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Enhanced basal and stimulated PMN chemiluminescence activity in children with atopic dermatitis: stimulatory role of colonizing staphylococci?

In adults, intense staphylococcal skin colonization and hyperactivity of polymorphonuclear leukocyte (PMN) oxidative metabolism are characteristic features of atopic dermatitis. Precise data on childhood atopic dermatitis are lacking. In a prospective study we analysed the PMN chemiluminescence activity with special reference to staphylococcal stimuli in 19 children (mean age 6.2 years) with mild to moderate atopic dermatitis. Staphylococcus aureus was isolated from 17/19 (90%) of children with atopic dermatitis and 13/45 (29%) of healthy age-matched controls (p less than 0.001). The mean (SEM) chemiluminescence activity of unstimulated atopic dermatitis-PMN was 0.34 (0.009) (controls: 0.092 (0.003) x 10(6) cpm/10(6) PMN/min (p less than 0.02). Staphylococcal antigens (S. aureus, S. epidermidis, S. haemolyticus) induced a 1.9-3.1-fold higher peak chemiluminescence response in children with atopic dermatitis than in controls (p less than 0.05). The time interval until peak chemiluminescence activity was considerably shorter for all stimuli in atopic dermatitis. We conclude that PMN of children with atopic dermatitis are "primed", showing enhanced release of reactive oxygen metabolites even in the "resting" state, and are easily stimulated by staphylococcal antigens present on the skin of patients with atopic dermatitis from early childhood on. We speculate that PMN hyperreactivity may contribute to chronic skin damage in atopic dermatitis.

Adolescent↗
PubMed1992

Eyelid dermatitis: an evaluation of 150 patients.

This study was performed to evaluate eyelid dermatitis in a group of patients of our Allergy Unit between January 1990 and April 1991. Among the 1158 patients seen during this period, 150 had eyelid dermatitis: 135 females and 15 males, with a mean age of 35 years. Of the 150 patients with eyelid dermatitis, 54 had eczema localized to the eyelids only, 49 to the eyelids and face, 19 to the eyelids and hands, and 28 to the eyelids and other sites. 98 patients (65.3%) were diagnosed as having allergic contact dermatitis, 25 (16.6%) irritant contact dermatitis, 21 (14%) atopic dermatitis, and 6 (4%) seborrhoeic dermatitis. Patch test reactions to nickel sulphate, Kathon CG and fragrance-mix occurred more frequently in patients with eyelid dermatitis than in those without.

Adult↗
PubMed1976

Sulfur amino acid requirement and foot pad dermatitis in turkey poults.

Five experiments were conducted with Large White poults to determine the effect of methionine and other sulfur-containing compounds on the incidence and severity of dermatitis and on growth and feed efficiency to three or four weeks of age. The poults were housed in battery brooders with wire screen floors in four experiments" and in floor pens with litter in one experiment. Male turkeys were used in four experiments and female turkeys in one experiment. Either a corn-soy diet or a cornstarch-soy diet was used as the basal diet in the various studies. A high incidence of foot-pad dermatitis was observed in poults fed the basal diets unsupplemented with methionine. A high incidence of a dermatitis on the upper part of the beak was also observed in poults maintained in battery brooders but not in floor pens. Adding methionine to the diets significantly lowered the incidence and severity of dermatitis, but cystine and potassium sulfate failed to modify dermatitis. Some foot-pad dermatitis was still observed in poults fed levels of methionine more than adequate to meet the requirements for optimum growth and feed efficiency. The incidence and severity of foot-pad dermatitis generally increased with age during the experiment among poults fed methionine-supplemented diets. Although methionine deficiency is a major cause of foot-pad dermatitis in poults, other environmental or dietary factors also appeared to be involved in the development of the condition. The methionine requirement for optimum growth, feed efficiency, and prevention of dermatitis was approximately 0.6% or 2.1 g. per mcal. of metabolizable energy (M.E.). This is higher than the present recommendation of the National Research Council. With corn-soybean meal diets the requirement for total sulfur amino acids is approximately 1.05% or 3.7 g. per mcal. of M.E.

Amino Acids, Sulfur↗
PubMed1977

Atopic dermatitis and tuberculin reactivitiy.

Transient suppression of already established tuberculin reactivity by a wide-spread, allergic contact dermatitis as well as by primary irritant contact dermatitis has been recently reported. Similar transient suppression of tuberculin reactivity by the eczematous inflammation of atopic dermatitis is now shown to occur. Thus, when the dermatitis is active, atopic dermatitis patients show diminished tuberculin reactivity. While they are in remission, however, a significant increase of their tuberculin reactivity occurs. Before the onset of dermatitis, their tuberculin reactivity was normal. Healed patients showed normal tuberculin reactivity. The presence of dermatitis may play an important role in the diminished cell-mediated immunity in atopic dermatitis.

Adolescent↗
PubMed1979

Failure to detect gliadin or gliadin binding sites in the skin of patients with dermatitis herpetiformis: immunofluorescence, organ culture and autoradiographic studies.

Recent investigations indicate an abnormal binding of gluten or gliadin to lymphocytes or intestinal mucosa cells in gluten sensitive enteropathy. Since dermatitis herpetiformis is closely associated to gluten sensitive enteropathy, similar receptors could also exist in the skin of patients with dermatitis herpetiformis. To prove this hypothesis, skin of normal volunteers and uninvolved skin of 3 patients with dermatitis herpetiformis was investigated for the presence of gliadin and gliadin binding sites. In vivo bound gliadin was not found by direct immunofluorescence using 3 different rabbit antigliadin antisera. In order to test skin for gliadin binding sites, normal sera and autologous dermatitis herpetiformis sera containing 25 mg% gliadin and tritium labeled gliadin, respectively, were used for incubation of normal and dermatitis herpetiformis skin cryocut sections and of normal and dermatitis herpetiformis skin specimens, grown under organ culture conditions. As checked by direct immunofluorescence and autoradiography, there was no specific in vitro binding of gliadin, indicating that gliadin does not fix to normal human or dermatitis herpetiformis skin. Thus, the role of gliadin in the fixation in vivo, of antibodies or immune complexes to skin in dermatitis herpetiformis, remains obscure.

Antibodies↗
PubMed1977

An in vitro study of depressed cell-mediated immunity and of T and B lymphocytes in atopic dermatitis.

Lymphocyte transformation tests, E binding(T) rosette assay and immunofluorescent preparations of B cells were studied in patients with atopic dermatitis, and also in healthy controls. Most of the patients were found to have high levels of IgE in serum. The patients were studied both during severe bouts of dermatitis and also when the dermatitis was almost healed. Lymphocyte transformation tests showed that patients were hyporeactive to PPD and herpes simplex antigen in vitro, both during periods of severe dermatitis and also when the dermatitis was in remission. The response to PHA in the patients was normal in vitro. No factors which could reduce cell-mediated immunity in vitro were found in patients' sera. A decreased number of T lymphocytes and a slight increase in the number of immunoglobulin-bearing lymphocytes (B cells) were demonstrated in the patients, both during remission and during recurrence of severe dermatitis. In 3 of 8 patients, increased numbers of IgE-bearing lymphocytes were found to be present when the patients had severe dermatitis. A possible correlation between high serum levels of IgE and depressed cell-mediated immunity in patients with atopic dermatitis is discussed.

Adult↗
PubMed1975

Occupational dermatitis in a 10-year material.

This study included 1,752 patients considered to have occupational dermatoses. The most common diagnosis was contact dermatitis. The dermatitis was of an allergic type in three-quarters of men and in half of women. One-fifth of the women with irritant contact dermatitis had an atopic history. Contact dermatitis was localized on the hands in 94% of women and in 84% of men. The most common allergens in men were chromium, rubber and plastic, and in women nickel, rubber and chromium. Chromium allergy occurred in four-fifths of the men in the building, metal and tanning industries. In one-fifth of the women, nickel allergy developed in cleaning work. Rubber allergy developed in the rubber industry in one-fifth of the cases. Half of the women with contact dermatitis were engaged in either nursing or cleaning work. A follow-up 2-3 years after treatment of 555 patients with contact dermatitis was completed by means of questionnaires. The eczema was healed in one-quarter of the patients, one-half had periodic symptoms, and one-quarter had permanent symptoms. The prognosis was the same for those who changed their work or stopped working as it was for those who continued their eczema-inducing work.

Adult↗
PubMed1992

Effectiveness of various barrier preparations in preventing and/or ameliorating experimentally produced Toxicodendron dermatitis.

BACKGROUND: Despite extensive research on hyposensitization and prior application of topical barrier preparations, efforts to prevent Toxicodendron dermatitis have been only minimally successful. OBJECTIVE: Seven different barrier creams were evaluated for topical protection against experimentally produced Toxicodendron dermatitis in a randomized, double-blind study. METHODS: Twenty patients had the seven barrier creams randomly applied to eight test sites (one untreated area as control) on each forearm before application of the Toxicodendron extract. Development of Toxicodendron dermatitis was followed for 8 days, with measurements of erythema, induration, vesiculation, and global severity taken at each site on days 1, 2, 3, 4, and 7 after Toxicodendron application. RESULTS: The barrier creams Stokogard, Hollister Moisture Barrier, and Hydropel significantly reduced the erythema, induration, and global severity of Toxicodendron dermatitis and did not differ from each other. The percent reductions in global dermatitis severity per day of assessment for the seven barriers in order of effectiveness were as follows: Stokogard, 59%; Hollister Moisture Barrier, 52%; Hydropel, 48%; Ivy Shield, 22%; Shield Skin, 13%; Dermofilm, 13%; and Uniderm, -9%. During the 8-day period, a significantly greater number of test sites pretreated with Stokogard, Hollister Moisture Barrier, and Hydropel were free of dermatitis compared with control sites and sites treated with the other four barriers. CONCLUSION: The results indicate that Stokogard, Hollister Moisture Barrier, and Hydropel are effective in the prevention of Toxicodendron dermatitis.

Administration, Cutaneous↗
PubMed1992

Genetic risk for asthma, allergic rhinitis, and atopic dermatitis.

In order to explore the genetic risk of a child with a family history of allergies developing asthma, allergic rhinitis, or atopic dermatitis, questionnaires filled in by 6665 families were analysed. The data were collected in a population based cross sectional survey of 9-11 year old schoolchildren living in Munich and southern Bavaria. The relation between asthma, allergic rhinitis, and atopic dermatitis and the number of allergic first degree relatives, and the type of allergic disease was examined. Analyses were done separately for families with single or multiple allergic diseases. In families with one allergic parent the risk of the child developing asthma was increased by asthma in a parent, with an odds ratio (OR) of 2.6 (95% confidence interval 1.7 to 4.0) but not by parental allergic rhinitis with OR 1.0 (0.7 to 1.5) or atopic dermatitis, OR 1.0 (0.6 to 1.6). For allergic rhinitis the highest risk with OR 3.6 (2.9 to 4.6) was observed with allergic rhinitis of one parent, apparently lower for asthma of one parent, OR 2.5 (1.6 to 4.0) or atopic dermatitis, OR 1.7 (1.1 to 2.5). Children with parental atopic dermatitis had a high risk for atopic dermatitis, OR 3.4 (2.6 to 4.4), compared with children with parental asthma, OR 1.5 (1.0 to 2.2), or parental allergic rhinitis, OR 1.4 (1.1 to 1.8). Risk factors in families with combined allergies of two relatives (parents and siblings) were analysed separately for the different combinations. These results support the hypothesis that asthma, allergic rhinitis, and atopic dermatitis are multifactorial diseases brought about by various familial and environmental influences.

Asthma↗