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Atopic dermatitis and nutrition

      Abstract

      Atopic dermatitis, a common chronic and pruritic inflammatory skin disorder, can create significant disruptions in sleep and quality of life. Atopic dermatitis is especially common in infants and children; therefore, safe and natural therapeutic options have considerable appeal. Over the past several decades, there has been an increase in the prevalence of atopic dermatitis in industrialized nations. Also, there is variability in the prevalence of atopic dermatitis in the United States, both across and within states. Environmental factors including diet are believed to be associated with this increased risk. Dietary interventions continue to be an area of keen interest and have been studied extensively, albeit with variable results. Maternal dietary restrictions during pregnancy and lactation, hydrolyzed or partially hydrolyzed formulas, delaying the introduction of solid foods, and omega-3 or omega-6 fatty acids supplementation do not appear to have a beneficial effect on the treatment and prevention of atopic dermatitis. Exclusive breastfeeding for 3 to 4 months, a diet high in fruits and vegetables, and prebiotics might have a beneficial effect. Because environmental triggers, including dietary exposures, are thought to play a role in the pathogenesis of atopic dermatitis, we herein review the current literature on the role of dietary habits, vitamin and mineral supplementation, and probiotics on the treatment and prevention of atopic dermatitis.
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      References

        • Werfel T.
        The role of leukocytes, keratinocytes, and allergen-specific IgE in the development of atopic dermatitis.
        J Invest Dermatol. 2009; 129: 1878-1891
        • Halbert AR
        • Weston WL
        • Morelli JG.
        Atopic dermatitis: is it an allergic disease?.
        J Am Acad Dermatol. 1995; 33: 1008-1018
        • Kramer ON
        • Strom MA
        • Ladizinski B
        • Lio PA.
        The history of atopic dermatitis.
        Clin Dermatol. 2017; 35: 344-348
        • Wallach D
        • Taïeb A.
        Atopic dermatitis/atopic eczema.
        Chem Immunol Allergy. 2014; 100: 81-96
        • Kolb L
        • Ferrer-Bruker SJ.
        Atopic dermatitis.
        StatPearls [Internet]. Treasure Island. StatPearls Publishing, FL2021
        • McKenzie C
        • Silverberg JI.
        The prevalence and persistence of atopic dermatitis in urban United States children.
        Ann Allergy Asthma Immunol. 2019; 123 (e1): 173-178
        • Shaw TE
        • Currie GP
        • Koudelka CW
        • Simpson EL.
        Eczema prevalence in the United States: Data from the 2003 national survey of children's health.
        J Invest Dermatol. 2011; 131: 67-73
        • Eichenfield LF
        • Hanifin JM
        • Beck LA
        • et al.
        Atopic dermatitis and asthma: parallels in the evolution of treatment.
        Pediatrics. 2003; 111: 608-616
        • Flohr C
        • Pascoe D
        • Williams HC.
        Atopic dermatitis and the ‘hygiene hypothesis’: too clean to be true?.
        Br J Dermatol. 2005; 152: 202-216
        • Järvinen KM
        • Mäkinen-Kiljunen S
        • Suomalainen H.
        Cow's milk challenge through human milk evokes immune responses in infants with cow's milk allergy.
        J Pediatr. 1999; 135: 506-512
        • Greer FR
        • Sicherer SH
        • Burks AW
        • et al.
        The effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, hydrolyzed formulas, and timing of introduction of allergenic complementary foods.
        Pediatrics. 2019; 143e20190281
        • Lilja G
        • Dannaeus A
        • Foucard T
        • Graff-Lonnevig V
        • Johansson SG
        • Oman H.
        Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to 18 months of age—in-vivo results.
        Clin Exp Allergy. 1989; 19: 473-479
        • Lilja G
        • Dannaeus A
        • Fälth-Magnusson K
        • et al.
        Immune response of the atopic woman and foetus: effects of high- and low-dose food allergen intake during late pregnancy.
        Clin Exp Allergy. 1988; 18: 131-142
        • Fälth-Magnusson K
        • Kjeltman NI.
        Allergy prevention by maternal elimination diet during late pregnancy—a 5-year follow-up of a randomized study.
        J Allergy Clin Immunol. 1992; 89: 709-713
        • Fälth-Magnusson K
        • Kjellman NI.
        Development of atopic disease in babies whose mothers were receiving exclusion diet during pregnancy—a randomized study.
        J Allergy Clin Immunol. 1987; 80: 868-875
        • Lilja G
        • Dannaeus A
        • Foucard T
        • Graff-Lonnevig V
        • Johansson SGO
        • Oman H.
        Effects of maternal diet during late pregnancy and lactation on the development of IgE and egg- and milk-specific IgE and IgG antibodies in infants.
        Clin Exp Allergy. 1991; 21: 195-202
        • American Academy of Pediatrics
        Committee on Nutrition. Hypoallergenic infant formulas.
        Pediatrics. 2000; 106: 346-349
        • Lack G
        • Fox D
        • Northstone K
        • Golding J.
        Factors associated with the development of peanut allergy in childhood.
        N Engl J Med. 2003; 348: 977-985
        • Kramer MS
        • Kakuma R.
        Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child.
        Evid Based Child Health. 2014; 9: 447-483
        • de Silva D
        • Geromi M
        • Halken S
        • et al.
        Primary prevention of food allergy in children and adults: systematic review.
        Allergy. 2014; 69: 581-589
        • Netting MJ
        • Middleton PF
        • Makrides M.
        Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches.
        Nutrition. 2014; 30: 1225-1241
        • Businco L
        • Marchetti F
        • Pellegrini G
        • Cantani A
        • Perlini R.
        Prevention of atopic disease in “at-risk newborns” by prolonged breast-feeding.
        Ann Allergy. 1983; 51: 296-299
        • Lovegrove JA
        • Hampton SM
        • Morgan JB.
        The immunological and long-term atopic outcome of infants born to women following a milk-free diet during late pregnancy and lactation: a pilot study.
        Br J Nutr. 1994; 71: 223-238
        • Hattevig G
        • Sigurs N
        • Kjellman B.
        Effects of maternal dietary avoidance during lactation on allergy in children at 10 years of age.
        Acta Paediatr. 1999; 88: 7-12
        • Sigurs N
        • Hattevig G
        • Kjellman B.
        Maternal avoidance of eggs, cow's milk, and fish during lactation: effect on allergic manifestations, skin-prick tests, and specific IgE antibodies in children at age 4 years.
        Pediatrics. 1992; 89: 735-739
        • Cant AJ
        • Bailes JA
        • Marsden RA
        • Hewitt D.
        Effect of maternal dietary exclusion on breast fed infants with eczema: two controlled studies.
        Br Med J (Clin Res Ed). 1986; 293: 231-233
        • Muraro A
        • Dreborg S
        • Halken S
        • et al.
        Dietary prevention of allergic diseases in infants and small children. Part III: critical review of published peer-reviewed observational and interventional studies and final recommendations.
        Pediatr Allergy Immunol. 2004; 15: 291-307
        • Grulee CG
        • Sanford HN.
        The influence of breast and artificial feeding oninfantile eczema.
        J Pediatr. 1936; 9: 223-225
        • Gdalevich M
        • Mimouni D
        • David M
        • Mimouni M.
        Breast-feeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies.
        J Am Acad Dermatol. 2001; 45: 520-527
        • Laubereau B
        • Brockow I
        • Zirngibl A
        • et al.
        Effect of breast-feeding on the development of atopic dermatitis during the first 3 years of life—results from the gini-birth cohort study.
        J Pediatr. 2004; 144: 602-607
        • Schoetzau A
        • Filipiak-Pittroff B
        • Franke K
        • et al.
        Effect of exclusive breast-feeding and early solid food avoidance on the incidence of atopic dermatitis in high-risk infants at 1 year of age.
        Pediatr Allergy Immunol. 2002; 13: 234-242
        • von Berg A
        • Koletzko S
        • Grübl A
        • et al.
        The effect of hydrolyzed cow's milk formula for allergy prevention in the first year of life: The German Infant Nutritional Intervention Study, a randomized double-blind trial.
        J Allergy Clin Immunol. 2003; 111: 533-540
        • Yang YW
        • Tsai CL
        • Lu CY.
        Exclusive breastfeeding and incident atopic dermatitis in childhood: a systematic review and meta-analysis of prospective cohort studies.
        Br J Dermatol. 2009; 161: 373-383
        • Lodge C
        • Tan D
        • Lau M
        • et al.
        Breastfeeding and asthma and allergies: a systematic review and meta-analysis.
        Acta Paediatr. 2015; 104: 38-53
        • Purvis DJ
        • Thompson JM
        • Clark PM
        • et al.
        Risk factors for atopic dermatitis in New Zealand children at 3.5 year of age.
        Br J Dermatol. 2005; 152: 742-749
        • Bergmann RL
        • Diepgen TL
        • Kuss O
        • et al.
        Breastfeeding duration is a risk factor for atopic eczema.
        Clin Exp Allergy. 2002; 32: 205-209
        • Miyake Y
        • Yura A
        • Iki M.
        Breastfeeding and the prevalence of symptoms of allergic disorders in Japanese adolescents.
        Clin Exp Allergy. 2003; 33: 312-316
        • Kajosaari M.
        Atopy prophylaxis in high-risk infants. Prospective 5-year follow-up study of children with six months exclusive breastfeeding and solid food elimination.
        Adv Exp Med Biol. 1991; 310: 453-458
        • Kajosaari M.
        Atopy prevention in childhood: the role of diet. Prospective 5-year follow-up of high-risk infants with six months exclusive breastfeeding and solid food elimination.
        Pediatr Allergy Immunol. 1994; 5: 26-28
        • Kramer MS
        • Kakuma R.
        Optimal duration of exclusive breastfeeding.
        Cochrane Database Syst Rev. 2012; 8CD003517
        • Halken S
        • Hansen KS
        • Jacobsen HP
        • et al.
        Comparison of a partially hydrolyzed infant formula with two extensively hydrolyzed for allergy prevention: a prospective, randomized study.
        Pediatr Allergy Immunol. 2000; 11: 149-161
        • Oldæus G
        • Anjou K
        • Björkstén B
        • Moran JR
        • Kjellman NI.
        Extensively and partially hydrolysed infant formulas for allergy prophylaxis.
        Arch Dis Child. 1997; 77: 4-10
        • Nentwich I
        • Michková E
        • Nevoral J
        • Urbanek R
        • Szépfalusi Z.
        Cow's milk-specific cellular and humoral immune responses and atopy sin symptoms in infants from atopic families fed a partially (pHF) or extensively (eHF) hydrolyzed infant formula.
        Allergy. 2001; 56: 1144-1156
        • Lowe AJ
        • Hosking CS
        • Bennett CM
        • et al.
        Effect of a partially hydrolyzed whey infant formula at weaning on risk of allergic disease in high-risk children: a randomized controlled trial.
        J Allergy Clin Immunol. 2011; 128 (e4): 360-365
        • Boyle RJ
        • Ierodiakonou D
        • Khan T
        • et al.
        Hydrolysed formula and risk of allergic or autoimmune disease: systematic review and meta-analysis.
        BMJ. 2016; (352i974)
        • Osborn DA
        • Sinn J.
        Soy formula for prevention of allergy and food intolerance in infants.
        Cochrane database Syst Rev. 2004; 3CD003741
        • Boyle RJ
        • Tang ML
        • Chiang WC
        • et al.
        Prebiotic-supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high-risk infants: A randomized controlled trial.
        Allergy. 2016; 71: 701-710
        • von Berg A
        • Filipiak-Pittroff B
        • Krämer U
        • et al.
        Allergies in high-risk schoolchildren after early intervention with cow's milk protein hydrolysates: 10-year results from the German Infant Nutritional Intervention (GINI) study.
        J Allergy Clin Immunol. 2013; 131: 1565-1573
        • Kleinman RE
        • Coletta FA.
        Historical overview of transitional feeding recommendations and vegetable feeding practices for infants and young children.
        Nutr Today. 2016; 51: 7-13
        • Fergusson DM
        • Horwood LJ
        • Shannon FT.
        Early solid feeding and recurrent childhood eczema: a 10-year longitudinal study.
        Pediatrics. 1990; 86: 541-546
        • Fergusson DM
        • Horwood LJ
        • Beautrais AL
        • Shannon FT
        • Taylor B.
        Eczema and infant diet.
        Clin Allergy. 1981; 11: 325-331
        • Morgan J
        • Williams P
        • Norris F
        • Williams CM
        • Larkin M
        • Hampton S.
        Eczema and early solid feeding in preterm infants.
        Arch Dis Child. 2004; 89: 309-314
        • Zutavern A
        • von Mutius E
        • Harris J
        • et al.
        The introduction of solids in relation to asthma and eczema.
        Arch Dis Child. 2004; 89: 303-308
        • Ierodiakonou D
        • Garcia-Larsen V
        • Logan A
        • et al.
        Timing of allergenic food introduction to the infant diet and risk of allergic or autoimmune disease: a systematic review and meta-analysis.
        JAMA. 2016; 316: 1181-1192
        • Palmer DJ
        • Metcalfe J
        • Makrides M
        • et al.
        Early regular egg exposure in infants with eczema: a randomized controlled trial.
        J Allergy Clin Immunol. 2013; 132 (e1): 387-392
        • Du Toit G
        • Roberts G
        • Sayre PH
        • et al.
        Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy.
        N Engl J Med. 2015; 372: 803-813
        • Greer FR
        • Sicherer SH
        • Burks AW
        • et al.
        Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas.
        Pediatrics. 2008; 121: 183-191
        • Bath-Hextall F
        • Delamere FM
        • Williams HC.
        Dietary exclusions for improving established atopic eczema in adults and children: systematic review.
        Allergy. 2009; 64: 258-264
        • Solvoll K
        • Søyland E
        • Sandstad B
        • Drevon CA.
        Dietary habits among patient with atopic dermatitis.
        Eur J Clin Nutr. 2000; 54: 93-97
        • Stalder JF
        • Taïeb A
        • Atherton DJ
        • et al.
        Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis.
        Dermatology. 1993; 186: 23-31
        • Thestrup-Pedersen K.
        Treatment principles of atopic dermatitis.
        J Eur Acad Dermatology Venereol. 2002; 16: 1-9
        • Atherton DJ
        • Sewell M
        • Soothill JF
        • Wells RS
        • Chilvers CE.
        A double-blind controlled crossover trial of an antigen-avoidance diet in atopic eczema.
        Lancet. 1978; 1: 401-403
        • Mabin DC
        • Sykes AE
        • David TJ.
        Controlled trial of a few foods diet in severe atopic dermatitis.
        Arch Dis Child. 1995; 73: 202-207
        • Dhar S
        • Srinivas SM.
        Food allergy in atopic dermatitis.
        Indian J Dermatol. 2016; 61: 645-648
        • Anderson PC
        • Dinulos JG.
        Atopic dermatitis and alternative management strategies.
        Curr Opin Pediatr. 2009; 21: 131-138
        • Bergmann MM
        • Caubet JC
        • Boguniewicz M
        • Eigenmann PA.
        Evaluation of food allergy in patients with atopic dermatitis.
        J Allergy Clin Immunol Pract. 2013; 1: 22-28
        • Kim J
        • Kwon J
        • Noh G
        • Lee SS.
        The effects of elimination diet on nutritional status in subjects with atopic dermatitis.
        Nutr Res Pract. 2013; 7: 488-494
        • Bronsnick T
        • Murzaku EC
        • Rao BK.
        Diet in dermatology: part I. Atopic dermatitis, acne, and nonmelanoma skin cancer.
        J Am Acad Dermatol. 2014; 71 (1039.e1-1039.e12)
        • Woods RK
        • Thien FC
        • Abramson MJ.
        Dietary marine fatty acids (fish oil) for asthma in adults and children.
        Cochrane Database Syst Rev. 2002; 3CD001283
        • Anandan C
        • Nurmatov U
        • Sheikh A.
        Omega 3 and 6 oils for primary prevention of allergic disease: systematic review and meta-analysis.
        Allergy. 2009; 64: 840-848
        • Hoppu U
        • Rinne M
        • Lampi A-M
        • Isolauri E.
        Breast milk fatty acid composition is associated with development of atopic dermatitis in the infant.
        J Pediatr Gastroenterol Nutr. 2005; 41: 335-338
        • Dunstan JA
        • Mori TA
        • Barden A
        • et al.
        Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial.
        J Allergy Clin Immunol. 2003; 112: 1178-1184
        • Dunstan JA
        • Mori TA
        • Barden A
        • et al.
        Maternal fish oil supplementation in pregnancy reduces interleukin-13 levels in cord blood of infants at high risk of atopy.
        Exp Allergy. 2003; 33: 442-448
        • Kitz R
        • Rose MA
        • Schönborn H
        • Zielen S
        • Böhles HJ.
        Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy.
        Pediatr Allergy Immunol. 2006; 17: 112-117
        • Bjørneboe A
        • Søyland E
        • Bjørneboe GE
        • Rajka G
        • Drevon CA.
        Effect of dietary supplementation with eicosapentaenoic acid in the treatment of atopic dermatitis.
        Br J Dermatol. 1987; 117: 463-469
        • Eriksen BB
        • Kåre DL.
        Open trial of supplements of omega 3 and 6 fatty acids, vitamins and minerals in atopic dermatitis.
        J Dermatolog Treat. 2006; 17: 82-85
        • van Gool CJ
        • Zeegers MP
        • Thijs C.
        Oral essential fatty acid supplementation in atopic dermatitis—a meta-analysis of placebo-controlled trials.
        Br J Dermatol. 2004; 150: 728-740
        • Kaczmarski M
        • Cudowska B
        • Sawicka-Żukowska M
        • Bobrus-Chociej A.
        Supplementation with long chain polyunsaturated fatty acids in treatment of atopic dermatitis in children.
        Postepy Dermatol Alergol. 2013; 30: 103-107
        • Morse NL
        • Clough PM.
        A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries?.
        Curr Pharm Biotechnol. 2006; 7: 503-524
        • Bamford JT
        • Ray S
        • Musekiwa A
        • van Gool C
        • Humphreys R
        • Ernst E.
        Oral evening primrose oil and borage oil for eczema.
        Cochrane Database Syst Rev. 2013; 4CD004416
        • Tsoureli-Nikita E
        • Hercogova J
        • Lotti T
        • Menchini G.
        Evaluation of dietary intake of vitamin E in the treatment of atopic dermatitis: a study of the clinical course and evaluation of the immunoglobulin E serum levels.
        Int J Dermatol. 2002; 41: 146-150
        • Jaffary F
        • Faghihi G
        • Mokhtarian A
        • Hosseini SM.
        Effects of oral vitamin E on treatment of atopic dermatitis: a randomized controlled trial.
        J Res Med Sci. 2015; 20: 1053-1057
        • Hoppu U
        • Rinne M
        • Salo-Väänänen P
        • Lampi AM
        • Piironen V
        • Isolauri E.
        Vitamin C in breast milk may reduce the risk of atopy in the infant.
        Eur J Clin Nutr. 2005; 59: 123-128
        • Sidbury R
        • Sullivan AF
        • Thadhani RI
        • Camargo Jr., CA
        Randomized controlled trial of vitamin D supplementation for winter-related atopic dermatitis in Boston: a pilot study.
        Br J Dermatol. 2008; 159: 245-247
        • Bäck O
        • Blomquist HK
        • Hernell O
        • Stenberg B.
        Does vitamin D intake during infancy promote the development of atopic allergy?.
        Acta Derm Venereol. 2009; 89: 28-32
        • Schlichte MJ
        • Vandersall A
        • Katta R.
        Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis.
        Dermatol Pract Concept. 2016; 6: 23-29
        • Kim MJ
        • Kim SN
        • Lee YW
        • Choe YB
        • Ahn KJ.
        Vitamin D status and efficacy of vitamin D supplementation in atopic dermatitis: a systematic review and meta-analysis.
        Nutrients. 2016; 8: 789
        • Hattangdi-Haridas SR
        • Lanham-New SA
        • Wong WHS
        • Ho MHK
        • Darling AL.
        Vitamin D deficiency and effects of vitamin D supplementation on disease severity in patients with atopic dermatitis: a systematic review and meta-analysis in adults and children.
        Nutrients. 2019; 11: 1854
        • Sánchez-Armendáriz K
        • García-Gil A
        • Romero CA
        • et al.
        Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial.
        Int J Dermatol. 2018; 57: 1516-1520
        • Javanbakht MH
        • Keshavarz SA
        • Djalali M
        • et al.
        Randomized controlled trial using vitamins E and D supplementation in atopic dermatitis.
        J Dermatolog Treat. 2011; 22: 144-150
        • Hata TR
        • Audish D
        • Kotol P
        • et al.
        A randomized controlled double-blind investigation of the effects of vitamin D dietary supplementation in subjects with atopic dermatitis.
        J Eur Acad Dermatology Venereol. 2014; 28: 781-789
        • Takahashi H
        • Nakazawa M
        • Takahashi K
        • et al.
        Effects of zinc deficient diet on development of atopic dermatitis-like eruptions in DS-Nh mice.
        J Dermatol Sci. 2008; 50: 31-39
        • Hataguchi Y
        • Tai H
        • Nakajima H
        • Kimata H.
        Drinking deep-sea water restores mineral imbalance in atopic eczema/dermatitis syndrome.
        Eur J Clin Nutr. 2005; 59: 1093-1096
        • Omata N
        • Tsukahara H
        • Ito S
        • et al.
        Increased oxidative stress in childhood atopic dermatitis.
        Life Sci. 2001; 69: 223-228
        • Tanaka T
        • Kouda K
        • Kotani M
        • et al.
        Vegetarian diet ameliorates symptoms of atopic dermatitis through reduction of the number of peripheral eosinophils and of PGE2 synthesis by monocytes.
        J Physiol Anthropol Appl Human Sci. 2001; 20: 353-361
        • Kawai M
        • Hirano T
        • Higa S
        • et al.
        Flavonoids and related compounds as anti-allergic substances.
        Allergol Int. 2007; 56: 113-123
        • Knekt P
        • Kumpulainen J
        • Järvinen R
        • et al.
        Flavonoid intake and risk of chronic diseases.
        Am J Clin Nutr. 2002; 76: 560-568
        • Lim H
        • Son KH
        • Chang HW
        • Kang SS
        • Kim HP.
        Effects of anti-inflammatory biflavonoid, ginkgetin, on chronic skin inflammation.
        Biol Pharm Bull. 2006; 29: 1046-1049
        • Fung AY
        • Look PC
        • Chong LY
        • But PP
        • Wong E.
        A controlled trial of traditional Chinese herbal medicine in Chinese patients with recalcitrant atopic dermatitis.
        Int J Dermatol. 1999; 38: 387-392
        • Isolauri E
        • Arvola T
        • Sütas Y
        • Moilanen E
        • Salminen S.
        Probiotics in the management of atopic eczema.
        Clin Exp Allergy. 2000; 30: 1604-1610
        • Majamaa H
        • Isolauri E.
        Probiotics: a novel approach in the management of food allergy.
        J Allergy Clin Immunol. 1997; 99: 179-185
        • Prescott SL
        • Björkstén B.
        Probiotics for the prevention or treatment of allergic diseases.
        J Allergy Clin Immunol. 2007; 120: 255-262
        • Rosenfeldt V
        • Benfeldt E
        • Valerius NH
        • Pærregaard A
        • Michaelsen KF.
        Effect of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis.
        J Pediatr. 2004; 145: 612-616
        • Osborn DA
        • Sinn JK.
        Prebiotics in infants for prevention of allergic disease and food hypersensitivity.
        Cochrane Database Syst Rev. 2007; 4CD006474
        • Pessi T
        • Sütas Y
        • Hurme M
        • Isolauri E.
        Interleukin-10 generation in atopic children following oral lactobacillus rhamnosus GG.
        Clin Exp Allergy. 2000; 30: 1804-1808
        • Strachan DP.
        Hay fever, hygiene, and household size.
        BMJ. 1989; 299: 1259-1260
        • Lee J
        • Seto D
        • Bielory L.
        Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis.
        J Allergy Clin Immunol. 2008; 121 (e11): 116-121
        • Pelucchi C
        • Chatenoud L
        • Turati F
        • et al.
        Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis.
        Epidemiology. 2012; 23: 402-414
        • Makrgeorgou A
        • Leonardi-Bee J
        • Bath-Hextall FJ
        • et al.
        Probiotics for treating eczema.
        Cochrane Database Syst Rev. 2018; 11CD006135
        • Kalliomäki M
        • Salminen S
        • Arvilommi H
        • Kero P
        • Koskinen P
        • Isolauri E.
        Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial.
        Lancet. 2001; 357: 1076-1079
        • Zhao M
        • Shen C
        • Ma L.
        Treatment efficacy of probiotics on atopic dermatitis, zooming in on infants: a systematic review and meta-analysis.
        Int J Dermatol. 2018; 57: 635-641
        • Meneghin F
        • Fabiano V
        • Mameli C
        • Zuccotti GV.
        Probiotics and atopic dermatitis in children.
        Pharmaceuticals (Basel). 2012; 5: 727-744
        • Moro G
        • Arslanoglu S
        • Stahl B
        • Jelinek J
        • Wahn U
        • Boehm G.
        A mixture of prebiotic oligosaccharides reduces the incidence of atopic dermatitis during the first six months of age.
        Arch Dis Child. 2006; 91: 814-819
        • Sen Chang Y
        • MK Trivedi
        • Jha A
        • Lin YF
        • Dimaano L
        • García-Romero MT
        Synbiotics for prevention and treatment of atopic dermatitis: a meta-analysis of randomized clinical trials.
        JAMA Pediatr. 2016; 170: 236-242