PeDRA

Pediatric Dermatology Research Alliance

Neonatal Skin

Neonatal Cutaneous Microbiome Predictors of Infantile Eczema

By

Principal Investigator:

Jennifer Schoch, MD
University of Florida

Overview:

Though the cause of eczema is yet unknown, animal studies suggest importance of the early interaction between bacteria present on the skin and the immune system. If bacteria are present on the skin of mice shortly after birth, then the immune system learns to “tolerate” the bacteria, and doesn’t create inflammation (i.e. eczema) when later exposed to the bacteria. To explore the possibility of a similar human mechanism, we will collect skin microbiome samples (including bacterial genetic material) from infants weekly for the first 4 weeks of life. The bacteria found on the skin in infants who later develop infantile eczema will be compared to infants who do not develop eczema. We hypothesize that specific bacteria (e.g. Staphylococcus) will be more abundant in the early skin microbiome of infants who do not develop eczema, compared to infants who do develop eczema. Successful completion will guide strategies to prevent eczema.

Status:

This study was funded through the 2021 Childhood Eczema Challenge Grant.

Unraveling Determinants of the Early Cutaneous Microbiome

By

Principal Investigator:

Jennifer Schoch, MD
University of Florida

Overview:

Prospective studies of the neonatal cutaneous microbiome are lacking. In this project, Dr. Schoch will collect weekly skin microbiome swabs from 25 very low birthweight infants in the neonatal intensive care unit. The goal of the study is to evaluate the impact of infant, maternal, and clinical variables on the longitudinal development of the cutaneous microbiome in the preterm neonate.

Status:

This study was funded through the 2018 Weston Career Development Award.

The Relationship between the Cutaneous Microbiome and Skin Barrier in Infantile Atopic Dermatitis

By

Principal Investigator:

Jennifer Schoch, MD
University of Florida

Co-Investigator:

Reesa Monir, MD
University of Florida

Overview:

Infantile atopic dermatitis (i.e. eczema) is a common pediatric skin condition leading to significant complications for patients and parents. Sleep disturbances, behavioral issues, and parental exhaustion are just a few of the negative ramifications. Though advances have been made in disease treatment, preventive interventions lag far behind.

Infancy is a unique, impressionable period of time during which the physical skin barrier, the cutaneous immune system, and the skin microbiome are developing in parallel. These closely intertwined factors are critical to the development of eczema. The skin barrier becomes “leaky” in kids with eczema, making it dry and prone to infection. The skin’s immune system becomes more reactive, leading to itching and inflammation. The collection of microbes that live in and on the skin (the skin microbiome) also changes in kids with eczema. The timeline of these changes and how they are related, however, is unclear.

In this study, we will begin exploration of the relationship between skin structure, cutaneous immunity, and the cutaneous microbiome. We will examine skin pH and the cutaneous microbiome in infants with newly-onset atopic dermatitis, compared to infants without eczema. Infants age three to nine months with newly-onset atopic dermatitis and without atopic dermatitis will be compared, with the goal of identifying how and when various aspects of skin development go awry. Understanding normal and pathologic skin changes is the first step in developing preventative interventions.

Status:

This study was funded through the 2019 PeDRA Research Hot Seat – A PeDRA Shark Tank.

Management of afebrile neonates with pustules

By

Principal Investigator:

Christine Lauren, MD
Columbia University

Overview:

The aim of this retrospective, multi-center study is to document the current practices of pediatric dermatologists across North America and establish recommendations for the evaluation and management of afebrile neonates with pustulosis.

Status:

Data collection underway.

Evaluation of skin care practices in the neonatal ICU setting

By

Principal Investigator:

Christine Lauren, MD
Columbia University

Overview:

The Survey of Skincare in Neonates to Update Guidelines (SoSNUG) project proposes to assess the practices and protocols regarding neonatal skin care that are currently utilized in newborn nurseries and NICUs across the United States and Canada. Neonates are most often cared for by skilled physicians and nurses, however pediatric dermatologists have specialized training in caring for the skin of newborns. Although guidelines exist in publication, the reality of clinical practice does not necessarily correspond to recommendations. Based on preliminary data, there are many aspects of routine neonatal skin care that vary within and among medical centers providing care to newborns. As pediatric dermatologists, we wish to publish clear and informative guidelines for neonatal skin care to ensure a unified practice. In order to provide the most effective guidelines, as a first step we seek to improve our understanding of current practices in neonatal skin care by means of a survey.

Status:

Data collection underway.

This project received a 2019 PeDRA Study Support Grant to analyze complex survey results. Analysis is being done at the Columbia University Irving Medical Center for Biostatistics, Epidemiology, and Research Design.