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Patients with atopic dermatitis often have generalized or localized dry skin. Dry skin seems to be worse during winter and best during summer months. The mechanism of this seasonal variation is not well understood. Two likely reasons are that sebaceous gland secretion decreases in the winter and that indoor humidity is lower in winter, too. But this does not explain why wintertime problems are often worse on skin around one's trunk. To determine whether residual washing detergent in cotton clothes plays a role in wither deterioration of dry skin, 148 children and adults (ages 6 to 58) with atopic dermatitis who visited a dermatology clinic were examined for distribution of their dry skin. These patients were asked to switch for two weeks from a common laundry detergent (typically anionic; with many additives like whiteners and proteolytic enzymes) to a nonionic detergent that was additive-reduced. Photographs were taken before and after switching detergents. An improvement in dryness occurred in 76% of patients after two-weeks of the new detergent. No patient showed worsening of dry skin. The authors concluded that residues of common washing detergents in cotton underclothes play an important role in winter deterioration of dry skin among patients with atopic dermatitis. (Kiriyama T et al. J Dermatol 2003; 30:708-712.) Contributed by:
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