Atopic Dermatitis (AD) is a common chronic, recurrent, and inflammatory skin disease. The
onset before 1 year old accounts for about 50% of all patients. The main manifestations are
dry skin, chronic eczema-like dermatitis and severe itching. The incidence of AD in infants
worldwide is as high as 30%. In our country, the prevalence of AD among infants aged 1-12
months is 30.48%, of which 23.97% are moderate and 1.44% are severe. Infant AD is mostly
related to non-IgE-mediated food allergies. The prevalence rate of food allergy in children
with moderate to severe AD under 2 years of age in our country is 49.7% confirmed by food
provocation test, which seriously affects the nutritional intake and growth and development
of children. Cause psychological and economic burdens on children and their families. At
present, AD is considered to be a multifactorial disease, involving genetic susceptibility,
immune disorders, microbial flora imbalance, environmental factors, and skin barrier function
defects. Different from adults, the immune system of infants and young children is not yet
mature. AD, allergic asthma and allergic rhinitis are known as the triad of children's
atopic. Among them, AD is the earliest age of onset. It may be the first step in the process
of allergic diseases. It is unique The pathogenesis related research is relatively limited,
and there are only a handful of drugs approved for infantile AD. Therefore, the prevention of
moderate to severe infantile AD should be more important than treatment.
Neonatal jaundice is one of the most common neonatal disorders. The incidence of full-term
infants within one week of birth is 60%, and premature infants are as high as 80%. Among
them, in order to prevent and treat bilirubin encephalopathy, children with severe neonatal
hyper-indirect bilirubinemia need to receive phototherapy. The most commonly used blue light
therapy in clinical practice is a simple, effective and relatively safe measure to reduce
jaundice. About 20% of children with jaundice receive phototherapy. Bilirubin is an
antioxidant that can neutralize free radicals produced in the body after birth. The imbalance
of the body's oxidation-antioxidation mechanism may cause allergic diseases. Studies have
focused on the occurrence and development of neonatal jaundice and allergic diseases. At the
same time, blue light therapy is suitable for moderate to severe neonatal hyperbilirubinemia,
which can cause the rapid conversion of Th2 to Th1, thereby increasing the pro-inflammatory
factor tumor necrosis factor-α (TNF-α), interleukin-8 (IL- 8) and IL-1β, and reduce IL-6 and
other anti-inflammatory factors, thereby exacerbating the inflammatory process and allergic
diseases. Some recent studies suggest that children with neonatal jaundice are more likely to
develop allergic diseases than those without jaundice, and the incidence is 14.1% higher;
early-onset neonatal jaundice is positively correlated with blue light therapy in the
occurrence and development of allergic diseases. Therefore, it is of great clinical
significance to take protective measures to reduce or delay the occurrence of moderate to
severe AD in infants and young children when blue light treatment is required for jaundice in
children at high risk of allergies.
At the same time, common adverse reactions of neonatal phototherapy include skin rash, fever,
diarrhea, etc., and long-term damage to the DNA of skin cells. In order to avoid damaging the
health of infants, it is indeed necessary to further standardize and rationalize
phototherapy. Infant functional skin care products have the functions of repairing the skin
barrier, moisturizing, and anti-inflammatory, and are important basic treatment methods for
children with AD. Studies have pointed out that topical moisturizers should be used as early
as possible in the neonatal period to reduce and postpone the occurrence of AD. At present,
only sensitive parts such as eyes, external genitalia, or vulva should be covered during
phototherapy of newborns. There is no research published on skin protection measures during
phototherapy.
In summary, neonatal jaundice and phototherapy due to jaundice are very likely to be related
to the occurrence and development of infantile AD, and AD is the earliest allergic disease.
The relevant clinical guidelines point out that the early standardized use of infant
moisturizing products can reduce the occurrence of moderate to severe AD. . Therefore, this
project intends to take the lead in conducting research on skin care for newborns at high
risk of allergies who need phototherapy. This study is a randomized controlled study. It
intends to randomly provide baby moisturizing product care for allergic high-risk newborns
who need phototherapy, and verify skin moisturizing during phototherapy of allergic high-risk
newborns through evaluation items such as skin microecology analysis, serum allergy
indicators, and AD clinical manifestations. It is an effective measure to delay and reduce
the severity of AD in infancy.