Objective  To investigate the influence of the factors related to home skin care for children with atopic dermatitis (AD).

Methods  Using the convenience sampling method, the children with AD treated in the type 2 inflammation multidisciplinary clinic center in Affiliated Hospital of Shandong Second Medical University from June 2022 to June 2023 were selected to investigate the severity of the disease, and analyze the general data and factors related to home skin care using Logistic regression.

Results  Among 358 children with AD, there were 214 (59.78%) mild cases, 144 (40.52%) moderate-severe cases. Multiple Logistic regression analysis showed that among the factors of home skin care, use of cleaning products, bath time 5~10 min, soft-water bathing, bath water temperature ≤38 ℃, bath frequency was greater than or equal to once a week, pH of cleaning products was neutral or weakly acidic, use of skin care products, weekly full-body skincare use ≥100 g, light colors for intimate apparel, and the replacement frequency was not more than 1 week/time, and post-application massage were protective factors for severity of AD in children (P<0.05). The pH of cleaning products was weakly alkaline, and bath duration >10 min were the risk factors for severity of AD in children (P<0.05).

Conclusion  This study puts forward the protective factors and risk factors of home skin care for children with AD, which provide theoretical basis and evidence-based basis for the formulation of home skin care measures and education and guidance for AD children.

1.中华医学会, 中华医学会杂志社, 中华医学会皮肤性病学分会, 等. 特应性皮炎基层诊疗指南(2022年) [J].中华全科医师杂志, 2022, 21(7): 609-619. [Chinese Medical Association, Chinese Medical Asscimtion Honse, Dermatology and Venereal Diseases Branch of Chinese Medical Association, et al. Guidelines for the primary diagnosis and treatment of atopic dermatitis (2022)[J]. Chinese Journal of General Practitioners, 2022, 21(7): 609-619.] DOI: 10.3760/cma.j.cn114798-20220215-00102.

2.张珍珍, 李萍, 严星强. 儿童特应性皮炎的流行病学研究现状[J]. 国际流行病学传染病学杂志, 2020, 47(2): 174-177. [Zhang ZZ, Li P, Yan XQ. Current status of epidemiological studies of atopic dermatitis in children[J]. International Journal of Epidemiology and Infectious Diseases, 2020, 47(2): 174-177.]DOI: 10.3760/cma.j.cn331340-20190928-00169.

3.Wu SE, Chen YH, Chung CH, et al. Atopic dermatitis as a risk factor for herpes zoster infection independent of treatment: a nationwide population-based cohort study[J]. Dermatitis, 2023, 34(3): 241-249. DOI: 10.1089/derm.2022.0094.

4.Guo Y, Li P, Tang J, et al. Prevalence of atopic dermatitis in Chinese children aged 1-7 years[J]. Sci Rep, 2016, 6: 29751. DOI: 10.1038/srep29751.

5.Ng YT, Chew FT. A systematic review and Meta-analysis of risk factors associated with atopic dermatitis in Asia[J].World Allergy Organ J, 2020, 13(11): 10047. DOI: 10.1016/j.waojou.2020.100477.

6.王建琴. 中国特应性皮炎诊疗指南(2020版)解读[J]. 皮肤性病诊疗学杂志, 2020, 27(5): 359-361. [Wang JQ. Interpretation of Chinese guidelines for diagnosis and treatment of atopic dermatitis (2020 edition)[J]. Journal of Diagnosis and Treatment on Dermato-venereology, 2020, 27(5): 359-361.] DOI: 10.3969/j.issn.1674-8468.2020.05.016．

7.汪春蕾,朱静,施芬,等. 武汉市学龄前儿童特应性皮炎现况调查及危险因素分析[J]. 实用预防医学, 2021, 28(11): 1388-1391. [Wang CL, Zhu J, Shi F, et al. Investigation on the current status and risk factors of atopic dermatitis in preschool children in Wuhan [J]. Practical Preventive Medicine, 2021, 28 (11): 1388-1391.]DOI: 10.3969/j.issn.1006-3110.2021.11.030.

8.吴媛媛, 郑洁, 肖风丽. 儿童特应性皮炎2 620例疾病严重程度相关因素分析[J]. 中华皮肤科杂志, 2019, 52(12): 915-919. [Wu YY, Zheng J, Xiao FL. Analysis of factors associated with disease severity in 2 620 cases of atopic dermatitis in children[J]. Chinese Journal of Dermatology, 2019, 52(12): 915-919.] DOI: 10.35541/cjd.20190751.

9.Cheng R, Zhang H, Zong W,et al.Development and validation of new diagnostic criteria for atopic dermatitis in children of China[J]. J Eur Acad Dermatol Venereol, 2020, 34(3): 542548. DOI: 10.1111/jdv.15979.

10.中华医学会皮肤性病学分会免疫学组, 特应性皮炎协作研究中心. 中国特应性皮炎诊疗指南(2014版) [J]. 中华皮肤科杂志, 2014, 47(6): 603-606, 615. [Immunology Group, Dermatology Society of Chinese Medical Association, Atopic Dermatitis Collaborative Research Center.  Guidelines for the diagnosis and treatment of atopic dermatitis in China (2014 edition)[J]. Chinese Journal of Dermatology, 2014, 47(6): 603-606, 615.] DOI: 10.13558/j.cnki.issn1672-3686.2014.06.002.

11.Wollenberg A, Barbarot S, Bieber T, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I[J]. J Eur Acad Dermatol Venereol. 2018, 32(6): 657-682. DOI:  10.1111/jdv.14891.

12.Lee NR, Lee HJ, Yoon NY, et al. Acidic water bathing could be a safe and effective therapeutic modality for severe and refractory atopic dermatitis[J]. Ann Dermatol. 2016, 28(1): 126-129. DOI: 10.5021/ad.2016.28.1.126.

13.Kim H, Ban J, Park MR, et al. Effect of bathing on atopic dermatitis during the summer season[J]. Asia Pac Allergy. 2012, 2(4): 269-274. DOI: 10.5415/apallergy.2012.2.4.269.

14.Barbarot S, Auziere S, Gadkari A, et al. Epidemiology of atopic dermatitis in adults: results from an international survey[J]. Allergy, 2018, 73(6): 1284-1293. DOI: 10.1111/all.13401.

15.Tsai TF, Rajagopalan M, Chu CY, et al. Burden of atopic dermatitis in Asia[J]. J Dermatol, 2019, 46(10): 825-834.DOI: 10.1111/1346-8138.15048.

16.Fonacier LS, Aquino MR. The role of contact allergy in atopic dermatitis[J]. Immunol Allergy Clin North Am, 2010, 30(3): 337-350. DOI: 10.1016/j.iac.2010.06.001.

17.Kim JE, Kim HJ, Lew BL, et al. Consensus guidelines for the treatment of atopic dermatitis in Korea (Part I): general management and topical treatment[J]. Ann Dermatol, 2015, 27: 563-577. DOI: 10.5021/ad.2015.27.5.563.

18.Nowicki R, Trzeciak M, Wilkowska A, et al. Atopic dermatitis: current treatment guidelines. Statement of the experts of the Dermatological Section, Polish Society of Allergology, and the Allergology Section, Polish Society of Dermatology[J]. Postepy Dermatol Alergol, 2015, 32: 239-249. DOI: 10.5114/pdia.2015.53319.

19.Tay YK, Chan YC, Chandran NS, et al. Guidelines for the management of atopic dermatitis in Singapore[J]. Ann Acad Med Singap, 2016, 45(10): 439-450. https://pubmed.ncbi.nlm.nih.gov/27832218/.

20.中国医师协会皮肤科医师分会皮肤美容事业发展工作委员会. 中国皮肤清洁指南[J]. 中华皮肤科杂志, 2016, 49(8): 537-540. [Skin Beauty Development Committee of Dermatologist Branch of Chinese Medical Doctor Association. Chinese skin cleansing guidelines[J]. Chinese Journal of Dermatology, 2016, 49(8): 537-540.]DOI: 10.3760/cma.j.issn.0412-4030.2016.08.003.

21.Li W, Xu X, Wen H, et al. Inverse association between the skin and oral microbiota in atopic dermatitis[J]. J Invest Dermatol, 2019, 139(8): 1779-1787. DOI: 10.1016/j.jid.2019.02.009.

22.张小敏, 刘惠丹, 谢思光, 等. 特应性皮炎患儿对皮肤屏障修复剂的依从性[J]. 国际医药卫生导报, 2019, 25(16): 2649-2651. [Zhang XM, Liu HD, Xie SG, et al. Adherence to skin barrier repair agents in children with atopic dermatitis[J]. International Medicine and Health Guidance News, 2019, 25(16): 2649-2651.] DOI: 10.3760/cma.j.issn.1007-1245.2019.16.007.

23.Wollenberg A, Bieber T. Proactive therapy of atopic dermatitis-- an emerging concept[J]. Allergy, 2009, 64(2): 276-278. DOI: 10.1111/j.1398-9995.2008.01803.x.

24.曾颖, 高春芳, 付桂莉, 等. 鱼肝油软膏联合地奈德乳膏治疗儿童变应性接触性皮炎疗效及皮肤屏障修复作用研究[J]. 药物流行病学杂志, 2023, 32(8): 856-861. [Zeng Y, Gao CF, Fu GL, et al. Effect of cod liver oil ointment combined with desonide cream on allergic contact dermatitis in children and skin barrier repair[J]. Journal of Pharmacoepidemiology, 2023, 32(8): 856-861.] DOI: 10.19960/j.issn.1005-0698.202308003.

25.中华医学会皮肤性病学分会儿童学组, 中国医师协会皮肤科医师分会儿童皮肤病专业委员会. 功效性护肤品在儿童特应性皮炎中的应用指南[J]. 中国皮肤性病学杂志, 2020, 34(9): 977-981. [Pediatric Group of the Dermatology and Venereology Branch of the Chinese Medical Association, Pediatric Dermatology Professional Committee of the Dermatologists Branch of the Chinese Medical Associationl. Guidelines for the application of efficacy skin care products in atopic dermatitis in children[J]. The Chinese Journal of Dermatovenereology , 2020, 34(9): 977-981.] DOI: 10.13735/j.cjdv.1001-7089.202006019.

26.袁勇勇, 郑捷, 张婷, 等. 银屑病的皮肤护理治疗[J]. 实用皮肤病学杂志, 2019, 12(4): 240-241, 248.[Yuan YY, Zheng J, Zhang T, et al. Skin care treatment of psoriasis[J]. Journal of Practical Dermatology, 2019, 12(4): 240-241, 248.] DOI: 10.11786/syptbxzz.1674-1293.20190414.

27.赵蓓蕾, 毛东方. 知信行理念下的护理对银屑病患者外用药物依从性的影响[J]. 山东医学高等专科学校学报, 2021, 43(1): 45-46. [Zhao BL, Mao DF. The influence of nursing under the concept of communication on the compliance of topical drugs in psoriasis patients[J]. Journal of Shandong Medical College, 2021, 43(1): 45-46. ] DOI: 10.3969/j.issn.1679-0947.2021.01.023.

28.陈赟, 李顶峰, 张玉, 等. 皮肤科外用药物涂抹箱的设计与应用[J]. 中西医结合护理(中英文), 2020, 6(6): 125-126.  [Chen Y, Li DF, Zhang Y, et al. Design and application of smear boxes for topical drugs in dermatology[J]. Journal of Clinical Nursing in Practice, 2020, 6(6): 125-126.] DOI: 10.11997/nitcwm.202006027.

29.刘亚楠. 个体化护理对特应性皮炎的临床疗效和生活质量影响研究[J]. 皮肤病与性病, 2019, 41(2): 296-297. [Liu YN. Study on the clinical efficacy and quality of life impact of individualized care on atopic dermatitis[J]. Journal of Dermatology and Venereology, 2019, 41(2): 296-297.] DOI: 10.3969/j.issn.1002-1310.2019.02.082.

30.Belkaid Y, Tamoutounour S. The influence of skin microorganisms on cutaneous immunity[J]. Nat Rev Immunol, 2016, 16(6): 353-366. DOI: 10.1038/nri.2016.48.

31.Dainichi T, Kitoh A, Otsuka A, et al. The epithelial immune microenvironment (EIME) in atopic dermatitis and psoriasis[J]. Nat Immunol, 2018, 19(12): 1286-1298. DOI: 10.1038/s41590-018-0256-2.

32.Nakamizo S, Egawa G, Honda T, et al. Commensal bacteria and cutaneous immunity[J]. Semin Immunopathol，2015, 37(1): 73-80.DOI: 10.1007/s00281-014-0452-6.

33.刘保光, 谢苗, 董颖, 等. 金黄色葡萄球菌研究现状 [J]. 动物医学进展, 2021, 42(4): 128-130. [Liu BG, Xie M, Dong Y, et al. Current research status of Staphylococcus aureus[J]. Progress in Veterinary Medicine, 2021, 42(4): 128-130.] DOI: 10.16437/j.cnki. 1007-5038.2021.04.026.

34.刘正强, 余红. 洗浴在儿童特应性皮炎中应用的研究进展[J]. 协和医学杂志, 2023, 14(4): 850-854. [Liu ZQ, Yu H. Progress in the application of bathing in pediatric atopic dermatitis[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 850-854.] DOI: 10.12290/xhyxzz.2022-0427.