Atopic Dermatitis--Conclusions From Systematic Reviews

Objective: To review 9 systematic reviews regarding prevention, treatment, and etiology of atopic dermatitis. Discussion: 2 systematic reviews confirmed the consistent and strong association between filaggrin mutations and eczema, and filaggrin mutations and allergic rhinitis with and without eczema. A systematic review of 12 trials found only 3 trials correlating risk of atopic dermatitis with transforming growth factor-β (TGF-β) levels in breast milk. Two of the studies found no correlation while the other suggested that TGF-β levels were increased in breast milk of mothers taking probiotics and that the risk of atopic dermatitis in their children was reduced. A systematic review of 27 studies and >30,000 patients found no difference in the risk of developing atopic dermatitis after exclusive breastfeeding for at least 3 months. A meta-analysis of studies looking at the prevention and development of allergic diseases found a nonsignificant decreased risk of developing atopic dermatitis after omega-6 oil supplementation and a nonsignificant increased risk after omega-3 oil supplementation. A recent Cochrane review of dietary exclusions in 421 patients found no evidence to support diets in the treatment of atopic dermatitis. A meta-analysis of 5 trials on probiotics detected a nonsignificant reduction in the atopic scoring rates and nonsignificant difference in quality of life. A systematic review analyzed 10 randomized controlled trials (RCTs) on tacrolimus and 9 on pimecrolimus comprising >7000 patients with atopic dermatitis. Both agents were more effective than placebo.