Alina MușEtescu

Background/Objectives: Pediatric atopic dermatitis (AD) is a barrier-driven inflammatory skin disease with systemic immune and microbial correlates. The gut–skin axis offers a biologically plausible framework through which early-life nutrition, gut microbial metabolism, intestinal barrier function, and immune maturation may influence disease risk and expression, but much of the supporting evidence remains associative. This narrative review asks which nutritional strategies are supported by clinical evidence in children with AD, which remain investigational, and how far the field is from precision nutrition. Methods: PubMed/MEDLINE, Scopus, and Web of Science were searched up to 31 July 2026; guidelines, systematic reviews, randomized trials, birth cohorts, and mechanistic studies with pediatric relevance were prioritized and appraised narratively. Results: Breastfeeding when possible, dietary diversity during complementary feeding, avoidance of unnecessary elimination diets, correction of documented nutritional deficiencies, and management of confirmed food allergy are supported by current guidance. Probiotics and synbiotics lower SCORAD in meta-analyses, but the pooled effect is small, heterogeneous, and below the minimal clinically important difference, so they are best described as an optional adjunct rather than a recommended treatment; Mediterranean-style or high-fiber dietary patterns are backed mainly by observational data. Microbiome profiling, metabolomics, multi-omics endotyping, and artificial intelligence remain research tools without validated predictive value for dietary responses. Conclusions: Nutrition is an adjunct to, not a substitute for, established topical and systemic therapy in pediatric AD. Precision nutrition is a promising research direction rather than an established component of routine care, and its clinical value will depend on standardized biomarkers and well-designed longitudinal and interventional studies.

Atopic dermatitis (AD) and food allergy frequently coexist during early childhood and are increasingly linked through interactions within the gut–skin axis. We evaluated the clinical outcomes of an integrated nutritional and microbiome-oriented management strategy in children with food allergy-associated AD under real-world conditions. This prospective, two-center, real-world observational cohort study included 85 children (median age, 11 months) with AD diagnosed according to the Hanifin–Rajka criteria and confirmed IgE- and/or non-IgE-mediated food allergy. Participants received individualized nutritional and microbiome-oriented management comprising elimination diets, conventional topical therapy, microbiome-directed interventions, and nutritional supplementation tailored to their clinical, allergological, and microbiological profile. Disease severity was assessed using the Scoring Atopic Dermatitis (SCORAD) index at baseline and after approximately 1 and 3 months of follow-up. Cow’s milk, egg, and wheat were the predominant food allergens, and 69.4% of children were polyallergic. SCORAD decreased significantly during follow-up, with a mean relative reduction of 51.6% and 63.5% of participants achieving a SCORAD50 response. Food allergy burden independently predicted baseline disease severity, whereas documented gut dysbiosis was associated with polyallergy and greater absolute clinical improvement, although this association lost statistical significance after adjustment for baseline disease severity and should therefore not be interpreted as a favorable prognostic effect of dysbiosis. Baseline SCORAD remained the strongest independent predictor of clinical improvement. Integrated nutritional and microbiome-oriented management was associated with substantial clinical improvement and may represent a valuable adjunct to standard care in children with food allergy-associated AD. Because of the observational, uncontrolled design, these findings describe associations rather than causal treatment effects. These findings support further evaluation of personalized nutritional strategies in randomized controlled trials.

Psoriasis, one of the most prevalent inflammatory diseases in dermatologic pathology, remains a challenge in regards to the therapeutic approach. Topical therapy for psoriasis is a current trending subject as it implies good compliance for the patient, few adverse systemic reactions and a targeted effect. Numerous substances are now being tested, from natural to synthetic compounds and already known substances in improved formulas such as vesicular systems. The aim of this article was to conduct a literature review regarding the topical therapy of psoriasis in animal models, between June, 27, 2019 and July 9, 2020. For this article, the authors conducted extensive research in PubMed with the following keywords: Psoriasis AND (topical OR local) and (therapy OR treatment) AND (mice OR rats). The main new studied substances included lycopene, sodium butyrate, salvianolic acid B, small interfering RNAs (siRNAs) in ionic liquids, albendazole, phosphodiesterase inhibitors, biomimetic reconstituted high-density lipoprotein nanocarrier gel containing microRNA (miRNA)-210 antisense, thymoquinone in ethosomal vesicle, Sea buckthorn oil (Hippophae rhamnoides), nitidine chloride, Melissa officinalis spp. Altissima extract and [1-(4-chloro-3-nitrobenzenesulfonyl)-1H-indol-3-yl]-methanol (CIM). New formulas of already known anti-psoriasis substances such as: Cyclosporine, methotrexate, calcipotriol, tazarotene, protein kinase p38 and integrin α5β1 as a target, are also reviewed. Recent research in topical psoriasis underlines the importance of animal experimental research in dermatology, providing a starting point for developing new therapeutic approaches in one of the most frequently diagnosed chronic dermatologic diseases. Vesicular systems are now providing the best vehicle for topical therapy, thus easing the action of the active substances at their target sites.