Effects of Treatments on the Microbiome in Healthy Volunteers and Patients With Atopic Dermatitis
Background: \- Atopic dermatitis, or eczema, is a chronic skin disorder. Patients sometimes have infections with S. aureus bacteria. Researchers want to study how eczema treatments affect the number and the type of bacteria on the skin.
Objectives: \- To study the effect of eczema treatments on skin bacteria.
Eligibility: * Individuals between 2 and 25 years of age who have moderate to severe atopic dermatitis. * Healthy volunteers between 18 and 40 years of age with no history of eczema.
Design: * Participants will be screened with a physical exam and medical history. Research samples will be collected. Skin biopsies may also be performed. * All participants will be assigned to one of several study groups. * Healthy volunteers must not have taken antibiotics in the year before the start of the study. * All participants will have regular study visits during their 1-year participation. More research samples will be collected at these visits. * Healthy volunteers may be asked to come in for a one-time follow up after the 1 year mark.
‣ Cohorts 1 \[NO FURTHER ACCRUAL\], 2 \[INACTIVE\], 4 \[NO FURTHER ACCRUAL\] and 5 \[INACTIVE\]: Healthy Volunteers
⁃ Males and females aged 18-50 years at time of initial protocol sampling
⁃ Subjects must participate fully and be willing to comply with the procedures of the protocol
⁃ Subjects must be co-enrolled in NIH protocol 08-HG-0059
⁃ Ability of subject to understand and provide written informed consent
⁃ Access to bathing facilities (Cohort 2 \[INACTIVE\])
⁃ Ability to swallow capsules or tablets
‣ Cohort 3 \[INACTIVE\]: Atopic Dermatitis Patients
⁃ Subjects must be aged 2-50 years
⁃ Subjects must be co-enrolled in NIH protocol 08-HG-0059
⁃ Subjects must have a diagnosis of atopic dermatitis on the basis of the criteria defined by UK Working Party s Diagnostic Criteria for Atopic Dermatitis
⁃ Subjects must have a primary care provider
⁃ Subjects must have an Objective SCORAD (SCORing Atopic Dermatitis) of greater than or equal to 15 indicating AD severity of moderate to severe
⁃ Prior to initiation of randomized treatment, subjects must have signs of bacterial skin infections (skin weeping, crusting, and/or pustules)
⁃ Access to bathing facilities
⁃ All subjects and/or their Legally Authorized Representative (LAR) must have the ability and agree to participate fully and comply with
‣ the procedures of the protocol and provide informed consent. Pediatric patients will be included in age appropriate discussions and
‣ age appropriate assent will be obtained in accordance with NIH guidelines.
• Ability of subject to understand and provide written informed consent
‣ Cohort 6: Healthy Volunteers
⁃ Subjects previously enrolled in Cohorts 1 \[NO FURTHER ACCRUAL\] and 4 \[INACTIVE\] who completed on-protocol antibiotic regimen
⁃ Subjects must participate fully and be willing to comply with the procedures of the protocol
⁃ Ability of subject to understand and provide written informed consent