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PubMed1995

[The correlation between the levels of anti-Malassezia furfur IgE antibodies and severities of face and neck dermatitis of patients with atopic dermatitis].

It is well known that the seborrheic areas including the face and neck of patients with atopic dermatitis (AD) are frequently affected after adolescence. Malassezia furfur (MF), a lipophilic yeast and a normal habitat of seborrheic areas, has been thought to be one of the most important factors in provoking face and neck lesions of AD. In the present study, we assessed serum levels of anti-MF IgE antibodies by enzyme-linked immunosorbent assay (AlaSTAT method) in 123 adolescent and adult AD patients and evaluated the correlations between levels of anti-MF IgE and those of total IgE and some other allergen-specific IgE. The correlation between the levels of anti-MF IgE and severities of face and neck dermatitis was also assessed. Anti-MF IgE antibodies were detected in high frequency in AD patients (77%), while they were not found in controls. Significant correlations were noted between the levels of anti-MF IgE and those of total IgE and anti-Candida IgE. The levels of anti-MF IgE were well correlated with the severities of face and neck dermatitis. These result may indicate that MF is an important provocative factor for face and neck dermatitis in AD patients.

Adolescent↗
PubMed1978

Neutrophil chemotaxis in patients with atopic dermatitis without infection.

Atopic dermatitis has been associated with recurrent infection and impaired neutrophil chemotaxis in some patients. In order to determine if dermatitis per se could decrease polymorphonuclear leukocyte (PMN) chemotaxis, we investigated chemotaxis in 13 patients with atopic dermatitis and no clinical or historical evidence of recurrent or severe infections. Most patients had extensive, but mild, disease. Leukocyte chemotaxis was measured by the Boyden chamber and agarose techniques; There was no difference between patient and control neutrophil chemoatactic activity. These findings suggest that atopic dermatitis is not ordinarily associated with impaired PMN chemotaxis in the absence of generalized erythroderma or increased susceptibility to infection.

Adolescent↗
PubMed2002

Multifocal relapsing-remitting myelitis in a patient with atopic dermatitis: multiple sclerosis or atopic myelitis?

We describe a patient with multifocal relapsing-remitting myelitis. This case had abnormal high intensity lesions in the spinal cord at the cervical and thoracic levels on magnetic resonance imaging (MRI). She had complicated atopic dermatitis and high serum IgE levels, which showed strong sensitivity to mite antigen. These features closely resemble those of atopic myelitis, suggesting that atopic myelitis may develop a relapse with multifocal involvement of the spinal cord, which can mimic multiple sclerosis.

Adult↗
PubMed1997

Neuropeptide modulation of Th1 and Th2 cytokines in peripheral blood mononuclear leucocytes in atopic dermatitis and non-atopic controls.

The neuropeptides substance P (SP) and vasoactive intestinal peptide (VIP) are present in the nerve endings in the skin and SP is thought to be present at abnormal concentrations in atopic dermatitis (AD) patients. Th1 and Th2 imbalance in AD has been the focus of recent immunological investigations and a preferential Th2 response by atopic cells on stimulation has been proposed. We wished to establish whether neuropeptides acted on T cells to affect their cytokine profile directly, using an accessory cell-independent stimulus (anti-CD3 monoclonal antibody and neuropeptides at several concentrations. We found that interferon (IFN)-gamma and interleukin (IL)-4 release were lower in AD. SP had an enhancing effect on both IFN-gamma and IL-4 at physiological concentrations (10(-10)-10(-6) mol/L) in AD, which was significantly different from controls (P < 0.05). VIP had inhibitory effects over this range in AD and in controls. We conclude that these neuropeptides have a modest effect on T-cell cytokine release and that their action is not cytokine-specific.

Adult↗
PubMed2003

[Atopic dermatitis and Malassezia species: a study of antigenic components of Malassezia species for immunoglobulin E of patients with atopic dermatitis].

Antigenic components extracted by treatment with beta-mercaptoethanol from M. furfur, M. globosa, M. restricta, M. slooffiae, and M. sympodialis were studied for immunoglobulin E antibodies in sera of patients with atopic dermatitis. CBB staining and lectin blots of the extracts showed that each Malassezia species contained species-dependent components at the protein level. In a Western blot with the 2-ME extracts,IgE antibodies against the Malassezia species were found in sera of 83% (for M. globosa), 74% (for M. sympodialis), 65% (for M. furfur), 56% (for M. restricta) and 50% (for M. slooffiae) of the AD patients. In the Western blot inhibition test, the 2-ME extract of M. globosa partially inhibited the reaction of the antigenic components of other Malassezia species with the patients IgE antibodies. These results indicated that Malassezia species contained both species-specific and common antigenic components at the IgE antibody level. A major component of M. globosa was isolated from the 2-ME extract of this fungus by ion-exchange column chromatography and was referred to as Malg46b. Dot blot with the Malg46b containing fraction immunologically reacted with 69% of the sera of the patients, and with 83% of the sera of those who were positive for IgE antibodies to the 2-ME extract of M. globosa in Western blot. The intensities generated for each dot correlated well with the total intensities generated for the 2-ME extract of M. globosa in Western blot (r=0.763) The polyclonal antibody to Malg46b reacted strongly only with the 2-ME extract of M. globosa and reacted slightly with M. restricta. These results indicate that a glycoprotein, Malg46b of M. globosa, is dominantly expressed in this fungus and is a possible major antigen for IgE antibodies in patients with AD.

Antibodies, Fungal↗
PubMedDate not supplied

Sugar is not an aggravating factor in atopic dermatitis.

Patients with atopic dermatitis frequently blame food for worsening their eczema. Recently, a sugar-free diet has become very popular among German patients. In order to investigate whether sucrose is an aggravating factor in atopic dermatitis, we conducted a prospective study in 30 patients. Double-blind, placebo-controlled food challenges with sugar were performed during a sugar-free diet period, which was started one week prior to the first challenge. Study parameters included the SCORAD index and eosinophilic cationic protein levels, which were determined before diet, on food challenges and one day after. In 29 evaluable patients we observed no significant difference in study parameters after the verum challenge compared to the placebo challenge. From these results, we conclude that sugar is not an aggravating factor in atopic dermatitis, which contradicts the view of many patients and underlines the importance of evidence-based medicine in the guidance of patients.

Adolescent↗
PubMed2001

Anxiety level and severity of skin condition predicts outcome of psychotherapy in atopic dermatitis patients.

BACKGROUND: Atopic dermatitis (AD) is a skin disease associated with an increased anxiety level. Psychotherapy studies of AD patients report improvement in anxiety level and skin condition after psychotherapy. METHODS: This psychotherapy study investigated 32 adult AD patients with mild to severe AD. Sixteen participants received 6 months of brief dynamic psychotherapy, while 16 were controls. The participants were compared using Spielberger's State-Trait Anxiety Index (STAI) and Severity Scoring of Atopic Dermatitis Index (SCORAD) pre- and post-therapy, and at follow-up after 12 months. RESULTS: Initially, no outcome differences were found between the two groups; however, a post hoc multiple regression analysis indicated that AD patients with a higher intake level of trait anxiety (TA) showed greater improvement after psychotherapy, in terms of anxiety level and skin condition, than did AD patients with a low intake level of TA. Atopic dermatitis patients with a higher anxiety level, in the no-treatment group, were more likely to discontinue the program. CONCLUSIONS: The results suggest that AD patients with a higher anxiety level are more likely to improve their psychologic and dermatologic condition after psychotherapy, but are more vulnerable to nonadherence when no adequate psychologic treatment is offered. The results underscore the importance of proper psychologic assessment and treatment in addition to dermatologic treatment.

Adult↗
PubMed1976

Atopic dermatitis: etiology and pathogenesis.

Atopic dermatitis is a recognizable phenotype that most likely results from several mechanisms. An increasing number of children with atopic dermatitis are recognized as having immune defects, although the exact incidence of such immunodeficiency states among patients with atopic dermatitis is unknown. Children with atopic dermatitis who suffer recurrent or persistent infections should undergo immunologic evaluation. Ideally, this should include evaluation of cell-mediated immunity as well as neutrophil and monocyte chemotaxis. Further investigation into the beta-blockade theory may enhance our understanding of atopic dermatitis. Careful attention to factors exacerbating atopic dermatitis is essential in understanding this problem. Abnormal sweating, dry skin, sensitivity to contactants, and emotional stress should always be considered in evaluation of children with atopic dermatitis.

Child↗
PubMed1976

Adrenergic mechanisms and the adenyl cyclase system in atopic dermatitis.

Patients with atopic dermatitis have abnormal autonomic responses of the arterioles, pilomotor smooth muscle, and sweat glands. Their lesions have been reported to contain increased amounts of the neurohumors, acetylcholine and norepinephrine, as well as increased activity of acetylcholinesterase and catechol-O-methyltransferase. In vitro studies of epidermis show that beta adrenergic agonists fail to evoke the normal inhibition of mitosis of basal cells of patients with atopic dermatitis. Epidermis removed not only from the lesions, but also from normal-appearing skin, responded abnormally. The increase in intracellular levels of cAMP after exposure to catecholamines was similar in normal and atopic epidermis. Lymphocytes and PMN leukocytes isolated from patients with atopic dermatitis show both a decreased physiologic response (glycogenolysis and inhibition of lysosome enzyme release) and a decreased rise in intracellular levels of cAMP upon incubation with beta agonists, but a normal response to PGE1. Cortisol increases the response of lymphocyte adenyl cyclase to both agonists and, in the case of the patients with atopic disease, more than overcomes the depressed response to beta agonists. Because the leukocytes respond normally to PGE1 and because others have reported normal activities of skin and adenyl cyclase, phosphodiesterase, and protein kinases, we conclude that the step responsible for the diminished beta adrenergic response lies antecedent to the catalytic site of adenyl cyclase.

Acetylcholine↗
PubMed2005

[Genotype analysis of the rRNA gene of Malassezia colonizing the skin surface of patients with atopic dermatitis].

Malassezia species are associated with pityriasis (tinea) versicolor, seborrheic dermatitis, and atopic dermatitis. Presently, eleven species are accepted in the genus Malassezia. Of these, M. globosa and M. restricta colonize the skin surface in atopic dermatitis patients, suggesting that they play a significant role in exacerbating the condition. The two species have different genotypes in the intergenic spacer (IGS) region of the rRNA gene, which correspond to patients and healthy individuals. In addition, the antifungal susceptibilities of the genotypic strains to itraconazole and ketoconazole differ. We found a new analytically significant role of the rRNA gene in Malassezia species, in addition to its use for fungal taxonomy and identification.

Dermatitis, Atopic↗
PubMed2002

Rarity of hypertension in adult patients with atopic dermatitis.

BACKGROUND: Patients with atopic dermatitis show a tendency for vasoconstriction of the small vessels in the skin. As peripheral vasoconstriction contributes to the cause of hypertension, it is natural to suppose that blood pressures might be on the high side in adult patients with atopic dermatitis. In the literature, however, there was little information on the subject. OBJECTIVES: To study the incidence of hypertension in adult patients with atopic dermatitis. PATIENTS/METHODS: Blood pressure was measured in 521 adult patients with active atopic dermatitis (235 males; 286 females) aged 30-59 years, and 87 adults with "healed" atopic dermatitis (26 males; 61 females) aged 34-52 years. The blood pressures were classified as definite hypertension, borderline hypertension or normal blood pressure. RESULTS: In those patients aged 30-39 years with active atopic dermatitis, the incidence of definite hypertension in the male patients and the female patients was 1.1% and 1.6%, respectively. The incidence remained almost at a plateau for the 30-39-year-old age group through to the 50-59-year-old age group, in both the male and female patients. There was no difference in the incidence of definite hypertension between patients with severe dermatitis and patients with mild dermatitis. Adult patients with "healed" atopic dermatitis also showed a low incidence of definite hypertension. CONCLUSIONS: These findings indicate that hypertension is rare in adult patients with atopic dermatitis. It is most probable that the rarity of hypertension is a primary feature of the disease.

Adult↗
PubMed2006

[Atopic dermatitis school: therapeutic education of atopic patients].

The difficulties encountered in treating refractory atopic dermatitis may be secondary to the severity of the disease, to poor compliance or to the extent of the psychological impact. Therapeutic education of the patient, as performed in the atopic dermatitis school, represents a major breakthrough in the care of such patients.

Dermatitis, Atopic↗
PubMed1991

Local cholinergic sweat stimulation in atopic dermatitis. An evaporimetric study.

In atopic dermatitis the nature of potential sweating disturbances is still obscure. Using an evaporimeter, local sweating response to a supra-threshold concentration of methacholine and baseline water loss were measured from non-eczematous back skin of 167 young males in five main groups (pure atopic dermatitis, atopic dermatitis with rhinitis/asthma, rhinitis/asthma, non-atopic dermatosis, and non-atopic healthy). Subjects with atopic dermatitis were further divided into two subgroups: dry-looking and normal-looking back skin. Compared with non-atopic healthy individuals, the sweat loss was significantly depressed (p less than 0.01) and the baseline water loss significantly increased (p less than 0.001) in the main groups with atopic dermatitis. Both these trends were most distinct in atopic dry-looking skin, whereas in normal-looking atopic skin only the sweat loss was depressed (p less than 0.05). Respiratory atopy had no effect on the sweating response. No significant correlation was found between the individual baseline water loss and the sweating response.

Adolescent↗
PubMed2003

Current management of atopic dermatitis and interruption of the atopic march.

Treatment of atopic dermatitis requires a comprehensive approach that includes evaluation of potential triggers and education of the patient and family regarding proper avoidance measures. Hydration of the skin and maintenance of an intact skin barrier remain integral to proper management. Although topical corticosteroids have been a mainstay of anti-inflammatory therapy, the newer topical calcineurin inhibitors offer advantages for treatment of this chronic, relapsing disease. Studies aimed at defining optimal combination therapy and early intervention might change the treatment paradigm for atopic dermatitis.

Anti-Inflammatory Agents↗
PubMed2004

[Anti-allergic action effect of Pseudolarix amabilis Rehd. extract and its efficacy on atopic dermatitis].

Pseudolarix amabilis Rehd. extract was examined in vitro for antibacterial effects, anti-inflammatory effects, and inhibitory effects on histamine release. Pseudolarix amabilis Rehd. extract was also examined for efficacy on dermatitis in atopic dermatitis model mice (NC mice) and effects on keratinous moisture level and transepidermal water loss in miniature pigs. Pseudolarix amabilis Rehd. extract had antibacterial effects on Staphylococcus aureus, Candida albicans, and Streptococcus pyogenes; however this antibacterial effect varied with the temperature at which and conditions under which Pseudolarix amabilis Rehd. was extracted. Pseudolarix amabilis Rehd. extract at the final concentration of 2 mg/mL significantly inhibited the hyaluronidase activity; and at 0.005, 0.05, and 0.5 mg/mL, it also significantly inhibited the histamine release. In the mice in which atopic dermatitis had been induced, 28-day administration of Pseudolarix amabilis Rehd. extract at 4 and 400 mg/mL significantly inhibited aggravation of dermatitis without having effects on body weight. In the dorsal skin of miniature pigs, Pseudolarix amabilis Rehd. extract at 4 and 400 mg/mL significantly increased keratinous moisture level with the increase in the number of dosing days, and caused no changes in transepidermal water loss. From the above results, it is clear that Pseudolarix amabilis Rehd. extract inhibits both proliferation of bacteria and inflammation caused by antigens. Furthermore, it is suggested that Pseudolarix amabilis Rehd. extract will serve as a medicinal drug which effectively moistens the skin and prevents and heals dermatitis.

Animals↗
PubMed1996

[Pulmonary function tests and bronchial reactiveness with histamine in patients with atopic dermatitis and bronchial asthma].

Atopic dermatitis and bronchial asthma are genetically dependent diseases, connected with an over-synthesis of IgE antibodies, in which a chronic inflammation is characteristic for their pathogenesis. The coincidence of bronchial hyperresponsiveness and symptoms of atopic dermatitis suggests to investigate the degree of bronchial reactions in atopic dermatitis or asthma patients. The main goal of this analysis was to compare the pulmonary functional tests and the bronchial histamine induced reactiveness in 71 patients. The investigation included 27 atopic dermatitis patients, 12 asthma-prurigo patients and 32 bronchial asthma patients. All of them were tested with "Pneumoscreen" (Jaeger), in order to define: VC, FEV1, FEF50, and Raw. The bronchial reactiveness with 1% histamine solution, was tested on "Bronchoscreen" (Jaeger). In atopic dermatitis and asthma-prurigo patients, no obstructive ventilation impairment was found. The bronchial hyper-reactiveness to histamine was found in 11.1% of atopic dermatitis patients, 16.7% of asthma-prurigo patients and 78.1% of bronchial asthma patients. The coexistence of bronchial asthma and atopic dermatitis increases the degree of bronchial reactiveness.

Adolescent↗