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PubMed1996

IgA and IgG binding components of wheat, rye, barley and oats recognized by immunoblotting analysis with sera from adult atopic dermatitis patients.

IgA and IgG antibody response of adult atopic dermatitis patients against neutral/ acidic fractions of wheat, rye, barley and oats was analyzed utilizing an immunoblotting method. Moreover, the antibody response against ethanol-soluble fraction of wheat was examined with serum pools of healthy donors, atopic dermatitis patients and patients with dermatitis herpetiformis or adult celiac disease. All patient sera revealed polymorphic IgA and IgG binding to cereal peptides with molecular weights of 11-97 kD. The antibody staining was essentially identical with atopic dermatitis patients and controls. Patients with dermatitis herpetiformis or celiac disease showed more intensive staining with the ethanol extract of wheat and showed more IgA-stained bands in immunoblotting. It seems that the presence of IgA and IgG antibodies to different cereal antigens is a result of natural exposure and in atopic dermatitis displays little diagnostic significance, in contrast to antigliadin antibody response in dermatitis herpetiformis and celiac disease.

Adolescent↗
PubMed2004

[Atopic dermatitis: which are the diagnostic criteria used in medical literature?].

INTRODUCTION: Diagnosis of atopic dermatitis currently relies on diagnostic criteria scales developed by Hanifin and Rafka in 1980 and by the "United Kingdom Working party" in 1994. Some authors have proposed: "AEDS" [sM1] and "Atopiform Dermatitis", which has led to the distinction between different sub-populations and the exclusion of certain diseases from the diagnosis of atopic dermatitis. The aim of our study was to collect the criteria retained in the scientific medical literature during the year 2002 for the definition of atopic dermatitis and to try to understand not only the interest but also the questions that the various definitions lead to. METHOD: A PubMed research was launched with the key word "atopic dermatitis" from January to September of 2002. All the scientific articles either in French or in English were studied. RESULTS: Hanifin and Rafka's criteria were selected in 44 p. 100 of the scientific articles, and the "United Kingdom Working Party" criteria in 12 p. 100. Personal definitions were used in 21 p. 100 of the articles; these were based on the level of total and specific IgE or on personal clinical criteria. For twenty-three p. 100 of the authors, the definition of atopic dermatitis was not specified. DISCUSSION: There was not just one definition of atopic dermatitis. This may affect the interpretation of diagnostic or therapeutic papers concerning the disease, because there has been no proof that these definitions cover the same population of patients.

Dermatitis, Atopic↗
PubMed1996

The chemotactic activity of T-lymphocytes in response to interleukin 8 is significantly decreased in patients with psoriasis and atopic dermatitis.

Involvement of T-lymphocytes in the pathogenesis of psoriasis and atopic dermatitis is well established. The question arises as to whether not only tissue infiltrating but also circulating T-lymphocytes are involved in the disease process. Therefore we sought to determine whether T-lymphocytes from patients with psoriasis and atopic dermatitis show abnormal biological behavior to the proinflammatory chemokine interleukin 8 (IL-8) in vitro as studied by their chemotactic activity. In addition, the expression of T-cell activation markers such as HLA-DR and interleukin 2 receptor (IL-2R) were analysed with FACS-technique. In all, 25 patients with psoriasis (13 patients with severe psoriasis and 12 patients with mild psoriasis) and 11 patients with atopic dermatitis were investigated. For comparison. T-lymphocytes from 14 healthy controls were tested equally. The results show that T-cell chemotactic responses to IL-8 were significantly decreased in patients with severe psoriasis as compared to healthy controls. T-cells from patients with atopic dermatitis demonstrated an even more pronounced decrease in chemotactic response as compared to T-cells from psoriasis patients or healthy controls. In contrast, increased expression of activation markers HLA-DR and IL-2R were demonstrated in circulating T-cells from patients with severe psoriasis and atopic dermatitis in comparison to healthy controls. It can be concluded that circulating T-cells in patients with severe psoriasis and atopic dermatitis show a decreased in vitro chemotactic response to IL-8. Furthermore, the in vivo phenotypic activation state of T-lymphocytes in these patients seemed to be associated with their decreased in vitro functional capacity.

Adolescent↗
PubMed1981

Abnormal suppressor cell function in atopic dermatitis.

A status of suppressor cells in patients with atopic dermatitis was studied. As a group, they showed absent concanavalin A-inducible suppressor cell function as measured by proliferative responses to pokeweed mitogen and decreased function as measured by responses to phytohemagglutinin or concanavalin A. Similarly, preincubation in medium enhanced proliferative responses in normal donors but not in atopic dermatitis patients, suggesting an absence of a short-lived suppressor cell population in the latter group. Suppressor cell function correlated negatively with log10 of serum IgE concentrations. Theophylline-sensitive suppressor cell numbers were significantly decreased in atopic dermatitis patients (p less than 0.01). In vitro preincubation of normal lymphocytes with aminophylline or isoproterenol (10 microgram/ml) enhanced subsequent proliferative responses to pokeweed mitogen. In contrast, actual depression was seen with cells from atopic dermatitis patients, suggesting abnormal immunomodulatory effects of these drugs in the disease.

Adolescent↗
PubMed2001

The ACVD task force on canine atopic dermatitis (I): incidence and prevalence.

There is an increasing incidence of atopic diseases (asthma, allergic rhinitis and atopic dermatitis) in humans, especially in developed countries. Although there is a genetic predisposition to the development of these diseases, the rapid rise in incidence is suspected to be caused by environmental rather than genetic factors. Neither the incidence nor the prevalence of atopic dermatitis in the general canine population has been studied. As many of the environmental factors associated with the increasing incidence of atopic dermatitis in humans are consistently found in the environment of dogs, it would seem likely that a similar increase in the incidence of this disease would be occurring also in dogs. Epidemiological studies of canine atopic dermatitis are needed to characterize the incidence and prevalence of atopic dermatitis, and to further study the factors that contribute to the development of this disease.

Animals↗
PubMed2001

[The incidence of food allergy in atopic dermatitis].

To clarify the incidence of food allergy in atopic dermatitis, non-selected 226 cases with atopic dermatitis visited in our hospital were evaluated by oral food challenge tests based on masked food allergy. 181 of 200 cases except 26 cases dropped out showed a positive reaction to at least one challenge test, after their skin manifestations had been relieved by environmental control and elimination diets. In conclusion, the incidence of food allergy in atopic dermatitis was 90.5%, and egg allergy, cow's milk allergy, soy bean allergy, wheat allergy, rice allergy were 83.5%, 51.5%, 33.5%, 20.0%, 2.5% respectively in 200 cases.

Adolescent↗
PubMed1997

[Candida albicans sensitization in patients with atopic bronchial asthma and atopic dermatitis].

Candida albicans, a component of normal human microflora, can induce synthesis of specific IgE-antibodies in patients with atopic bronchial asthma and atopic dermatitis. The study included 25 patients with atopic dermatitis sensitized to C.albicans and 23 patients with atopic dermatitis non-sensitized to C.albicans. The sensitization was determined by the skin test and enzyme immunoassay. The patients had the history of atopic dermatitis exacerbation after taking food containing baking yeasts. Atopic dermatitis with sensitization to C.albicans is characterized by severe course correlating with the following indices: high total IgE (r = 0.6), level of IgE antibodies to C.albicans (r = 0.6), level of serum IgG (r = 0.46) and IgA (r = 0.33). Contrary to adults, children with sensitization to C.albicans had decreased relative number of CD4+, CD8+ and CD72+ of lymphocyte subpopulations. Thus, sensitization to C.albicans manifests in severe atopic dermatitis which in children is often associated with immune deficiency.

Adolescent↗
PubMed2002

The effect of antibiotics on the production of superantigen from Staphylococcus aureus isolated from atopic dermatitis.

Staphylococcus aureus (S. aureus) often colonizes on the skin of patients with atopic dermatitis. It is known that superantigens which are staphylococcal enterotoxins can activate T cells without processing by antigen presenting cells. It has been suggested that activated T cells release various cytokines which may exacerbate or prolong the cutaneous inflammation associated with atopic dermatitis. Reduction of bacterial colonization from skin lesions has been reported to be effective in the treatment of atopic dermatitis. Therefore, antimicrobial therapy using antibiotics may be a treatment option for atopic dermatitis in selected patients. We examined the effect of antibiotics on the production of superantigen from S. aureus in vitro to determine the action mechanism of antibiotics in the treatment of atopic dermatitis. It was found that antibiotics with inhibitory effect on protein synthesis can suppress the production of superantigen. On the other hand, the superantigen production was not suppressed by antibiotics having either the inhibitory effect on cell wall synthesis or on nucleic acid synthesis. Levels of the suppressive effect on superantigen production by S. aureus varied with strains tested in this study. Moreover, we demonstrated that replication of DNA coding of superantigen produced by S. aureus was suppressed only by roxithromycin (ROX), which is a new macrolide. This finding suggests that ROX may have an effect at the gene level. These results suggested that the suppressive effects of antimicrobial agents that act as inhibitors of protein synthesis on superantigen production from S. aureus may be useful in the treatment of atopic dermatitis.

Anti-Bacterial Agents↗
PubMed1996

Out-patient treatment of atopic dermatitis with crude coal tar.

BACKGROUND: Patients with atopic dermatitis benefit from treatment with crude coal tar. We started a program for the treatment of patients with atopic dermatitis in an out-patient facility using intermittent applications of crude coal tar. OBJECTIVE: To study the efficacy and feasibility of an out-patient regimen using crude coal tar in atopic dermatitis. METHODS: We treated 18 patients in the out-patient setting. A trained nurse and after thorough instruction the patients themselves at home applied crude coal tar in a zinc paste 2 or 3 times a week. We studied the improvement by visual scoring and compared the results with patients treated with daily applications at the in-patient department. RESULTS: The improvement was comparable at the end of the treatment period for both settings. The treatment period, however, was longer for the patients treated in the out-patient setting. CONCLUSION: The out-patient programme proved to be an efficacious and a well-appreciated approach.

Administration, Topical↗
PubMed2005

The new scoring system for evaluation of skin inflammation extent and severity in patients with atopic dermatitis.

The new scoring system for assessment of the extent and severity of skin inflammation index in atopic dermatitis patients, W-AZS, is presented. The system provides detailed assessment of both subjective and objective signs and symptoms of atopic dermatitis. With the use of W-AZS, acute and chronic skin manifestations of inflammatory process are appropriately evaluated and scored. It also enables the practitioner to assess various localizations of skin lesions at different time points. W-AZS is a relatively easy and rapid index to perform, and it seems very beneficial for clinicians. Other scoring systems used in atopic dermatitis are also presented, analyzed and compared, e.g., Atopic Dermatitis Area and Severity Index (ADASI), SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), and Three-Item Severity score (TIS). There is a strong necessity to standardize clinical evaluation of the extent and severity of skin diseases such as atopic dermatitis, as laboratory techniques and parameters are not really of great use for practitioners.

Dermatitis, Atopic↗
PubMed2002

Atopic dermatitis and concomitant disease patterns in children up to two years of age.

There are few prospective studies of atopic dermatitis and co-existing diseases such as respiratory infections in children up to 2 years of age. Using annual questionnaires, we studied the cumulative incidence of atopic dermatitis and concomitant symptoms indicating other atopic diseases and respiratory infections in 0-2-year-old children in a prospective birth cohort of 4089 children. We found associations between atopic dermatitis and asthma (ratio of proportion 1.45, 95% CI 1.16-1.80), allergic rhinoconjunctivitis (RP 2.25, CI 1.77-2.85), adverse reactions to foods (RP 3.20, CI 2.83-3.62), urticaria (RP 2.04, CI 1.80-2.31), acute otitis media (RP 1.13, CI 1.05-1.21), more than one pneumonia during the first and/or second year of life (RP 2.17, CI 1.14-4.15), and use of antibiotics at least twice yearly (RP 1.29, CI 1.07-1.56). The association between atopic dermatitis and respiratory infections persisted after stratification for asthma. There was a higher proportion of atopic disease manifestations, but not respiratory infections, in children with onset of atopic dermatitis during the first year of life than during the second. The study shows that during the first 2 years of life there is a significant association not only between atopic dermatitis and other atopic disease manifestations, but also between atopic dermatitis and respiratory infections manifested in an increased rate of acute otitis media, pneumonia and use of antibiotics.

Acute Disease↗
PubMed1986

Atopic dermatitis. A genetic-epidemiologic study in a population-based twin sample.

Atopic dermatitis is a multifactorial disease that seems both to rise in frequency and to be dependent on a genetic predisposition. In order to clarify these issues we encircled a representative twin series with atopic dermatitis from a total twin population of 592 like-sexed twin pairs. We found that the cumulative incidence rate (0-7 years) of atopic dermatitis in Denmark has increased significantly from 0.03 for the birth cohort 1960-1964 to 0.10 for the birth cohort 1970-1974, that monozygotic twin pairs are more often concordant for atopic dermatitis than dizygotic twin pairs, that monozygotic twins run a risk of 0.86 of having atopic dermatitis if the twin partner has the disease, whereas the disease risk of 0.21 run by dizygotic partners does not differ from the frequency seen in ordinary brothers and sisters. The results indicate that genetic factors play a decisive role in the development of atopic dermatitis and that widespread environmental factors are operating in genetically susceptible individuals.

Child↗
PubMed2003

Premenstrual deterioration of skin symptoms in female patients with atopic dermatitis.

BACKGROUND: Although it has been recognized that women with atopic dermatitis often show menstrual-cycle-associated skin deterioration, information about this subject is meager. OBJECTIVE: To clarify the clinical features of the monthly worsening of atopic dermatitis. METHODS: A total of 286 Japanese women with atopic dermatitis were interviewed to see whether the menstrual cycle had any influence upon their skin lesions, and whether they had symptoms of premenstrual syndrome. Patients suffering from monthly skin deterioration were then observed during and after the monthly worsening. RESULTS: Of the 286 patients interviewed, 134 (47%) had monthly skin deterioration, most of which occurred in the premenstrual week. There was individual difference in severity of the monthly skin worsening. All patients with the premenstrual skin aggravation had symptoms of premenstrual syndrome. CONCLUSIONS: Premenstrual worsening of skin lesions occurs in approximately half of women with atopic dermatitis. The premenstrual skin deterioration is related to the premenstrual syndrome.

Adolescent↗
PubMed2001

The leukotriene antagonist montelukast as a therapeutic agent for atopic dermatitis.

BACKGROUND: Cysteinyl leukotrienes have been shown to be important in the pathogenesis of allergen-induced (atopic) asthma and rhinitis. Skin manifestations of atopic dermatitis have been reported to improve with leukotriene antagonists. Montelukast, a newer leukotriene antagonist, which is efficacious and safe in patients with asthma 6 years of age and older, has not been reported as therapy for atopic dermatitis. This article reports findings from a pilot study designed to determine whether montelukast is effective in decreasing the signs or symptoms of atopic dermatitis. OBJECTIVE: Our purpose was to compare the efficacy of montelukast with placebo as a treatment for patients with atopic dermatitis. METHODS: The study involved 8 adult patients (male and female) with at least 1 year of intermittent or persistent atopic dermatitis as determined by Hanifin criteria. Medication was given in a randomized, double-blind, placebo-controlled, crossover manner over 8 weeks as adjunctive treatment. Global evaluation of 6 signs (erythema, induration, excoriation, lichenification, scaling, erosion) were scored on a 0 to 3 scale each week, with a blinded investigator evaluating at the initiation, crossover, and final visit. A 30% decrease in total score was considered clinically significant. RESULTS: A significant difference in atopic dermatitis scores between placebo and active agent (P =.014) was recognized. There was no significant interaction between order and treatment. Atopic dermatitis scores tended to be higher with placebo. The mean standard deviation was 8.7 +/- 2.0. The mean for active agent was 6. 8 +/- 2.1. CONCLUSION: This study demonstrates that there is a modest, but significant, alleviation of atopic dermatitis with the use of the leukotriene antagonist montelukast used in an adjunctive manner over a 4-week period.

Acetates↗
PubMed1997

Skin colonization of Staphylococcus aureus in atopic dermatitis patients seen at the National Skin Centre, Singapore.

OBJECTIVE: This prospective study sought to determine the bacterial colonization rates on eczematous and non-eczematous skin and nasal mucosa of patients with atopic dermatitis attending a tertiary dermatologic referral clinic in Singapore. The colonization rates were evaluated according to age, sex, race, and severity of dermatitis compared with controls. The results may help to determine whether antibiotics should be considered in the treatment of atopic dermatitis. PATIENTS: Patients, of any age, presenting with atopic dermatitis at the subsidized clinic of the National Skin Centre, Singapore, between 23 August 1996 and 14 September 1996, were included in the study. RESULTS: Thirty-three patients with atopic dermatitis were seen at the outpatient clinic during the study period. Staphylococcus aureus was isolated in 69.7% of the eczematous lesions and in 42.4% of non-eczematous skin of patients with atopic dermatitis. S. aureus was isolated in 53% of patients with mild dermatitis, and in 100% with moderate and severe dermatitis. The nasal carriage rate of S. aureus was higher in atopic dermatitis patients (51.5%) than in non-atopics (35%) (not significant). S. aureus was isolated in 42% of non-eczematous skin in atopics compared with only 5% in the control group (p = 0.003). In patients with atopic dermatitis, all S. aureus isolated was sensitive to cloxacillin, cephalexin, clindamycin, and co-trimoxazole; 92% was sensitive to erythromycin, but only 13% was sensitive to penicillin and ampicillin. In the control group, all S. aureus isolated was sensitive to cloxacillin, cephalexin, erythromycin, clindamycin, and co-trimoxazole, but only 13% was sensitive to penicillin and ampicillin, and 87% to tetracycline. CONCLUSIONS: This study confirmed that the skin of patients with atopic dermatitis was more frequently colonized with S. aureus than that of non-atopics. The more severe the dermatitis, the higher the rate of colonization. S. aureus is also more of than present in non-eczematous skin of atopics than of non-atopics. There is also a higher percentage of S. aureus nasal carriage in patients with atopic dermatitis than in non-atopics. Hence antibiotics may have a role in the treatment of atopic dermatitis. Because 87% of S. aureus is resistant to penicillin and ampicillin, antibiotics such as cloxacillin and cephalexin should be used to eradicate S. aureus in the skin of atopic dermatitis individuals.

Adolescent↗
PubMed1985

[Vitiligoid achromias and severe atopic dermatitis. Apropos of 4 cases].

Four patients with important and disabling atopic dermatitis persisting during adulthood have presented leucodermia in certain areas of eczema. As melanosomes and melanocytes have totally disappeared in these regions, this depigmentation corresponds thus to an achromia. Clinically, we noted macular achromia with hyperpigmented border of special topography since touching pleat regions initially present eczema lesions: anterior face of wrists and footnecks. Slight lichenification is noted in achromic regions. In spite of many analogies with vitiligo, we differentiate this achromia from vitiligo on the basis of absence of familial post-history and absence of new localisations after 5 to 6 years cause. A review of depigmentations described during atopic dermatitis does not show similar facts. Depigmentation induced by local steroid therapy does not give such clinical and ultrastructural aspects. In 3 patients, there was no local application of depigmenting agent. In one case, 8-oxyquinoleine was applied transiently. Vitiliginous achromias of pleat regions initially presenting important atopic dermatitis are probably due to multifactorial factors: possible factors are inflammation and secondary epidermal modification due to local steroid therapy and may be some excipients. Being a rare situation in atopy, we have registered it only 14 times in 860 followed atopic dermatitis. The study of series of atopic dermatitis followed on a long-term basis should allow to evaluate the frequency of such incidents and the respective role of aetiological factors with we suspect.

Adult↗
PubMed1996

Elevated plasma RANTES levels in patients with atopic dermatitis.

Eosinophils and T cells are involved in the pathologic process of atopic dermatitis. To further understand the role of these cells, and the possible involvement of RANTES, in the pathogenesis of atopic dermatitis, we measured the plasma level of RANTES using the sandwich ELISA. The mean plasma level of RANTES in 11 patients with atopic dermatitis was significantly higher than that of 15 normal control subjects. RANTES levels were higher in patients with severe form of atopic dermatitis than that of patients with mild disease. These findings suggest that RANTES may play a role in the recruitment and activation of eosinophils and T cells in atopic dermatitis.

Adolescent↗