Atopic dermatitis is a leading health concern in Western societies. The disease is diagnosed once the patient experiences chronic skin problems resulting from an abnormal reaction of the immune system, however the exact causative agent that causes skin lesions is usually difficult to determine. The disease may develop as fast as a few months after the child is born, and although a clinical remission may be achieved after a few years, the ailment may also develop into a chronic type of AD lasting lifelong. Of note, the atopy may convert to another allergic manifestation, for example atopic asthma or allergic rhinitis. Atopic dermatitis is predominantly prevalent in countries with a high degree of economic and industrial development. It is estimated that in Poland AD occurs even in every fifth child.
Symptoms of atopic dermatitis
Symptoms of AD are extremely annoying for a patient. Typically symptoms include: chronic dryness of skin with its redness and flaking, predominantly around hand joints, elbows and knees bends, as well as in the face. These symptoms are accompanied by persistent pruritus, being a major cause of irritation of the child and consequently behaviour deterioration. Additionally, bacterial and fungal superinfections of skin lesions are frequently observed, which enforce necessity for antimicrobial therapy implementation (antibiotics/antifungals)
Treatment of atopic dermatitis
The treatment of atopic dermatitis is almost exclusively symptomatic, based on the use of ointments and other skin cosmetics ensuring soothing and immunosuppressive properties, as well as glucocorticosteroids. Unfortunately, in most cases skin lesions occur shortly after such therapy discontinuation which make the course of the disease as vicious circle.
At present, providing tailored probiotics and prebiotics and nutritional therapy aiming to relief of symptoms and prevent of recurrence of the disease is widely discussed, both in children and adults. There is a body of evidence indicating that atopy, like allergy, is a consequence of excessive hygienization. Intestinal microbiota composition may be responsible for such hypersensitivity of the immune system during the atopy. Low abundance of commensals in the gut may lead to a disruption of the immune balance and, consequently, hypersensitivity to environmental factors (foods, pollen and others), which manifests itself as skin lesions. In addition, excessive intestinal permeability, a symptom of dysbiosis, is often observed in patients with AD.
Disrupted intestinal barrier makes insufficiently digested food molecules to be penetrated into the circulatory system. This results in additional activation of the immune system and deterioration of the skin condition in a patient suffering from AD.
Persistent dryness, flakiness and recurrent skin problems require a comprehensive, holistic approach which affects the aetiology of skin hypersensitivity. Tailored probiotic therapy enables disturbed intestinal microflora to be rebuild and makes intestinal barrier to be integral (causative treatment). On the other hand, the assessment of food hypersensitivity of IgA and IgG classes (latent, delayed type) is to eliminate foods that worsen the condition of the skin (symptomatic treatment). This type of treatment scheme is the fastest and the most effective in improving the skin condition in patients with AD.