Abstract and Introduction
Abstract
Many factors may worsen atopic dermatitis (AD) including sweating, skin infections, food, inhalant allergens, climatic conditions, stress, and chemical or physical irritants. Especially in children, clothing can be an effective barrier against flare-inducing factors and persistent scratching, allowing more rapid improvement of the eczematous lesions. On the contrary, some fabrics used for clothing may exacerbate skin conditions due to their rough fibers, such as wool and nylon. Conventional silk has smooth fibers that are generally woven for textiles in the manufacturing of clothes, but this material is not particularly useful in the management of children with AD since it reduces transpiration and may cause discomfort. Herein, we evaluate the data concerning a special silk fabric (MICROAIR DermaSilk®) shown to be suitable for patients with AD. The unique properties of this knitted silk allow the skin to breathe and lack irritative potential. Moreover, this fabric is treated with a water-resistant antimicrobial finish known as AEGIS AEM 5772/5. This novel knitted silk fabric appears to be useful in managing children with AD due to its non-irritating and antibacterial features. Additionally, a synthetic silk-like fabric (DermaTherapy®) has received US FDA clearance as a Class I medical device and is commercially available as bedding; their use by AD patients has shown interesting results.
Introduction
Atopic dermatitis (AD) is the most frequent chronic inflammatory skin disease of childhood. AD usually starts during the first few years of life, commonly following a chronically relapsing course. Many factors are known to worsen or trigger the disease, including perspiration, food and inhalant allergens, climatic factors, skin infections due to Staphylococcus aureus (S. aureus), stress, and chemical or physical irritants. Recent investigations have shown that one of the most important pathogenetic factors is skin barrier impairment due to alteration of structural proteins (e.g., filaggrin) or enzyme imbalance (e.g., protease and antiprotease).
In the management of AD, an effective therapeutic program requires a multifaceted approach that incorporates control of skin inflammation, identification and elimination of triggering factors, and implementation of strategies aimed at improving the alterations/defects of the skin barrier
Clothing can be an effective barrier against persistent scratching, allowing more rapid improvement of the eczematous lesions and limiting exposure to bacterial pathogens that can cause skin infections. On the contrary, certain fabrics used for clothing can exacerbate AD in some patients, which may be attributable to their rough fibers (e.g., wool and nylon), whereas silk fibers are generally smooth. However, conventional silk fabric used for the manufacturing of clothing is not particularly practical in managing children with AD, since it reduces transpiration and may cause discomfort or irritation when in direct contact with the skin.