Abstract
Background and aims: Impaired skin barrier function is a feature of atopic dermatitis (AD). Transepidermal Water Loss (TEWL) represents a non-invasive measurement of skin barrier integrity. We sought to identify if elevated TEWL measurements at 2 days, 2 months and 6 months of life could predict the development of AD.
Methods: 211 participants were recruited from BASELINE, an ongoing birth cohort study. TEWL was measured at 2 days, 2 months and 6 months. Standardised questionnaires for AD were completed at 6 months of age. Complete physical examination was carried out in all cases.
Results: TEWL increased significantly from day 2 to 2 months (mean increase 4.18gH2O/m2/hr, p< 0.001). This increase was greater in those who met diagnostic criteria for AD at 6 months (mean increase 7.55gH2O/m2/hr, p< 0.001). TEWL did not significantly increase between 2 and 6 months of life (mean difference -0.1gH2O/m2/hr, p=0.872). While TEWL at 2 and 6 months was more likely to be increased in those with AD (p=0.027 at 2 months and 0.004 at 6 months), an isolated elevated TEWL measurement at 2 days of life was not shown to predict AD development (p=0.091).
Conclusions: Increased TEWL at 6 months is understandably associated with AD at the same age. infants who develop AD by 6 months of age have an elevated TEWL by 2 months of age. However, it is the rate of change in TEWL in the first 2 months of life rather than any absolute value that better predicts the subsequent development of AD.
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McCarthy, C., Gallagher, A., Smith, H. et al. A Longitudinal Cohort Study of Transepidermal Water Loss in the First Six Months of Life as a Predictor of Subsequent Atopic Dermatitis. Pediatr Res 70 (Suppl 5), 293 (2011). https://doi.org/10.1038/pr.2011.518
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DOI: https://doi.org/10.1038/pr.2011.518