Fecal microbiota transplantation (FMT): first RCT. ➜ DOI: 10.1111/all.16372 This Chinese randomized, double-blind, placebo-controlled clinical trial, studied the efficacy and safety assessment of FMT for moderate-to-severe adult patients with AD. All patients received FMT or placebo as capsules sourced for FMT verum from 2 strictly screened healthy donors once a week for 3 weeks, in addition to their standard background treatments. Patients underwent disease severity assessments at weeks 0, 1, 2, 4, 8, 12, and 16, and blood and fecal samples were collected for immunologic analysis and metagenomic shotgun sequencing. The results show a weak and transient signal of efficacy at week 4 post FMT, and no safety issues. The most intriguing result of this study is the excellent outcome in the placebo arm, but details are lacking concerning the placebo capsules.
Comorbidities in AD: A large UK primary care study. ➜ DOI: 10.1038/s41467-024-54035-1 The authors analyze primary care records (1997−2023), comparing up to 3.6 million people with AD to 16.8 million without. This study confirms that AD is mainly associated with allergic conditions, molluscum and alopecia areata. It also points out that urticaria and Hodgkin’ s lymphoma are strongly associated with AD, and other cancers not. With the usual reservation that coding may be wrong, clinical experience shows that urticaria is frequently misdiagnosed in AD patients as a flare of AD, but Hodgkin’s lymphoma pruritus as a common presenting sign in young adults may have been misdiagnosed as AD by primary care physicians.
Overdiagnosis of AD in children in Japan using UKWP criteria ➜ DOI: 10.1016/j.alit.2024.09.008 The authors examined the interobserver concordance for AD and non-AD diagnoses between two dermatologists who examined >1600 children. AD prevalence determined by the United Kingdom (UK) diagnostic criteria were compared with the diagnoses made by the two dermatologists, using data from a skin health survey. Among the 1,638 children, 393 (24.0 %), and 597 (37.2 %) were diagnosed with AD by the two dermatologists and the UK diagnostic criteria, respectively. Interobserver concordance for AD or non-AD diagnoses between the two dermatologists was substantial. The authors conclude that self-reported diagnoses (based on yes to the question: has your child ever been diagnosed with AD by a physician?) exhibited low sensitivity that potentially indicated underdiagnosis of AD, whereas the UK diagnostic criteria might overdiagnose AD.
Computable phenotypes (CP) in electronic health record research: application to AD ➜ DOI: 10.1016/j.jid.2024.08.025 This review shows the complexity of creating CPs from standardized electronic health records (EHR) especially with the chosen example, AD. When appropriate subsets of patients can be identified accurately, a wealth of potential applications can be derived such as exploring variations in pharmaceutical prescription, evaluating treatment outcomes, clinical trial recruitment, and survival analysis. Furthermore, EHRs represent real world patient populations better than conventional trials, which often include only a subset of patients meeting specific criteria. The authors highlight that validated CPs are particularly important in dermatologic research, where heterogeneity in disease presentation and data capture make accurate cross-institutional identification of patients for large-scale research studies challenging.
Toothbrushing to prevent AD ➜ DOI: 10.3390/jcm13206087 This is a Japanese retrospective review of mandatory medical questionnaires administered during legally mandated freshman medical checkups between 2017 and 2019 at the University of Tokyo, Japan. 9098 cases involving individuals under the age of 20 were included in the analysis. Respondents were classified into three groups based on their daily toothbrushing frequency and duration. The risk of atopic dermatitis was found to increase with shorter toothbrushing times, suggesting that dental self-care during adolescence is important not only for oral health but also for general health, possibly by modulating the microbiote. A very simple preventive intervention!
