PubMed Health⌕ Search

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 433 records · Page 24Linked to original sources
PubMed1999

Clinical anti-inflammatory efficacy of arofylline, a new selective phosphodiesterase-4 inhibitor, in dogs with atopic dermatitis.

Forty atopic dogs were studied for 28 days after the oral administration of four randomised treatments: (A) arofylline (1 mg/kg) twice daily for four weeks; (B) prednisone (0.5 mg/kg) twice daily for the first week, once a day during the second week and every 48 hours for the remaining two weeks; (C) prednisone following the same protocol but at a dose of 0.25 mg/kg; or (D) arofylline (1 mg/kg) twice daily for four weeks plus prednisone (0.25 mg/kg) following the same protocol as in (B) and (C). The degree of pruritus and skin lesions and the side effects were evaluated and graded from 0 to 3 before and weekly during the treatments. In all cases there was a progressive clinical improvement in the clinical signs, with no statistical differences among the four treatments. However, many of the dogs treated with arofylline vomited and had adverse gastrointestinal signs.

Administration, Oral↗
PubMed2002

Tacrolimus ointment: a new therapy for atopic dermatitis--review of the literature.

Atopic dermatitis is a chronic inflammatory skin disease characterized by severe pruritus, typical morphology and distribution of skin lesions, and personal and family history of atopy. The management of atopic dermatitis is directed at preventing the inflammation, itch, and secondary lesions. Therapy relies on general management measures, anti-inflammatory agents, antiprurites, antibiotics, and immunosuppressants. Treatment options for patients with severe or longstanding disease, extensive body surface area involvement of facial lesions are limited. Tacrolimus ointment is the first in the class of topical immunomodulators that has been formulated for the treatment of atopic dermatitis in children (2 to 15 years of age) and adult patients. The mechanism of action of tacrolimus in atopic dermatitis seems to involve T-cells, Langerhans cells, mast cells and basophiles. Experimental evidence suggests that tacrolimus inhibits T-lymphocytes activation by binding to an intracellular protein, FKBP-12. This binding phenomenon inhibits the ability of calcineurin to activate the promotor region of the gene for IL-2, IL-3, IL-4, IL-5, interferon gamma, tumor necrosis factor alpha, and granulocyte macrophage colony-stimulating factor, all of which participate in the early immune response and play a role in the pathogenesis of atopic dermatitis. Tacrolimus ointment is not atrophogenic, and is associated with minimal systemic absorption. There were no consistent changes in any laboratory variable during topical tacrolimus therapy. The most common adverse events associated with its use were transient skin burning and pruritus at the site of application. Tacrolimus ointment is safe and efficacious therapy for the treatment of pediatric and adult patients with atopic dermatitis on all skin regions including the face, neck and intertriginous areas. An overview is given of tacrolimus in atopic dermatitis.

Dermatitis, Atopic↗
PubMed1993

Increased interleukin 6 production by T cells derived from patients with atopic dermatitis.

Many immunologic aspects of atopic dermatitis have been studied, but basic pathobiologic mechanisms of this disease remain unknown. In this study, we measured the production of interleukin-6 (IL-6) by peripheral blood T cells and monocytes from patients with atopic dermatitis in comparison to normal control subjects and patients with chronic psoriasis. We found that peripheral blood T cells isolated from patients with atopic dermatitis produced significantly higher levels of IL-6 (36.1 +/- 5.1 units/ml, n = 22) than T cells derived from either normal subjects (12.6 +/- 1.9 units/ml, n = 22) or patients with chronic psoriasis (26.7 +/- 4.1 units/ml, n = 7). T-cell activation was also measured in the patients with atopic dermatitis by soluble serum IL-2 receptor levels and were found to be significantly higher (623.7 +/- 8.1 units/ml, n = 8) than normal subjects (357.2 +/- 26.0 units/ml, n = 8). In contrast to the increased production of IL-6 by T cells in atopic dermatitis, there was no significant difference in the IL-6 production by peripheral blood monocytes derived from patients with atopic dermatitis compared to normal subjects. Thus, peripheral blood T cells derived from patients with AD spontaneously produce increased amounts of IL-6 compared to T cells from normal subjects, which may reflect the increased activation state of T cells in atopic dermatitis. These data support the concept that activated T cells or subsets of T cells may be important effector cells in mediating inflammatory activity in atopic disease.

Biological Availability↗
PubMed1979

On the significance of the trichophytin reactivity in atopic dermatitis.

Patients with pure atopic dermatitis with and without tinea infection were investigated and compared with patients with long-lasting tinea infections and with controls, for presence of intracutaneous reactivity to trichoptin, Penicillium, Cladosporium and Alternaria antigens. RAST to Penicillium and Cladosporium was also performed. The results showed a lack of delayed reactivity, but an immediate reactivity to trichophytin in 50%/40% of atopic patients with/without tinea infection. Non-atopics infected with tinea showed 66% immediate and 33% delayed response to trichophytin. The reactivities in atopic dermatitis (but not in the non-atopic group) went general parallel with mould reactions tested intracutaneously or by RAST. It is assumed that a positive trichophytin reaction in atopic dermatitis does not necessarily mean sensitisation to dermatophytes, but is primarily the sign of a cross sensitivity to moulds.

Adult↗
PubMed1993

Descendant family history of atopic dermatitis.

Descendant family history of atopic dermatitis was examined in 270 adult patients with this skin disease and their 529 children. Of the 529 children, 316 (60%) had a history of atopic dermatitis. Boys and girls were equally affected. The prevalence of affected children was 56% (180/321) in those patients whose spouses did not have a history of both atopic dermatitis and respiratory atopy, 81% (48/59) in those patients whose spouses had a history of atopic dermatitis, and 59% (88/149) in those patients whose spouses had a history of respiratory atopy only. These results indicate that the mode of inheritance of atopic dermatitis is autosomal dominant. They also suggest that the genetic background of atopic dermatitis is not identical with that of respiratory atopy.

Adult↗
PubMed1997

IgE-binding components of staphylococcal enterotoxins in patients with atopic dermatitis.

BACKGROUND: The exacerbation of atopic dermatitis may be associated with infection of the skin with Staphylococcus aureus (S.aureus). S. aureus isolated from the skin of patients with atopic dermatitis secretes enterotoxin A, B, and toxic shock syndrome toxin 1. This is of interest because these patients may develop specific IgE antibodies against components from staphylococci. OBJECTIVE: The objective was to demonstrate IgE-sensitization to components of Staphylococcus aureus enterotoxins A and B (purified and partially purified), toxic shock syndrome toxin 1, and the bacterial cell component lipoteichoic acid, in patients with atopic dermatitis. METHODS: Blood samples from 34 patients with atopic dermatitis and 10 controls were tested by leukocyte histamine release to the enterotoxins and lipoteichoic acid. The toxins were separated by sodium dodecylsulfate polyacrylamide gel electrophoresis and analyzed by IgE-immunoblotting with sera from the same patients. RESULTS: The majority of patients (96%) with clinical signs of skin infection produced specific IgE-antibodies to all three toxins. Nearly half of the patients produced IgE to enterotoxin A and B. Only 63% of the patients with atopic dermatitis showed cellular response judged by the release of histamine from patient basophils when challenged in vitro with the toxins. This may indicate clinically unimportant sensitization in a number of patients. The immunoblotting revealed that the major allergens of the toxins were 24 and 28 kD proteins. Partially purified toxins showed a higher frequency of leukocyte histamine release responses than purified toxin. The only obvious difference was a difference in the content of pure toxin of the two preparations. Lipoteichoic acid showed nonspecific activity. CONCLUSION: These findings suggest that staphylococcal enterotoxins may act as specific allergens and induce IgE-antibodies to enterotoxins that may exacerbate the skin inflammation in some patients with atopic dermatitis.

Allergens↗
PubMed1996

Type 4 phosphodiesterase inhibitors have clinical and in vitro anti-inflammatory effects in atopic dermatitis.

Increased cyclic AMP-phosphodiesterase activity in peripheral blood leukocytes is associated with the immune and inflammatory hyperreactivity that characterizes atopic dermatitis. Atopic phosphodiesterase has high sensitivity to a variety of enzyme inhibitors, suggesting an increased therapeutic advantage. The objective of this study was to use in vitro assays to identify a potent phosphodiesterase inhibitor and then to investigate its effectiveness in treating atopic dermatitis. Leukocyte enzyme activity was measured by radioenzyme assay, whereas prostaglandin E2 and interleukins 10 (IL-10) and 4 (IL-4) were measured in 24-h culture supernatants of mononuclear leukocytes by immunoassays. The effect of a topical phosphodiesterase inhibitor on atopic dermatitis lesional skin was assessed by double-blind, paired comparisons of active drug and placebo ointments applied to symmetrically involved sites over a 28-d period. Using in vitro, assays, we demonstrated the ability of selective high-potency phosphodiesterase inhibitors to reduce prostaglandin E2, IL-10, and IL-4 production in atopic mononuclear leukocyte cultures. We selected the Type 4 phosphodiesterase inhibitor, CP80,633, based on its inhibitory potency, for clinical testing by topical, bilateral paired comparisons in 20 patients with atopic dermatitis and demonstrated significant reductions of all inflammatory parameters. Phosphodiesterase inhibitors modulate several pathways contributing to the exaggerated immune and inflammatory responses, which characterize atopic dermatitis. This in vivo demonstration of anti-inflammatory efficacy may provide a useful alternative to the over-reliance on corticosteroid therapy in atopic disease.

Administration, Topical↗
PubMed1982

Natural cell-mediated cytotoxic activity in the peripheral blood of patients with atopic dermatitis.

Ten patients with atopic dermatitis and ten healthy control subjects, matched for age, sex, and skin color, were studied for their peripheral blood natural cell-mediated cytotoxic activity against K-562 human leukemia cell line target cells, using the sodium chromate Cr 51 release assay. There was a great reduction in the natural cytotoxic activity of the patients with atopic dermatitis compared with that of their respective control subjects; the patients with atopic dermatitis had a mean value of 41.9 alpha +/- 28.3% of that of the control subjects.

Adult↗
PubMed2006

Atopic dermatitis. A clinical challenge.

Atopic dermatitis has a significant impact on both the pediatric and adult population worldwide, which has triggered extensive research on the topic. However, various limitations have created difficulties both in making accurate diagnoses and effectively managing atopic dermatitis patients. This review summarizes the current knowledge in the field, providing an overview of the pathophysiology, disease progression, clinical presentation, and diagnosis and treatment of atopic dermatitis.

Dermatitis, Atopic↗
PubMed1992

[Skin tests with Pityrosporum ovale extract in atopic dermatitis].

The etiology of atopic dermatitis is multifactorial. Immediate-type sensitivity to the lipophilic yeast, Pityrosporum ovale, may be important, especially in a subgroup of patients with dermatitis predominantly in the head and neck region. 100 patients with atopic dermatitis were investigated by means of skin prick tests, including Pityrosporum ovale extract. Positive tests were found more often in atopic patients with "head and neck"-dermatitis, but the correlation between a positive prick test to Pityrosporum and the severity of atopic dermatitis, estimated by means of clinical criteria and total IgE, was even higher.

Adolescent↗
PubMed1998

Flucloxacillin in the treatment of atopic dermatitis.

Although colonization of atopic dermatitis by Staphylococcus aureus is universal and bacterial infection is common, it is not known whether antibiotic therapy is helpful in eczematous children who do not have any signs suggestive of bacterial infection. Fifty children aged 1-16 years with atopic dermatitis took part in a randomized double-blind placebo-controlled study of 4 weeks treatment with oral flucloxacillin, with an 8-week follow-up period. The change in the mean of the log10 of the counts/cm2 of S. aureus after 4 weeks of treatment was significantly different for patients receiving treatment, compared with the change for those receiving the placebo (P = 0.008). However, the difference in the change at 14 days after stopping treatment was not significant (P = 0.32). Methicillin-resistant strains of S. aureus were cultured from five children during or after treatment. Flucloxacillin did not improve the symptoms or clinical appearance of atopic dermatitis and only temporarily changed skin colonization by S. aureus.

Adolescent↗
PubMed1998

Risk for hand eczema in employees with past or present atopic dermatitis.

Persons with atopic dermatitis run a considerable risk of developing hand eczema when exposed to occupational agents that are a burden to the skin. This also pertains to those with a history of skin atopy in childhood. This review presents estimates of the risk of developing hand eczema and examines the evidence for an effect modification by skin atopy on exposure. Skin atopy at least doubles the effects of irritant exposure and, thus, doubles the risk in occupations where hand eczema is a common problem. On the basis of this evidence, guidelines for occupational counseling can be given. Further development of a scale indicating the degree of atopic skin diathesis should facilitate the targeting of this counseling toward specific high-risk groups.

Dermatitis, Atopic↗
PubMedDate not supplied

Rebound phenomenon to systemic corticosteroid in atopic dermatitis.

Three patients with atopic dermatitis, one boy and two girls, aged between 6 and 17 years, presented eczematous skin, pruritus, scarifications, lichenification and a family history of atopy. During exacerbations, the patients sought emergency care and were prescribed oral corticosteroids for a period of approximately 15 days. Initially, the patients improved but after cessation of therapy or dose reduction, marked worsening occurred with the development of lesions with extreme pruritus, several confluent lesions, scarification and intense exudates, as well as fever and dehydration. The patients' condition was so severe that two were admitted to the allergy unit. The medication was withdrawn and intravenous hydration was administered, together with hydrating skin creams and antihistamine therapy. In addition, weak topical corticosteroids were applied on the most severely affected areas. All three patients progressively improved. We conclude that the patients with atopic dermatitis described herein presented a rebound phenomenon after the use of corticosteroids. We believe that systemic corticosteroids may exacerbate the acute phase of atopic dermatitis, mediated by IgE, accentuating the Th2 pattern in these patients.

Acute Disease↗
PubMed1997

Characterization of the cutaneous inflammatory infiltrate in canine atopic dermatitis.

Sections from lesional atopic, clinically normal atopic, and normal canine skin were investigated by light microscopy and an immunoperoxidase method using monoclonal antibodies specific for canine leukocyte antigens. We confirmed that skin-infiltrating cells of canine atopic dermatitis are constituted of mast cells, dendritic antigen-presenting cells, memory helper T-lymphocytes, low numbers of eosinophils and neutrophils, and rare B-lymphocytes. The presence of epidermal eosinophil microaggregates and clustered Langerhans' cells supports the hypothesis of epidermal allergen contact. The hyperplasia of epidermal T-cells expressing the gamma/delta T-cell receptor appears specific to canine atopic dermatitis compared with its human counterpart. This finding could be explained by an interspecies difference in skin immune systems or, alternatively, by an active participation of these epitheliotropic gamma/delta T-cells in the cutaneous allergic immune response in dogs. The paucity of dermal neutrophils in spontaneous lesions of canine atopic dermatitis is notably different from the neutrophil-rich late-phase reactions provoked by intradermal allergen injections in allergic dogs. This difference in the cellular infiltrate probably results from variations in the immune reaction between single and repeated allergen exposure as well as epidermal versus dermal antigen contact.

Allergens↗
PubMed2002

Topical [symbol: see text] tacrolimus--a role in atopic dermatitis?

Conventional treatment of atopic dermatitis includes the regular, frequent use of emollients, and intermittent application of topical corticosteroids to control acute 'flares'. [symbol: see text] Tacrolimus (pronounced ta-kro-li-mus), which is available for systemic use for the prevention of organ rejection following allogenic liver and kidney transplantation, is now formulated as an immunosuppressant ointment (Protopic-Fujisawa). This is licensed for use in adults and children aged 2 years and over with moderate to severe atopic dermatitis inadequately responsive to conventional therapy. Promotion states that, in these groups, tacrolimus is "at least as effective as topical steroids" and "without the potential side effects of conventional therapy". Here we consider the place of tacrolimus ointment in the management of atopic dermatitis.

Administration, Cutaneous↗
PubMed1998

IgE-sensitization to cellular and culture filtrates of fungal extracts in patients with atopic dermatitis.

BACKGROUND: Patients with atopic dermatitis may experience exacerbations of eczema triggered by various inflammatory stimuli. One mechanism may be IgE-mediated reactions to dermatophytes since these patients are more likely to acquire skin infections with dermatophytes and may become sensitized. OBJECTIVE: This study investigates IgE-sensitization to fungi in patients with atopic dermatitis and compares the biologic activity of culture filtrates and cellular fungal extracts. The following allergen extracts were provided as culture filtrates and cellular extracts: Candida albicans, Fusarium moniliforme, and Penicillium notatum. In addition, Pityrosporum ovale and Trichophyton rubrum cultures were included in the test panel. METHODS: Fifteen patients with clinical findings suggesting dermatophytosis and 11 controls were selected. Each subject was tested by leukocyte histamine release and skin prick test to each fungal extract. The extracts were separated and reduced by sodium dodecylsulfate polyacrylamide gel electrophoresis and analyzed by IgE-immunoblotting with sera from all study subjects. RESULTS: Fourteen patients (93%) reacted to one or several fungal extracts by releasing histamine when challenged in vitro. By immunoblotting experiments, patient sera showed binding to a wide range of components in all extracts. Patient sera recognized allergenic components shared by culture filtrates and cellular extracts but with higher frequent and greater intensity in culture filtrates. Although culture filtrates generated more frequent and potent IgE-reactions than the cellular extracts, the difference was not statistically significant. Biologic potency was similar when evaluated by skin prick tests and leukocyte histamine release. CONCLUSION: Patients with atopic dermatitis may develop specific IgE-antibodies to a number of fungi as demonstrated by IgE-immunoblotting. In selected patients, fungi may trigger an IgE-mediated reaction that may contribute to the exacerbation of eczema. Approximately, one-half of the patients, however, produced IgE-antibodies to fungal (glyco)proteins without a significant histamine release or skin test response possibly because of nonspecific interaction with carbohydrate moieties on IgE and poor biologic activity of IgE antibodies directed to cross-reactive carbohydrate determinants of fungal glycoproteins. This warrants caution when interpreting clinical relevance of serologic measurements of fungal IgE-antibodies.

Adolescent↗
PubMed1984

Comparison of results of skin tests, RAST, and double-blind, placebo-controlled food challenges in children with atopic dermatitis.

Forty children with atopic dermatitis were evaluated for clinical evidence of hypersensitivity to foods by double-blind, placebo-controlled food challenges. Twenty-four children (60%) experienced 33 positive challenges, manifested by cutaneous symptoms in 31 (94%), gastrointestinal symptoms in 14 (42%), nasal symptoms in nine (27%), and respiratory in six (18%). Results of prick skin tests (STs) and RASTs to eight food antigens frequently eliciting hypersensitivity reactions were compared with those from food challenges to determine the diagnostic accuracy in children with atopic dermatitis. Defining a positive ST as a wheal 3 mm larger than the negative control wheal and a positive RAST as a Phadebas RAST score of 3 or 4, the sensitivity, specificity, and predictive accuracies of these tests were found to be comparable except in the case of wheat antigen where the ST was clearly superior to the RAST. Accepting a RAST score of 2 or more as a positive slightly improved sensitivity in some cases but dramatically decreased specificity. Combining results of STs and RASTs did not improve significantly the diagnostic accuracy over results of the tests used individually. These studies demonstrate no advantage of RAST alone or in combination with prick skin testing over prick skin testing alone in the evaluation of food hypersensitivity in children with atopic dermatitis. Furthermore, skin testing should be considered a good test for excluding immediate food hypersensitivity but only a suggestive positive indicator of hypersensitivity due to the high rate of clinically insignificant positive STs.

Adolescent↗