SEARCH · PubMed Health

Results for “DERMATITIS, ATOPIC”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources

PubMed2004

Atopic dermatitis and Staphylococcus aureus.

Atopic dermatitis is chronic, pruritic inflammatory skin disorder strongly influenced by environmental factors. Staplylococcus aurcus is the common pathogen and colonize the normal skin but it is not number of normal skin flora. Damaged protective skin function by atopic dermatitis, the disturbance of quantity and quality of lipids of stratum corneum are some of the reasons for increasing degree of skin colonisation with staphylococcus aureus. We had presented frequency of the isolation staphylococcus aureus from eczematous atopic skin, from the nose and throat of atopic patients and also from clinically unaffected atopic skin in the group of 30 children compared with 15 healthy children without positive atopic family history. Staphylococcus aureus had been significantly more isolated by all earlier mentioned places in atopic group of children. There is a direct correlation between intensity and also extensity of atopic dermatitis and frequency of the isolation of staphylococcus aureus from mentioned places. The role of staphylococcus aureus in pathogenesis of atopic dermatitis was discussed.

Adolescent↗

PubMed2003

Infection in atopic dermatitis.

PURPOSE OF REVIEW: Atopic dermatitis is a chronic inflammatory skin disease commonly seen in children, but it also occurs in adults. This skin disease is often triggered by bacterial, fungal, or viral skin infections. The mechanisms resulting in this increased propensity for skin infections have been an area of active investigation. RECENT FINDINGS: Recent studies suggest that the skin of patients with atopic dermatitis has increased avidity for binding to Staphylococcus aureus and is deficient in its ability to generate antimicrobial peptides needed to eradicate infectious agents. SUMMARY: The current review will examine recent literature on the etiology and pathogenesis of infection in atopic dermatitis. These observations are likely to have importance implications for management of atopic dermatitis.

Dermatitis, Atopic↗

PubMed2002

The prevalence and descriptive epidemiology of atopic dermatitis in Singapore school children.

BACKGROUND: Atopic dermatitis is a common disease that appears to be increasing in frequency during recent decades. Most of the studies are based on the Western population, and there are few data in the Asian population. OBJECTIVES: To determine the prevalence and descriptive epidemiology of atopic dermatitis among school children in the general community in Singapore. METHODS: This is a questionnaire study of 12 323 students done over a 1-year period, comprising 7 year olds (4605), 12 year olds (3940) and 16 year olds (3778) from 19 primary and 17 secondary schools randomly selected in Singapore. All children had a complete cutaneous examination. The diagnosis of atopic dermatitis was based on the U.K. Working Party diagnostic criteria. The questionnaire was translated into Chinese and both the English and Chinese versions were issued simultaneously to the students. RESULTS: The 1-year period prevalence of atopic dermatitis was 20.8%. Atopic dermatitis was present in 22.7% of 7 year olds, 17.9% of 12 year olds and 21.5% of 16 year olds. The overall sex ratio was equal. There were slightly more boys with atopic dermatitis among the younger children (6 and 12 year olds, 1.18 : 1 and 1.19 : 1, respectively) but more girls were affected (1.57 : 1) among the 16 year olds. Atopic dermatitis was more common among the Chinese (21.6%) and Malays (19.8%) compared with the Indians (16%) and other races (14%). The onset of the disease occurred before the age of 10 years in 49.5% of the 16 year olds. "Pure" atopic dermatitis without concomitant respiratory allergies was noted in 788 respondents (30.7%); 1775 (69.3%) suffered from a "mixed" type, with 34.3% having allergic rhinitis, 9.5% having asthma and 25.5% having both asthma and allergic rhinitis. More boys had atopic dermatitis and concomitant respiratory allergies whereas more girls were affected with "pure" atopic dermatitis alone (1.4 : 1). At least one first-degree family member with atopy was noted in 1435 children (56%): atopic dermatitis (70%), asthma (62%) and allergic rhinitis (68%). Among siblings with one parent with atopic dermatitis, 37% had either a father or a mother with atopic dermatitis. Common aggravating factors reported included exercise, heat and sweating, grass intolerance, thick clothing and stress. Pityriasis alba was noted in 25% of the study population, keratosis pilaris in 13% and ichthyosis vulgaris in 8%. Most respondents had mild to moderate atopic dermatitis that could be controlled with a fairly simple regimen of moisturizers, topical steroids, antihistamines and antibiotics. CONCLUSIONS: The high prevalence of atopic dermatitis in Singapore is similar to that observed in developed countries, suggesting that environmental factors may be important in determining the expression of the disease.

Adolescent↗

PubMed1991

Stratum corneum lipid abnormalities in atopic dermatitis.

Patients with atopic dermatitis (AD) often present with a dry skin. To clarify the relationship between dry skin and lipid abnormalities within stratum corneum, stratum corneum lipids were collected from six AD patients aged 15 to 25 years and from sex- and age-matched controls. All major stratum corneum lipid classes were separated and quantitated by high-performance thin-layer chromatography/photodensitometry. Six ceramide fractions were also isolated and quantitated by thin-layer chromatography/photodensitometry. Esterified fatty acids of both ceramide 1 (acylceramides) and wax esters were analysed by capillary gas chromatography. The relative amounts of all the stratum corneum lipid classes including squalene, cholesterol esters, wax esters, triglycerides, free fatty acids, cholesterol, ceramides, cholesterol sulphate and phospholipids did not differ statistically between AD patients and controls. However, a significant decrease in proportion of ceramide 1, which is believed to be a carrier of linoleate responsible for a water-barrier function, and increased levels of esterified C18:1 fatty acids (oleate) of ceramide 1 were observed in AD patients. On the other hand, the fatty acid compositions as well as the proportions of C16:1 straight-chain component in sebum wax esters of AD patients were very similar to those of controls. These results suggest that a significantly reduced amount and/or structural alterations of ceramide 1 deriving from epidermal keratinocytes may be responsible for the impaired water-barrier function of the skin in AD.

Adolescent↗

PubMed2004

Keratinocytes in atopic dermatitis: inflammatory signals.

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that usually predates the development of allergic airway disease. In most cases, this is thought to be an allergen-driven disease with prominent roles played by antigen presenting cells and effector Th2 cells. But keratinocytes, by virtue of their location, provide an important window to the environment and are also thought to contribute to the development of AD. In this review, we discuss several biologic attributes of keratinocytes that are relevant for AD: 1) intrinsic defects in barrier function, 2) production of inflammatory mediators that promote or maintain allergic inflammation, 3) keratinocyte apoptosis, 4) effects of staphylococcal toxins on keratinocytes, and 5) potential consequences of the expression of cosignaling molecules (eg, B7 family members) and receptors important for innate immune responses (eg, Toll receptors). Clearly, these findings have highlighted a more active role played by the epithelium than was previously recognized.

Apoptosis↗

PubMed2006

The ocular manifestations of atopic dermatitis and rosacea.

Atopic dermatitis and rosacea are chronic diseases that have both dermatologic and ocular manifestations. The occurrence of ocular disease is often proportionately higher than that of dermatologic disease. Even if the skin abnormalities appear well controlled, these patients require ophthalmic evaluation as well. Optimal management usually requires a team approach that includes internists, dermatologists, and ophthalmologists. Both disorders are characterized by acute exacerbations and require maintenance therapy for control. Exacerbations need aggressive treatment to limit ocular signs and symptoms and to reduce ocular inflammation that can lead to permanent visual loss. Topical corticosteroid use, although at times needed, should be minimized for both disorders. Future research will continue to emphasize the use of steroid-sparing and immune-modulating agents that have the potential to provide long-lasting anti-inflammatory control with a more favorable side-effect profile.

Adrenal Cortex Hormones↗

PubMed1989

Natural history of food hypersensitivity in children with atopic dermatitis.

Patients with atopic dermatitis and food hypersensitivity who were adhering to an elimination diet underwent repeat double-blind, placebo-controlled oral food challenges annually for follow-up of their food allergy. After 1 year, 19 of 75 patients lost all signs of clinical food hypersensitivity (15 of 45 patients allergic to one food, and 4 of 21 allergic to two foods). Of the individual foods, 38 of 121 no longer elicited symptomatic responses. After 2 years, patients underwent a second rechallenge; 4 of 44 patients tested lost their clinical food hypersensitivity. In 20 patients undergoing a third rechallenge, no food hypersensitivity was lost. Loss rate of food hypersensitivity varied among foods; after 1 year, there was a 26% loss of symptomatic food allergy to five major allergens (egg, milk, soy, wheat, and peanut) compared with a 66% loss rate to other food allergens. Loss of symptomatic allergy was not affected by the patient's age at diagnosis, except with milk allergy, for which older patients were more likely to lose clinical food hypersensitivity (p less than 0.05). Total serum IgE and prick skin tests were not useful for predicting loss of symptomatic food hypersensitivity. There was no significant decrease in skin test wheal size corresponding to loss of clinical food hypersensitivity. Patients developing only skin symptoms during the initial challenge were most likely to lose symptomatic food hypersensitivity.

Adolescent↗

PubMed1994

Atopic dermatitis: triggering factors.

Atopic dermatitis is a hereditary disorder, frequently associated with allergic rhinitis and bronchial asthma. The disease may be influenced by many triggering factors such as irritants, aeroallergens, food, microbial organisms, sex hormones, stress factors, sweating, and climatologic factors. Moreover, it is important to be aware of contact allergy as a complicating factor. This review deals with recent clinical, experimental, and some therapeutic data on these triggering factors.

Dermatitis, Atopic↗

PubMed2006

Investigation of the chromosome 17q25 PSORS2 locus in atopic dermatitis.

Psoriasis and atopic dermatitis (AD) are strongly genetic and inherited as multi-factorial traits. In both diseases, linkage has been reported to chromosome 17q25. For psoriasis, the locus has been labelled PSORS2. Two peaks of association here contain the psoriasis candidate genes SLC9A3R (solute carrier family 9, isoform 3 regulatory factor), NAT9 (N-acetyltransferase superfamily), and RAPTOR (rapamycin (TOR)). We genotyped 14 of the most significantly associated single-nucleotide polymorphisms (SNPs) in these genes in a panel of 148 families (ECZ1) identified through a proband with active AD. The panel contains 350 siblings and 245 sib-pairs. Replication of positive findings was sought in a second panel, MRC-E, comprising of 278 families, 634 siblings, and 470 sib-pairs. SNP genotyping was carried out by Sequenom MassArray technology. Using family-based tests of association (transmission disequilibrium test), rs878906, in intron 3 of NAT9, was significantly associated with AD (P = 0.010) in the ECZ1 panel. In the MRC-E panel, rs895691, between the end of exon 6 of SLC9A3R1 and exon 7 of NAT9, was associated with AD (P = 0.037). These were not significant when multiple comparisons were taken into account. Haplotype analysis revealed no significant associations in either population. These results suggest that the psoriasis candidate genes do not account for previously observed linkage of the 17q25 PSORS2 locus to AD.

Acetyltransferases↗

PubMed1999

The characteristics of nocturnal scratching in adults with atopic dermatitis.

Patients with atopic dermatitis (AD) are known to suffer from nocturnal itch, and the resultant scratching may worsen the skin lesions. We observed nocturnal scratching for 112 nights in 35 adult patients with AD, using an infrared video camera system. To quantify the amount of scratching, we counted scratching bouts lasting more than 5 s and calculated the duration of all the scratching bouts (total scratching time, TST). The percentage of TST in the total recording time (TST%) was used as an index of nocturnal scratching. Mean +/- SD TST% was 14.3 +/- 13.9 for patients with severe AD, 6.2 +/- 3.7 for those with moderate AD and 0.7 +/- 0.4 for those with mild AD. The higher TST% in the severely affected group was attributed mainly to a longer duration rather than a higher frequency of bouts. Patients scratched more in the first third of the night than in the later two-thirds. Both the group of patients whose disease distribution pattern was generalized and those who showed a head-neck-shoulder type distribution scratched their heads, faces and necks for longer than other parts of the body. Repeated measurement performed on individual subjects resulted in a similar TST% when there was little change in skin lesions. TST% reduced by 15 +/- 21% when the patients showed marked improvement. The measurement of nocturnal scratching helps to evaluate the severity of itch in AD. In addition, the infrared video successfully detected the location and nature of nocturnal scratching in AD.

Adolescent↗

PubMed2003

Localization and content of nerve growth factor in peripheral blood eosinophils of atopic dermatitis patients.

BACKGROUND: Atopic dermatitis (AD) is a chronic and relapsing eczematous skin disorder characterized by eosinophilia. Nerve growth factor (NGF) modulates the allergic response through interactions with immune-inflammatory cells. Eosinophils have been reported to store NGF as a preformed mediator. OBJECTIVE: To gain further insight into the significance of eosinophils in association with NGF in the pathogenesis of AD, the localization of NGF within eosinophils and the difference of the eosinophil-derived NGF content in the peripheral blood of normal volunteers vs. AD patients were investigated. METHODS: We examined the localization of NGF within human eosinophils using the post-embedding immunoelectron microscopy and compared NGF content in freshly isolated eosinophil sonicates from the peripheral blood of 31 normal volunteers vs. 42 AD patients by immunoenzymatic assay. A possible correlation between the levels of NGF and major basic protein was also examined. RESULTS: Immunoelectron microscopic studies revealed that NGF was localized in the central core of normal eosinophil granules, where major basic protein is also present as a preformed mediator, in homogeneous granules and in intergranular ductal or vesicular structures adjacent to specific granules of eosinophils. NGF content in eosinophils was significantly increased in AD patients. Furthermore, there was a significant correlation between levels of NGF and major basic protein in eosinophils of AD patients. CONCLUSIONS: Increased levels of NGF contained in eosinophils of the peripheral blood from AD patients, when released with other mediators such as basic proteins, could promote inflammation and local tissue damage.

Adult↗

PubMed2002

Reactivity of anti-Blomia tropicalis IgG and IgE in patients with atopic dermatitis.

Patients with atopic dermatitis (AD) commonly develop antibodies of subclasses IgG and IgE to house dust mites, such as Dermatophagoides pteronyssinus and D. farinae. The domestic mite Blomia tropicalis is prevalent in Brazil and can cause the exacerbation of AD. The objectives of this study were to assess skin reactivity to B. tropicalis extracts of AD patients and a control group of nonallergic subjects, and to determine the in vitro reactivity of anti-B. tropicalis IgG and IgE in the serum of AD patients and a control group of nonallergic individuals. Subjects were 36 patients with confirmed AD and the controls were 25 nonallergic individuals. Skin sensitivity to B. tropicalis extracts was tested by the prick-test, and anti-B. tropicalis IgG reactivity in the serum was detected by the Western blot. Anti-B. tropicalis IgE reactivity in the serum was measured by RAST. Patients with AD reacted 7.12 times more often to extracts from B. tropicalis than the control group. A positive association was observed between the presence of anti-B. tropicalis IgG and IgE and AD. AD patients showed a high degree of sensitization to B. tropicalis; it can thus be considered a risk factor for the development of AD exacerbations in patients exposed to this mite species.

Adolescent↗

PubMed2004

UVA/UVB phototherapy for atopic dermatitis revisited.

BACKGROUND: Atopic dermatitis (AD) is a genetically determined pruritic skin disease affecting predominantly young people. The therapy of AD includes mainly corticosteroids (CS), antihistamines and immunosuppressors. CS are known to cause a variety of side effects and attempts have been made to reduce or eliminate their use through alternative methods such as phototherapy (UVA/UVB, UVA(1), UVB 311 nm). In order to optimize therapeutic efficacy the effects of CS and UV radiation are often combined. OBJECTIVE: To evaluate the efficacy of UVA/UVB and UVA/UVB plus topical CS phototherapy of AD and to compare the two regimens with regard to their therapeutic effect, duration of treatment and remissions, cumulative UVA and UVB doses and side effects. METHODS: Thirty-one patients (mean age 19 years) with moderate-to-severe forms of AD were enrolled in the study (mean disease duration of 17.7 years). Seventeen patients were treated with UVA/UVB phototherapy (Group I). Fourteen patients received UV irradiation combined with topical CS (Group II). The starting UVA dose was 2-2.5 J/cm(2). The initial UVB dose depended on skin phototype. The procedures were held five times weekly. In order to evaluate therapeutic efficacy, 10 severity criteria and 10 topographic sites were scored at the beginning and at the end of treatment. RESULTS: A statistically significant difference in the severity of the disease was observed before and after phototherapy in both groups (overall clinical score Group I: t=10.1, p=0.0001; Group II: t=13.9, p=0.0001). Erythema (t=12.1, p<0.0001), excoriations (t=10.1, p<0.0001) and vesiculation improved most dramatically after UVA/UVB phototherapy. Lichenification (t=2.5, p=0.024), xerosis (t=10.2, p<0.001) and pruritus (t=13.7, p<0.0001) also diminished significantly. The combination regimen had a similar effect on different severity criteria, but initial signs of improvement appeared earlier. Side effects observed during phototherapy included erythema, burning, skin xerosis and sweating. No statistically significant difference was established between the therapeutic efficacy of the two treatment modalities (t=0.2, p=0.904), but the addition of CS reduced the duration of treatment (number of procedures: t=2.5, p=0.02) and total UVB dose (t=2.3, p=0.03). There was no significant difference between the duration of remissions (t=0.9, p=0.39) and frequency of side effects in the two groups of patients. CONCLUSION: Both UVA/UVB monotherapy and UVA/UVB + topical CS lead to significant clinical improvement in patients with AD, but the addition of CS reduces the total UVB dose and duration of treatment without influencing the duration of remissions and frequency of side effects.

Administration, Topical↗

PubMed1999

Anti-elongation factor-1alpha autoantibody in adult atopic dermatitis patients.

Adult atopic dermatitis (AD) patients develop severe facial lesions, which sometimes distribute in sun-exposed areas similar to the rash of systemic lupus erythematosus. To declare autoimmunity in the pathogenesis of AD, we investigated serum antinuclear antibody (ANA) in 256 adult AD patients and identified its ligands. A high titer of ANA was found in 31.3% of AD patients and 75% of the ANA showed a homogenous pattern. Sixty-five percent of ANA(+) sera reacted to a 52 kDa protein (p52) in HeLa cell immunoblots. By screening the HeLa cell cDNA expression library with anti-p52 sera, a clearly positive clone was isolated. The sequence of this cDNA was identical to human elongation factor (hEF)-1alpha. The eluate of IgG bound to hEF-1alpha-glutathione S-transferase (GST) fusion protein recognized a band at 52 kDa in a HeLa cell immunoblot, and stained Hep-2 cell nuclei and cytoplasma as reported in hEF-1alpha distribution. The anti-p52 AD sera recognized the hEF-1alpha-GST fusion protein. The anti-hEF-1alpha antibody-positive AD patients were characterized by higher facial involvement and lower white blood cell counts compared with antibody-negative patients. The present results suggest the possible involvement of autoimmunity in the pathogenesis of adult AD.

Adult↗

PubMed1990

Interleukin-2 production of T cells in atopic dermatitis.

Patients with atopic dermatitis (AD) were treated with Tranilast, Interleukin-2 (IL-2) (production of T cells in vitro) and blood histamine values, before and after Tranilast therapy, were measured, and the following results were obtained: 1) Compared with healthy controls, the IL-2 producing ability of T cells in patients with AD was increased. 2) After Tranilast therapy, IL-2 production of T cells in AD decreased in quantity to the control level. 3) Skin lesion severities of AD were correlated with the quantity of IL-2 production of T cells. 4) Serum histamine levels were not significantly different between AD patients and healthy controls, before or after Tranilast therapy.

Adult↗

PubMed2004

Antimicrobial susceptibility of skin-colonizing S. aureus strains in children with atopic dermatitis.

Children with atopic dermatitis (AD) are prone to recurrent cutaneous and occasional systemic infections caused by Staphylococcus aureus. Antibiotic therapy represents an important component of the overall management of AD, especially during exacerbations of disease. Erythromycin is still widely used as a first-line antibiotic for this indication. We studied 115 consecutive children (mean age: 2.7 yr, range: 0.2-15) with moderate to severe AD (mean SCORAD: 43.2, range: 16-77) presenting to our outpatient department. Staphylococcus aureus was isolated from 100 of 115 (87%). Antimicrobial susceptibility testing revealed resistance against erythromycin in 18 and against roxithromycin in 19%, respectively. Six percentage of the strains were resistant or only intermediately susceptible to fusidic acid, 13% to amoxicillin and 1% to clindamycin. All strains isolated were susceptible to oxacillin, amoxicillin/clavulanic acid, cefadroxil and cefuroxim. The high rate of primary resistance to macrolides should be born in mind when starting antibiotic therapy in children with AD. Since Gram-positive cocci represent the only relevant microbial agents in AD, first generation cephalosporins such as cefadroxil, whose antimicrobial spectrum is basically restricted to Gram-positive bacteria, would appear to be the ideal first-line antibiotics for the treatment of bacterial superinfections.

Adolescent↗

PubMedDate not supplied

Topical tacrolimus in the management of atopic dermatitis in Japan.

Atopic dermatitis (AD) is a common, chronic, relapsing, severely pruritic, eczematous skin disease. Topical steroids are the mainstay of treatment. However, the adverse effects of steroids on hormonal function are the major obstacle for their use as long-term topical therapy. Topical calcineurin inhibitors, such as tacrolimus, not only complement existing treatment options but also overcome some of the drawbacks of topical steroid therapy and fulfill the long-term needs of patients in preventing disease progression. Short- and long-term efficacy and safety of topical tacrolimus has been widely recognized and it is also accepted as a first-line treatment for the inflammation of AD. In order to reduce the possible long-term adverse effects, it is important to monitor the clinical dose in daily clinics.

Administration, Cutaneous↗

PubMed2002

Atopic dermatitis and fungi.

Atopic dermatitis (AD) is a chronic, itching, inflammatory skin disease which is associated with asthma and/or hay fever and a familial occurrence of these conditions. Genetic factors are important in the development of AD, but the exact hereditary pathway is still unknown. Dry skin and the weakened barrier function in patients with AD is very important for the patient's reactions to irritants and other external trigger factors including microorganisms. The standard treatments are topical corticosteroids, topical immunomodulating agents, and emollients. If AD cannot be controlled by this type of treatment, systemic immunomodulating agents may be used. UVB, UVA, or psoralen-UVA may also be used for widespread severe lesions. However, some patients do not respond to these standard treatment, and then it is important to consider the role of microorganisms, house dust mites or food. The role of the Malassezia yeasts in AD, especially AD located to the head and neck region, is now documented in several papers. There are also several papers indicating the role of Candida as an aggravating factor in AD. Patients with AD also develop chronic dermatophyte infections more easily, and patients with AD and chronic dermatophyte infections may show improvement in their AD when treated with antifungal drugs.

Animals↗