyo, Japan

Hideaki Morita, MD, PhD , Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan

Masami Narita , National Center for Child Health and Development, Tokyo, Japan

Mai Kondo, MD , Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan

Shigenori Kabashima, MD, PhD , Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan

Eisuke Inoue, PhD , The Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan

Hironori Niizeki , Division of Dermatology, Department of Surgical Subspecialties, National Center for Child Health and Development, Tokyo, Japan

Kenji Matsumoto , National Research Institute for Child Health & Development, Tokyo, Japan

Yukihiro Ohya , National Center for Child Health and Development, Tokyo, Japan

Hirohisa Saito, MD, PhD , National Research Institute for Child Health & Development, Tokyo, Japan

Background: Atopic dermatitis (AD) is characterized by skin barrier dysfunction. Few studies have used non-invasive skin measurement techniques to measure epidermis function in asymptomatic neonates. We therefore conducted a post-hoc analysis to determine whether skin barrier function in the first week of life predicted AD development and allergen sensitizationby age 32 weeks.

Methods: Data of 116 infants collected during our previous randomized controlled study were analyzed. Skin barrier function was measured through transepidermal water loss (TEWL), stratum corneum hydration (SCH), and pH. Study participants were divided into 2 groups based on the results of Cox regression analyses of skin measurement values and cumulative AD incidence by 32 weeks of age. A Kaplan–Meier analysis and log–rank test were used to analyze skin barrier function and cumulative AD incidence. Allergic sensitization based on IgE levels to egg white and ovomucoid at 32 weeks of age was assessed by a Chi–squared test.

Results: TEWL (with an optimal cut-off level of 6.5 g/m2/h) measured on the forehead within the first week of life showed a lower p-value than TEWL measured on the lower leg, SCH, and pH measurements. We found a significant difference in cumulative AD incidence between the high and low TEWL groups (p <0.05). Moreover, the high TEWL group exhibited a higher (but not statistically significant) rate of sensitization to ovomucoid (p = 0.07).

Conclusions: TEWL measured on the forehead during the first week of life is associated with AD development.