SAIGE I: Staphylococcus aureus, Immunological, Genetic, and Environmental (SAIGE) Factors Contributing to Atopic Dermatitis and the Use of Ceramide-Containing Skincare.

Atopic dermatitis (AD) is a common heterogeneous disorder that typically starts in infancy and early childhood, is associated with the development of comorbidities, and may persist into adulthood. Skin barrier dysfunction is a pivotal contributor to AD and is impacted by S. aureus colonization and immunological, genetic, and environmental (SAIGE) factors. Managing AD in clinical practice remains challenging due to multiple contributing SAIGE factors. A global expert panel of 7 pediatric dermatologists and dermatologists used a modified Delphi process comprising face-to-face discussions and an online follow-up to define five consensus statements providing recommendations based on the literature, clinical experience, and the panel’s opinion for healthcare providers treating pediatric patients with AD. The panel defined SAIGE factors that compromise skin barrier function and contribute to AD development. The recommendations focus on the impact of SAIGE factors in pediatric AD development, reducing exposure to modifiable risk factors to mitigate skin barrier dysfunction. Continuous skincare that is initiated from birth may delay and mitigate AD, specifically in high-risk populations. According to panel consensus, recognizing and mitigating SAIGE factors and initiating ceramide-containing skincare from birth are important. The panel recommendations underscore the need for clinician education to improve knowledge of the impact of SAIGE factors and therapeutic mitigation strategies to delay flare development and reduce AD severity.