vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v19i6.2144vsp-2446Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCEВлияние климата на течение атопического дерматита и возможности терапевтической коррекцииClimatic Effect on Atopic Dermatitis Course and Therapeutic Capabilitieshttps://orcid.org/0000-0003-2252-8570МурашкинН. Н.MurashkinNikolay N.

Мурашкин Николай Николаевич, доктор медицинских наук, заведующий отделением дерматологии с группой лазерной хирургии, заведующий лабораторией патологии кожи у детей отдела научных исследований в педиатрии НМИЦ здоровья детей, профессор кафедры дерматовенерологии и косметологии ЦГМА, профессор кафедры педиатрии и детской ревматологии Первого МГМУ им. И.М. Сеченова, заведующий отделом детской дерматологии НИИ педиатрии и охраны здоровья детей ЦКБ РАН

119296, Москва, Ломоносовский пр-т, д. 2, стр. 1

Moscow

m_nn2001@mail.ruhttps://orcid.org/0000-0002-4107-4642ЕпишевР. В.EpishevRoman V.https://orcid.org/0000-0002-6034-8231МатерикинА. И.MaterikinAlexander I.https://orcid.org/0000-0002-8232-8936АмбарчянЭ. Т.AmbarchyanEduard T.https://orcid.org/0000-0002-0858-8780ОпрятинЛ. А.OpryatinLeonid A.https://orcid.org/0000-0002-0081-0981ИвановР. А.IvanovRoman A.https://orcid.org/0000-0002-1450-4942БакулевА. Л.BakulevAndrey L.Национальный медицинский исследовательский центр здоровья детей Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет); Центральная государственная медицинская академия Управления делами Президента РФ; НИИ педиатрии и охраны здоровья детей ЦКБ РАНРоссияNational Medical Research Center of Children’s Health Sechenov First Moscow State Medical University (Sechenov University); Central State Medical Academy of Department of Presidential Affairs; Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”Russian FederationНациональный медицинский исследовательский центр здоровья детейРоссияNational Medical Research Center of Children’s HealthRussian FederationСаратовский государственный медицинский университет им. В.И. РазумовскогоRussian FederationSaratov State Medical University n.a. V.I. RazumovskyRussian Federation202002092020196520525Copyright © Мурашкин Н.Н., Епишев Р.В., Материкин А.И., Амбарчян Э.Т., Опрятин Л.А., Иванов Р.А., Бакулев А.Л., 20202020Мурашкин Н.Н., Епишев Р.В., Материкин А.И., Амбарчян Э.Т., Опрятин Л.А., Иванов Р.А., Бакулев А.Л.Murashkin N.N., Epishev R.V., Materikin A.I., Ambarchyan E.T., Opryatin L.A., Ivanov R.A., Bakulev A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2446

Атопический дерматит (АтД) — хроническое рецидивирующее воспалительное заболевание кожи с высокой распространенностью и значимым негативным влиянием на качество жизни пациентов. Патогенез АтД обусловлен сложным взаимодействием факторов генетической природы, иммунных механизмов, состояния кожного барьера и воздействия окружающей среды. Климат представляет собой совокупность многих компонентов: температуры, влажности, осадков, ветра и времени года. Все они играют фундаментальную роль в формировании естественной экосистемы и здоровья человека. Климат быстро меняется, и изменения прогрессируют быстрее, чем когда-либо за последнюю тысячу лет. В обзоре рассмотрено, как изменения климата и факторов окружающей среды могут влиять на течение АтД. Приведены данные об эффективности использования «эмолентов плюс» для нивелирования последствий негативного влияния неблагоприятных климатических условий на эпидермальные структуры при АтД.

Atopic dermatitis (AD) is chronic recurrent inflammatory skin disease with a high prevalence and significant negative effect on patients' quality of life. AD pathogenesis is based on the complex interactions between genetic factors, immune mechanisms, state of the skin barrier and environmental effects. The climate itself is the complex of many components, such as: temperature, humidity, precipitation, wind and season. All of them play fundamental role in the natural ecosystem and human health establishment. The climate is changing rapidly, and these changes are progressing faster than ever in the last thousand years. This review shows how climate and environmental changes can affect the course of AD. The data on utilization efficiency of emollient plus for moderating of climatic conditions adverse effects on epidermal structures at patients with AD is presented.

атопический дерматитклиматмикробиомдетиatopic dermatitisclimatemicrobiomechildrenСтатья опубликована при поддержке ООО «Пьер Фабр».The article has been supported by Pierre Fabre LLCReferencesCook J, Nuccitelli D, Green SA, et al. Quantifying the consensus on anthropogenic global warming in the scientific literature. Environ Res Lett. 2013;8(2):024024. doi: 10.1088/1748-9326/8/2/024024.Cook J, Nuccitelli D, Green SA, et al. Quantifying the consensus on anthropogenic global warming in the scientific literature. Environ Res Lett. 2013;8(2):024024. doi: 10.1088/1748-9326/8/2/024024.Sanchez-Lugo A, Berrisford P, Morice C. Surface temperature [in ‘‘State of the Climate in 2014’’]. Bull Amer Meteor Soc. 2015; 96(7): S9–S14.Sanchez-Lugo A, Berrisford P, Morice C. Surface temperature [in ‘‘State of the Climate in 2014’’]. Bull Amer Meteor Soc. 2015; 96(7): S9–S14.IPCC 2007: Summary for Policymakers. In: Metz B, Davidsson OR, Bosch PR, Dave LAM R, eds. Climate change 2007: mitigation contribution of working group III to the fourth assessment report of the Intergovernmental Panel on Climate Change. Cambridge (United Kingdom) and New York (NY): Cambridge University Press; 2007. pp. 1–19.IPCC 2007: Summary for Policymakers. In: Metz B, Davidsson OR, Bosch PR, Dave LAM R, eds. Climate change 2007: mitigation contribution of working group III to the fourth assessment report of the Intergovernmental Panel on Climate Change. Cambridge (United Kingdom) and New York (NY): Cambridge University Press; 2007. pp. 1–19.McCoy D, Hoskins B. The science of anthropogenic climate change: what every doctor should know. BMJ. 2014;349:g5178. doi: 10.1136/bmj.g5178.McCoy D, Hoskins B. The science of anthropogenic climate change: what every doctor should know. BMJ. 2014;349:g5178. doi: 10.1136/bmj.g5178.Woodward A, Smith KR, Campbell-Lendrum D, et al. Climate change and health: on the latest IPCC report. Lancet. 2014; 383(9924):1185–1189. doi: 10.1016/S0140-6736(14)60576-6.Woodward A, Smith KR, Campbell-Lendrum D, et al. Climate change and health: on the latest IPCC report. Lancet. 2014; 383(9924):1185–1189. doi: 10.1016/S0140-6736(14)60576-6.Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023): 1109–1122. doi: 10.1016/S0140-6736(15)00149-X.Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023): 1109–1122. doi: 10.1016/S0140-6736(15)00149-X.Murota H, Katayama I. Exacerbating factors of itch in atopic dermatitis. Allergol Int. 2017;66(1):8–13. doi: 10.1016/j.alit.2016.10.005.Murota H, Katayama I. Exacerbating factors of itch in atopic dermatitis. Allergol Int. 2017;66(1):8–13. doi: 10.1016/j.alit.2016.10.005.Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537): 733–743. doi: 10.1016/S0140-6736(06)69283-0. Erratum in: Lancet. 2007;370(9593):1128. doi: 10.1016/S0140-6736(07)61513-X.Asher MI, Montefort S, Bjorksten B, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537): 733–743. doi: 10.1016/S0140-6736(06)69283-0. Erratum in: Lancet. 2007;370(9593):1128. doi: 10.1016/S0140-6736(07)61513-X.Odhiambo JA, Williams HC, Clayton TO, et al. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. 2009;124:1251–1258.e23. doi: 10.1016/j.jaci.2009.10.009.Odhiambo JA, Williams HC, Clayton TO, et al. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. 2009;124:1251–1258.e23. doi: 10.1016/j.jaci.2009.10.009.Mei-Yen Yong A, Tay YK. Atopic dermatitis: racial and ethnic differences. Dermatol Clin. 2017;35(3):395–402. doi: 10.1016/j.det.2017.02.012.Mei-Yen Yong A, Tay YK. Atopic dermatitis: racial and ethnic differences. Dermatol Clin. 2017;35(3):395–402. doi: 10.1016/j.det.2017.02.012.Silverberg JI. Public health burden and epidemiology of atopic dermatitis. Dermatol Clin. 2017;35(3):283–289. doi: 10.1016/j.det.2017.02.002.Silverberg JI. Public health burden and epidemiology of atopic dermatitis. Dermatol Clin. 2017;35(3):283–289. doi: 10.1016/j.det.2017.02.002.Palmer CN, Irvine AD, Terron-Kwiatkowski A, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–446. doi: 10.1038/ng1767.Palmer CN, Irvine AD, Terron-Kwiatkowski A, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–446. doi: 10.1038/ng1767.Carson CG, Rasmussen MA, Thyssen JP, et al. Clinical presentation of atopic dermatitis by filaggrin gene mutation status during the first 7 years of life in a prospective cohort study. PLoS ONE. 2012; 7(11):e48678. doi: 10.1371/journal.pone.0048678.Carson CG, Rasmussen MA, Thyssen JP, et al. Clinical presentation of atopic dermatitis by filaggrin gene mutation status during the first 7 years of life in a prospective cohort study. PLoS ONE. 2012; 7(11):e48678. doi: 10.1371/journal.pone.0048678.Nemoto-Hasebe I, Akiyama M, Nomura T, et al. Clinical severity correlates with impaired barrier in filaggrin-related eczema. J Invest Dermatol. 2009;129(3):682–689. doi: 10.1038/jid.2008.280.Nemoto-Hasebe I, Akiyama M, Nomura T, et al. Clinical severity correlates with impaired barrier in filaggrin-related eczema. J Invest Dermatol. 2009;129(3):682–689. doi: 10.1038/jid.2008.280.Sasaki T, Furusyo N, Shiohama A, et al. Filaggrin loss-offunction mutations are not a predisposing factor for atopic dermatitis in an Ishigaki Island under subtropical climate. J Dermatol Sci. 2014; 76(1):10–15. doi: 10.1016/j.jdermsci.2014.06.004.Sasaki T, Furusyo N, Shiohama A, et al. Filaggrin loss-offunction mutations are not a predisposing factor for atopic dermatitis in an Ishigaki Island under subtropical climate. J Dermatol Sci. 2014; 76(1):10–15. doi: 10.1016/j.jdermsci.2014.06.004.Rodriguez E, Baurecht H, Herberich E, et al. Meta-analysis of filaggrin polymorphisms in eczema and asthma: robust risk factors in atopic disease. J Allergy Clin Immunol. 2009; 123: 1361–1370. e7. doi: 10.1016/j.jaci.2009.03.036.Rodriguez E, Baurecht H, Herberich E, et al. Meta-analysis of filaggrin polymorphisms in eczema and asthma: robust risk factors in atopic disease. J Allergy Clin Immunol. 2009; 123: 1361–1370. e7. doi: 10.1016/j.jaci.2009.03.036.van Mierlo MMF, Totte JEE, Fieten KB, et al. The influence of treatment in alpine and moderate maritime climate on the composition of the skin microbiome in patients with difficult to treat atopic dermatitis. Clin Exp Allergy. 2019;49(11):1437–1445. doi: 10.1111/cea.13492.van Mierlo MMF, Totte JEE, Fieten KB, et al. The influence of treatment in alpine and moderate maritime climate on the composition of the skin microbiome in patients with difficult to treat atopic dermatitis. Clin Exp Allergy. 2019;49(11):1437–1445. doi: 10.1111/cea.13492.Kong HH, Oh J, Deming C, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22(5):850–859. doi: 10.1101/gr.131029.111.Kong HH, Oh J, Deming C, et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22(5):850–859. doi: 10.1101/gr.131029.111.Gonzalez ME, Schaffer JV, Orlow SJ, et al. Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis. J Am Acad Dermatol. 2016; 75(3):481–493.e8. doi: 10.1016/j.jaad.2016.04.066.Gonzalez ME, Schaffer JV, Orlow SJ, et al. Cutaneous microbiome effects of fluticasone propionate cream and adjunctive bleach baths in childhood atopic dermatitis. J Am Acad Dermatol. 2016; 75(3):481–493.e8. doi: 10.1016/j.jaad.2016.04.066.Vocks E. Climatotherapy in atopic eczema. In: Ring J, Ruzicka T, eds. Handbook of atopic eczema. Berlin, Heidelberg: SpringerVerlag; 2006. pp. 507–523. doi: 10.1007/3-540-29856-8.Vocks E. Climatotherapy in atopic eczema. In: Ring J, Ruzicka T, eds. Handbook of atopic eczema. Berlin, Heidelberg: SpringerVerlag; 2006. pp. 507–523. doi: 10.1007/3-540-29856-8.Rijssenbeek-Nouwens LH, Bel EH. High-altitude treatment: a therapeutic option for patients with severe, refractory asthma? Clin Exp Allergy. 2011;41(6):775–782. doi: 10.1111/j.1365-2222.2011.03733.x.Rijssenbeek-Nouwens LH, Bel EH. High-altitude treatment: a therapeutic option for patients with severe, refractory asthma? Clin Exp Allergy. 2011;41(6):775–782. doi: 10.1111/j.1365-2222.2011.03733.x.Fieten KB, Weststrate AC, van Zuuren EJ, et al. Alpine climate treatment of atopic dermatitis: a systematic review. Allergy. 2015;70(1):12–25. doi: 10.1111/all.12514.Fieten KB, Weststrate AC, van Zuuren EJ, et al. Alpine climate treatment of atopic dermatitis: a systematic review. Allergy. 2015;70(1):12–25. doi: 10.1111/all.12514.Heeringa JJ, Fieten KB, Bruins FM, et al. Treatment for moderate to severe atopic dermatitis in alpine and moderate maritime climates differentially affects helper T cells and memory B cells in children. Clin Exp Allergy. 2018;48(6):679–690. doi: 10.1111/cea.13136.Heeringa JJ, Fieten KB, Bruins FM, et al. Treatment for moderate to severe atopic dermatitis in alpine and moderate maritime climates differentially affects helper T cells and memory B cells in children. Clin Exp Allergy. 2018;48(6):679–690. doi: 10.1111/cea.13136.Simon D, Borelli S. The effects of high altitude climate therapy. Phys Med Rehab Kuror. 2001;11(3):104–109.Simon D, Borelli S. The effects of high altitude climate therapy. Phys Med Rehab Kuror. 2001;11(3):104–109.Pearse AD, Gaskell SA, Marks R. Epidermal changes in human skin following irradiation with either UVB or UVA. J Invest Dermatol. 1987;88(1):83–87. doi: 10.1111/1523-1747.ep12465094.Pearse AD, Gaskell SA, Marks R. Epidermal changes in human skin following irradiation with either UVB or UVA. J Invest Dermatol. 1987;88(1):83–87. doi: 10.1111/1523-1747.ep12465094.Hong SP, Kim MJ, Jung MY, et al. Biopositive effects of lowdose UVB on epidermis: coordinate upregulation of antimicrobial peptides and permeability barrier reinforcement. J Invest Dermatol. 2008;128(12):2880–2887. doi: 10.1038/jid.2008.169.Hong SP, Kim MJ, Jung MY, et al. Biopositive effects of lowdose UVB on epidermis: coordinate upregulation of antimicrobial peptides and permeability barrier reinforcement. J Invest Dermatol. 2008;128(12):2880–2887. doi: 10.1038/jid.2008.169.Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy. 2014;69(1):3–16. doi: 10.1111/all.12270.Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy. 2014;69(1):3–16. doi: 10.1111/all.12270.Hart PH, Gorman S, Finlay-Jones JJ. Modulation of the immune system by UV radiation: more than just the effects of vitamin D? Nat Rev Immunol. 2011;11(9):584–596. doi: 10.1038/nri3045.Hart PH, Gorman S, Finlay-Jones JJ. Modulation of the immune system by UV radiation: more than just the effects of vitamin D? Nat Rev Immunol. 2011;11(9):584–596. doi: 10.1038/nri3045.Круглова Л.С., Котенко К.В., Корчажкина Н.Б., Турбовская С.Н. Физиотерапия в детской дерматологии. — М.: ГЭОТАР; 2017. — 304 с.Kruglova LS, Kotenko KV, Korchazhkina NB, Turbovskaya SN. Fizioterapiya v detskoi dermatologii. Moscow: GEOTAR; 2017. 304 p. (In Russ).Patra V, Byrne SN, Wolf P. The skin microbiome: is it affected by UV-induced immune suppression? Front Microbiol. 2016;7:1235. doi: 10.3389/fmicb.2016.01235.Patra V, Byrne SN, Wolf P. The skin microbiome: is it affected by UV-induced immune suppression? Front Microbiol. 2016;7:1235. doi: 10.3389/fmicb.2016.01235.Thyssen JP, Zirwas MJ, Elias PM. Potential role of reduced environmental UV exposure as a driver of the current epidemic of atopic dermatitis. J Allergy Clin Immunol. 2015;136(5):1163–1169. doi: 10.1016/j.jaci.2015.06.042.Thyssen JP, Zirwas MJ, Elias PM. Potential role of reduced environmental UV exposure as a driver of the current epidemic of atopic dermatitis. J Allergy Clin Immunol. 2015;136(5):1163–1169. doi: 10.1016/j.jaci.2015.06.042.Wang Y, Zhu W, Shu M, et al. The response of human skin commensal bacteria as a reflection of UV radiation: UVB decreases porphyrin production. PLoS One. 2012;7(10):e47798. doi: 10.1371/journal.pone.0047798.Wang Y, Zhu W, Shu M, et al. The response of human skin commensal bacteria as a reflection of UV radiation: UVB decreases porphyrin production. PLoS One. 2012;7(10):e47798. doi: 10.1371/journal.pone.0047798.Ullrich SE, Byrne SN. The immunologic revolution: photoimmunology. J Invest Dermatol. 2012;132(3 Pt 2):896–905. doi: 10.1038/jid.2011.405.Ullrich SE, Byrne SN. The immunologic revolution: photoimmunology. J Invest Dermatol. 2012;132(3 Pt 2):896–905. doi: 10.1038/jid.2011.405.Hancox JG, Sheridan SC, Feldman SR, et al. Seasonal variation of dermatologic disease in the USA: a study of office visits from 1990 to 1998. Int J Dermatol 2004;43(1):6–11. doi: 10.1111/j.1365-4632.2004.01828.x.Hancox JG, Sheridan SC, Feldman SR, et al. Seasonal variation of dermatologic disease in the USA: a study of office visits from 1990 to 1998. Int J Dermatol 2004;43(1):6–11. doi: 10.1111/j.1365-4632.2004.01828.x.Nilsson L, Bjorksten B, Hattevig G, et al. Season of birth as predictor of atopic manifestations. Arch Dis Child. 1997;76(4): 341–344. doi: 10.1136/adc.76.4.341.Nilsson L, Bjorksten B, Hattevig G, et al. Season of birth as predictor of atopic manifestations. Arch Dis Child. 1997;76(4): 341–344. doi: 10.1136/adc.76.4.341.Kuzume K, Kusu M. Before-birth climatologic data may play a role in the development of allergies in infants. Pediatr Allergy Immunol. 2007;18(4):281–287. doi: 10.1111/j.1399-3038.2006.00526.x.Kuzume K, Kusu M. Before-birth climatologic data may play a role in the development of allergies in infants. Pediatr Allergy Immunol. 2007;18(4):281–287. doi: 10.1111/j.1399-3038.2006.00526.x.Suarez-Varela MM, Garcia-Marcos Alvarez L, Kogan MD, et al. Climate and prevalence of atopic eczema in 6- to 7-year-old school children in Spain. ISAAC phase III. Int J Biometeorol. 2008; 52(8):833–840. doi: 10.1007/s00484-008-0177-0.Suarez-Varela MM, Garcia-Marcos Alvarez L, Kogan MD, et al. Climate and prevalence of atopic eczema in 6- to 7-year-old school children in Spain. ISAAC phase III. Int J Biometeorol. 2008; 52(8):833–840. doi: 10.1007/s00484-008-0177-0.Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol. 2013;133(7):1752–1759. doi: 10.1038/jid.2013.19.Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol. 2013;133(7):1752–1759. doi: 10.1038/jid.2013.19.Yura A, Shimizu T. Trends in the prevalence of atopic dermatitis in school children: longitudinal study in Osaka Prefecture, Japan, from 1985 to 1997. Br J Dermatol. 2001;145(6):966–973. doi: 10.1046/j.1365-2133.2001.04506.x.Yura A, Shimizu T. Trends in the prevalence of atopic dermatitis in school children: longitudinal study in Osaka Prefecture, Japan, from 1985 to 1997. Br J Dermatol. 2001;145(6):966–973. doi: 10.1046/j.1365-2133.2001.04506.x.Wang X, Li L-F, Zhao D-Y, ShenY-W. Prevalence and clinical features of atopic dermatitis in China. Biomed Res Int. 2016; 2016:2568301. doi: 10.1155/2016/2568301.Wang X, Li L-F, Zhao D-Y, ShenY-W. Prevalence and clinical features of atopic dermatitis in China. Biomed Res Int. 2016; 2016:2568301. doi: 10.1155/2016/2568301.Dhar S, Kanwar AJ. Epidemiology and clinical pattern of atopic dermatitis in a North Indian pediatric population. Pediatr Dermatol. 1998; 15(5):347–351. doi: 10.1046/j.1525-1470.1998.1998015347.x.Dhar S, Kanwar AJ. Epidemiology and clinical pattern of atopic dermatitis in a North Indian pediatric population. Pediatr Dermatol. 1998; 15(5):347–351. doi: 10.1046/j.1525-1470.1998.1998015347.x.Kathuria P, Silverberg JI. Association of pollution and climate with atopic eczema in US children. Pediatr Allergy Immunol. 2016; 27(5):478–485. doi: 10.1111/pai.12543.Kathuria P, Silverberg JI. Association of pollution and climate with atopic eczema in US children. Pediatr Allergy Immunol. 2016; 27(5):478–485. doi: 10.1111/pai.12543.Remes ST, Korppi M, Kajosaari M, et al. Prevalence of allergic rhinitis and atopic dermatitis among children in four regions of Finland. Allergy. 1998;53(7):682–689. doi: 10.1111/j.1398-9995.1998.tb03954.x.Remes ST, Korppi M, Kajosaari M, et al. Prevalence of allergic rhinitis and atopic dermatitis among children in four regions of Finland. Allergy. 1998;53(7):682–689. doi: 10.1111/j.1398-9995.1998.tb03954.x.Osborne NJ, Ukoumunne OC, Wake M, Allen KJ. Prevalence of eczema and food allergy is associated with latitude in Australia. J Allergy Clin Immunol. 2012;129(3):865–867. doi: 10.1016/j.jaci.2012.01.037.Osborne NJ, Ukoumunne OC, Wake M, Allen KJ. Prevalence of eczema and food allergy is associated with latitude in Australia. J Allergy Clin Immunol. 2012;129(3):865–867. doi: 10.1016/j.jaci.2012.01.037.Langan SM, Silcocks P, Williams HC. What causes flares of eczema in children? Br J Dermatol. 2009;161(3):640–646. doi: 10.1111/j.1365-2133.2009.09320.x.Langan SM, Silcocks P, Williams HC. What causes flares of eczema in children? Br J Dermatol. 2009;161(3):640–646. doi: 10.1111/j.1365-2133.2009.09320.x.Kramer U, Weidinger S, Darsow U, et al. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005;124(3): 514–523. doi: 10.1111/j.0022-202X.2005.23625.x.Kramer U, Weidinger S, Darsow U, et al. Seasonality in symptom severity influenced by temperature or grass pollen: results of a panel study in children with eczema. J Invest Dermatol. 2005;124(3): 514–523. doi: 10.1111/j.0022-202X.2005.23625.x.Sargen MR, Hoffstad O, Margolis DJ. Warm, humid, and high sun exposure climates are associated with poorly controlled eczema: PEER (Pediatric Eczema Elective Registry) cohort, 2004–2012. J Invest Dermatol. 2014;134(1):51–57. doi: 10.1038/jid.2013.274. Erratum in: J Invest Dermatol. 2014;134(6):1779.Sargen MR, Hoffstad O, Margolis DJ. Warm, humid, and high sun exposure climates are associated with poorly controlled eczema: PEER (Pediatric Eczema Elective Registry) cohort, 2004–2012. J Invest Dermatol. 2014;134(1):51–57. doi: 10.1038/jid.2013.274. Erratum in: J Invest Dermatol. 2014;134(6):1779.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 Eur Acad Dermatol Venereol. 2018;32(5):657–682. doi: 10.1111/jdv.14891.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 Eur Acad Dermatol Venereol. 2018;32(5):657–682. doi: 10.1111/jdv.14891.Chrostowska-Plak D, Reich A, Szepietowski JC. Relationship between itch and psychological status of patients with atopic dermatitis. J Eur Acad Dermatol Venereol. 2013;27(2):e239–e242. doi: 10.1111/j.1468-3083.2012.04578.x.Chrostowska-Plak D, Reich A, Szepietowski JC. Relationship between itch and psychological status of patients with atopic dermatitis. J Eur Acad Dermatol Venereol. 2013;27(2):e239–e242. doi: 10.1111/j.1468-3083.2012.04578.x.Darsow U, Scharein E, Simon D, et al. New aspects of itch pathophysiology: component analysis of atopic itch using the ‘Eppendorf Itch Questionnaire’. Int Arch Allergy Immunol. 2001;124(1–3): 326–331. doi: 10.1159/000053748.Darsow U, Scharein E, Simon D, et al. New aspects of itch pathophysiology: component analysis of atopic itch using the ‘Eppendorf Itch Questionnaire’. Int Arch Allergy Immunol. 2001;124(1–3): 326–331. doi: 10.1159/000053748.McGlone F, Reilly D. The cutaneous sensory system. Neurosci Biobehav Rev. 2010;34(2):148–159. doi: 10.1016/j.neubiorev.2009.08.004.McGlone F, Reilly D. The cutaneous sensory system. Neurosci Biobehav Rev. 2010;34(2):148–159. doi: 10.1016/j.neubiorev.2009.08.004.Wilson SR, Thes L, Batia LM, et al. Epithelial cell-derived atopic dermatitis cytokine TSLP activates neurons to induce itch. Cell. 2013;155(2):285–295. doi: 10.1016/j.cell.2013.08.057.Wilson SR, Thes L, Batia LM, et al. Epithelial cell-derived atopic dermatitis cytokine TSLP activates neurons to induce itch. Cell. 2013;155(2):285–295. doi: 10.1016/j.cell.2013.08.057.Pfab F, Valet M, Sprenger T, et al. Temperature modulated histamine-itch in lesional and nonlesional skin in atopic eczema — a combined psychophysical and neuroimaging study. Allergy. 2010;65(1):84–94. doi: 10.1111/j.1398-9995.2009.02163.x.Pfab F, Valet M, Sprenger T, et al. Temperature modulated histamine-itch in lesional and nonlesional skin in atopic eczema — a combined psychophysical and neuroimaging study. Allergy. 2010;65(1):84–94. doi: 10.1111/j.1398-9995.2009.02163.x.Vocks E, Busch R, Froehlich C, et al. Influence of weather and climate on subjective symptom intensity in atopic eczema. Int J Biometeorol. 2001;45(1):27–33. doi: 10.1007/s004840000077.Vocks E, Busch R, Froehlich C, et al. Influence of weather and climate on subjective symptom intensity in atopic eczema. Int J Biometeorol. 2001;45(1):27–33. doi: 10.1007/s004840000077.Lukas A, Wolf G, Folster-Holst R. Special features of topical and systemic dermatologic therapy in children. J Dtsch Dermatol Ges. 2006;4(8):658–678; quiz 679–680. doi: 10.1111/j.1610-0387.2006.05995.x.Lukas A, Wolf G, Folster-Holst R. Special features of topical and systemic dermatologic therapy in children. J Dtsch Dermatol Ges. 2006;4(8):658–678; quiz 679–680. doi: 10.1111/j.1610-0387.2006.05995.x.Stamatas GN, Nikolovski J, Mack MC, Kollias N. Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. Int J Cosmet Sci. 2011; 33(1):17–24. doi: 10.1111/j.1468-2494.2010.00611.x.Stamatas GN, Nikolovski J, Mack MC, Kollias N. Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. Int J Cosmet Sci. 2011; 33(1):17–24. doi: 10.1111/j.1468-2494.2010.00611.x.Nikolovski J, Stamatas GN, Kollias N, Wiegand BC. Barrier function and water-holding and transport properties of infant stratum corneum are different from adult and continue to develop through the first year of life. J Invest Dermatol. 2008;128(7):1728–1736. doi: 10.1038/sj.jid.5701239.Nikolovski J, Stamatas GN, Kollias N, Wiegand BC. Barrier function and water-holding and transport properties of infant stratum corneum are different from adult and continue to develop through the first year of life. J Invest Dermatol. 2008;128(7):1728–1736. doi: 10.1038/sj.jid.5701239.Ortiz de Frutos FJ, Torrelo A, de Lucas R, et al. Patient perspectives on triggers, adherence to medical recommendations, and disease control in atopic dermatitis: the DATOP study. Actas Dermosifiliogr. 2014;105(5):487–496. doi: 10.1016/j.ad.2014.01.004.Ortiz de Frutos FJ, Torrelo A, de Lucas R, et al. Patient perspectives on triggers, adherence to medical recommendations, and disease control in atopic dermatitis: the DATOP study. Actas Dermosifiliogr. 2014;105(5):487–496. doi: 10.1016/j.ad.2014.01.004.Andersen LK, Hercogova J, Wollina U, Davis MDP. Climate change and skin disease: a review of the English-language literature. Int J Dermatol. 2012;51(6):656–661; quiz 659, 661. doi: 10.1111/j.1365-4632.2011.05258.x.Andersen LK, Hercogova J, Wollina U, Davis MDP. Climate change and skin disease: a review of the English-language literature. Int J Dermatol. 2012;51(6):656–661; quiz 659, 661. doi: 10.1111/j.1365-4632.2011.05258.x.Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017;13(1):15–26. doi: 10.1080/1744666X.2016.1212660.Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017;13(1):15–26. doi: 10.1080/1744666X.2016.1212660.Engebretsen KA, Johansen JD, Kezic S, et al. The effect of environmental humidity and temperature on skin barrier function and dermatitis. J Eur Acad Dermatol Venereol. 2016;30(2):223–249. doi: 10.1111/jdv.13301.Engebretsen KA, Johansen JD, Kezic S, et al. The effect of environmental humidity and temperature on skin barrier function and dermatitis. J Eur Acad Dermatol Venereol. 2016;30(2):223–249. doi: 10.1111/jdv.13301.Foelster-Holst R, Galecka J, Weißmantel S, et al. Birch pollen influence the severity of atopic eczema — prospective clinical cohort pilot study and ex vivo penetration study. Clin Cosmet Investig Dermatol. 2015;8:539–548. doi: 10.2147/CCID.S81700.Foelster-Holst R, Galecka J, Weißmantel S, et al. Birch pollen influence the severity of atopic eczema — prospective clinical cohort pilot study and ex vivo penetration study. Clin Cosmet Investig Dermatol. 2015;8:539–548. doi: 10.2147/CCID.S81700.Lee YL, Su HJ, Sheu HM, et al. Traffic-related air pollution, climate, and prevalence of eczema in Taiwanese school children. J Invest Dermatol. 2008;128(1):2412–2420. doi: 10.1038/jid.2008.110.Lee YL, Su HJ, Sheu HM, et al. Traffic-related air pollution, climate, and prevalence of eczema in Taiwanese school children. J Invest Dermatol. 2008;128(1):2412–2420. doi: 10.1038/jid.2008.110.Huss-Marp J, Eberlein-Koenig B, Breuer K, et al. Influence of short-term exposure to airborne Der p 1 and volatile organic compounds on skin barrier function and dermal blood flow in patients with atopic eczema and healthy individuals. Clin Exp Allergy. 2006;36(3):338–345. doi: 10.1111/j.1365-2222.2006.02448.x.Huss-Marp J, Eberlein-Koenig B, Breuer K, et al. Influence of short-term exposure to airborne Der p 1 and volatile organic compounds on skin barrier function and dermal blood flow in patients with atopic eczema and healthy individuals. Clin Exp Allergy. 2006;36(3):338–345. doi: 10.1111/j.1365-2222.2006.02448.x.Song S, Lee K, Lee YM, et al. Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis. Environ Res. 2011;111(3):394–399. doi: 10.1016/j.envres.2010.10.010.Song S, Lee K, Lee YM, et al. Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis. Environ Res. 2011;111(3):394–399. doi: 10.1016/j.envres.2010.10.010.Kim EH, Kim S, Lee JH, et al. Indoor air pollution aggravates symptoms of atopic dermatitis in children. PLoS ONE. 2015; 10(3):e0119501. doi: 10.1371/journal.pone.0119501.Kim EH, Kim S, Lee JH, et al. Indoor air pollution aggravates symptoms of atopic dermatitis in children. PLoS ONE. 2015; 10(3):e0119501. doi: 10.1371/journal.pone.0119501.Kim J, Kim EH, Oh I, et al. Symptoms of atopic dermatitis are influenced by outdoor air pollution. J Allergy Clin Immunol. 2013; 132(2):495–498.e1. doi: 10.1016/j.jaci.2013.04.019.Kim J, Kim EH, Oh I, et al. Symptoms of atopic dermatitis are influenced by outdoor air pollution. J Allergy Clin Immunol. 2013; 132(2):495–498.e1. doi: 10.1016/j.jaci.2013.04.019.Ahn K. The role of air pollutants in atopic dermatitis. J Allergy Clin Immunol. 2014;134(5):993–999. doi: 10.1016/j.jaci.2014.09.023.Ahn K. The role of air pollutants in atopic dermatitis. J Allergy Clin Immunol. 2014;134(5):993–999. doi: 10.1016/j.jaci.2014.09.023.Herbarth O, Fritz GJ, Rehwagen M, et al. Association between indoor renovation activities and eczema in early childhood. Int J Hyg Environ Health. 2006;209(3):241–247. doi: 10.1016/j.ijheh.2006.01.003.Herbarth O, Fritz GJ, Rehwagen M, et al. Association between indoor renovation activities and eczema in early childhood. Int J Hyg Environ Health. 2006;209(3):241–247. doi: 10.1016/j.ijheh.2006.01.003.Yi O, Kwon HJ, Kim H, et al. Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. Environ Res. 2012;113:40–45. doi: 10.1016/j.envres.2011.12.012.Yi O, Kwon HJ, Kim H, et al. Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. Environ Res. 2012;113:40–45. doi: 10.1016/j.envres.2011.12.012.Lee JY, Seo JH, Kwon JW, et al. Exposure to gene-environment interactions before 1 year of age may favor the development of atopic dermatitis. Int Arch Allergy Immunol. 2012;157(4):363–371. doi: 10.1159/000328778.Lee JY, Seo JH, Kwon JW, et al. Exposure to gene-environment interactions before 1 year of age may favor the development of atopic dermatitis. Int Arch Allergy Immunol. 2012;157(4):363–371. doi: 10.1159/000328778.Ng JP, Liew HM, Ang SB. Use of emollients in atopic dermatitis. J Eur Acad Dermatol Venereol. 2015;29(5):854–857. doi: 10.1111/jdv.12864.Ng JP, Liew HM, Ang SB. Use of emollients in atopic dermatitis. J Eur Acad Dermatol Venereol. 2015;29(5):854–857. doi: 10.1111/jdv.12864.Aries MF, Hernandez-Pigeon H, Vaissiere C, et al. Anti-inflammatory and immunomodulatory effects of Aquaphilus dolomiae extract on in vitro models. Clin Cosmet Investig Dermatol. 2016; 9:421–434. eCollection 2016. doi: 10.2147/CCID.S113180.Aries MF, Hernandez-Pigeon H, Vaissiere C, et al. Anti-inflammatory and immunomodulatory effects of Aquaphilus dolomiae extract on in vitro models. Clin Cosmet Investig Dermatol. 2016; 9:421–434. eCollection 2016. doi: 10.2147/CCID.S113180.Bade I, Meges S, Lauze C, et al. Sensory analysis of 4 medical spa spring waters conlaining various mineral concentrations. Int J Dermatol. 1999;38(10):784–786. doi: 10.1046/j.1365-4362.1999.00789.x.Bade I, Meges S, Lauze C, et al. Sensory analysis of 4 medical spa spring waters conlaining various mineral concentrations. Int J Dermatol. 1999;38(10):784–786. doi: 10.1046/j.1365-4362.1999.00789.x.Boisnic S, Branchet-Gumila MC, Segard C, et al. Inghibilory effect of Avene spring water on vasoactive intestinal peptideinduced inflammation in surviving human skin. Int J Tissue Read. 2001;23(3):89–95.Boisnic S, Branchet-Gumila MC, Segard C, et al. Inghibilory effect of Avene spring water on vasoactive intestinal peptideinduced inflammation in surviving human skin. Int J Tissue Read. 2001;23(3):89–95.Fostini AC, Georgescu V, Decoster CJ, et al. A cream based on Aquaphilus dolomiae extracts alleviates non-histaminergic pruritus in humans. Eur J Dermatol. 2017;27(3):317–318. doi: 10.1684/ejd.2017.2994.Fostini AC, Georgescu V, Decoster CJ, et al. A cream based on Aquaphilus dolomiae extracts alleviates non-histaminergic pruritus in humans. Eur J Dermatol. 2017;27(3):317–318. doi: 10.1684/ejd.2017.2994.Nguyen T, Castex-Rizzi N, Redoules D. Activites immunomodulatrice, anti-inflammatoire, antiprurigineuse et tolerogenique induites par I-modulia®, un extrait issu de culture d’Aquaphilus dolomiae, dans les modeles pharmacologiques de dermatite atopique: Immunomodulatory, anti-inflammatory, anti-pruritus and tolerogenic activities induced by I-modulia®, an Aquaphilus dolomiae culture extract, in atopic dermatitis pharmacology models. Ann Dermatol Venereol. 2017;144(Suppl 1):S42–S49. doi: 10.1016/S0151-9638(17)31042-6.Nguyen T, Castex-Rizzi N, Redoules D. Activites immunomodulatrice, anti-inflammatoire, antiprurigineuse et tolerogenique induites par I-modulia®, un extrait issu de culture d’Aquaphilus dolomiae, dans les modeles pharmacologiques de dermatite atopique: Immunomodulatory, anti-inflammatory, anti-pruritus and tolerogenic activities induced by I-modulia®, an Aquaphilus dolomiae culture extract, in atopic dermatitis pharmacology models. Ann Dermatol Venereol. 2017;144(Suppl 1):S42–S49. doi: 10.1016/S0151-9638(17)31042-6.Laborel-Preneron E, Bianchi P, Boralevi F, et al. Effects of the Staphylococcus aureus and Staphylococcus epidermidis Secretomes Isolated from the Skin Microbiota of Atopic Children on CD4+ T Cell Activation. PLoS One. 2015;10(11):e0144323. doi: 10.1371/journal.pone.0144323.Laborel-Preneron E, Bianchi P, Boralevi F, et al. Effects of the Staphylococcus aureus and Staphylococcus epidermidis Secretomes Isolated from the Skin Microbiota of Atopic Children on CD4+ T Cell Activation. PLoS One. 2015;10(11):e0144323. doi: 10.1371/journal.pone.0144323.Nocera T, Fabre P, Rossi AB, Mengeaud V. Clinical development program of a new dermocosmetic range of products containing I-modulia (Aquaphilus dolomiae extract) in atopic dermatitis. J Am Acad Dermatol. 2014;70(5 Suppl 1):AB62. doi: 10.1016/j.jaad.2014.01.257.Nocera T, Fabre P, Rossi AB, Mengeaud V. Clinical development program of a new dermocosmetic range of products containing I-modulia (Aquaphilus dolomiae extract) in atopic dermatitis. J Am Acad Dermatol. 2014;70(5 Suppl 1):AB62. doi: 10.1016/j.jaad.2014.01.257.Bianchi P, Theunis J, Casas C, et al. Effects of a New EmollientBased Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis. Pediatr Dermatol. 2016; 33(2):165–171. doi: 10.1111/pde.12786.Bianchi P, Theunis J, Casas C, et al. Effects of a New EmollientBased Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis. Pediatr Dermatol. 2016; 33(2):165–171. doi: 10.1111/pde.12786.

The authors declare that there are no conflicts of interest present.