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Atopic Dermatitis ( Eczema) and Probiotics

By Jacqueline Wivinus and Kristina Hegarty. Atopic Dermatitis ( Eczema) and Probiotics. Objective: To study the effects of the use of probiotics in pediatric patients that suffer from atopic dermatitis. Clinical Significance:

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Atopic Dermatitis ( Eczema) and Probiotics

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  1. By Jacqueline Wivinus and Kristina Hegarty Atopic Dermatitis (Eczema) and Probiotics

  2. Objective: To study the effects of the use of probiotics in pediatric patients that suffer from atopic dermatitis. Clinical Significance: Intestinal permeability and dysbiosis influence gut immune function GI permeability is thought to be greatest in early infancy and to decline with intestinal maturation. GI permeability and microbiota are thought to be critical influences in allergic disease. 1 Probiotics compete with pathogens Probiotics alleviate immunogenicity of potential allergens “Effect of probiotics on the treatment of children with atopic dermatitis”

  3. Double-blind randomized, placebo-controlled study • Pediatric patients: 1-13 yo • Probiotic complex • Bifidobacteriumbifidum • Lactobacillus acidophilus • Lactobacillus casei • Lactobacillus salivarius • Placebo control group • Skim milk powder • dextrose Methods

  4. Results

  5. Results

  6. Strengths • Randomized, double-blind, controlled trial • Statistically significant results • Measuring multiple inflammatory markers • Weaknesses • Skim milk placebo • Small sample size • Limited to pediatric patients • Duration • SCORAD subjectivity Limitations

  7. The Cochrane Database • 12 randomized controlled trials reviewed • No significant improvement with probiotics • Up to Date Database • Meta-analyses of using probiotics for eczema treatment • Problems of quality with some studies and heterogeneity • Probiotics benefit IgE sensitized individuals Database review

  8. Natural Standard • Probiotics for children is promising • Infants benefit from mothers probiotics use • May reduce cow’s milk allergy and other allergic reactions • Stabilize intestinal barrier function Database review

  9. Probiotic supplementation Limit/avoid stress Skin or serum testing Elimination diet Recommended treatment strategies

  10. Mahan L, Escott-Stump S, Raymond J.Krause’s Food and the Nutrition Care Process. St. Louis, Missouri: Elsevier Inc; 2012. YesilovaY, Calka O, Akdeniz N, Berktas M. Effect of Probiotics on the Treatment of Children with Atopic Dermatitis. Ann Dermatol. 2012; 24: 189-193. Boyle, RJ, Bath-Hextall, FJ, Leonardi-Bee, J, Murrell, DF, Tang, MLK. Probiotics for treating eczema (Review). Wiley [serial online]. 2008; 4: 1-57. Available from: The Cochrane Library. Accessed June 1, 2012. West, C, Prescott, S. Prebiotics and probiotics for treatment of allergic disease. Wolters Kluwer Health [serial online]. 2011. Available from: UpToDate. Accessed June 1, 2012. Natural Standard. Probiotics (Bifidobacterium, Lactobacillus, Saccharomyces boulardii) page. Available at: http://www.naturalstandard.com/databases/ herbssupplements/patient-probiotics.asp#. Accessed May 30, 2012. References

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