This article is more than 5 years old. Information may no longer be current.

Skin barrier dysfunction at birth, 2 months preceded atopic dermatitis

Newborn children lacking filaggrin and experiencing high transepidermal water loss at 2 days and 2 months are at an increased risk for atopic dermatitis, according to study results.

“We have shown that changes in skin barrier predate clinical [atopic dermatitis (AD)] with a signal for barrier impairment detected in asymptomatic infants at day 2 and more markedly at 2 months,” Alan D. Irvine, MD, of Our Lady’s Children’s Hospital in Dublin, and colleagues wrote.

Alan D. Irvine

Irvine and colleagues measured the transepidermal water loss (TEWL) of 1,691 infants at 2 days after birth, 2 months and 6 months. The researchers also genotyped 1,300 infants in the study for FLG mutations.

At 6 months, 18.7% of the infants screened were diagnosed with AD. At 12 months, 15.53% of those screened were diagnosed with AD.

“FLG mutation carriers did not have elevated change in TEWL from 2 months to 6 months, implying that the major changes in skin barrier function in those who develop AD by 12 months start in the first 2 months of life,” the researchers wrote.

Infants with a TEWL reading of 9 or greater were 7.1 times more likely to be diagnosed with AD by age 1 year than were infants with a lower TEWL reading.

The researchers wrote that, in univariate analysis, the OR for AD at 12 months given by both parents being atopic was 2.5 compared with an OR of 3.1 for a high TEWL at 2 months.

Disclosure: See the study for a full list of relevant financial disclosures.