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Biomedical subjects

E Svejgaard

Publications and source records attributed to E Svejgaard.

At least 19 recordsLinked to original sources
PubMed1992

Pityrosporum ovale and atopic dermatitis in children and young adults.

Children aged 0-21 years, 60 children with atopic dermatitis (AD), 40 children with rhinoconjunctivitis and or asthma (RA) and 40 children with no atopic history (HC) were studied to evaluate the relationship between skin colonisation with Pityrosporum ovale and the occurrence of specific IgE antibodies to P. ovale. The following studies were done: culture for P. ovale, measurement of IgE antibodies to P. ovale (skin prick test, RAST), Candida albicans, and Cladosporium herbarum (RAST) and IgG antibodies to P. ovale. P. ovale could be cultured with about the same frequency in children and young adults with AD and age-matched children with or without other atopic manifestations. In spite of similar colonisation, IgE antibodies against P. ovale occur only in atopy and more frequently in children with AD than in those with other types of atopic disease.

Adolescent↗
PubMed1990

Immune reactions to Pityrosporum ovale in adult patients with atopic and seborrheic dermatitis.

Pityrosporum ovale is a lipophilic yeast commonly present in the seborrheic areas of the skin of adults. Fifty-five young adult patients with atopic dermatitis, 19 patients with seborrheic dermatitis, and 19 healthy control subjects were examined for immune reactions to P. ovale, including tests for specific IgE antibodies (prick test, histamine release), IgG antibodies and epicutaneous testing. IgE antibodies against P. ovale were found in two thirds of the patients with atopic dermatitis and were more frequent in patients with lesions predominantly in the seborrheic areas. In addition, some atopic patients had positive reactions to epicutaneous tests, which suggest that delayed allergic reactions to P. ovale may also be important. In patients with seborrheic dermatitis, no evidence of immediate or delayed hypersensitivity to P. ovale was found. IgG antibody levels were low in all groups.

Adolescent↗
PubMed1990

Itraconazole in onychomycosis. Open and double-blind studies.

Fifteen patients with onychomycosis caused by Trichophyton rubrum or T. mentagrophytes were treated with 50 mg itraconazole daily for 3 to 6 months. Fingernail infections were cured in two patients and two responded with marked improvement, e.g. small residual lesion remained and positive microscopy. The infected toenails were markedly improved in nine of 13 patients. Twenty-seven patients with T. rubrum infected nails were given 100 mg itraconazole daily for 6 to 8 months. Fingernails were cured in nine of eleven patients, while toenail infections were cured in one and markedly improved in 14 of 25 cases. Responses to 100 mg itraconazole versus 500 mg griseofulvin daily for 6 months were compared and evaluated in 20 patients with onychomycosis caused by T. rubrum or T. mentagrophytes. Fingernail infections responded equally well to both drugs with half of the cases cured or markedly improved, whereas toenails responded better to itraconazole, e.g. 4 of 9 were markedly improved versus one of 10 on griseofulvin. In patients given 50 mg itraconazole daily a significantly better response was observed in persons below 30 years of age compared to older individuals. Also, side-effects which were mainly mild and located to the gastro-intestinal tract or the central nervous system were seen less often in this group of patients on the low dose. Follow-up studies showed that cured nails remained cured, that markedly improved toenails continued to improve until cure in three of 21 patients but that aggravation took place through the one year of follow-up in more than half of the patients evaluated as markedly improved at the end of treatment.

Adolescent↗
PubMed1990

The role of microorganisms in atopic dermatitis.

The course of atopic dermatitis is widely determined by environmental factors such as physical or psychogenic stress and reactions to allergens or microorganisms. The latter include bacteria, viruses and fungi, especially Staphylococcus auerus, Herpes simplex virus (HSV), and Pityrosporum orbiculare. In childhood, Impetigo around the big joints is frequently seen, while the characteristic reaction to S. auerus in the young adults is pruritic pustules on the extremities or an exacerbation of the eczema to an exudative dermatitis. Similarily, P. orbiculare may induce a flare-up of the eczema of the head and neck, while HSV may cause a true wide-spread infection known as eczema herpeticum. An immunological disorder, a fragile skin, and special properties of the microorganism may account for the altered response to infection or severe colonization in the patient with atopic eczema. During exacerbations of the eczema, supplementary treatment with proper antimicrobial agents has been shown to be of great value.

Bacterial Physiological Phenomena↗
PubMed1989

Recent investigations on the relationship between fungal skin diseases and atopic dermatitis.

Atopic dermatitis may be associated with chronic dermatophyte infections and Pityrosporum related disorders. Recent epidemiologic studies in school children and young recruits have confirmed that atopic individuals have an increased susceptibility to Trichophyton rubrum infections of the feet and an increased risk for persistent infections. In contrast, an investigation on skin reactivity in dermatophyte infected atopic patients indicated that a group of these patients is fully able to eliminate the fungi concomitant with the development of a delayed type skin reactivity. Facial erythema and scaling, often including neck and shoulders, is present in many young adults with atopic dermatitis. Preliminary data from a Danish-Swedish investigation have shown that atopic dermatitis patients with head-neck-shoulder dermatitis compared to a group without this disorder and normal individuals more often demonstrate positive prick test, RAST and specific histamine release using extract of Pityrosporum ovale. These findings indicate that the presence of Pityrosporum ovale in the skin may cause an allergic reaction leading to dermatitis.

Arthrodermataceae↗
PubMed1988

Esophageal candidosis in progressive systemic sclerosis: occurrence, significance, and treatment with fluconazole.

Esophageal mucosal brushings from 51 consecutive patients with progressive systemic sclerosis (PSS) (group I), 18 PSS patients continuously treated with high-dose ranitidine or omeprazole (group II), 34 controls referred to the outpatient clinic for endoscopy (group III), and 10 patients receiving long-term potent antireflux therapy for idiopathic gastroesophageal reflux (group IV) were cultured for Candida albicans. There were 44%, 89%, 9%, and 0% Candida albicans culture-positive patients in groups I through IV, respectively. Fifteen patients with candida esophagitis from group II were treated with fluconazole systemically. Eleven and 14 patients became culture-negative after 2 and 4 weeks' treatment, respectively. Three months after fluconazole withdrawal the recurrence rate was 100%. It is concluded that esophageal dysmotility predisposes for candidosis. Adding gastric acid inhibitory treatment to dysmotility enhances the risk significantly (p less than 0.01). The efficiency of fluconazole treatment was close to 100%, but so was the recurrence rate within a short period.

Adult↗
PubMed1986

Tinea pedis and erythrasma in Danish recruits. Clinical signs, prevalence, incidence, and correlation to atopy.

Prior to military service, 665 recruits were examined clinically and microbiologically for tinea pedis and erythrasma and 546 of these were reexamined at the end of military service. The prevalence of clinical signs, erythrasma, and dermatophyte infection at the first investigation was 58.8%, 51.3%, and 6.2%, respectively, and at the second investigation, 81.1%, 77.1%, and 7.0%, respectively. The incidence of tinea pedis was 4.2% during the 9 months of military service. Of those infected at the first visit 41% had persistent infection mainly due to Trichophyton rubrum, whereas new infections were largely caused by Trichophyton mentagrophytes. Some of those persistently infected had signs of chronicity at the follow-up visit, indicating that chronic dermatophytosis may become established in the early twenties. The prevalence of atopy was 15.0% in all the recruits but was almost 50% in those with persistent tinea pedis.

Adolescent↗
PubMed1986

Humoral antibody responses in the immunopathogenesis of dermatophytosis.

Cell-mediated immunity is generally considered as the principal immunological response to dermatophyte infection. However, certain clinical manifestations associated with a humoral antibody response occasionally occur as complications to dermatophytosis (e.g. vasculitis, urticaria). Immediate wheal reaction to intradermal application of "trichophytin" is frequent in patients with chronic T. rubrum infection and can be passively transferred with serum, which demonstrates the presence of specific IgE antibodies in these patients. Crossed immunoelectrophoresis and modifications thereof were applied for studies of (i) the antigenic structure of dermatophytes in sera from patients with dermatophytosis. The antigenic composition was found to differ between species but was characteristic and constant for different strains of the same species. Partial cross reactivity between different species, especially T. rubrum and T. mentagrophytes was noted. The presence of specific IgG antibodies towards corresponding dermatophytes was associated with tinea capitis (100%), tinea pedis with dermatophytid eruption (62%) and chronic T. rubrum infection (25%). Sera from 50 healthy persons were all negative. Specific IgE antibodies toward T. rubrum were demonstrated in serum from eight patients with chronic T. rubrum infection while specific IgE antibodies were not present in sera from ten patients with tinea capitis and four controls. The possible role of IgG and IgE antibodies in inflammatory and non-inflammatory dermatophyte infections is discussed.

Antibody Formation↗
PubMed1986

Recent trends in the immunology of dermatophytosis.

The application of modern techniques for in vitro studies of the cell-mediated and humoral immune responses has lead to clarification of some immunological mechanisms in human acute and chronic dermatophytosis.

Antibodies, Fungal↗
PubMed1986

Epidemiology and clinical features of dermatomycoses and dermatophytoses.

Dermatophytosis, candidosis and pityriasis versicolor account for the majority of fungal skin diseases in Denmark and are seen in 8% of patients with dermato-venerological problems. In children, zoophilic species like Microsporum canis (from cats), Trichophyton (T) verrucosum (from cattle) and T. mentagrophytes granulare (from rodents) are the common causes of dermatophytosis and are seen in approximately 15% of all cases. Anthropophilic species are the main cause of dermatophytosis in adults and are isolated more often in males than in females. T. rubrum (48%), T. mentagrophytes interdigitale (14%) and Epidermophyton floccosum (10%) are the species usually involved. The feet are the site of infection in about 50% of the cases, toenails, glabrous skin and inguinal folds equally often in 42%, palms in 6% and the scalp in 2%. The prevalence of tinea pedis in 15-year-old school children and 20-year-old males was found to be 4% and 6%, respectively. A relative risk of 3.1 for contracting tinea pedis when being an atopic or having an atopic family was demonstrated in the former group. Pityriasis versicolor and candidosis of skin and mucosal membranes are both secondary dermatomycoses caused by endosaphrophytic yeasts. Local or systemic predisposing disorders are usually required for the development of symptoms.

Adolescent↗
PubMed1986

Immunologic properties of a fraction of Trichophyton rubrum with affinity to concanavalin A.

The antigens of Trichophyton rubrum were studied by means of concanavalin A affinity chromatography and immunoelectrophoresis. The lectin was found to bind 8 of the 35 antigens present in a crude T. rubrum extract. This concanavalin A fraction induced antibody formation in rabbits. Moreover, some human anti-T. rubrum antibodies reacted with this fraction, which was also able to induce lymphocyte transformation in vitro in lymphocytes from infected patients. In addition, skin test studies demonstrated its ability to elicit relevant immediate- and delayed-type hypersensitivity reactions. Thus the antigens of the concanavalin A fraction elicit both IgE and precipitating antibodies and cell-mediated immunity.

Animals↗
PubMed1985

Studies of HLA-ABC and DR antigens in pure atopic dermatitis and atopic dermatitis combined with allergic respiratory disease.

The HLA-ABC antigens were investigated in 29 patients with pure atopic dermatitis and 43 patients with atopic dermatitis combined with atopic respiratory disease (ARD). Furthermore, the DR antigens were studied in 10 patients with dermatitis alone and in 24 patients with combined atopic disease. The frequencies of antigens and the HLA phenotypes A1, B8 and A3, B7 in the entire group of patients and in two subgroups did not differ significantly from those in controls, when correction was made for the number of comparisons made. However, the frequency of HLA-DR7 was strikingly low, but this observation needs confirmation. IgE levels were measured in eight patients with pure dermatitis and in 24 patients with dermatitis combined with ARD and found equally increased in both groups compared to controls.

Adolescent↗
PubMed1985

Oral ketoconazole as an alternative to griseofulvin in recalcitrant dermatophyte infections and onychomycosis.

In an open study 58 patients with chronic dermatophytosis mainly caused by Trichophyton rubrum and five patients with Tinea capitis were treated with ketoconazole. The indications were ineffectiveness of or side effects to griseofulvin. Response to treatment varied from 1 week in scalp infections to 11 weeks in toe-nail lesions. Dermatophytosis of hands and feet were cured in 25%, marked improvement observed in further 30%. Toe- and finger-nail infections were cured in 20% and 43%, respectively, and marked improvement seen in further 36% and 14%, respectively. All scalp infections were cured without relapse. Recurrence of infections before 6 months after treatment was seen in 55-60% of hand and foot lesions and 33-38% of finger and toe-nail infections. In a double-blind study 20 patients with onychomycosis caused by T. rubrum the efficacy of ketoconazole was compared to that of griseofulvin. Cure rates in the griseofulvin group were 25% for finger-nails and zero for toe-nails, while 50% and 57% experienced marked improvement. In the ketoconazole group, 25% of finger-nail infections were cured and 75% markedly improved, while the corresponding figures for toe-nails were 11% and 89%, respectively. Adverse reactions to ketoconazole were seen in 29 (46%) of the patients in the open study and in 2 (20%) in the double-blind study and comprised mainly minor complaints. Side effects caused discontinuation in 12 patients, in two of whom due to toxic hepatitis.

Administration, Oral↗
PubMed1985

Trichophyton rubrum specific IgE in serum in patients with chronic T. rubrum infection as demonstrated by crossed radio-immuno-electrophoresis.

By means of crossed radio-immunoelectrophoresis specific IgE antibodies to Trichophyton rubrum were demonstrated in serum from seven of eight patients with chronic T. rubrum infection. Total IgE values were within normal limits in all. In contrast, no specific IgE antibodies were found in sera from 10 patients with inflammatory ringworm lesions due to Microsporum canis, T. mentagrophytes or T. verrucosum or from six non infected controls. A long-lasting exposure to a constant antigen load is considered of importance for the development of humoral immunity including IgE production.

Antibodies, Fungal↗
PubMed1984

Clinical and immunological studies in chronic dermatophytosis caused by Trichophyton rubrum.

Twenty-six patients with chronic dermatophytosis (CD) by Trichophyton rubrum (TR) through one year were included in a double-blind clinical trial with Levamisole/Placebo. All patients were treated with griseofulvin concomitantly. Before, during and after the trial, studies of the cellular and humoral immune response were performed. The result of treatment with griseofulvin plus levamisole (62.5% cured or improved) did not differ from that of griseofulvin plus placebo (58% improved). All patients but one showed normal general cellular immune responses. Stimulation of lymphocytes with a specific TR antigen extract showed a significantly stronger response in the patient group than in the group of 39 controls (p = 0.01-0.00003) at all investigation dates. Immediate weal reactions to the TR extract were seen in 42% of the patients and increased concentration of IgE antibodies was demonstrated in 46%. Specific IgG antibodies towards TR were observed in 42% of the patients. The presence of specific IgG antibodies and a strong specific cellular immune response were related to the severity of clinical involvement. Environmental factors and atopy were associated disorders in 81% and 77% respectively.

Adult↗
PubMed1984

Antigen-free diet in adult patients with atopic dermatitis. A double-blind controlled study.

The efficacy of an antigen-free diet on the activity of atopic dermatitis was examined in a double-blind study, comprising 33 adults with severe atopic dermatitis. The antigen-free diet (Vivasorb) was compared to a placebo diet during three weeks of hospitalization. Twenty-five patients were evaluable, two of whom had their diet stopped after a few days due to exacerbation. Nine patients improved, while 16 patients were unchanged. Among those who improved five patients had Vivasorb and four placebo diet. In the remaining group 11 patients had Vivasorb and five had placebo. Four patients reported of less pruritus, sleeplessness and antihistamine consumption (three Vivasorb, one placebo) while 21 did not (13 Vivasorb, eight placebo). Thus, there were no significant differences between the groups. Paraclinical studies of circulating eosinophilocytes, serum IgE, orosomucoid, HLA-antigens, and immunofluorescence of skin biopsies showed no differences between the Vivasorb and the placebo groups. The results from the examination of this relatively small number of patients suggest that elementary intolerance plays little role in the etiology of atopic dermatitis in adults.

Adolescent↗