Open questions — skin-barrier-dysfunction

• What fraction of toddlers with eczema in South Africa (and other non-European populations) carry FLG loss-of-function mutations, and which variants? European figures (10–60%) may not transfer.
• In toddlers, does early aggressive control of eczema (emollients ± topical steroids) actually reduce later food allergy, as the dual-allergen exposure hypothesis predicts? Emollient-only trials (BEEP, PreventADALL) were negative; results from steroid-inclusive trials (e.g. PACI) are pending.
• Is the hard-water association causal? Softeners did not help established eczema, but could softening water from birth prevent onset in high-risk infants?