The importance of the epidermal acid mantle in maintaining the natural flora of the skin and its role in skin barrier homeostasis has been known for decades. Despite well-established evidence that the skin barrier pH is elevated in patients with inflammatory dermatoses such as atopic dermatitis, epidermal pH modification has been an underexplored therapeutic option that could potentially prevent overuse of antibiotics, topical glucocorticoids, and immune modulators. By optimizing the skin using a novel therapeutic regimen, we report three cases of recalcitrant atopic dermatitis that were successfully treated based on the concept of epidermal acidification combined with optimization of the skin barrier.
Quy Pham, MD, PharmD, College of Medicine, University of Oklahoma, Oklahoma City, OK.
Cheryl Lee Eberting, MD, Alpine Dermatology & Laser, Alpine, UT.
Quy Pham has no relevant disclosures or conflicts of interest. Cheryl Lee Eberting, is the CEO and founder of CherylLeeMD, Sensitive Skin Care, and of AZOVA Inc.
Correspondence concerning this article should be addressed to Quy Pham, MD, PharmD, OU College of Medicine, 1100 N Lindsay Ave, Oklahoma City, OK 73104. E-mail: email@example.com