Denise Atique Goulart
acometimento ocular nos indica que a conjuntivite alérgica nada mais é que uma das formas de expressão da atopia, assim como são a rinite, a bronquite e a dermatite.PURPOSE: To study the response to skin prick tests in patients with vernal keratoconjunctivitis and compare with the allergic population without ocular disease. METHODS: We performed skin prick tests in 48 patients with VKC (10 with limbal form, 19 with palpebral and 19 with both. Controls were 52 patients from Allergy Clinic of the Santa Casa de São Paulo, with systemic allergy but without ocular disease. Skin prick tests were performed in 48 patients from the Ocular Allergy Sector at the Ophthalmology Department of the Santa Casa de São Paulo's Hospital, from July 2001 to September 2002. We studied responses to the following allergens: house dust mite, Dermatophagoides pteronissynus, Dermatophagoides farinae, Tyrophagus putrescentiae, Blomia tropicalis, Rhizopus spp, Penicilium, Alternaria alternata and rye grass. RESULTS: Male sex was the most frequent, with 32 patients (66.6% in the study group, and 27 (51.9% in controls. Mean age was 10.0 ± 4.7 years in the study group and 6.83 ± 3.6 in controls. The most frequent allergen was Dermatophagoides pteronissynus, followed by Dermatophagoides farinae, Blomia tropicalis, house dust mite, Tyrophagus putrescentiae and Rhizopus spp. CONCLUSIONS: The resemblance of the results in the control group indicates that allergic conjunctivitis is nothing else but another form of atopy, just as rhinitis, bronchitis and dermatitis.
Metcalfe, T W; Doran, R. M.; Rowlands, P L; Curry, A.; Lacey, C. J.
A male patient is described with acquired immune deficiency syndrome (AIDS) who developed chronic keratoconjunctivitis and chronic sinusitis due to infection with the microsporidian Encephalitozoon cuniculi. Diagnosis was confirmed by electron microscopic examination of conjunctival epithelial cells and nasal polypectomy specimens. Treatment with propamidine isethionate 0.1% (Brolene) eye drops six times daily led to a prompt resolution of the keratoconjunctivitis.
Thomsen, Simon Francis
Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The aetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of atopic dermatitis to asthma in later childhood...... may be halted. Atopic dermatitis is not always easily manageable and every physician should be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural history, clinical features, and treatment of atopic dermatitis....
Chiemela C. Okoro
Full Text Available We present a case of medicamentosa keratoconjunctivitis in a 42-year-old woman who complained of eye redness, blurred vision and pain after using inappropriate medications for treatment. Examination revealed severe conjunctival injection as well as punctate stains on the corneas. The patient was advised to stop her former medications and was prescribed an artificial tear supplement, an antibiotic-steroid combination and a topical nonsteroidal anti-inflammatory drug. Possible conditions that could elicit similar clinical features are highlighted. The purpose of the case report is to raise issues relating to drug-induced allergic/sensitivity reactions based on recent clinical and experimental reports and also the roles of active ingredients and preservatives.Keywords: Superficial punctate epitheliopathy; Medicamentosa; Factitious disease; Dry eye syndrome; Benzalkonium chloride
Aalders-Deenstra, V; Kok, P T; Bruynzeel, P L
Total IgE levels in lacrimal fluid of patients suffering from different eye disorders were quantitatively measured by a modification of the paper radio immuno sorbent test (PRIST). The geometric mean values for patients with atopic conjunctivitis, patients with keratoconjunctivitis vernalis, and patients with asthma without conjunctivitis differed significantly from those for control persons and those for patients without atopic conjunctivitis. Besides lacrimal fluid IgE levels, serum IgE lev...
Juberias, J R; Calonge, M; Montero, J; Herreras, J M; Saornil, M A
Phlyctenular keratoconjunctivitis, a delayed hypersensitivity reaction to foreign proteins (i.e., bacterial products), occurs more often in children and young adults sensitized to Staphylococcus aureus inhabiting the lid margins. Clinical manifestations occur on the conjunctiva and/or the cornea. Management strategies used to treat a 14-year-old girl with a long history of keratoconjunctivitis with severe corneal involvement and secondary lacrimal gland enlargement included a complete ocular examination, blood workups, cultures, vigorous lid hygiene, topical antibiotics and steroids, and systemic doxycycline. Phlyctenular keratoconjunctivitis was diagnosed, and Streptoccocus viridans was found colonizing the lid margins and fornices. Subsequent treatment quieted the active inflammation and the secondary lacrimal gland enlargement. However, the residual corneal scarring permanently compromised visual acuity. This patient demonstrates the potentially blinding consequences of untreated phlyctenular keratoconjunctivitis. Moreover, Streptoccocus viridans is not frequently associated with this disorder. To our knowledge hypertrophy of the lacrimal gland, as a secondary complication of this disorder, has not been reported previously. PMID:22827417
SHEN Xi; XU Ge-zhi; JIAO Qin; LI Xia; SHI Ruo-fei
Objective To describe the ocular complications of 62 patients with active atopic dermatitis( AD) during the period of 2003 2006. Methods Routine ophthalmic examinations, including slit-lamp microscope, indirect ophthalmoscope or Goldmann three-mirror lens, A-scan and B-scan ultrasound, ultrasound biomicroscope (UBM) and corneal topography, as well as tear film break-up time (BUT) and Schirmer tests were carried out. Results Cataract (28 eyes), keratoconjunctivitis (42 eyes), superficial punctate keratopathy (45 eyes) and tear function abnormality ( 76 eyes) were major ocular complications in AD patients. Retinal detachment (6 eyes) was the most severe ocular complication in the AD patients. Conclusion Ocular complications are common in AD patients and a very careful examination of eyes is essential in treating AD patients. If the eyes can be examed carefully and in time, some operations and severe complications can be avoidable, especially for the patients with retinal breaks or retinal detachment.
... in Chinese 中國 ) What Is Atopic Dermatitis? (in Korean 한국어) What Is Atopic Dermatitis? (in Vietnamese bằng ... Phototherapy: Use of ultraviolet A or B light waves, alone or combined, can be an effective treatment ...
Armando José Vásquez Lobo
Atopic dermatitis is a good prognosis,multietiologic inflammatory, cornice, skin disease. Itsdiagnosis is clinically done. Atopic dermatitis’ prevalence hasgrown in last decades. It may affect children and adults.Attention primary physicians could do the treatment foratopice dermatitis. Specialists are required for severe andcomplicated cases.
Jakiyah Daud; Siti Raihan Ishak; Zakuan Zainy Deris; Wan Hazabbah Wan Hitam
Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world. Although its typically self-limiting and treatable in almost all of the cases, but we need to be aware of the rare and potentially life threatening if the cause is not promptly identified and treated accordingly. In our case report, we highlighted the rare case of Neisseria meningitidis as a primary cause of keratoconjunctivitis. Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection. The infection may potentially fatal if systemic invasion occurred, however with immediate and proper treatment the outcome is satisfactory. Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection. Public health intervention is needed to prevent outbreak of the disease.
Bangal Surekha V, Bankar Mahima S, Bhandari Akshay J, Kalkote Prasad R
Full Text Available Vernal Keratoconjunctivits (VKC is a bilateral recurrent allergic interstitial conjunctival inflammation with a periodic seasonal incidence and of self limiting nature, mainly affecting the younger population. Patients of VKC on steroid therapy are at higher risk of developing steroid induced glaucoma. Raised intraocular pressure due to steroids typically occurs within few weeks of starting steroid therapy and comes back to normal on immediate stoppage of steroids. A case of steroid induced glaucoma in a 30 years old female with vernal keratoconjunctivitis. She was on topical steroids for 3-4 years. She was incompliant with the instructions to stop steroids. She eventually developed steroid induced glaucoma and glaucomatous optic neuropathy with tunnel vision.
Full Text Available Abstract Atopic dermatitis (AD is a common, chronic skin disorder that can significantly impact the quality of life of affected individuals as well as their families. Although the pathogenesis of the disorder is not completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune abnormalities. There are no specific diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient’s history and clinical manifestations. Successful management of the disorder requires a multifaceted approach that involves education, optimal skin care practices, anti-inflammatory treatment with topical corticosteroids and/or topical calcineurin inhibitors (TCIs, the use of first-generation antihistamines to help manage sleep disturbances, and the treatment of skin infections. Systemic corticosteroids may also be used, but are generally reserved for the acute treatment of severe flare-ups. Topical corticosteroids are the first-line pharmacologic treatments for AD, and evidence suggests that these agents may also be beneficial for the prophylaxis of disease flare-ups. Although the prognosis for patients with AD is generally favourable, those patients with severe, widespread disease and concomitant atopic conditions, such as asthma and allergic rhinitis, are likely to experience poorer outcomes.
Full Text Available Fifteen cases of keratoconjunctivitis sicca (KCS of unknown etiology were treated with soft contact lenses for the purpose of their bandage effects and moisuture supply. A soft contact lens was worn on one of the eyes of each case but not on the other to compare its effectiveness. New opthalmic drops or contact lens wearers were dropped in both eyes. Furthermore, the KCS-index was worked out on the basis of the complaints of 23 patients of KCS of unknouwn etiology. The indexes before and after treatment were compared. Corneal objective findings were improved in all the eyes wearing soft contact lensen for along period, and seven stopped wearing them although corneal objective findings were much better, because they had some troubles with handlings were much better, because they had some troubles with handling the lenses, because they had lost rhem, or because their visual acuity decreased while wearing the lenses. Forlong term wearing the flattest lenses should be used in the beginning and changed gradually to lenses of greater curvature which are better able to keep their centering. Then immediately after successful fitting, the lenses should be given appropriate refractive power. The new ophthalmic drops for soft contact lens wearers were very much effective as artificial tears to both eyes with and without sofy contact lenses. KCS-indexes were numerical values relating to patients subjective symptoms. KSC-indexes improves by an average of +6.4±7.5 after treatment. On the other hand, KCS-indexes improved by +10.7±7.9 in the group that succeeded in wearing SCL for a long period, and by +7.6±2.1 even in the group that failed.
... it healthy Protection from allergens. Atopic Dermatitis and Vaccination Against Smallpox People with atopic dermatitis should not ... Genetics Biochemical changes in skin and white blood cells Immune factors Light ... Phone: 301-495-4484 Toll free: 877-22-NIAMS ( ...
Nikhil S Gokhale
Full Text Available We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation. Child showed a dramatic improvement and stabilization with oral cyclosporine therapy. Oral cyclosporine therapy can be tried in severe vision-threatening allergy refractory to conventional therapy.
Sunil Dogra; Rahul Mahajan
Background: The aim of these guidelines is to review the available published literature regarding the effectiveness of phototherapy and photochemotherapy in atopic dermatitis and put forward recommendations regarding their use in atopic dermatitis. Materials and Methods: A literature search was performed to collect data from PubMed, EMBASE, and the Cochrane Library published till March 2014. Keywords used were "phototherapy", "photochemotherapy", "NB-UVB", "BBUVB", "PUVA", "UVA1", "atopic der...
... rash and rashes clinical tools newsletter | contact Share | Eczema (Atopic Dermatitis) A parent's guide for infants and babies A ... scaling, red, slightly elevated lesions typical of atopic dermatitis (eczema). Overview Eczema, formally known as atopic dermatitis, ...
Bjerrum, Kirsten Birgitte
ophthalmology, Sjögren's syndrome, keratoconjunctivitis sicca, conjunctiva, dry eye, Schirmer-1 test, Rose Bengal score, break-up time, tear film, Copenhagen criteria......ophthalmology, Sjögren's syndrome, keratoconjunctivitis sicca, conjunctiva, dry eye, Schirmer-1 test, Rose Bengal score, break-up time, tear film, Copenhagen criteria...
Purified atopic allergens have been found to emit flue fluorescence upon irradiation with ultraviolet light of 365 mμ wavelength. The maximum of fluorescence is in the region 445–490 mμ and the intensity is of the same order of magnitude for different atopic allergens. Synthetic model compounds, inc
... extra ingredients. A good, cheap moisturizer is plain petroleum jelly (such as Vaseline). Use moisturizers that are ... a flare-up? SourceSome information taken from: National Institutes of Health. Handout on Health: Atopic Dermatitis. Accessed ...
von der Schulenburg, Johann-Matthias
Full Text Available Objectives: Major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Methods: This health technology assessment (HTA evaluates systemically randomized controlled studies (RCT on the therapy of atopic dermatitis which were published between 1999 and 2004. Further it includes some important clinical studies which have been published after 2004 and other updates the English HTA report by Hoare et al. . Results: Topical corticosteroids and topical calcineurin-inhibitors are the principal substances which are currently used for anti-inflammatory therapy in atopic dermatitis. These substances have shown a significant therapeutic efficacy in controlled studies. In newer controlled studies no difference was observable when corticosteroids were applied once or more than once daily onto the skin. Moreover, there is now one controlled study available which points to the fact that an interval therapy with a stronger topical corticosteroid over a limited time (some weeks may lower the risk of recurrent flares of atopic dermatitis. Both topical calcineurin-inhibitors pimecrolimus and tacrolimus have shown a significant therapeutical efficacy in a number of placebo-controlled prospective studies. The wealth of data is high for these substances. Both substances have been shown to be efficient in infants, children and adult patients with atopic dermatitis. The importance of a so-called basic therapy with emollients which have to be adapted to the current status of skin is generally accepted in clinical practice. Controlled studies show the efficacy of ”basic therapy” - although the level of evidence is quite low for this approach. The skin of patients with atopic dermatitis is colonized in the majority with Staphylococcus aureus, a gram-positive bacterium. Therefore, a therapeutical approach for the treatment of atopic dermatitis is the anti-bacterial or
Noushin Sohrabi; Majid Tebianian; Heidarali Moeini
Background & Objectives: Keratoconjunctivitis is considered as the most prevalent ocular disease which is caused by multiple microorganisms. Considering the fact that identifying etiologic agents of Keratoconjunctivitis in a specific geographical area, and determining their antibiotic resistance pattern could be very important in specifying treatment strategy of such patients, the present research has been conducted to discriminate and evaluate etiologic microbial agents of this disease in pa...
Hande Taylan Þekeroðlu
Aim: To determine the clinical features of vernal keratoconjunctivitis and to evaluate the safety and the efficacy of the medical treatment on clinical grades. Material and Method: All patients with vernal keratoconjunctivitis who had been treated with mast-cell stabilizers, antihistamines and artificial tear drops previously were enrolled in the study. Topical steroids were added during recurrences, were tapered and discontinued according to the clinical improvement. Topical cyclosporin 0.05...
Adamus, G.; Mulczyk, M; Witkowska, D; Romanowska, E
Active immunization of guinea pigs and rabbits with outer membrane proteins (OMP) isolated from Shigella flexneri 3a and Shigella sonnei phase I protected the animals against keratoconjunctivitis shigellosa induced with the homologous or heterologous strain. Protection was also achieved in rabbits after passive immunization with anti-OMP immune serum. Active immunization with lipopolysaccharide of S. flexneri 3a did not protect rabbits against keratoconjunctivitis shigellosa.
Casas, E; Stone, R T
Infectious bovine keratoconjunctivitis, also known as pinkeye, is an economically important disease in cattle. The objective of this study was to detect QTL associated with infectious bovine keratoconjunctivitis in offspring from a Brahman x Hereford sire. The sire was mated to Hereford, Angus, and F1 cows to produce 288 offspring in 1994 and mated to MARC III ((1/4) Hereford, (1/4) Angus, (1/4) Red Poll, and (1/4) Pinzgauer) cows in 1996 to produce 259 offspring (547 animals total). Infectious bovine keratoconjunctivitis was diagnosed by physical examination in 36 animals of the family. Records included unilateral and bilateral frequency, but not severity. Records were binary: 0 for unaffected and 1 for affected cattle. A putative QTL for infectious bovine keratoconjunctivitis was identified on chromosome 1, with a maximum F-statistic (F = 10.15; P = 0.0015) at centimorgan 79 of the linkage group. The support interval spanned centimorgans 66 to 110. There was also evidence suggesting the presence of a QTL for infectious bovine keratoconjunctivitis on chromosome 20, with a maximum F-statistic (F = 10.35; P = 0.0014) at centimorgan 16 of the linkage group. The support interval ranged from centimorgan 2 to 35. This report provides the initial evidence of QTL for infectious bovine keratoconjunctivitis. Although a candidate gene was identified for one of the regions of interest, further studies are needed to identify the genetic basis of resistance to the disease. PMID:17093209
... rash and rashes clinical tools newsletter | contact Share | Eczema (Atopic Dermatitis) A parent's guide to condition and treatment information ... and inflamed areas of skin typical of atopic dermatitis (eczema) on a person with darker skin. Overview ...
... rash and rashes clinical tools newsletter | contact Share | Eczema (Atopic Dermatitis) Information for adults A A A This image displays extensive atopic dermatitis (eczema); note the skin is dry and scaly, ...
... Research Matters NIH Research Matters January 14, 2013 Protein Linked to Atopic Dermatitis Normal skin from a ... in mice suggests that lack of a certain protein may trigger atopic dermatitis, the most common type ...
Jacob, Sharon E; Goldenberg, Alina; Nedorost, Susan;
Flexural eczema and atopic dermatitis are frequently synonymized. As respiratory atopy is rarely tested for and found in these patients, systematically equating a flexural distribution of dermatitis with atopic dermatitis may too frequently result in misclassified diagnoses and potentially missed...... opportunity for intervention toward improving patients' symptoms and quality of life. We present a critical review of the available evidence for the atopic dermatitis diagnosis and discuss the similarities between atopic dermatitis and allergic contact dermatitis. Because neither flexural predilection nor...... atopy is specific for atopic dermatitis, we conclude that the term atopic dermatitis is a misnomer and propose an etymologic reclassification of atopic dermatitis to "atopy-related" dermatitis. Allergic contact dermatitis can induce an atopic dermatitis-like phenotype, and thus, flexural dermatitis...
Clausen, Maja-Lisa; Agner, Tove; Thomsen, Simon Francis
The atopic diseases: atopic dermatitis, asthma and allergic rhinoconjunctivitis are frequent diseases in the population occurring sequentially in the young (the atopic march).The discovery of filaggrin gene (FLG) mutations and impairments in the skin barrier as predisposing factors for atopic......—with atopic dermatitis and FLG mutations being a prerequisite for the development of the other atopic diseases, particularly asthma. This review discusses the role of the skin barrier function, particularly the role of FLG mutations, in the atopic march....
Yingfang, Fan; Zhuang, Bo; Wang, Cheng; Xu, Xuelian; Xu, Wei; Lv, Zhihua
Poor corneal penetration and short residence time on the ocular surface are two major bottlenecks for conventional ophthalmic formulations. To overcome the foregoing dilemmas, we prepared two novel formulations of pimecrolimus nanomicelles (PNM) with particle size of 37.85 ± 1.21 nm and thermosensitive hydrogel (PTH) for treating Keratoconjunctivitis Sicca (KCS). PNM were investigated by transmission electron microscopy (TEM), Malvern laser particle size analyzer, X-ray diffraction (XRD) system, and the content of drug in PNM was measured by high-performance liquid chromatography (HPLC). The drug loading and encapsulation efficiency reached to 7.57% ± 0.10% and 97.9% ± 1.26%, respectively. PTH displayed special gel-sol transition behavior with temperature increasing from 4 °C to 37 °C. The in vitro release profile demonstrated that PNM and PTH exhibited sustained-release behavior compared with free pimecrolimus oil-based eye drop (FPO). In addition, we established a mouse model of KCS induced by benzalkonium chloride to evaluate the therapeutic outcome of different pimecrolimus formulations. The production of tear, fluorescein staining scores and histopathologic examinations of the cornea were assessed in detail. The results confirmed that PNM had the best therapeutic effect among all formulations based on its higher drug encapsulation capability, favourable permeability and sustained release. All these indicated that PNM could serve as a potent ophthalmologic agent for KCS. PMID:26731192
Full Text Available Background: The aim of these guidelines is to review the available published literature regarding the effectiveness of phototherapy and photochemotherapy in atopic dermatitis and put forward recommendations regarding their use in atopic dermatitis. Materials and Methods: A literature search was performed to collect data from PubMed, EMBASE, and the Cochrane Library published till March 2014. Keywords used were "phototherapy", "photochemotherapy", "NB-UVB", "BBUVB", "PUVA", "UVA1", "atopic dermatitis", and "atopic eczema". Systematic reviews, meta-analysis, national guidelines, randomized controlled trials, prospective open label studies, and retrospective case series in English literature mentioning use of above-mentioned keywords were reviewed. Results: Six hundred and eighty eight studies were evaluated, 38 of which fulfilled the criteria for inclusion in the guidelines. Conclusions and Recommendations: Both UV1 and narrow-band UVB are effective in significantly decreasing the eczema severity although UV1 may be preferred in acute flares and narrow-band UVB in chronic eczema, especially in adults (Level of evidence 1+, Grade of recommendation A. Among various doses of UVA1, medium dose UVA1 may be preferred over others as its efficacy is similar to high dose and better than low dose UVA1 phototherapy. Narrow-band UVB is preferred to broad-band UVB (Level of evidence 1+, Grade of recommendation A. Medium-dose UVA1 is similar in efficacy to narrow-band UVB (Level of evidence 1+, Grade of recommendation A. In children, despite its efficacy, narrow-band UVB phototherapy should be used only as a second line therapy due to its potential for long-term adverse effects (Level of evidence 2+, Grade of recommendation B.
Powers, Claire E; McShane, Diana B; Gilligan, Peter H; Burkhart, Craig N; Morrell, Dean S
Atopic dermatitis is a chronic inflammatory skin condition with drastic impacts on pediatric health. The pathogenesis of this common disease is not well understood, and the complex role of the skin microbiome in the pathogenesis and progression of atopic dermatitis is being elucidated. Skin commensal organisms promote normal immune system functions and prevent the colonization of pathogens. Alterations in the skin microbiome may lead to increased Staphylococcus aureus colonization and atopic dermatitis progression. Despite the evidence for their important role, probiotics have not been deemed efficacious for the treatment of atopic dermatitis, although studies suggest that probiotics may be effective at preventing the development of atopic dermatitis when given to young infants. This review will cover the most recent published work on the microbiome and pediatric atopic dermatitis. PMID:26388516
Swinger, Robert L; Schmidt, Karl A; Dubielzig, Richard R
A 12-year-old Pug presented with a 3-mm corneal mass OD. The dog was currently being treated for keratoconjunctivitis sicca (KCS) and pigmentary keratitis OU. A superficial keratectomy followed by cryotherapy was performed OD. A histopathologic diagnosis of epithelial dysplasia and suppurative keratitis was made and the lesion resolved. Two months later, a yellow/tan conjunctival mass, diffuse chemosis and conjunctival thickening was discovered OD. Necrotizing conjunctivitis with protozoal parasites was diagnosed with histopathology. Complete blood count and a serum biochemistry panel were normal. Neospora caninum and Toxoplasma gondii titers were negative. The conjunctivitis resolved after a 6-week course of oral clindamycin. Two months later, the patient presented with a similar conjunctival mass OS. Toxoplasma gondii was confirmed as the etiologic agent with immunohistochemical staining. Repeat T. gondii titers were negative. Oral clindamycin was re-instituted. The corneal biopsy was re-reviewed and protozoal organisms were discovered. Three months later, a recurrence was suspected and oral ponazuril was initiated for 28 days. There has been no evidence of recurrence since this treatment. Ocular toxoplasmosis is rare in the dog but reports have included episcleritis, scleritis, retinitis, anterior uveitis, ciliary epithelium hyperplasia, optic neuritis and polymyositis. To our knowledge, this is the first confirmed report of toxoplasmosis causing only corneal and conjunctival disease in the dog. We hypothesize that these localized lesions may be associated with topical immunomodulating therapy for KCS. Toxoplasmosis should be considered as a differential for canine conjunctivitis and corneal disease and has the potential to manifest in one or both eyes. PMID:19152600
Giampaolo Ricci; Federica Bellini; Arianna Dondi; Annalisa Patrizi; Andrea Pession
Atopic dermatitis (AD) is a chronic inflammatory skin disorder that typically occurs during childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typical onset in the first years of life and with a 10- 30% prevalence among young children. AD prevalence in adolescence has been estimated aro...
Hande Taylan Þekeroðlu
Full Text Available Aim: To determine the clinical features of vernal keratoconjunctivitis and to evaluate the safety and the efficacy of the medical treatment on clinical grades. Material and Method: All patients with vernal keratoconjunctivitis who had been treated with mast-cell stabilizers, antihistamines and artificial tear drops previously were enrolled in the study. Topical steroids were added during recurrences, were tapered and discontinued according to the clinical improvement. Topical cyclosporin 0.05% four times daily was used additionally in cases of inadequate response to treatment or evident steroid dependance. Main outcome measures were the clinical features, change of clinical grades, response to treatment, rate of recurrences and side effects of the eyedrops. Results: Twenty patients ( 13 males, 7 females with vernal keratoconjunctivitis in different severity scales were included. The median age of the patients was 10 (9-11 years. The median follow-up time was 35 (15-56 months. Ten patients received topical cyclosporine. The rate of recurrences was similar in patients who received topical cyclosporine compared to those who were followed with topical steroids. (p=0.17 No severe adverse reaction to any of the formulations was seen. Discussion: Topical 0.05% cyclosporin is safe and effective for the treatment of vernal keratoconjunctivitis as a steroid sparing agent. It helps to obtain good clinical response without serious adverse effects and provides improvement on the clinical grades.
Wang, Min; WANG Jia-wei
Atopic myelitis (AM), also described as idiopathic eosinophil myelitis, is a kind of myelitis associated with atopic diathesis, and is considered to be one kind of primary acute transverse myelitis (ATM). It mainly develops in Japan. Since the first case was reported by Kira, et al, Japan has reported more than 100 cases. In South Korea and Europe there were cases reported in recent years. In this paper, the research progress on atopic myelitis is reviewed. doi: 10.3969/j.issn.1672-6731....
Full Text Available Atopic myelitis (AM, also described as idiopathic eosinophil myelitis, is a kind of myelitis associated with atopic diathesis, and is considered to be one kind of primary acute transverse myelitis (ATM. It mainly develops in Japan. Since the first case was reported by Kira, et al, Japan has reported more than 100 cases. In South Korea and Europe there were cases reported in recent years. In this paper, the research progress on atopic myelitis is reviewed. doi: 10.3969/j.issn.1672-6731.2014.06.016
Atopic dermatitis now affects 15% to 20% of chil dren in developed countries, and prevalence in cities in developing countries undergoing rapid demographic changes is quickly following suit.1 Most cases of atopic dermatitis in a given community are mild, but children with moderate to severe disease can have continuous itching and associated loss of sleep. The social stigma of a visible skin disease can also be soul destroying for both patient and family. A few stud...
Full Text Available Atopic dermatitis (AD is a chronic inflammatory skin disorder that typically occurs during childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typical onset in the first years of life and with a 10- 30% prevalence among young children. AD prevalence in adolescence has been estimated around 5-15% in European countries. AD persists from childhood through adolescence in around 40% of cases and some risk factors have been identified: female sex, sensitization to inhalant and food allergens, allergic asthma and/or rhinoconjunctivitis, the practice of certain jobs. During adolescence, AD mainly appears on the face and neck, often associated with overinfection by Malassezia, and on the palms and soles. AD persistence during adolescence is correlated with psychological diseases such as anxiety; moreover, adolescents affected by AD might have problems in the relationship with their peers. Stress and the psychological problems represent a serious burden for adolescents with AD and cause a significant worsening of the patients’ quality of life (QoL. The pharmacological treatment is similar to other age groups. Educational and psychological approaches should be considered in the most severe cases.
Full Text Available Scleroderma is autoimmune connective tissue disorder which destroys healthy body tissues that causes widespread systemic and ocular features. A buildup of collagen in the skin and other organs leads to symptoms of the disease. It is of two types localized and diffuse. Systemic sclerosis has tendency to affect internal organs. It shows a non - mendelian pattern of inheritance with gene polymorphism. 1 Incidence of the disease is 9 - 19 cases per million 2 . Mortality is 30% with life threatening and visual threaten ing complications. 3 Occurrence of keratoconjunctivitis sicca in localized form of scleroderma is a quite a rare abnormality. We have presented a 38 year old female patient exhibiting characteristic features of localized scleroderma with keratoconjunctiviti s sicca and then the literature is reviewed.
Full Text Available Background & Objectives: Keratoconjunctivitis is considered as the most prevalent ocular disease which is caused by multiple microorganisms. Considering the fact that identifying etiologic agents of Keratoconjunctivitis in a specific geographical area, and determining their antibiotic resistance pattern could be very important in specifying treatment strategy of such patients, the present research has been conducted to discriminate and evaluate etiologic microbial agents of this disease in patients referred to ophthalmology ward of Feiz health center in Isfahan. Materials & Methods: This descriptive study has been conducted in an 18-month period on 196 patients, referred to ophthalmology ward of Feiz hospital with positive symptoms of Keratoconjunctivitis. Ocular secretions were sampled with sterile swap and from conjuctival sac. Then the related samples were transferred and cultured in the medium for bacteria. Antibiogram of isolated strains was performed by method of disc diffusion. One of the samples related to patients was transferred to virus transport media and was used for direct immunofluorescence test. The possible content of IgM anti-adenovirus was investigated by ELISA method and on serum samples of patients. Resulst: From among the total 196 evaluated samples, 75 cases were infected with bacterial agents, 37 cases with adenovirus, and 58 cases with both bacterial and adenovirus agents. The isolated bacterial agents were as follows with respect to their prevalence, Staphylococcus aureus (28.1%, Coagulase negative Staphylococci (16.8%, Bacillus spp (6.6%, Pseudomonas aeruginosa (5.1 %, Enterobacter (4.2%, Klebsiella (3.6% and Streptococcus group D (3.6%. From among antibiotic drugs, the highest rate of sensitivity for S. aureus and P. aeruginosa was observed in Ciprofloxacin and Tobramycin respectively. Conclusion: The results of the study could be applied in specifying treatment strategies for patients suffering from
Hartman, A B; Van De Verg, L L; Collins, H H; Tang, D B; Bendiuk, N O; Taylor, D N; Powell, C J
This study used the guinea pig keratoconjunctivitis model to examine the importance of route of administration (mucosal versus parenteral), frequency and timing of immunization (primary versus boosting immunization), and form of antigen given (live attenuated vaccine strain versus O-antigen-protein conjugate) on the production of protective immunity against Shigella infection. Since local immune response to the lipopolysaccharide (LPS) O-antigen of Shigella spp. is thought to be important for...
Pragati Gautam; Gauri Shankar Shrestha; Ananda Kumar Sharma
Background: This study was conducted to determine clinical profile and etiological factors for phlyctenular keratoconjunctivitis (PKC) in our patients. Materials and Methods: In the descriptive study, 50 pediatric cases of PKC were enrolled into the study from outpatient department of BP Koirala Lions Center for Ophthalmic Studies between August 2011 and August 2012. The age, sex, exposure to tuberculosis, ocular symptoms, and systemic complaints were recorded. Morphological description of...
Pier Luigi Dodi Department of Veterinary Medicine Sciences, University of Parma, Parma, Italy Abstract: Keratoconjunctivitis sicca (KCS) is a frequent canine ophthalmic disease, resulting from the deficiency of one or more elements in the precorneal tear film. There are different known causes of KCS in dogs, including congenital, metabolic, infectious, drug induced, neurogenic, radiation, iatrogenic, idiopathic, and immune mediated, though the last one is the most prevalent form in dogs. Ini...
Revold, Tobias; Abayneh, Takele; Brun-Hansen, Hege; Kleppe, Signe L; Ropstad, Ernst-Otto; Hellings, Robert A; Sørum, Henning
Listeria monocytogenes has been reported to cause various infectious diseases in both humans and animals. More rarely, ocular infections have been reported. To our knowledge, only two cases of Listeria keratitis have been described in horses. We report kerato-conjunctivitis in four Norwegian horses associated with L. monocytogenes. Clinically, all cases were presented with recurrent unilateral kerato-conjunctivitis. L. monocytogenes bacteria were isolated from swab samples from all cases, and cytology carried out in 3 cases was indicative of L. monocytogenes infection. The present report describes the first known cases in which L. monocytogenes has been isolated from keratitic lesions in horses in Norway. A potential risk factor may be feeding of silage or haylage, but other sources of infection cannot be ruled out. The phenotypic features including antimicrobial susceptibility and serotype of the isolates are described. Laboratory detection of L. monocytogenes demands extra caution since only low numbers of bacteria were detected in the eye-swabs, probably due to the low volume of sample material and the intracellular niche of the bacterium. A general poor response to treatment in all these cases indicates that clinicians should pay extra attention to intensity and duration of treatment if L. monocytogenes is identified in connection with equine kerato-conjunctivitis. PMID:26552393
Kim, Ha J.; Kim, Eun T.; Lim, Chae Y.; Park, Chul; Kang, Byeong T.; Kim, Ju W.; Yoo, Jong H.; Park, Hee M.
IgG immunoreactivity to Malassezia pachydermatis was compared in atopic and non-atopic dogs. Malassezia pachydermatis proteins with a molecular weight of 98 kDa were recognized at a significantly higher frequency in the sera of atopic dogs. Most of the atopic dogs with Malassezia dermatitis had a greater IgG response than did normal dogs.
... Grant Request DONATE Traditional Smallpox Vaccines and Atopic Dermatitis Frequently Asked Questions Eczema Living with Eczema Get ... News Research Donate Traditional Smallpox Vaccines and Atopic Dermatitis Frequently Asked Questions What is the traditional smallpox ...
Simon Francis Thomsen
Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The aetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of atopic dermatitis to asthma in later childhood may be halted. Atopic dermatitis is not always easily manageable and every physician should be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural histor...
Kahr, Niklas; Naeser, Vibeke; Stensballe, Lone Graff;
INTRODUCTION: The development of atopic diseases early in life suggests an important role of perinatal risk factors. OBJECTIVES: To study whether early-life exposures modify the genetic influence on atopic diseases in a twin population. METHODS: Questionnaire data on atopic diseases from 850...
Elmose, Camilla; Thomsen, Simon Francis
about filaggrin and its role in the atopic march and provide suggestions for future research in this area. Methods. We identified all twin studies (published after 1970) that have calculated the concordance rate and/or the heritability of AD, or the genetic and environmental correlations between AD and...... around 85% explained by genetic pleiotropy. Conclusions. Genetic factors account for most of the variability in AD susceptibility and for the association between AD and asthma. Controversy remains as to whether the atopic diseases are causally related or whether they are diverse clinical manifestations...
Nightingale, J.; Rogers, D.; Hart, L.; Kharitonov, S; Chung, K.(The University of Iowa, Iowa City, U.S.A); Barnes, P.
BACKGROUND—Inhalation of lipopolysaccharide (LPS) causes an inflammatory response in the lungs. To explore this response, inflammatory indices were measured in induced sputum from atopic asthmatic patients and compared with atopic and non-atopic subjects after inhalation of LPS. METHODS—The effects of inhaled LPS (60 µg) or placebo (0.9% saline) were examined in a randomised, double blind, crossover trial in 11 non-atopic normal subjects, seven atopic, non-asthmatic indiv...
Darsow, U.; Wollenberg, A.; Simon, D; A. Taïeb; Werfel, T.; A. Oranje; C. Gelmetti; Svensson, A; Deleuran, M.; A. Calza; Giusti, F.; Lübbe, J; Seidenari, S; Ring, J.
Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred...
Full Text Available Vernal keratoconjunctivitis is a chronic, recurrent and severe ocular allergic disease, which is characterized by persistent allergic inflammation of the conjunctiva. It can be accompanied by ocular discomfort and visual disturbance. All forms are characterized by intense itching, tearing, mucous secretions and a severe photophobia, which often forces children to live virtually in dark places. Conjunctival proliferative changes, such as the formation of giant papillae are the characteristic findings of affected individuals. Giant papillae develop as a result of infiltration of inflammatory cells, changes in the epithelial layer, and increased deposition of extracellular matrix molecules such as collagen and proliferation of conjunctival fibroblasts. Currently several therapeutic options such as corticosteroids, mast cell stabilizers and cyclosporine are applied for treatment of Vernal keratoconjunctivitis but in long-term, the chronic and recurrent nature of this problem leads to failure or appearance of side effects of current treatment in many patients. Recently, Green tea extract and its principal active ingredient, epigallocatechin gallate , are gaining attention and increased usage due to its healthful properties. It has considerable anticatactogenic effect by inducing apoptosis in lens epithelial cells and antioxidant effects. Also its great benefits were achieved in attenuation of damaging influences to the retina caused by ischemia/reperfusion. Based on evidences supported beneficial effects of green tea, we hypothesize that local administration of green tea and its extract seems to be a proper substitute or adjunct to current treatments of Vernal keratoconjunctivitis. This plant contains a series of antioxidants that can abolish the process of allergic cascade. Moreover, by suppressing TNF-alpha potentially, it can reduce proinflammatory reaction, as well as fibroblast proliferation and subsequently decrease giant papilla formation
Leonardi, A.; Borghesan, F.; Avarello, A.; Plebani, M.; Secchi, A.
AIM—To validate the use of tear eosinophil cationic protein (ECP) as a marker for eosinophil activation, and its pharmacological modulation, in addition to evaluating the efficacy of lodoxamide and sodium cromoglycate in the treatment of vernal keratoconjunctivitis (VKC). METHODS—Tears were collected from 30 patients affected by active mild to moderate VKC before and after therapy with disodium cromoglycate 4% (DSCG) (n=15) or lodoxamide 0.1% (n=15) for 10 days. Tear cytology and ECP measurem...
Sun, L.; Y. Zhao; W. M. HUANG; H. Purnawali; Fu, Y. Q.
Many surface related properties, such as surface roughness, surface tension and reflection etc are heavily dependent on the surface morphology of materials. Patterned surfaces may have significant effects on these properties. In this paper, we compare wrinkles produced atop three different types of shape memory materials, namely, shape memory alloy, shape memory polymer and shape memory hybrid. We show the advantages and disadvantages of them in terms of the processing techniques and the resu...
Schneider, Lynda; Weinberg, Adriana; Boguniewicz, Mark; Taylor, Patricia; Oettgen, Hans; Heughan, Lisa; Zaccaro, Daniel; Armstrong, Brian; Holliday, Aaron; Leung, Donald Y. M.
Atopic dermatitis subjects and controls had similar cellular immune responses to Varicella vaccine. Atopic dermatitis subjects with a history of eczema herpeticum made high levels of Varicella specific IgE.
Full Text Available Pier Luigi Dodi Department of Veterinary Medicine Sciences, University of Parma, Parma, Italy Abstract: Keratoconjunctivitis sicca (KCS is a frequent canine ophthalmic disease, resulting from the deficiency of one or more elements in the precorneal tear film. There are different known causes of KCS in dogs, including congenital, metabolic, infectious, drug induced, neurogenic, radiation, iatrogenic, idiopathic, and immune mediated, though the last one is the most prevalent form in dogs. Initially, clinical signs of KCS include blepharospasm caused by ocular pain, mucoid to mucopurulent ocular discharge, and conjunctival hyperemia; secondary bacterial infection may also occur, with chronicity, corneal epithelial hyperplasia, pigmentation, neovascularization, and corneal ulceration. The diagnosis of KCS is based on the presence of consistent clinical signs and measurement of decreased aqueous tear production using the Schirmer tear test. Therapy is based on administering the following topical drugs: ocular lubricant, mucolytics, antibiotics, corticosteroids, pilocarpine, and immunomodulators. These last drugs (eg, cyclosporine, pimecrolimus, and tacrolimus have immunosuppressive activity and stimulate tear production. Furthermore, the nerve growth factor is a new subject matter of the research. Although these therapies are advantageous, stimulation of natural tear production seems to provide the highest recovery in clinical signs and prevention of vision loss. The goal of the following article is to describe the recent developments about KCS in dogs emphasizing the use of new therapies. Keywords: dogs, keratoconjunctivitis sicca, treatment, NGF
Full Text Available Atopic dermatitis is an inflammatory skin disease with a chronic relapsing course. The benefical effects of ultraviolet light on atopic dermatitis has been appreciated for many years. Along with topical and systemic treatment,photo(chemotherapy is one of the three fundamental alternatives for managing atopic dermatitis. While broadband UVB and psoralen UVA (PUVA have been the mainstay of phototherapy more new modalities including UVA-1 and narrow-band UVB have been used succesfully in recent years.
Menon, Balaraj B; Zhou, Xiaohong; Spurr-Michaud, Sandra; Rajaiya, Jaya; Chodosh, James; Gipson, Ilene K
Human adenoviruses (HAdV), species D in particular (HAdV-D), are frequently associated with epidemic keratoconjunctivitis (EKC). Although the infection originates at the ocular surface epithelium, the mechanisms by which HAdV-Ds bypass the membrane-associated mucin (MAM)-rich glycocalyx of the ocular surface epithelium to trigger infection and inflammation remain unknown. Here, we report that an EKC-causing adenovirus (HAdV-D37), but not a non-EKC-causing one (HAdV-D19p), induces ectodomain release of MUC16-a MAM with barrier functions at the ocular surface-from cultured human corneal and conjunctival epithelial cells. HAdV-D37, but not HAdV-D19p, is also found to decrease the glycocalyx barrier function of corneal epithelial cells, as determined by rose bengal dye penetrance assays. Furthermore, results from quantitative PCR (qPCR) amplification of viral genomic DNA using primers specific to a conserved region of the E1B gene show that, in comparison to infection by HAdV-D19p, infection by HAdV-D37 is significantly increased in corneal epithelial cells. Collectively, these results point to a MUC16 ectodomain release-dependent mechanism utilized by the EKC-causing HAdV-D37 to initiate infection at the ocular surface. These findings are important in terms of understanding the pathogenesis of adenoviral keratoconjunctivitis. Similar MAM ectodomain release mechanisms may be prevalent across other mucosal epithelia in the body (e.g., the airway epithelium) that are prone to adenoviral infection. IMPORTANCE Human adenoviruses (HAdVs) are double-stranded DNA viruses that cause infections across all mucosal tissues in the body. At the ocular surface, HAdVs cause keratoconjunctivitis (E. Ford, K. E. Nelson, and D. Warren, Epidemiol Rev 9:244-261, 1987, and C. M. Robinson, D. Seto, M. S. Jones, D. W. Dyer, and J. Chodosh, Infect Genet Evol 11:1208-1217, 2011, doi:10.1016/j.meegid.2011.04.031)-a highly contagious infection that accounts for nearly 60% of conjunctivitis cases
Thomsen, Simon F
The atopic diseases - atopic dermatitis, asthma, and hay fever - pose a great burden to the individual and society, not least, since these diseases have reached epidemic proportions during the past decades in industrialized and, more recently, in developing countries. Whereas the prevalence of the...... atopic diseases now seems to have reached a plateau in many Western countries, they are still on the increase in the developing world. This emphasizes continuing research aimed at identifying the causes, risk factors, and natural history of these diseases. Herein, the fundamental aspects of the natural...... history and epidemiology of the atopic diseases are reviewed....
The basics of treatment discussed in this guideline are based on the "Guidelines for the Treatment of Atopic Dermatitis 2008" prepared by the Health and Labour Sciences Research and the "Guidelines for the Management of Atopic Dermatitis 2012 (ADGL2012" prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle. The guidelines for the treatment of atopic dermatitis are summarized in the "Japanese Guideline for the Diagnosis and Treatment of Allergic Disease 2013" together with those for other allergic diseases.
Böttcher (Fagerås), Malin; Bjurström, Jenny; Mai, Xiaomei; Nilsson, Lennart; Jenmalm, Maria
Atopic asthma is characterized by excessive T helper 2 (Th2)-like immunity to allergens in the bronchial mucosa. The Th2-cytokine interleukin (IL)-4 induces IgE production, while the Th2-cytokine IL-5 promotes eosinophilic inflammation in the airways of asthmatics. Most asthmatics are atopic, but a subgroup is non-atopic. We hypothesize that allergen-induced Th2, particularly IL-5, responses can be observed in peripheral blood in both atopic and non-atopic asthmatic children but not in health...
Objective: To determine the prevalence of ACD in atopics in comparison to non-atopics in our community. Design: Cross sectional study. Place and Duration of Study: Departments of Dermatology, King Edward Medical College/Mayo Hospital, Lahore, from May 1998 to July 1999. Subjects and Methods: Two hundred and fifty patients, 34 with past or present atopic dermatitis (Group I), 88 with personal or familial atopy (Group II) and 128 non-atopic with contact dermatitis (Group III) were subjected to patch testing with European standard series. The results were interpreted according to International Contact Dermatitis Research Group guidelines. Results: Positive reactions were seen in 50%, 70.4% and 67.8% of patients in the respective groups (p>0.05). Conclusion: Our results suggest that atopics are equally affected with contact dermatitis as compared with non-atopics and recalcitrant cases of atopic dermatitis should be patch tested to find out aggravating factors. (author)
Kumar Pramod; Pai Ganesh S
A total of 80 atopic dermatitis cases were studied. The incidence was 4.2 per 1000 among OPD patients. The overall crude M : F ratio was 1.4:1 which after standardization was 0.9:1, 32.5% had the disease for the first time, 48.75% of patients had observed itching preceding rash, 26% of patients gave history of food allergy. The incidence of personal history of atopy and family history of atopy was 56.25% and 63.75% respectively. Facial involvement was common...
Hello, M; Aubert, H; Bernier, C; Néel, A; Barbarot, S
Atopic dermatitis (AD) of the adult is a common skin disease. Its prevalence has greatly increased during the past decades. AD is commonly associated with other atopic disorders. Its impact on quality of life is often underestimated. Various immunopathologic mechanisms are involved in AD: innate epidermal barrier dysfunction due to filaggrin gene mutations, innate and adaptative abnormalities of the immune system (an initial Th2 phase precedes a chronic Th1 phase), intestinal and cutaneous microbiomes dysbiosis, and environmental factors. Diagnosis of AD is clinical and there is no predictive biomarker of future severity. The main differential diagnoses are: scabies, psoriasis, cutaneous adverse reaction, cutaneous T cell lymphoma, primary immunodeficiency, and Netherton's syndrome. Therapeutic management is challenging and should integrate a therapeutic education program. Topical corticosteroids are the first line treatment, including a preliminary assessment of possible topical corticosteroids phobia. Systemic treatments are recommended in severe, chronic and resistant AD, after careful evaluation in a reference centre. Dupilumab, an IL4/IL13 inhibitor, might be the first effective targeted therapy in AD, whereas therapies that specifically target the mechanisms of pruritus represent an exciting perspective. PMID:26617291
Fujimura, Masaki; Ohkura, Noriyuki; Makimura, Koichi
We have shown that some patients presenting with chronic bronchodilator-resistant non-productive cough have a global atopic tendency and cough hypersensitivity without nonspecific bronchial hyperresponsiveness, abbreviated as atopic cough (AC). The cough can be treated successfully with histamine H1 antagonists and/or glucocorticoids. Eosinophilic tracheobronchitis and cough hypersensitivity are pathological and physiological characteristics of AC. Fungus-associated chronic cough (FACC) is defined as chronic cough associated with basidiomycetous (BM) fungi found in induced sputum, and recognition of FACC has provided the possibility of using antifungal drugs as new treatment strategies. Bjerkandera adusta is a wood decay BM fungus, which has attracted attention because of its potential role in enhancing the severity of cough symptoms in FACC patients by sensitization to this fungus. Before making a diagnosis of “idiopathic cough” in cases of chronic refractory cough, remaining intractable cough-related laryngeal sensations, such as “a sensation of mucus in the throat (SMIT),” which is correlated with fungal colonization, should be evaluated and treated appropriately in each patient. The new findings, i.e., the detection of environmental mushroom spores that should not be present in the human airways in addition to the good clinical response of patients to antifungal drugs, may lead to the development of novel strategies for treatment of chronic cough. PMID:25383202
Ricci, G; Patrizi, A; Bellini, F; Medri, M
Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease which usually starts during the first years of life. In the management of AD, the correct approach requires a combination of multiple treatments to identify and eliminate trigger factors, and to improve the alteration of the skin barrier. In this article we try to explain the importance of skin care in the management of AD in relation to the use of textiles: they may be useful to improve disrupted skin but they are also a possible cause of triggering or worsening the lesions. Garments are in direct contact with the skin all day long, and for this reason it is important to carefully choose suitable fabrics in atopic subjects who have disrupted skin. Owing to their hygienic properties fabrics produced from natural fibres are preferential. Wool fibres are frequently used in human clothes but are irritant in direct contact with the skin. Wool fibre has frequently been shown to be irritant to the skin of atopic patients, and for this reason wool intolerance was included as a minor criterion in the diagnostic criteria of AD by Hanifin and Rajka in 1980. Cotton is the most commonly used textile for patients with AD; it has wide acceptability as clothing material because of its natural abundance and inherent properties like good folding endurance, better conduction of heat, easy dyeability and excellent moisture absorption. Silk fabrics help to maintain the body temperature by reducing the excessive sweating and moisture loss that can worsen xerosis. However, the type of silk fabric generally used for clothes is not particularly useful in the care and dressing of children with AD since it reduces transpiration and may cause discomfort when in direct contact with the skin. A new type of silk fabric made of transpiring and slightly elastic woven silk is now commercially available (Microair Dermasilk) and may be used for the skin care of children with AD. The presence of increased bacterial colonization
Darsow, Ulf; Wollenberg, Andreas; Simon, Dagmar; Taïeb, Alain; Werfel, Thomas; Oranje, Arnold; Gelmetti, Carlo; Svensson, Ake; Deleuran, Mette; Calza, Anne-Marie; Giusti, Francesca; Lübbe, Jann; Seidenari, Stefania; Ring, Johannes
Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial / antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. "Eczema school" educational programs have been proven to be helpful. PMID:23663504
Taïeb, A; Boralevi, F
Topical steroids are still used suboptimally, but remain the mainstay of atopic dermatitis treatment. Topical steroid phobia is rampant in many countries, a real advantage for the entry on the market of topical immunomodulators (TIMs), which inhibit both antigen specific and non-specific T cell activation in the skin, by blockade of gene transcription of proinflammatory cytokines such as IL2 and TNF alpha. Topical tacrolimus and pimecrolimus have the most advanced clinical development. Tacrolimus, already used orally in transplantation medicine, is already available in France since 2003 as a 0.03% ointment for children (Protopic, Fujisawa). Its introduction on the market has substantially changed prescription habits in atopic dermatitis. Recalcitrant adolescent and adult head and neck lesions are the major target, but the drug is is also widely used in children, with a good safety profile. The risk of herpes virus superinfections did not increase significantly in clinical trials but needs further monitoring. Long-term prescription will need a closer look at a still much debated increased skin cancer risk. The marked efficacy on thin skin sites and absence of atrophogenic properties of the drug balance its side effects at the first applications on inflamed skin (pruritus, burning sensation). Clinical studies using pimecrolimus (Elidel, Novartis), marketed as a 1% cream, show a satisfactorily efficacy profile in adults and children including infants. The drug is better tolerated and is already widely introduced on the international market since 2002 with a pediatric positioning, but is nor available yet in 2004 in France. Besides phototherapy, systemic immunosuppressants remain useful drugs in severe disease especially in older children and adolescents, cyclosporin remaining the leading drug. Preventive immunomodulation modifying the intestinal microflora is very promising approach which deserves a large-scale assessment. PMID:15808446
Fujimura, M; Ogawa, H; Nishizawa, Y; Nishi, K
Background: We have described a group of patients who present with isolated chronic bronchodilator resistant non-productive cough with an atopic constitution, eosinophilic tracheobronchitis, and airway cough receptor hypersensitivity without bronchial hyperresponsiveness, which we have termed "atopic cough". Although cough variant asthma (in which the cough responds to bronchodilators) is recognised as a precursor of typical asthma, it is not known whether atopic cough is also a precursor of ...
Sonja Alexandra Grundmann
Full Text Available Phototherapy has still great importance in the treatment of atopic dermatitis, though costs, compliance, and long-term risks narrow its relevance. In spite of its long history, up to now, the therapeutic regimes are mostly empirical. Narrowband UVB und UVA1 are the most frequently applied regimens in atopic dermatitis with proven efficacy. However, even for these modalities randomized prospective and controlled studies are still pending. Advances in photoimmunology and molecular biology had demonstrated that phototherapy targets inflammatory cells, alters cytokine production, and has a significant antimicrobial effect within atopic skin. This paper summarizes the current literature on the different regimes of phototherapy and also discusses therapeutic modalities like photochemotherapy and extracorporeal photopheresis. These more complex regimes should be restricted to severe cases of atopic dermatitis, which are refractory to topical treatment.
Sonja Alexandra Grundmann; Stefan Beissert
Phototherapy has still great importance in the treatment of atopic dermatitis, though costs, compliance, and long-term risks narrow its relevance. In spite of its long history, up to now, the therapeutic regimes are mostly empirical. Narrowband UVB und UVA1 are the most frequently applied regimens in atopic dermatitis with proven efficacy. However, even for these modalities randomized prospective and controlled studies are still pending. Advances in photoimmunology and molecular biology had d...
Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy- three patients of atopic dermatitis and 71 age matched controls were studi...
Full Text Available Ahmet Zülfikar Akelma,1 Aziz Alper Biten2 1Pediatric Allergy and Immunology Unit, Ankara Kecioren Teaching and Research Hospital, Ankara, Turkey; 2General Directorate of Management Services, Republic of Turkey Ministry of Health, Ankara, Turkey Abstract: Pediatric eczema is a common disease which causes economic and social burden. Its incidence differs among the societies, with an incidence reported to reach up to 20% in developed countries. Eczema is the first allergic disease seen in the childhood, and it is recognized as a precursor for the development of atopic diseases such as asthma, allergic rhinitis, and food allergy in the forthcoming years of children. Increased incidence of eczema in recent years has led to new research in epidemiology, prevention, and intervention of this disease. It is no doubt important to treat itching, rash, and excoriation of the skin; however, treatment of pediatric eczema should not be considered only as a treatment of skin lesions. Considering skin treatment as the tip of the iceberg, proper management of the allergic processes can be accepted as the rest of the iceberg. The role of probiotics in the prevention of atopic eczema is yet to be clarified. Evidence presented by existing studies suggesting that probiotics may prevent pediatric eczema is not strong enough. A positive effect, if any, may be related with onset time, dose, duration, and use of specific probiotics. To date, there is no strong evidence for use of probiotics in the treatment of eczema; however, administration of probiotics in breast-feeding mothers in the prenatal period and in infants in the postnatal period can be accepted as a safe and helpful option in the prevention of eczema. Nevertheless, there are still questions to be answered in the future about probiotic administration for eczema. Clinical use of probiotics will gradually become more widespread when these questions are answered. Based on current information, the administration
A Study to Evaluate and Compare the Efficacy and Safety of Topical Cyclosporine A 0.5% with Topical Placebo (Artificial Tears in Alleviating the Principal Signs Associated with Vernal Keratoconjunctivitis
The use of topical cyclosporine for treatment of vernal keratoconjunctivitis should be encouraged to prevent complications associated with the natural course of the disease and prolonged topical use of corticosteroids. Keywords: vernal keratoconjunctivitis, cyclosporine-A, papillary hypertrophy, limbal changes, itching [Natl J Med Res 2016; 6(1.000: 38-41
Napolitano, Maddalena; Megna, Matteo; Patruno, Cataldo; Gisondi, Paolo; Ayala, Fabio; Balato, Nicola
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease which predominantly affects children usually clearing up during or after childhood. However, AD may persist with a chronic recurrent course until adulthood, being recalcitrant to any treatment strategy. Moreover, in some patients AD is not present during childhood but starts later in life (i.e. after 16 years of age) being defined late-onset AD. Even if AD incidence is increasing worldwide with cases in which clinical manifestations first appeared or persisted during adolescence and adulthood raising, especially in industrialized countries, studies on adult AD are still scant. Since this subgroup of AD patients often has a nonflexural rash distribution, and atypical morphologic variants and validated diagnostic criteria are lacking, there is no clear consensus on the diagnostic work-up that should be performed when evaluating adult patients with AD. In this review the many aspects of work-up in adult patients with AD, such as diagnostic criteria, epidemiology, quality of life and pathogenesis are discussed. PMID:25658440
Villatoro, Antonio J.; Fernández, Viviana; Rico-Llanos, Gustavo A.; Becerra, José; Andrades, José A.
Keratoconjunctivitis sicca (KCS) or dry eye disease (DED) is an immune-mediated multifactorial disease, with high level of prevalence in humans and dogs. Our aim in this study was to investigate the therapeutic effects of allogeneic adipose-derived mesenchymal stromal cells (Ad-MSCs) implanted around the lacrimal glands in 12 dogs (24 eyes) with KCS, which is refractory to current available treatments. Schirmer tear test (STT) and ocular surface integrity were assessed at 0 (before treatment), 3, 6, and 9 months after treatment. Average STT values and all clinical signs showed a statistically significant change (P < 0.001) during the follow-up with reduction in all ocular parameters scored: ocular discharge, conjunctival hyperaemia, and corneal changes, and there were no signs of regression or worsening. Implanted cells were well tolerated and were effective reducing clinical signs of KCS with a sustained effect during the study period. None of the animals showed systemic or local complications during the study. To our knowledge, this is the first time in literature that implantation of allogeneic Ad-MSCs around lacrimal glands has been found as an effective therapeutic alternative to treat dogs with KCS. These results could reinforce a good effective solution to be extrapolated to future studies in human. PMID:25802852
Full Text Available Hormones may play a role in the pathophysiology of vernal keratoconjunctivitis (VKC. An increased incidence of thyroid autoantibodies was recently observed in VKC, although there were no data on thyroid function. Two hundred and eighty-eight patients (202 males, 86 females; range 5.5 to 16.9 years with VKC were evaluated and compared with 188 normal age- and sex-matched subjects. In all subjects, serum concentrations of free T4, TSH, thyroperoxidase, thyroglobulin, and TSHr autoantibodies were evaluated. In VKC, the family history of thyroid diseases showed no significant differences compared to the controls (9.4 versus 8.6%, whereas the family history of autoimmune diseases was significantly higher (13.2% versus 6.3%; P<0.05. Subclinical hypothyroidism was diagnosed in 6.6% (versus 1.6% of the controls; P<0.05 and overt hypothyroidism in 0.7% (versus 0.0% of the controls; P=NS. Finally, 5.2% of patients were positive for thyroid autoantibodies, which were significantly higher with respect to the controls (0.5%, P<0.05. In the patients positive for thyroid autoantibodies, 80% showed a sonography pattern that suggested autoimmune thyroiditis. Thyroid function and autoimmunity abnormalities are frequently present in children with VKC. Children with VKC should be screened for thyroid function and evaluated for thyroid autoimmunity.
SUN Jinghua; LIU Changming; ZHANG Yuzhao; WANG Hui
In this study, the effect of cyclosporin A (CsA) eye drop on keratoconjunctivitis Sicca (KCS) and its mechanism were studied. The KCS models were established by injecting Pertussis vaccine, complete freunds adjuvant (CFA) and antigen of conjunctiva from isotype mice. Then the KCS models were treated with cyclosporin A eye drop. Changes in breaking-up time (BUT), lacrimal secretion in 30 min and diversion in 24 h were measured. The percentage of beaker cells, the lymphocytic infiltration in conjunctiva were observed. The expression levels of Aquaporin-3(AQP3) in conjunctiva epithelial cells, beaker cells and accessory lacrimal gland were immunohistochemically detected. The results showed that there were significant differences in BUT, the percentage of beaker cells, lacrimal secretion in 30 min, the lymphocytic infiltration and the expression of AQP3 between the experimental group and an control group. It was concludedthat CsA eye drop exerts marked therapeutic effect on KCS by inhibiting T lymph cells, increasing the goblet cells and AQP3 expression in conjunctiva.
Mørtz, Charlotte G; Andersen, K E; Dellgren, C;
BACKGROUND: While much is known about childhood atopic dermatitis, little is known about persistence of atopic dermatitis into adult life. We report, to our knowledge for the first time, the clinical course of atopic dermatitis in an unselected cohort of adolescents followed into adulthood. METHODS......: The course of atopic dermatitis from adolescence to adulthood was studied prospectively in a cohort of unselected 8th-grade schoolchildren established in 1995 and followed up in 2010 with questionnaire and clinical examination. RESULTS: The lifetime prevalence of atopic dermatitis was high (34.......1%), and a considerable number of adults still suffered from atopic dermatitis evaluated both by questionnaire (17.1%) and clinical examination (10.0%). Persistent atopic dermatitis was found in 50% of those diagnosed in school age, and persistent atopic dermatitis was significantly associated with early...
Bayraktutar, Betül N; Uçakhan, Ömur Ö
Subepithelial infiltrates secondary to adenoviral keratoconjunctivitis may persist for years and cause blurred vision, halos, glare, and photophobia. These infiltrates arise from immune reaction against the virus, and few studies have reported topical cyclosporine A to be effective in the treatment of subepithelial infiltrates. Herein, we describe a patient with adenoviral keratoconjunctivitis-related subepithelial infiltrates who did not respond to treatment with a new topical cyclosporine A emulsion prepared with castor oil (Depores 0.05%; Deva İlaç, Kocaeli, Turkey), while the FDA-approved nanoemulsion formulation provided improvement in symptoms and reduced the inflammatory reaction (Restasis 0.05%; Allergan, Irvine, Calif., USA). PMID:27065851
Kaercher, Thomas; Buchholz, Patricia; Kimmich, Friedemann
Objective: To evaluate the efficacy and tolerability of Optive™, a new dry eye product containing sodium carboxymethylcellulose (0.5%) and glycerol (0.9%), in patients with keratoconjunctivitis sicca (KCS). Methods: This was a non-interventional and observational study including patients with dry eye who required a change of medication or were naïve to dry eye treatment (N = 5,277). Disease severity, tear break-up time (TBUT), tolerability, and change in clinical symptoms were recorded at bas...
Lien, Tina Y.; Goldman, Ran D.
Question Many children are affected by atopic dermatitis (AD) at a very young age. I often consider whether nonpharmacologic interventions could prevent or mitigate the development of AD. Do breastfeeding or changes to the maternal diet help prevent the development of childhood AD?
Diepgen, T L; Blettner, M
In order to determine the relative importance of genetics and the environment on the occurrence of atopic diseases, we investigated the familial aggregation of atopic eczema, allergic rhinitis, and allergic asthma in the relatives of 426 patients with atopic eczema and 628 subjects with no history of eczema (5,136 family members in total). Analyses were performed by regression models for odds ratios (OR) allowing us to estimate OR for the familial aggregation and simultaneously to adjust for other covariates. Three models were analyzed assuming that the OR i) is the same among any two members of a family, ii) depends on different familial constellations, i.e., whether the pairs are siblings, parents, or parent/sibling pairs, and iii) is not the same between the father and the children and between the mother and the children. The OR of familial aggregation for atopic eczema was 2.16 (95% confidence interval (95%-CI) 1.58-2.96) if no distinction was made between the degree of relationship. Further analyses within the members of the family showed a high OR among siblings (OR = 3.86; 95%-CI 2.10-7.09), while the OR between parents and siblings was only 1.90 (95%-CI 1.31-2.97). Only for atopic eczema was the familial aggregation between fathers and siblings (ms: OR = 2.66; fs: OR = 1.29). This can be explained by stronger maternal heritability, shared physical environment of mother and child, or environmental events that affect the fetus in utero. Since for all atopic diseases a stronger correlation was found between siblings than between siblings and parents, our study indicates that environmental factors, especially during childhood, seem to explain the recently observed increased frequencies of atopic diseases. PMID:8618061
Parilova O. O.
Full Text Available The correlation between high exhaled nitric oxide levels and eosinophilic-mediated airway inflammation in patients with atopic asthma has been well documented. This generates prerequisites that a regulatory feedback mechanism exists between them. Therefore, the paper briefly describes evidence implementing biosynthesis, enzyme structural features, expression regulation of its isoforms and effects of nitric oxide, which have helped elucidate molecular mechanisms by which nitric oxide selectively promotes asthma exacerbation. In previous study we have demonstrated that airway infiltrate of immune cells contributes to NO synthesis in the respiratory tract during allergic inflammation under guinea pig model of acute asthma with multiple challenges. On the basis of these findings the authors posits that nitric oxide represents an additional signal of the induction of Th2 subset response and be considerably involved in the complex network of immune regulation distinctive for atopic asthma phenotype.
Full Text Available Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy- three patients of atopic dermatitis and 71 age matched controls were studied. All the subjects were examined using a set of 34 potentially useful clinical features selected from different studies, including features for evaluation of photosensitivity. Multiple regression technique was used for analysing the data. It was found that 6 clinical features were diagnostic, 1. presence of itch, 2. history of flexural involvement, 3. history of dry skin, 4. family history of atopy, 5. personal history of diagnosed asthma and 6, visible flexural dermatitis. Photosensitivity was not a significant feature.
Furue, Masutaka; Chiba, Takahito; Takeuchi, Satoshi
Atopic dermatitis (AD) is a common, chronic or chronically relapsing, severely pruritic, eczematous skin disease. AD is the second most frequently observed skin disease in dermatology clinics in Japan. Prevalence of childhood AD is 12-13% in mainland Japan; however, it is only half that (about 6%) in children from Ishigaki Island, Okinawa. Topical steroids and tacrolimus are the mainstay of treatment. However, the adverse effects and emotional fear of long-term use of topical steroids have induced a "topical steroid phobia" in patients throughout the world. Undertreatment can exacerbate facial/periocular lesions and lead to the development of atopic cataract and retinal detachment due to repeated scratching/rubbing/patting. Overcoming topical steroid phobia is a key issue for the successful treatment of AD through education, understanding and cooperation of patients and their guardians. PMID:22053299
Parilova O. O.; Volodina T. T.; Shandrenko S. G.
The correlation between high exhaled nitric oxide levels and eosinophilic-mediated airway inflammation in patients with atopic asthma has been well documented. This generates prerequisites that a regulatory feedback mechanism exists between them. Therefore, the paper briefly describes evidence implementing biosynthesis, enzyme structural features, expression regulation of its isoforms and effects of nitric oxide, which have helped elucidate molecular mechanisms by which nitric oxide selective...
Fung, Y. M.; Mayberry, J F; Rhodes, J.; Newcombe, R G
One hundred and sixty Chinese men and 96 women resident in Hong Kong completed a questionnaire about atopic disease and their responses were compared with replies from 500 Britons. Asthma and hayfever were less common in the Chinese and this could not be attributed to medical awareness as the results were similar in Chinese surgical patients and Chinese medical students. The role of heredity and environment may be assessed by studying Chinese people who have moved to Britain.
Magni Chiara; Chellini Elisa; Zanasi Alessandro
Abstract Chronic cough has been reported to be the fifth most common complaint seen by primary care physicians in the world, the third in Italy. Chronic cough in non-smoking, non-treated with ACE-inhibitor adults with normal chest radiogram could be a symptom of asthma and can be sub-classified into: cough-variant asthma, atopic cough, and eosinophilic bronchitis. This review discusses the differential diagnosis of these three disorders.
Ersin Aydin; Ercan Karabacak; Ali Kutlu; Bilal Dogan
Atopic Dermatitis (AD) is a chronic, relapsing, inflammatory skin disease, associated with food and inhalant allergies. The relationship between food and AD is controversial. Greater than 90% parents and 60 % of primary care providers considers that food allergies as the cause for AD. However, it is difficult to reveal that food aggravating AD. In this article the relationship between AD and food allergy was reviewed. [TAF Prev Med Bull 2013; 12(1.000): 105-110
Atopic dermatitis (AD) is an inflammatory skin disease, typically with a chronic relapsing course and a defective skin barrier function. Recently, mutations of the skin barrier gene encoding filaggrin have been reported in a portion of the patients. In this thesis some aspects of defence defects in AD were studied. In paper I, the risk of developing any cancer was increased by 13%. Excess risks were observed for cancers of the esophagus, pancreas, brain, and lung and for...
Furue, Masutaka; Chiba, Takahito; Takeuchi, Satoshi
Atopic dermatitis (AD) is a common, chronic or chronically relapsing, severely pruritic, eczematous skin disease. AD is the second most frequently observed skin disease in dermatology clinics in Japan. Prevalence of childhood AD is 12-13% in mainland Japan; however, it is only half that (about 6%) in children from Ishigaki Island, Okinawa. Topical steroids and tacrolimus are the mainstay of treatment. However, the adverse effects and emotional fear of long-term use of topical steroids have in...
Rather, Irfan A.; Bajpai, Vivek K.; Kumar, Sanjay; Lim, Jeongheui; Paek, Woon K.; Park, Yong-Ha
Atopic dermatitis (AD) is a common, recurrent, chronic inflammatory skin disease that is a cause of considerable economic and social burden. Its prevalence varies substantially among different countries with an incidence rate proclaimed to reach up to 20% of children in developed countries and continues to escalate in developing nations. This increased rate of incidence has changed the focus of research on AD toward epidemiology, prevention, and treatment. The effects of probiotics in the pre...
Jäderberg, Ida; Thomsen, Simon F; Kyvik, Kirsten Ohm; Skytthe, Axel; Backer, Vibeke
Jäderberg I, Thomsen SF, Kyvik KO, Skytthe A, Backer V. Atopic diseases in twins born after assisted reproduction. Paediatric and Perinatal Epidemiology 2012; 26: 140-145. We examined the risk of atopic diseases in twins born after assisted reproduction. Data on atopic diseases and assisted...... reproduction in 9694 twin pairs, 3-20 years of age, from the Danish Twin Registry were collected via multidisciplinary questionnaires. The risk of atopic diseases in twins born after assisted reproduction was compared with the risk in twins born after spontaneous conception using logistic regression and...... variance components analysis. Children born after assisted reproduction did not have a different risk of atopic outcomes (adjusted odds ratios [95% confidence intervals] for asthma: 0.95 [0.85, 1.07], P = 0.403; hay fever: 1.01 [0.86, 1.18], P = 0.918; and atopic dermatitis: 1.02 [0.81, 1.11], P = 0...
Full Text Available Thomas Kaercher1, Patricia Buchholz2, Friedemann Kimmich31Augenarztpraxis, Heidelberg, Germany; 2Allergan Europe, Ettlingen, Germany; 3Eyecons, Pfinztal, GermanyObjective: To evaluate the efficacy and tolerability of OptiveTM, a new dry eye product containing sodium carboxymethylcellulose (0.5% and glycerol (0.9%, in patients with keratoconjunctivitis sicca (KCS.Methods: This was a non-interventional and observational study including patients with dry eye who required a change of medication or were naïve to dry eye treatment (N = 5,277. Disease severity, tear break-up time (TBUT, tolerability, and change in clinical symptoms were recorded at baseline and at final visit (2 to 4 weeks after first treatment.Results: The severity of KCS was mild in 18.6%, moderate in 59.9%, and severe in 21.5% of patients based on physicians’ assessment. TBUT was measured in 4,338 patients before switching to or initiating therapy with Optive and at final visit. Baseline measurement of mean TBUT was 7.7 ± 3.9 seconds. This value increased to 10.0 ± 4.7 seconds at final visit. Most patients (85.4% reported improvement in local comfort. The majority (75.1% of patients felt an improvement in symptoms after changing their treatment. Two percent of patients reported adverse events, and 0.4% were treatment-related.Conclusions: Optive was well tolerated and improved the symptoms of dry eye after 2 to 4 weeks.Keywords: keratoconjunctivitis sicca, dry eye, sodium carboxymethylcellulose, glycerol, OptiveTM
G. Carson, Charlotte
developing AD at 3 years of age. Our data suggested a strong heredity of AD and confirmed the risk associated with the non-functional FLG allele mutations after adjustments for confounders. Besides this mother's dermatitis and father's allergic rhinitis were found to increase the risk of AD. Perinatal...... 7 years follow-up period (HR 1.44, 95% CI 1.05-1.99, p=0.024). The increased risk was still significant after confounder adjustment for mother's education, AD and smoking habits during the 3rd trimester. There was no association between alcohol intake during pregnancy and other atopic endpoints...
Thomas Kaercher; Patricia Buchholz; Friedemann Kimmich
Thomas Kaercher1, Patricia Buchholz2, Friedemann Kimmich31Augenarztpraxis, Heidelberg, Germany; 2Allergan Europe, Ettlingen, Germany; 3Eyecons, Pfinztal, GermanyObjective: To evaluate the efficacy and tolerability of OptiveTM, a new dry eye product containing sodium carboxymethylcellulose (0.5%) and glycerol (0.9%), in patients with keratoconjunctivitis sicca (KCS).Methods: This was a non-interventional and observational study including patients with dry eye who required a change of medicatio...
Oldhoff, Jantje Maria
Atopic dermatitis (AD, or atopic eczema) is an inflammatory itchy skin disease. AD patients often have high serum immunoglobulin E (IgE) levels, T-cell activation and eosinophilia in peripheral blood. The dermal infiltrate of AD contains mainly T-cells, eosinophils and dendritic cells. Epicutaneous
Roosje, Pieternella Janna
The term atopic dermatitis (AD) is commonly used in cats. At present, however, there is little known about the pathogenesis of feline AD. The aim was to investigate various aspects of the immunopathogenesis in a defined group of cats with signs and symptoms of atopic dermatitis and compare our findi
Sokolowska-Wojdylo, Malgorzata; Baranska-Rybak, Wioletta; Cegielska, Agnieszka;
We describe here 4 patients with Sézary syndrome masquerading as adult-onset atopic dermatitis. The patients presented with a clinical picture compatible with wide-spread atopic dermatitis and did not fulfil the criteria for Sézary syndrome (lack of lymphoadenopathy and blood involvement, skin...
E.E.A. Brenninkmeijer; C.M. Legierse; J.H. Sillevis Smitt; B.F. Last; M.A. Grootenhuis; J.D. Bos
Atopic dermatitis mainly covers the period of infancy to adulthood, an important period in the development of an individual. The impairment of quality of life and the psychological wellbeing of children with atopic dermatitis have been well documented but so far no data exist about the impact of ato
Wintzen, M.; Donker, AS; Zuuren, van EJ
Atopic dermatitis is often complicated by allergic contact dermatitis, although patch testing may reveal positive reactions of uncertain relevance. We report a case of a 35-year-old woman with recalcitrant atopic dermatitis, with a positive patch-test reaction to Compositae mix (CM). Initially, sens
Christina M Gelbard
Full Text Available Christina M Gelbard1, Adelaide A Hebert1,21Departments of Dermatology; 2Pediatrics, University of Texas-Houston, Houston, TX, USAAbstract: Atopic dermatitis is a chronic, inflammatory skin condition that affects 10% to 20% of children and 1% to 3% of adults in the US. Symptoms often result in sleeplessness, psychological stress, poor self-esteem, anxiety, and poor school or work performance. The cost of atopic dermatitis is estimated to be US$0.9 to 3.8 billion every year. Topical steroids are first-line treatment for atopic dermatitis, and recent advances in vehicle technologies have resulted in improved patient tolerability and compliance. Topical calcineurin inhibitors are also safe and effective topical treatments for atopic dermatitis, and provide an additional therapeutic option for patients with this disease. Systemic immunomodulators are used in the treatment of severe refractory disease. Cyclosporine, methotrexate, azathioprine, mycophenolate mofetil, and interferon gamma have been used in the management of severe atopic dermatitis. This review highlights the current and emerging trends in the treatment of atopic dermatitis.Keywords: atopic dermatitis, topical corticosteroids, calcineurin inhibitors, methotrexate, cyclosporine, mycophenolate mofetil, IFN-γ
Eller, Esben; Kjaer, Henrik Fomsgaard; Høst, Arne;
Eller E, Kjaer HF, Høst A, Andersen KE, Bindslev-Jensen C. Development of Atopic Dermatitis in the DARC birth cohort. Pediatr Allergy Immunol 2009. (c) 2009 John Wiley & Sons A/SThe aim was to describe the relapsing pattern, sensitization and prognosis of atopic dermatitis (AD) in the first 6 yr in....... Severity of AD was measured by objective SCORing Atopic Dermatitis (SCORAD). Point-prevalence of AD peaked at 18 months of age (10%) and decreased at 36 and 72 months to slightly below 7%. The 6-yr cumulative incidence was 22.8% and sensitization was found in 43% of children with AD. It was predominately...
Full Text Available Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD.
Vestita, Michelangelo; Filoni, Angela; Congedo, Maurizio; Foti, Caterina
Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD. PMID:25973433
Full Text Available Purpose. Vernal keratoconjunctivitis (VKC is a chronic allergic disease mainly affecting boys in prepubertal age and usually recovering after puberty. To evaluate a possible role of sex hormones in VKC, serum levels of sex hormones in children and adolescents with VKC were assessed. Methods. 12 prepubertal and 7 early pubertal boys with active VKC and 6 male patients with VKC in remission phase at late pubertal age and 48 healthy age and sex-matched subjects were included. Serum concentration of estrone, 17 beta-estradiol, dehydroepiandrosterone-sulfate, total testosterone and free testosterone, dihydrotestosterone (DHT, cortisol, delta-4-androstenedione, follicle-stimulating hormone, luteinizing hormone, and sex-hormones binding globuline (SHBG were evaluated. Results. Serum levels of Estrone were significantly increased in all groups of patients with VKC when compared to healthy controls (P<0.001. Prepubertal and early pubertal VKC showed a significant decrease in DHT (P=0.007 and P=0.028, resp. and SHBG (P=0.01 and P=0.002, resp. when compared to controls and serum levels of SHBG were increased in late pubertal VKC in remission phase (P=0.007. Conclusions and Relevance. VKC patients have different circulating sex hormone levels in different phases of the disease and when compared to nonallergic subjects. These findings suggest a role played by sex hormones in the pathogenesis and/or activity of VKC.
José Alvaro Pereira Gomes
Full Text Available As ceratoconjuntivites cicatriciais (CCC representam um grupo de doenças que induz seis tipos principais de alterações oculares: olho seco; alterações palpebrais; destruição do limbo e células germinativas corneais; destruição da membrana basal; processo inflamatório; alteração na integração neuroanatômica da superfície ocular. Essas alterações acabam causando instabilidade epitelial corneal, vascularização e inflamação crônica. O resultado final é a perda de transparência da córnea e diminuição da acuidade visual. O autor descreve os seis tipos de alterações e faz uma revisão atualizada do tratamento de cada um deles.Cicatricial keratoconjunctivitis is a group of diseases that induces six different types of ocular disorders: dry eye; eyelid blinking disturbances; destruction of limbal stem cells; destruction of basement membrane; inflammation; and neuroanatomic disintegration. These disorders cause corneal epithelial instability, neovascularization and chronic inflammation which result in loss of corneal transparency and decreased visual acuity. The author describes the six types of disorders and reviews the latest therapeutic approaches for each of them.
JIANG Dongling; ZHANG Mingchang; HU Yanhua
To evaluate the efficacy and safety of resection and cryotherapy combined with amniotic membrane transplantation (AMT) for the treatment of vernal keratoconjunctivitis (VKC) with giant papillae (GP). Eight patients (16 eyes involved) with VKC, characterized by GP on the upper tarsal conjunctiva, underwent resection and cryotherapy in combination with AMT. The follow-up lasted for 3-22 months. The results showed that corneal shield ulcers and superficial punctuate keratitis healed during the first week after surgery and did not recur. Fourteen eyes (87.5 %) were symptom-free 1 month after surgery, and no GP, ectropion, trichiasis and other complications were noted, but the blood vessels of upper tarsal conjunctiva could not be clearly seen and a little conjunctival scar was observed. Recurrence of GP was observed in 2 eyes (12.5 %), with the area being less and irritation milder as compared with those before the operation. Among the two eyes, one eye was treated by cyclosporine eyedrops with improvement, but the other eye showed no improvement after the treatment, and underwent a second surgery with a cotton patch soaked in fluorouracil applied onto the supratarsal area after resection and cryotherapy. Four months after the treatment the patient presented no symptoms and GP did not recur. It is concluded that the resection and cryotherapy combined with AMT is an effective and safe treatment for VKC with GP.
Devlin, J; David, T J
Children treated with dietary restriction for food intolerance may require calcium supplementation, particularly if cows' milk and milk substitutes are not tolerated. We report two children with atopic eczema who reacted adversely to a number of calcium supplement formulations.
Full Text Available Aim: The evaluation of soy allergy in patients over 14 years of age suffering from atopic dermatitis. The evaluation of the correlation to the occurence of peanut and pollen allergy. Materials and Methods: Altogether 175 persons suffering from atopic dermatitis were included in the study: Specific IgE, skin prick tests, atopy patch tests to soy, history and food allergy to peanut and pollen allergy were evaluated. Results : The early allergic reaction to soy was recorded in 2.8% patients. Sensitization to soy was found in another 27.2% patients with no clinical manifestation after soy ingestion. The correlation between the positive results of examinations to soy and between the occurence of peanut and pollen allergy was confirmed in statistics. Conclusion: Almost one third of patients suffering from atopic dermatitis are sensitized to soy without clinical symptoms. The early allergic reaction to soy occur in minority of patients suffering from atopic dermatitis.
Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff;
Aim. To study the impact of birth characteristics on the risk of atopic dermatitis in a twin population. Methods. In a population-based questionnaire study of 10,809 twins, 3-9 years of age, from the Danish Twin Registry, we identified 907 twin pairs discordant for parent-reported atopic dermatitis....... We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit) = 1.23 (1.06-1.44), P = 0.008, and female sex, OR = 1.31 (1.06-1.61), P...... = 0.012, were risk factors for atopic dermatitis in cotwin control analysis, whereas birth anthropometric factors were not significantly related to disease development. Risk estimates in monozygotic and dizygotic twins were not significantly different for the identified risk factors. Conclusions. In...
Wollenberg, Andreas; Ehmann, Laura Maximiliane
Atopic eczema, also known as atopic dermatitis, is a frequent, highly pruritic, chronic skin disease, which is typically running in flares. The traditional treatment mainly consists of the reactive application of topical anti-inflammatory agents such as topical corticosteroids and topical calcineurin inhibitors. The short term benefit of this approach is well known, but long term remission between flares is difficult to achieve. Therefore, innovative long-term treatment strategies targeting f...
Toorn, Leon; Overbeek, Shelley; de Jongste, Johan; Leman, K.; Hoogsteden, Henk; Prins, Jan-Bas
textabstractSymptoms of atopic asthma often disappear at puberty. However, asthmatic subjects in clinical remission will frequently have a relapse later in life. The aim of this study was to investigate whether subjects in clinical remission of atopic asthma have persistent airway inflammation and/or airway remodeling. Bronchial biopsies were obtained from subjects in clinical remission, asthmatic subjects, and healthy control subjects. The presence and/or activation state of eosinophils, mas...
Sivaranjani, N.; Rao, S. Venkata; Rajeev, G.
Background: In humans, oxidative stress is involved in many diseases such as atherosclerosis, Parkinson’s disease, heart failure, myocardial infarction, Alzheimer’s disease, Fragile X syndrome and chronic fatigue syndrome. Atopic dermatitis (AD), also known as atopic eczema, is a non-contagious, relapsing inflammatory skin disease which is characterized by eczema and pruritus. The skin reacts abnormally to irritants, food and environmental allergens and it becomes very itchy, which leads to s...
Mesquita, Kleyton de Carvalho; Igreja, Ana Carolina de Souza Machado; Costa, Izelda Maria Carvalho
Patients with atopic dermatitis have genetically determined risk factors that affect the barrier function of the skin and immune responses that interact with environmental factors. Clinically, this results in an intensely pruriginous and inflamed skin that allows the penetration of irritants and allergens and predisposes patients to colonization and infection by microorganisms. Among the various etiological factors responsible for the increased prevalence of atopic diseases over the past few ...
Celakovská Jarmila; Ettlerová Kvetuše; Ettler Karel; Vanecková Jaroslava; Bukac Josef
Aim: The evaluation of soy allergy in patients over 14 years of age suffering from atopic dermatitis. The evaluation of the correlation to the occurence of peanut and pollen allergy. Materials and Methods: Altogether 175 persons suffering from atopic dermatitis were included in the study: Specific IgE, skin prick tests, atopy patch tests to soy, history and food allergy to peanut and pollen allergy were evaluated. Results : The early allergic reaction to soy was recorded in 2.8% patients. Sen...
textabstractAtopic dennatitis (AD) is a conUllon chronically relapsing skin disorder affecting 9-20% of those born after 1970 [Schultz Larsen 1993]. TI,e aetiology is still not entirely elucidated and research is complicated by the multifactorial nature of the disease. Both genetical and environmental factors are involved in the pathogenesis of AD. The prevalence of atopic dennatitis seems to have increased along with astluna and allergic rhinitis during the past three decades [Williams 1992,...
Praha: Gema Art, 2009 - (Sedláková, L.), s. 361-366 ISBN 978-80-904422-0-7 Institutional research plan: CEZ:AV0Z80330511 Keywords : Milan Grygar * Czech painting and experimental music of the 20th century * list of exhibitions and events Subject RIV: AL - Art, Architecture, Cultural Heritage
Drell, Tiina; Larionova, Anneli; Voor, Tiia; Simm, Jaak; Julge, Kaja; Heilman, Kaire; Tillmann, Vallo; Štšepetova, Jelena; Sepp, Epp
Although gut microbiota has been studied relatively extensively in the context of allergic diseases, there have been several contradictions between these studies. By applying high-throughput sequencing, we aimed to analyze the differences in gut microbiota between atopic and healthy children at 5 and 12 years of age. 51 stool samples were collected from 14 atopic and 15 healthy children and analyzed with 454 pyrosequencing of the 16S rRNA gene. At the ages of 5 and 12 years, Bacteroides, Prevotella, and Dialister dominated gut microbiota in both atopic and healthy groups of children. Children in the atopic group had lower abundance and prevalence of Akkermansia in gut microbiota than their healthy counterparts. Thus, the composition of gut microbiota does not seem to be significantly different between atopic and healthy children, but lower abundance and prevalence of Akkermansia indicate that this bacterium may accompany or play a role in IgE-mediated atopic diseases. PMID:25869237
Damsgaard, T E; Olesen, A B; Sørensen, Flemming Brandt;
Stereological quantification of mast cell numbers was applied to sections of punch biopsies from lesional and nonlesional skin of atopic dermatitis patients and skin of healthy volunteers. We also investigated whether the method of staining and/or the fixative influenced the results of the...... determination of the mast cell profile numbers. The punch biopsies were taken from the same four locations in both atopic dermatitis patients and normal individuals. The locations were the scalp, neck and flexure of the elbow (lesional skin), and nates (nonlesional skin). Clinical scoring was carried out at the...... yielded the following results: (1) in atopic dermatitis lesional skin an increased number of mast cell profiles was found as compared with nonlesional skin, (2) comparing atopic dermatitis skin with normal skin, a significantly increased number of mast cell profiles per millimetre squared was found in...
Wensheng Li; Hongli Liu; Xiaofeng Yang; Jin Zheng; Yili Wang; Lusheng Si
To develop a prophylactic recombinant HPV58L1-attenuated Shigella live vector vaccine and evaluate its protective efficacy and immunogenicity in the guinea pig keratoconjunctivitis model, the HPV58L1 gene was cloned into vector pUCmt, and then subcloned into the suicide vector pCVD442. The recombinant plasmid pCVD442-HPV58L1 was introduced into attenuated Shigella (sf301:△virG) with the helper plasmid PRK2013 by filter mating. The positive colonies were harvested and confirmed by polymerase chain reaction. The expression of the HPV58L1 protein with a molecu-lar weight of 60 kDa was confirmed by western blot. The ability of the interested protein to self-assemble into virus-like particles was identified by transmission electron microscope, and murine erythrocyte hemagglu-tination assay. The guinea pig keratoconjunctivitis model was used to evaluate the protective efficacy and immunogenicity of the vaccine. Animal experiments showed that there was no keratoconjunctivitis occurred in the immunized group (HPV58-attenuated Shigella), and the serum levels of anti-HPV58L1-IgG and -IgA were obviously increased (P0.05). Enzyme-linked immunosorbent spot assay showed that HPV58L1-specific IgA-antibody-secreting cells (ASC) and IgG-ASC of spleen and lymph nodes were also obviously increased (P<0.01). In this study, a recombi-nant HPV58L1-attenuated Shigella live vector vaccine was successfully constructed, and it could induce strong humoral immune responses in the immunized animals, and induce protective antibody production.
Eichenfield, Lawrence F; Tom, Wynnis L; Berger, Timothy G; Krol, Alfons; Paller, Amy S; Schwarzenberger, Kathryn; Bergman, James N; Chamlin, Sarah L; Cohen, David E; Cooper, Kevin D; Cordoro, Kelly M; Davis, Dawn M; Feldman, Steven R; Hanifin, Jon M; Margolis, David J; Silverman, Robert A; Simpson, Eric L; Williams, Hywel C; Elmets, Craig A; Block, Julie; Harrod, Christopher G; Smith Begolka, Wendy; Sidbury, Robert
Atopic dermatitis is a common and chronic, pruritic inflammatory skin condition that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this second of 4 sections, treatment of atopic dermatitis with nonpharmacologic interventions and pharmacologic topical therapies are reviewed. Where possible, suggestions on dosing and monitoring are given based on available evidence. PMID:24813302
Thyssen, J P; Linneberg, A; Engkilde, K;
Introduction: It has been much debated whether atopic dermatitis is associated with contact sensitization since past findings have conflicted. A positive association might change our clinical practice. Objective: To investigate the association between atopic dermatitis and contact sensitization...... self-reported atopic dermatitis from this study mainly suffered from mild disease. However, clinicians should be aware of increased levels of contact sensitization in individuals with atopic dermatitis. Patch testing should therefore be considered at an early point in individuals with a history of...... atopic dermatitis and active disease. The fundamental relationship between atopic disease and environmental chemical exposure may be of a more complex and intimate nature than previously supposed....
Mueller, R S; Specht, L; Helmer, M; Epe, C; Wolken, S; Denk, D; Majzoub, M; Sauter-Luis, C
Canine atopic dermatitis is a common disease and is considered as an animal model of the human disease. Immunomodulation by helminths is reported in several species. The aim of this study was to determine whether nematodes have an immunomodulatory effect on atopic dermatitis in dogs. In the pilot study, 12 atopic dogs were infected with either embryonated eggs of Trichuris vulpis (500 and 2500 eggs in 3 dogs each) or L3 larvae of Uncinaria stenocephala (100, 500 and 2500 eggs in 2 dogs each), respectively, for 3 months. Pruritus was evaluated with visual analogue scales and clinical lesions with the canine atopic dermatitis extent and severity index (CADESI). Skin biopsies were obtained for histopathology at the beginning and end of the study. In the subsequent placebo-controlled, double-blinded, randomised study, 21 dogs received either 2500 embryonated T. vulpis eggs or placebo and were evaluated similarly. In addition, allergen-specific serum IgE concentrations were determined. All dogs in the pilot study improved in their lesion scores, most in their pruritus scores. The cutaneous inflammatory infiltrate did not change significantly. In the subsequent randomised study, there was no significant difference between placebo and Trichuris administration in regard to pruritus or CADESI. IgE concentrations also did not change significantly. Infection with T. vulpis did not significantly change clinical signs of canine atopic dermatitis. PMID:21621922
Ping Liu; Yan Zhao; Zhang-Lei Mu; Qian-Jin Lu; Li Zhang; Xu Yao; Min Zheng
Background:Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching.Most patients have personal and/or family history of atopic diseases.Several criteria have been proposed for the diagnosis of AD.Although the clinical features of childhood AD have been widely studied,there has been less large-scale study on adult/adolescent AD.The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.Methods:A hospital-based study was performed.Forty-two dermatological centers participated in this study.Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study.Questionnaires were completed by both patients and investigators.The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.Results:A total of 2662 valid questionnaires were collected (1369 male and 1293 female).Of all 2662 patients,2062 (77.5％) patients had the disease after 12 years old,while only 600 (22.5％) patients had the disease before 12 years old,suggesting late-onset eczema/AD is common.Two thousand one hundred and thirty-nine (80.4％) patients had the disease for more than 6 months.One thousand one hundred and forty-four (43.0％) patients had a personal and/or family history of atopic diseases.One thousand five hundred and forty-eight (58.2％) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE.Based on these clinical and laboratory features,we proposed Chinese criteria for adult/adolescent AD.Of all 2662 patients,60.3％ were satisfied with our criteria,while only 48.2％ satisfied with Hanifin Rajka criteria and 32.7％ satisfied with Williams criteria,suggesting a good sensitivity of our criteria in adult/adolescent AD patients.Conclusion:Late-onset of eczema or AD is common
Fuglsang, G; Madsen, G; Halken, S;
In a multicenter study conducted at four Danish hospital pediatric departments, the parents of 472 consecutive children were informed of this project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis......, rhinitis, or urticaria. After a 2-week period on an additive-free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, preservatives, citric acid, and flavoring agents. Carbonated "lemonade" containing the dissolved additives was used for...... dermatitis, asthma, urticaria, gastrointestinal symptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms). The incidence of intolerance of food additives was 2% (6/335), as based on the double-blind challenge, and 7% (23/335), as based on the open challenge with lemonade. Children with atopic...
Fuglsang, G.; Madsen, Charlotte Bernhard; Halken, S.;
In a multicenter study conducted at four Danish hospital pediatric departments, the parents of 472 consecutive children were informed of this project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis......, rhinitis, or urticaria. After a 2-week period on an additive-free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, preservatives, citric acid, and flavoring agents. Carbonated ''lemonade'' containing the dissolved additives was used for...... dermatitis, asthma, urticaria, gastrointestinal symptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms). The incidence of intolerance of food additives was 2% (6/335), as based on the double-blind challenge, and 7% (23/335), as based on the open challenge with lemonade. Children with atopic...
Mesquita, Kleyton de Carvalho; Igreja, Ana Carolina de Souza Machado; Costa, Izelda Maria Carvalho
Patients with atopic dermatitis have genetically determined risk factors that affect the barrier function of the skin and immune responses that interact with environmental factors. Clinically, this results in an intensely pruriginous and inflamed skin that allows the penetration of irritants and allergens and predisposes patients to colonization and infection by microorganisms. Among the various etiological factors responsible for the increased prevalence of atopic diseases over the past few decades, the role of vitamin D has been emphasized. As the pathogenesis of AD involves a complex interplay of epidermal barrier dysfunction and dysregulated immune response, and vitamin D is involved in both processes, it is reasonable to expect that vitamin D's status could be associated with atopic dermatitis' risk or severity. Such association is suggested by epidemiological and experimental data. In this review, we will discuss the evidence for and against this controversial relationship, emphasizing the possible etiopathogenic mechanisms involved. PMID:24474104
Jonathan M Spergel
Full Text Available Jonathan M SpergelDivision of Allergy and Immunology, The Children’s Hospital of Philadelphia Department of Pediatrics, University of Pennsylvania School of MedicineAbstract: Atopic eczema is a common pediatric skin disorder. This review examines the use of pimecrolimus cream in the treatment of acute and chronic stages of the disease. The standard therapy is the treatment of acute flares with topical medications including pimecrolimus. The use of pimecrolimus cream for the first sign and symptoms of atopic eczema reduces the occurrence of flares as defined by the need for topical corticosteroids. The side effects of pimecrolimus cream are mild without any increase of infections or systemic immune suppression.Keywords: pimecrolimus, atopic eczema, long-term management
Jøhnke, H; Vach, W; Norberg, L A;
BACKGROUND: Epidemiological studies have shown different estimates of the frequency of atopic eczema (AE) in children. This may be explained by several factors including variations in the definition of AE, study design, age of study group, and the possibility of a changed perception of atopic...... diseases. The role of IgE sensitization in AE is a matter of debate. OBJECTIVES: To determine the prevalence and cumulative incidence of AE in a group of unselected infants followed prospectively from birth to 18 months of age using different diagnostic criteria; to evaluate the agreement between criteria......; and to describe the association between atopic heredity and postnatal sensitization, respectively, and the development of AE according to the different diagnostic criteria. METHODS: During a 1-year period a consecutive series of 1095 newborns and their parents were approached at the maternity ward at...
Jonathan S. Tam
Full Text Available Dendritic cells are important residents of the lung environment. They have been associated with asthma and other inflammatory diseases of the airways. In addition to their antigen-presenting functions, dendritic cells have the ability to modulate the lung environment to promote atopic disease. While it has long been known that respiratory viral infections associate with the development and exacerbation of atopic diseases, the exact mechanisms have been unclear. Recent studies have begun to show the critical importance of the dendritic cell in this process. This paper focuses on these data demonstrating how different populations of dendritic cells are capable of bridging the adaptive and innate immune systems, ultimately leading to the translation of viral illness into atopic disease.
Beriat, Güçlü Kaan; Akmansu, Şefik Halit; Doğan, Cem; Taştan, Eren; Topal, Ferda; Sabuncuoğlu, Bizden
Summary Background In recent years, pimecrolimus 1% cream has been demonstrated to reduce symptoms of atopic dermatitis in patients when applied topically. Material/Methods In our study we compared the therapeutic effects of local 1% pimecrolimus to 1% hydrocortisone, and to a control group in a mouse model with atopic dermatitis in the external ear canals. Atopic dermatitis was created by application of Dinitrochlorobenzene in the external ear canals of mice. The development of atopic dermat...
Grueber, Christoph; van Stuijvenberg, Margriet; Mosca, Fabio; Moro, Guido; Chirico, Gaetano; Braegger, Christian P.; Riedler, Josef; Boehm, Guenther; Wahn, Ulrich
Background: Most infants developing atopic dermatitis have a low risk for atopy. Primary prevention of atopic dermatitis is difficult. Objective: To assess the effect of supplementation of an infant and follow-on formula with prebiotic and immunoactive oligosaccharides on the occurrence of atopic de
Ali Abdirahman A
Full Text Available Abstract Background Infectious bovine keratoconjunctivitis (IBK or ‘pinkeye’ is an economically important ocular disease that significantly impacts animal performance. Genetic parameters for IBK infection and its genetic and phenotypic correlations with cattle tick counts, number of helminth (unspecified species eggs per gram of faeces and growth traits in Australian tropically adapted Bos taurus cattle were estimated. Methods Animals were clinically examined for the presence of IBK infection before and after weaning when the calves were 3 to 6 months and 15 to 18 months old, respectively and were also recorded for tick counts, helminth eggs counts as an indicator of intestinal parasites and live weights at several ages including 18 months. Results Negative genetic correlations were estimated between IBK incidence and weight traits for animals in pre-weaning and post-weaning datasets. Genetic correlations among weight measurements were positive, with moderate to high values. Genetic correlations of IBK incidence with tick counts were positive for the pre-weaning and negative for the post-weaning datasets but negative with helminth eggs counts for the pre-weaning dataset and slightly positive for the post-weaning dataset. Genetic correlations between tick and helminth eggs counts were moderate and positive for both datasets. Phenotypic correlations of IBK incidence with helminth eggs per gram of faeces were moderate and positive for both datasets, but were close to zero for both datasets with tick counts. Conclusions Our results suggest that genetic selection against IBK incidence in tropical cattle is feasible and that calves genetically prone to acquire IBK infection could also be genetically prone to have a slower growth. The positive genetic correlations among weight traits and between tick and helminth eggs counts suggest that they are controlled by common genes (with pleiotropic effects. Genetic correlations between IBK incidence
Christina M Gelbard; Hebert, Adelaide A.
Christina M Gelbard1, Adelaide A Hebert1,21Departments of Dermatology; 2Pediatrics, University of Texas-Houston, Houston, TX, USAAbstract: Atopic dermatitis is a chronic, inflammatory skin condition that affects 10% to 20% of children and 1% to 3% of adults in the US. Symptoms often result in sleeplessness, psychological stress, poor self-esteem, anxiety, and poor school or work performance. The cost of atopic dermatitis is estimated to be US$0.9 to 3.8 billion every year. Topical steroids ar...
Oldhoff, Jantje Maria
Atopic dermatitis (AD, or atopic eczema) is an inflammatory itchy skin disease. AD patients often have high serum immunoglobulin E (IgE) levels, T-cell activation and eosinophilia in peripheral blood. The dermal infiltrate of AD contains mainly T-cells, eosinophils and dendritic cells. Epicutaneous patch tests with aeroallergen application for 24-48 h can induce eczematous lesions in sensitized patients with AD. This is named the atopy patch test (APT). The APT is used as in vivo research mod...
Wolsk, Helene Mygind; Marquart, Hanne V; Laub, Bodil; Gniadecki, Robert; Nysom, Karsten; Ifversen, Marianne
Two children are presented with autosomal recessive hyper IgE syndrome caused by a mutation in the dedicator of cytokinesis 8 gene (DOCK8). The manifestations are typically severe atopic dermatitis, food allergies, elevated serum IgE concentration, viral skin infections and risk of malignancies. DOCK8 deficiency was first reported in 2009, following the death of the oldest sibling. The youngest sibling was cured after allogenic stem cell transplantation. This case report illustrates the need of awareness of primary immunodeficiency in children with atypical manifestation of atopic dermatitis in combination with recurrent infections. PMID:26692033
Sehgal, Virendra N; Khurana, Ananta; Mendiratta, Vibhu; Saxena, Deepti; Srivastava, Govind; Aggarwal, Ashok K; Chatterjee, Kingshuk
Atopic dermatitis (AD) is an intriguing clinical entity. Its clinical connotations are varied, the updates of which are required to be done periodically. An attempt to bring its various facets have been made highlighting its clinical features keeping in view the major and the minor criteria to facilitate the diagnosis, differential diagnosis, complications, and associated dermatoses. The benefit of the current dissertation may percolate to the trainees in dermatology, in addition to revelations that atopic undertones in genetic susceptibility and metabolic disorder may provide substantive insight for the future in the understanding of thus far enigmatic etiopathogenesis of AD. PMID:27293243
Full Text Available Omar Pacha, Adelaide A HebertDepartment of Dermatology, University of Texas Health Science Center, Houston, TX, USAAbstract: Advances in current understanding of the pathophysiology of atopic dermatitis have led to improved targeting of the structural deficiencies in atopic skin. Ceramide deficiency appears to be one of the major alterations in atopic dermatitis and the replenishment of this epidermal component through topically applied ceramide based emollients appears to be safe, well tolerated, and effective. Recently a ceramide hyaluronic acid foam has become commercially available and increasing evidence supports its safety and efficacy in patients who suffer from atopic dermatitis.Keywords: atopic dermatitis, ceramide, Hylatopic, eczema, non-steroidal, dermatology
Full Text Available Aim: To evaluate with SCORAD system the contribution of the diagnostic hypoallergenic diet on the severity of atopic dermatitis and especially on the the intensity criteria and subjective parametersin patients over 14 years of age. Materials and Methods: The diagnostichypoallergenic diet was recommended for the period of 3 weeks. Severity of eczema was scored in agreement with SCORAD score, and especially the intensity criteria (erythema, edema, crusting, excoriations, lichenifications, dryness and subjective parameters (pruritus, sleeplessness were evaluated at the beginning and at the end of this diet. Results: One hundred and forty-eight patients suffering from atopic dermatitis were included in the study: 107 women and 41 men with the average age of 26.03 (s.d. 9.6 years, min. 14 max. 63 years. In the end of 3 weeks diagnostic hypoallergenic diet there was a statistically significant reduction in severity of sleepless and pruritus and in all of the intensity criteria except of lichenification. Conclusion: The diagnostic hypoallergenic diet can improve the intensity criteria and subjective parameters of atopic dermatitis evaluated in SCORAD, but not the lichenification. We recommend to introduce this diet before a challenge tests and as a temporary medical arrangement in patients suffering from moderate or severe form of atopic dermatitis.
A. Wolkerstorfer (Albert)
textabstractAtopic dennatitis (AD) is a conUllon chronically relapsing skin disorder affecting 9-20% of those born after 1970 [Schultz Larsen 1993]. TI,e aetiology is still not entirely elucidated and research is complicated by the multifactorial nature of the disease. Both genetical and environment
Fowler, Joseph F; Nebus, Judith; Wallo, Warren; Eichenfield, Lawrence F
Colloidal oatmeal has been used for decades to soothe and ameliorate atopic dermatitis and other pruritic and/or xerotic dermatoses. In-vitro and/or in-vivo studies have confirmed the anti-inflammatory, barrier repair, and moisturizing properties of this compound. A broad set of studies has been conducted in recent years to assess the effects of colloidal oatmeal as adjunct treatment in the management of atopic dermatitis (AD). This paper will review these studies. In these investigations, patients in all age groups (3 months to 60 years) with mild to moderate atopic dermatitis were included and allowed to continue their prescribed topical medications. These studies found that the daily use of moisturizers and/or cleansers containing colloidal oatmeal significantly improved many clinical outcomes of atopic dermatitis from baseline: investigator's assessment (IGA), eczema area and severity index (EASI), itch, dryness, and quality of life indices. Safety results showed that the formulations were well tolerated in babies, children, and adults with AD. PMID:22777219
Linneberg, A; Petersen, Janne; Grønbaek, M;
BACKGROUND: There is evidence that antenatal factors play a role in the development of atopic dermatitis (AD). However, little is known about the effects of maternal lifestyle factors during pregnancy on the risk of AD in the offspring. OBJECTIVE: To investigate the effect of alcohol consumption...
Full Text Available Tumor necrosis factor-α inhibitors may induce various cutaneous side effects including eczematous-like lesions. The management of such side effects can be challenging. Herein, we report a case of a 55-year-old man who had a flare-up and subsequent improvement of atopic dermatitis during treatment of severe psoriasis with adalimumab.
Bonfim, Camila Barreto; dos Santos, Darci Neves; Barreto, Maurício Lima
This study aims to describe the types of intrafamilial violence perpetrated against children according to living conditions, family factors, and child characteristics, and to identify the association between types of intrafamilial violence and asthma symptoms in atopic and non-atopic children. A cross-sectional study was carried out with 1,370 caregivers as part of the Social Changes, Asthma and Allergy in Latin America (SCAALA) study, conducted in 2006 in Brazil. The study population was selected by random sampling. The main outcome measures were atopic and non-atopic asthma. We investigate the association between intrafamilial violence and asthma symptoms in atopic and non-atopic children. A backward multivariate logistic polytomous regression was performed to verify the main association. Nonviolent discipline (NVD) and maltreatment nonviolent discipline (MNVD) were positively associated with non-atopic asthma symptoms (NVD: odds ratio (OR)=1.95/95% confidence interval (CI)=1.17-3.25; MNVD: OR=1.95/95% CI=1.19-3.20). However, for the most severe intrafamilial violence, this association was not found after control of potential confounders. This study demonstrates the effect of types of intrafamilial violence on non-atopic asthma. Intrafamilial violence against children represents one more component in the determination of non-atopic asthma in Latin America. PMID:26149733
Ali, A.; O'Neill, C.J.; Thomson, P.C.;
Background: Infectious bovine keratoconjunctivitis (IBK) or 'pinkeye' is an economically important ocular disease that significantly impacts animal performance. Genetic parameters for IBK infection and its genetic and phenotypic correlations with cattle tick counts, number of helminth (unspecified...... recorded for tick counts, helminth eggs counts as an indicator of intestinal parasites and live weights at several ages including 18 months. Results: Negative genetic correlations were estimated between IBK incidence and weight traits for animals in pre-weaning and post-weaning datasets. Genetic...... correlations among weight measurements were positive, with moderate to high values. Genetic correlations of IBK incidence with tick counts were positive for the pre-weaning and negative for the post-weaning datasets but negative with helminth eggs counts for the pre-weaning dataset and slightly positive for...
Cláudio Maciel de Sena
Full Text Available OBJETIVO: Apresentar os primeiros resultados do uso da Homeopatia entre os pacientes com conjuntivite primaveril, avaliados no Serviço de Córnea e Doenças Externas do Hospital São Geraldo. MÉTODOS: Foram incluídos no presente estudo 13 pacientes apresentando ceratoconjuntivite primaveril, examinados no período de janeiro de 1998 a dezembro de 1999. A idade média dos pacientes foi de 9,5 anos, sendo nove do sexo masculino e quatro do sexo feminino. Todos os pacientes já haviam feito uso de corticóide tópico antes da sua inclusão no estudo. Antes de iniciar o tratamento homeopático, todos os pacientes foram examinados por um dos autores, sendo acompanhados pelo mesmo médico, mensalmente até os seis meses e depois trimestralmente até completar um ano do tratamento homeopático. O tratamento homeopático foi realizado por meio de uma dose única, via oral, baseando-se na totalidade sintomática do paciente. RESULTADOS: A porcentagem de melhora dos sinais e sintomas, entre os pacientes, foi de: lacrimejamento e dor ocular 100%; secreção ocular 92%; sensação de corpo estranho 86%; prurido e fotofobia 84%; relatavam diminuição ou ausência do desconforto que a ceratoconjuntivite primaveril provocava nas suas atividades diárias 84%; nódulos de Trantas 62,5%; hiperemia conjuntival 61%; erosões epiteliais 58% e hipertrofia da papila tarsal 8%. CONCLUSÃO: Este estudo sugere efeito benéfico da medicação homeopática no tratamento da ceratoconjuntivite primaveril, com melhora dos sinais e sintomas da doença. Sugere-se a realização de estudo duplo-cego, com maior número de casos, para a confirmação desses resultados.PURPOSE: To present a preliminary report of homeopathic medicine in the treatment of vernal keratoconjunctivitis, at the Cornea service, of the São Geraldo Hospital. METHODS: Thirteen patients with vernal keratoconjunctivitis, examined from January 1998 to December 1999, were included in the present study
Garcia Ortiz, Patricia; Hansen, Steen H; Shah, Vinod P;
Appropriate methodologies for the determination of drug penetration in diseased skin have not yet been established. The aim of this study was to determine the cutaneous penetration of a metronidazole cream formulation in atopic dermatitis, employing dermal microdialysis and tape strip sampling...... atopic dermatitis compared with uninvolved skin (p<0.001). Tape stripping methodology did not disclose this difference in penetration. Thus, the skin layer of interest and the integrity of the skin barrier should be considered when selecting sampling methodology. Microdialysis sampling is the method of...... techniques. Non-invasive measuring methods were used for the quantification of the severity of the dermatitis. Skin thickness and the depth of the microdialysis probes in the skin were measured by 20 MHz ultrasound scanning. Metronidazole concentration, sampled by microdialysis, was 2.4-fold higher in the...
Perczel, Kristóf; Gál, János
Hypnosis is well known for its modulatory effects on immune and inflammatory processes, and it is a therapeutic option for certain diseases of such pathogenesis. The authors report treatment of an adult patient with extensive atopic dermatitis, who was only minimally responsive to conservative treatment. In a 15 session hypnotherapy the authors combined the use of direct, symptom-oriented suggestive techniques with hypnotic procedures to identify and modify comorbid psychological issues. To monitor the effect of the treatment, patient diaries (quality and quantity of sleep, intensity of pain and itch) and repeated psychometric tests were used. At the end of treatment there were improvements in all measured dimensions (itch, pain, insomnia, activity, anxiety and emotional state) both clinically and psychometrically. The authors conclude, that hypnosis can be an effective adjunctive therapy in atopic dermatitis, and in certain severe cases may constitute a salvage therapy. PMID:26929974
Keil, T; Kulig, M; Simpson, A;
BACKGROUND: The reasons for the rise in asthma and allergies remain unclear. To identify risk or protective factors, it is essential to carry out longitudinal epidemiological studies, preferably birth cohort studies. In Europe, several birth cohort studies on asthma and atopic diseases have been...... initiated over the last two decades. AIM: One of the work packages within the Global Allergy and Asthma European Network (GA(2)LEN) project was designed to identify and compare European birth cohorts on asthma and atopic diseases. The present review (part I) describes their objectives, study settings......, recruitment process and follow-up rates. A subsequent review (part II) will compare outcome and exposure parameters. METHODS: For each birth cohort, we collected detailed information regarding recruitment process, study setting, baseline data (pregnancy, birth, parents/siblings) as well as follow-up rates...
Full Text Available The goal of our study was to assess the chemotactic activity for eosinophils (ECA and neutrophils (NCA and histamine releasing activity (HRA in crude supernatants of mononuclear cells in monosensitized atopic asthmatics and healthy controls. Chemotactic activity for ECA and neutrophils was measured in supernatants of cultured mononuclear cells with modified Boyden’s chamber and HRA was assessed on healthy donor basophils. With respect to ECA generation two distinct subgroups of subjects were distinguished: releasers [ECA (+] and non-releasers [ECA (–]. In atopic and non-atopic ECA (+ the mean ECA index was 3.78 ± 0.49 and 2.47 ± 0.27 respectively (P > 0.05. Supernatants from the remaining subjects (seven of 22 atopic and five of 11 non-atopic did not express ECA, but revealed significant inhibitory activity for chemokinesis of eosinophils (mean chemotactic index 0.25 ± 0.16 and 0.48 ± 0.22 for atopic and non-atopic non-releasers respectively. Stimulation with antigen of MNC from atopic and with PHA from non-atopic ECA (– restored cells ability to release ECA. Sephadex gel chromatography revealed that supernatants of MNC contained chemotactic and chemokinesis inhibitory activity in different fractions. The spontaneous productions of NCA and HRA by mononuclear cells was sim ilar in ECA releasers and non-releasers, although the HRA was higher following stimulation with PHA in the non-atopic ECA (+ subgroup. Our study demonstrated, for the first time, that MNC are capable of generating not only chemotactic activity but also chemokinesis inhibitory activity for eosinophils.
Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda
Chronic otitis media with effusion (OME) is associated with irreversible changes in the middle ear, sometimes leading to hearing loss and abnormal language development in children. While the pathogenesis of OME is not fully understood, inflammatory and allergic factors are thought to be involved. The study aimed to investigate the role of cytokines in the local development of chronic OME, and assess differences in the cytokine profiles between atopic and non-atopic children. 84 atopic and non-atopic children with chronic OME (mean age of 6 years 7 months) were studied. Age-matched children with hypertrophy of the adenoids and Eustachian tube dysfunction served as the control group. The number of past acute otitis media (AOM) episodes, their age, and the type of effusion were recorded for all children. Pro-inflammatory cytokine concentrations (TNF-α, IL-1β, IL-6 and IL-8) were determined and the presence of pathogenic bacteria in the patients' effusions was examined. High concentrations of TNF-α, IL-1β, IL-6 and IL-8 were found in the effusions in all children with chronic OME, with the highest levels observed in the non-atopic group. The atopic group showed persistently high IL-1β levels, while in the non-atopic children, IL-1β and TNF-α levels positively correlated with the patient's age and the number of past AOM episodes. Pathogenic bacteria were more frequently isolated from effusions in non-atopic children. In both atopic and non-atopic children, pro-inflammatory cytokines are found at high concentrations. This argues in favor of instituting anti-inflammatory management for treating OME, regardless of atopy. PMID:26078091
Kim, Si-Heon; Hur, Jae; Jang, Jae-Yeon; Park, Hae-Sim; Hong, Chang Hyung; Son, Sang Joon; Chang, Ki Jung
Abstract The relationship between atopic dermatitis (AD) and psychological distress has been well established for children and adolescents. However, it is unclear whether this relationship exists in young adults. This study aimed to assess the relationship between AD and psychological distress in young male adults in South Korea. A cross-sectional study was conducted using regional conscription data from 2008 to 2012. A dermatologist diagnosed AD based on historical and clinical features, and...
Jarmila Celakovska; Josef Bukac
Aim: To evaluate with SCORAD system the contribution of the diagnostic hypoallergenic diet on the severity of atopic dermatitis and especially on the the intensity criteria and subjective parametersin patients over 14 years of age. Materials and Methods: The diagnostichypoallergenic diet was recommended for the period of 3 weeks. Severity of eczema was scored in agreement with SCORAD score, and especially the intensity criteria (erythema, edema, crusting, excoriations, lichenifications, dryne...
Ali R. Tehrani
Full Text Available Problem statement: Atopic diseases, including asthma, eczema and allergic rhinitis, are characterized by a chronic inflammatory reaction mediated by T helper 2 cells, while type 1 diabetes mellitus is mediated by T helper 1 cells. Approach: The aim of this study was to compare the prevalence of atopic dermatitis between children with type 1 diabetes mellitus and age-matched controls. We conducted a case-control study enrolling 150 cases with type 1 diabetes mellitus between 2-20 years from pediatric endocrine out patient clinic and 450 controls randomly selected from the general population matched on sex and age. The diagnosis of atopic dermatitis was determined for patients and controls by the Hanifin and Rajkas diagnostic criteria. Results: From 150 cases, 75 (50% were male and 75 (50% were female, with the age between 2 and 20 and among the 450 controls, 228 were male (50. 66% and 222 were female (49.33% the age was as the case. Dermatitis past or present, was identified in 1.3% of cases and 3.1% of controls, a difference which was not statistically significant (P>0.05. Conclusion: In present study, the prevalence of atopic dermatitis was comparable in diabetic children and the controls which may be due to difference between races and geographic areas and lack of support for an inverse relationship between the Th2-mediated atopy and th1-mediated autoimmune disorder. Further studies are needed to show the difference in serum IgE and cytokine profiles between the groups.
Patrizi A; Raone B; Ravaioli GM
Annalisa Patrizi, Beatrice Raone, Giulia Maria RavaioliDepartment of Specialized, Diagnostic and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, ItalyAbstract: Atopic dermatitis (AD) is a common chronic inflammatory skin disease that can affect all age groups. It is characterized by a relapsing course and a dramatic impact on quality of life for patients. Environmental interventions together with topical devices represent the mainstay of treatment for AD, in pa...
Full Text Available Melatonin is the main secretory product synthesized and secreted by the pineal gland during the night. Melatonin is a pleitropic molecule with a wide distribution within phylogenetically distant organisms and has a great functional versatility, including the regulation of circadian and seasonal rhythms and antioxidant and anti-inflammatory properties. It also possesses the capacity to modulate immune responses by regulation of the TH1/TH2 balance and cytokine production. Immune system eradicates infecting organisms without serious injury to host tissues, but sometimes these responses are inadequately controlled, giving rise to called hypersensitivity diseases, or inappropriately targeted to host tissues, causing the autoimmune diseases. In clinical medicine, the hypersensitivity diseases include the allergic or atopic diseases and the hallmarks of these diseases are the activation of TH2 cells and the production of IgE antibody. Regarding autoimmunity, at the present time we know that the key events in the development of autoimmunity are a failure or breakdown of the mechanisms normally responsible for maintaining self-tolerance in B lymphocytes, T lymphocytes, or both, the recognition of self-antigens by autoreactive lymphocytes, the activation of these cells to proliferate and differentiate into effector cells, and the tissue injury caused by the effector cells and their products. Melatonin treatment has been investigated in atopic diseases, in several animal models of autoimmune diseases, and has been also evaluated in clinical autoimmune diseases. This review summarizes the role of melatonin in atopic diseases (atopic dermatitis and asthma and in several autoimmune diseases, such as arthritis rheumatoid, multiple sclerosis, systemic lupus erythematosus, type 1 diabetes mellitus, and inflammatory bowel diseases.
Ayşegül Akan; Emine Dibek Mısırlıoğlu; Can Naci Kocabaş
Atopic dermatitis (AD) is a multifactorial skin disease manifested by the interaction between environmental factors, immune system and the genes predisposing to the disease. It affects the quality of life of patients and their family considerably. The prevelance for children is 10-20% in developed countries, while frequency of AD is considered as rising all over the world. According to the studies conducted in our country, the frequency is about 4.9% to 8.1%. Currently, there a...
Spergel, Jonathan M.
Jonathan M SpergelDivision of Allergy and Immunology, The Children’s Hospital of Philadelphia Department of Pediatrics, University of Pennsylvania School of MedicineAbstract: Atopic eczema is a common pediatric skin disorder. This review examines the use of pimecrolimus cream in the treatment of acute and chronic stages of the disease. The standard therapy is the treatment of acute flares with topical medications including pimecrolimus. The use of pimecrolimus cream for the first si...
Carr, Warner W
Atopic dermatitis (AD) is an inflammatory skin disease commonly affecting children and managed by pediatricians, primary care physicians, allergists, and dermatologists alike. For many years, the only available topical pharmacological treatment was topical corticosteroids. This changed in 2000–2001, when topical formulations of two calcineurin inhibitors (tacrolimus and pimecrolimus) were approved for short-term or chronic intermittent treatment of AD in patients ≥2 years of age, in whom othe...
Clinedinst, Winston C.; Slominski, Christopher J.; Dickson, Richard W.; Wolverton, David A.
The individual software processes used in the flight computers on-board the Advanced Transport Operating System (ATOPS) aircraft have many common functional elements. A library of commonly used software modules was created for general uses among the processes. The library includes modules for mathematical computations, data formatting, system database interfacing, and condition handling. The modules available in the library and their associated calling requirements are described.
Debra J. Palmer
A “vitamin D hypothesis” has been proposed to explain the increased prevalence of eczema in regions with higher latitude. This review focuses on the current available evidence with regard to the possible effect of vitamin D on the development of atopic eczema. Observational studies have indicated a link between vitamin D status and eczema outcomes, including lower serum vitamin D levels associated with increased incidence and severity of eczema symptoms. Vitamin D is known to have a regulator...
Raquel Leão Orfali
Full Text Available OBJECTIVE: Atopic dermatitis (AD is a chronic inflammatory disease causing intense pruritus, and with typical clinical features. There are few epidemiological studies concerning AD in adults, as well as little information about its prognostic. The aim of this study was to evaluate the clinical and epidemiological course of adults with AD. METHODS: 80 patients aged above 18 years (mean age = 29 years were selected (30 males and 50 females and interviewed about hospitalization, systemic corticoid usage, age of AD onset, and personal and/or familial history of atopy. Disease severity was evaluated through the Scoring Atopic Dermatitis (SCORAD tool. Laboratory examination included IgE serum levels and eosinophil blood count. RESULTS: 71 out of 80 patients referred association with respiratory symptoms (18 had asthma, 17 had rhinitis, and 36 had both conditions; nine out of 80 patients denied any respiratory disease. AD patients were divided in mild (n = 25, moderate (n = 30, and severe (n = 25; 56% had one or more hospitalizations due to AD. A positive association was found between IgE serum levels, eosinophil blood count, and disease severity. CONCLUSION: Adult AD represents a clinical challenge that needs to be better characterized, since it can be misdiagnosed and interferes with the patient's social and personal life. The association of skin and respiratory atopic disease is frequent, and laboratory parameters such as circulating IgE levels and eosinophil blood count may be helpful to assess disease severity.
Lauritzen, Lotte; Halkjaer, Liselotte Brydensholt; Mikkelsen, Tina Buur; Olsen, Sjurdur F; Michaelsen, Kim F; Loland, Lotte; Bisgaard, Hans
, that of atopic mothers had significantly higher concentrations of 22:5n-6 and lower concentrations of 20:5n-3; moreover,20:4n-6/20:5n-3, 22:5n-6/22:6n-3, and long-chain n-3 PUFA/18:3n-3 were shifted toward n-6 PUFA and 18:3n-3 in nonatopic and atopic mothers, respectively. No differences in breast......-milk PUFA composition were evident between the subject groups. The diets of the groups differed only slightly with respect to protein intake. However, the PUFA composition of the breast milk was associated with diet and time of milk sampling, and the above difference in milk PUFAs disappeared when those...... factors were taken into account. CONCLUSION: Our data do not support the possibility that the fatty acid composition of breast milk is affected by atopic dermatitis or atopy in general, because most differences in breast-milk PUFA composition appear to be explained by the diet....
Rationale Globally, the prevalence of atopic diseases continues to rise. Up to 20% of the population is thought to be affected, exerting enormous health, social and financial burdens. Emerging data suggests atopic dermatitis precedes allergic sensitization and may increase the predisposition to food allergy, allergic rhinitis and asthma later in life. Pilot testing has suggested infant skin barrier protection may reduce the risk of atopic dermatitis. Parallel research has suggested exposur...
Yeşilova, Yavuz; Çalka, Ömer; Akdeniz, Necmettin; Berktaş, Mustafa
Background Atopic dermatitis, a chronic recurrent disease, is frequently encountered in clinical practice. In the last 30 years, the prevalence of atopic dermatitis has rapidly increased due to industrialization. Therefore, there have been attempts in recent years to find new ways of treating and preventing atopic dermatitis. Objective In this double-blind, randomized, placebo-controlled study, a combination of Bifidobacterium bifidum, Lactobacillus acidophilus, Lactobacillus casei, and Lacto...
William Abramovits; Mark Boguniewicz; Paller, Amy S.; Diane L. Whitaker-Worth; Mary M. Prendergast; Michael Tokar; Tong, Kuo B
Atopic dermatitis is a common, chronic, relapsing inflammatory skin disease frequently affecting infants and children. The worldwide prevalence of atopic dermatitis is estimated to be 5-20% of the paediatric population. First-line therapy has generally consisted of dry skin care, avoidance of triggers, application of topical corticosteroids, and administration of antihistamines and oral antibacterials. Topical corticosteroids improve the lesions of atopic dermatitis; however, concern on the p...
Full Text Available Abstract Background Atopic eczema is a common and distressing disease. This study aims to review PubMed indexed research statistics on atopic eczema over a-10 year period to investigate the clinical relevance and research interest about this disease. Methods PubMed (a service of the U.S. National Library of Medicine was searched for the terms “atopic dermatitis” and “eczema”, with limits activated (Humans, Clinical Trial, Meta-Analysis, Randomized Controlled Trial, English, published in the last 10 years, and editorials, letters, practice guidelines, reviews, and animal studies excluded. Journal impact factor (IF is in accordance with Journal Citation Report (JCR 2009, a product of Thomson ISI (Institute for Scientific Information. Results A total of 890 articles were retrieved. Taking out publications that were irrelevant and those without an impact factor, 729 articles were obtained. These articles were grouped into dermatology (n = 337, mean IF: 3.01, allergy/immunology (n = 215, mean IF: 4.89, pediatrics (n = 118, mean IF: 2.53 and miscellaneous subject categories (n = 142, mean IF: 5.10. The impact factors were highest in the miscellaneous category (p = 0.0001, which includes such prestigious journals as the New England journal of Medicine (n = 1, IF: 47.05, the Lancet (n = 4, IF: 30.76 and BMJ (n = 6, IF: 13.66. There was no publication in any family medicine or general practice journal. The British Journal of Dermatology (n = 78, Pediatric Allergy and Immunology (n = 49 and Journal of Allergy and Clinical Immunology (n = 46 had the highest number of publications on the subject. Atopic eczema ranked higher in impact factors in allergy/immunology although more publications appeared in the dermatology category. Conclusions Atopic eczema is a multidisciplinary disease. Its clinical relevance and research interests are definitely beyond that of a mere cutaneous disease. Investigators may
Allen, B; Lakhanpaul, M.; Morris, A.(School of Physics and Astronomy, University of Edinburgh, Edinburgh, United Kingdom); Lateo, S; Davies, T.; Scott, G.; Cardno, M; Ebelin, M; Burtin, P.; Stephenson, T
Aims: To measure pimecrolimus blood concentrations and to evaluate tolerability and efficacy in children and infants treated topically for atopic dermatitis with pimecrolimus cream 1% for three weeks.
Strina, Agostino; Mauricio L. Barreto; Cooper, Philip J.; Rodrigues, Laura C
Background The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings. Objective To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents. Methods A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE. Results Studies of...
A. Strina; Barreto, ML; Cooper, PJ; Rodrigues, LC
BACKGROUND The study of non-atopic asthma/wheeze in children separately from atopic asthma is relatively recent. Studies have focused on single risk factors and had inconsistent findings. OBJECTIVE To review evidence on factors associated with non-atopic asthma/wheeze in children and adolescents. METHODS A review of studies of risk factors for non-atopic asthma/wheeze which had a non-asthmatic comparison group, and assessed atopy by skin-prick test or allergen-specific IgE. RES...
Full Text Available Background Atopic dermatitis is the first manifestation of allergic disease in early life. Early interventions may prevent the development of allergy disease. Allergy trace cards have been used to identify the level of allergic risk, based on family atopy scores. Because environmental factors may also influence the development of atopic dermatitis, the usefulness of the allergy trace card needs to be reevaluated. Objective To compare the incidence of atopic dermatitis in infants aged 0-4 months with total family atopy scores of > 0 to those with scores of 0. Methods We conducted this cohort study from June 1, 2012 to December 31, 2012 at Sanglah Hospital, Denpasar. Family atopy score was tabulated from all pregnant woman in the Obstetric Outpatient Clinic and the Maternity Room. Subjects were divided into two groups based on their total family atopy score: those with scores > 0 and those with scores of 0. The appearance of atopic dermatitis symptoms in the infants were evaluated until they reached 4 months of age. The incidence of atopic dermatitis in two groups was compared using Chi-square test. Results The incidence of atopic dermatitis in this study was 10.9%. The group with total family atopy scores of 0 had a significantly higher incidence of atopic dermatitis than the group with scores > 0 (adjusted RR 22.5; 95%CI 8.8 to 57.0; P = 0.001. Conclusion The incidence of atopic dermatitis is higher in infants with total family atopy score > 0 and this group has a 22.5 times higher risk of atopic dermatitis compared to infants with total family atopy score of 0. Allergy trace cards are relevant in differentiating the risk of atopy with regards to development of atopic dermatitis. We suggest that family atopy scores be evaluated during antenatal care in order to limit the development of atopic dermatitis in infants. [Paediatr Indones. 2014;54:330-7.].
Ricci, Giampaolo; Dondi, Arianna; Patrizi, Annalisa
Eczema, frequently named atopic dermatitis, is the most frequent chronic skin disease of early childhood, with a high prevalence in industrialized countries and a relapsing-remitting course that is responsible for a serious burden on affected children and their families. Even though most facets of this disease are nowadays well known and numerous guidelines are available, some confusion still exists regarding certain aspects. First, several names have been proposed for the disorder. We suggest that the name and definition adopted by the World Allergy Organization should be used: 'eczema,' divided into 'atopic,' when an allergic sensitization can be demonstrated, and 'non-atopic,' in the absence of sensitization. Several diagnostic criteria have been proposed, but at present the two most reliable are the 2003 revision by the American Academy of Dermatology of the Hanifin-Rajka criteria, and those by Williams revised in 2005. To date, 20 different clinical scores have been published to assess the severity; however, only the EASI (Eczema Area and Severity Index), the SCORAD (SCORing Atopic Dermatitis), and the POEM (Patient-Oriented Eczema Measure) seem to have been adequately validated and are recommended for use in clinical practice and trials. The diagnostic tests to identify associated allergy or sensitization include skin-prick tests, determination of the specific IgE in serum using different assays, and atopy patch tests; in the case of suspected food allergy, a food challenge may be necessary to define the diagnosis. To evaluate quality of life, tools exist that allow both the child's and family's impairment to be considered. In addition, several algorithms exist to help decide therapy on a step-wise basis. However, such guidelines and algorithms represent only an aid to the physician and not an obligatory directive, since the ultimate judgment regarding any therapy must be performed by the physician and tailored to individual needs. A clear and validated
Uskov, O.; Markova, M.
Uskov O., Markova M. Grounding psychological help for adolescents with atopic dermatitis. Journal of Education, Health and Sport. 2015;5(5):138-150. ISSN 2391-8306. DOI 10.5281/zenodo.17465 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%285%29%3A138-150 https://pbn.nauka.gov.pl/works/559212 http://dx.doi.org/10.5281/zenodo.17465 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011 – 2014 http://journal.rsw.edu.pl/index.php/JHS/issue/...
Full Text Available â€Prick testâ€ was carried out in 15 patients with atopic dermatitis (AD and 10 patients with chronic urticaria (CU. Of the various aeroallergens tested, house dust mite (HDM, pollens, aspergillus furnigatus and insects were found to be most commonly positive. The common food allergens showing prick test positivity were egg white, fish, milk, brinjal, dal, groundnut and banana. Use of nasal filters showed 10-20% improvement in AD and 5 â€" 10% improvement in urticaria. Withdrawal of the responsible food article(s showed 20-30% improvement in patients with AD and urticaria.
Slominski, Christopher J.; Parks, Mark A.; Debure, Kelly R.; Heaphy, William J.
The software created for the Control Display Units (CDUs), used for the Advanced Transport Operating Systems (ATOPS) project, on the Transport Systems Research Vehicle (TSRV) is described. Module descriptions are presented in a standardized format which contains module purpose, calling sequence, a detailed description, and global references. The global reference section includes subroutines, functions, and common variables referenced by a particular module. The CDUs, one for the pilot and one for the copilot, are used for flight management purposes. Operations performed with the CDU affects the aircraft's guidance, navigation, and display software.
Simpson, Eric L; Irvine, Alan D; Eichenfield, Lawrence F; Friedlander, Sheila F
Studies of the prevalence of atopic dermatitis (AD) have provided insights into associated environmental risk factors, demonstrating the complex interactions between the presence of filaggrin (FLG) gene defects and environment. Among other important findings is that elevated transepidermal water loss (TEWL) in newborns is a strong predictor of AD, regardless of FLG status. Recently recognized predictors of disease course and severity include onset of AD signs and symptoms before 12 months of age and the presence of an FLG mutation and concomitant immunoglobulin E sensitization early in life. Semin Cutan Med Surg 35(supp5):S84-S88. PMID:27525380
Gu, Sherman X.; Zhang, Anthony L; Coyle, Meaghan E.; Mo, Xiumei; Lenon, George B.; Cranswick, Noel E.; Chen, DaCan; Xue, Charlie C.
Background Atopic eczema or atopic dermatitis is a chronic inflammatory skin disease. Current conventional medical treatment for moderate and severe atopic eczema is not satisfactory. There is promising evidence derived from randomised clinical trials to support the clinical use of Chinese herbal medicine in the management of atopic eczema. However, the available evidence is compromised by the high risk of bias associated with most of the included trials. Therefore, well-designed and adequate...
Poddighe, Dimitri; Brazzelli, Valeria; Licari, Amelia; Marseglia, Gian Luigi
Atopic dermatitis is considered an important risk factor for chronic hand dermatitis, which can be seen in children too. Pimecrolimus cream 1% is approved to treat atopic dermatitis in children aged 2 years or older. In adults, this drug has been used for some clinical indications other than atopic dermatitis, such as chronic hand dermatitis. Here, we describe an adverse drug reaction in a 2-year-old child affected with atopic dermatitis, who was treated with topical pimecrolimus in order to ...
Henriksen, Lonny; Simonsen, Jacob; Haerskjold, Ann;
BACKGROUND: Several studies have shown that the prevalence of the frequent chronic conditions of atopic dermatitis, asthma, and allergy has increased substantially for reasons not fully understood. Atopic diseases affect quality of life in both children and their family members. OBJECTIVE: Using...
SUÁREZ, Andrea L.; Feramisco, Jamison D.; Koo, John; Steinhoff, Martin
Atopic dermatitis is a chronic inflammatory skin disease characterized by impaired epidermal barrier function, inflammatory infiltration, extensive pruritus and a clinical course defined by symptomatic flares and remissions. The mechanisms of disease exacerbation are still poorly understood. Clinical occurrence of atopic dermatitis is often associated with psychological stress. In response to stress, upregulation of neuropeptide mediators in the brain, endocrine organs, and peripheral nervous...
Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel
The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes r
Full Text Available Background: N-acetylcysteine (NAC is the choice treatment for acetaminophen overdose. The main side effect of intravenous NAC therapy is anaphylaxis or anaphylactoid reactions. We investigated the prevalence of anaphylactoid or anaphylaxis reactions to IV-NAC therapy in acetaminophen poisoned patients with atopic disease. Methods: A case series antrograde and descriptive–analytic study was done on acetaminophen poisoned patients who treated with IV-NAC from September 2003 to September 2004 in Isfahan, Iran. Results: Of 173 infused IV-NAC patients, 77 patients (44.5% developed an anaphylactoid reaction. Its side effects was nausea and vomiting (n=49, 63.15%, flashing (n=23, 30.26%, bronchospasm (n=20, 26.31%, vertigo (n=18, 23.68%, skin rash (n=25, 32.36% and hypotension (n=12, 15.75%. Also, 71 patients (41% had history of atopic disease. Atopic diseases were asthma (n=12, 6.9%, atopic dermatitis (n=7, 4%, allergic rhinitis (n=5, 2.8% and allergic conjunctivitis (n=1, 0.5%. Among 71 atopic patients, 59 patients (83.13 % developed side effects to NAC. There was a relation between previous history of atopic disease and anaphylactoid reaction to NAC. Conclusions: We report substantially higher incidence of anaphylactoid reactions to IV-NAC than previous studies. Different atopic diseases must be considered as a risk factor in the development of side effects to IV-NAC-therapy. Keywords: Poisoning, Acetaminophen, Anaphylactoid reaction, N-acetylcysteine, Atopic disease
Treatment and, ultimately prevention of complex diseases such as atopic diseases, should start with the identification of individuals at risk for developing (an) atopic disease(s). Gene expression profiles, that is, whether a gene is expressed as mRNA, can reflect both genetic and environmental fact
Minoo Dadkhah; Asghar Aghamohammadi; Masoud Movahedi; Mohammad Gharagozlou
Background: Most of the hypogammaglobulinemic patients have a clinical history in favor of allergic respiratory disease. Nevertheless, in these patients the importance and prevalence of atopic disorders have not been completely explained. Objectives: This study was aimed to evaluate atopic manifestations (dermatitis, allergic rhinitis and asthma) and pulmonary function in patients with hypogammaglobulinemia. ...
E. Hajdarbegovic (Enes); A. Bloem (Annemieke); D.M.W. Balak (Deepak); B.H. Thio (Bing); T.E.C. Nijsten (Tamar)
textabstractBackground: Keloids and atopic disorders share common inducing and maintaining inflammatory pathways that are characterized by T-helper cell 2 cytokines. Aims and Objectives: The objective of this study was to test for associations between keloids and atopic eczema, asthma and hay fever.
A.C.A. Devillers (Arjan)
textabstractAtopic dermatitis (AD) or atopic eczema , is a chronic inflammatory skin disease characterized by dry skin, itching and recurrent red and scaly skin lesions. It is a relatively common skin disease with an estimated prevalence of 10-20%. The majority of patients show their first clinical
Atopic dermatitis in dogs Novel insights into mechanisms of disease Atopic dermatitis in dogs is the most important canine pruritic disorder, described for the first time in 1971. It is defined as a genetically-predisposed inflammatory and pruritic allergic skin disease with characteristic clinical
Kerkhof, M; Koopman, LP; van Strien, RT; Wijga, A; Smit, HA; Aalberse, RC; Neijens, HJ; Brunekreef, B; Postma, DS; Gerritsen, J
Background It has been suggested that the period immediately after birth is a sensitive period for the development of atopic disease. Objective We investigated whether birth characteristics and environmental factors are associated with the development of atopic dermatitis in the first year of life.
Full Text Available Background: A few reports demonstrate the comorbidity of food allergy and allergic march in adult patients. Aims and Objectives: To evaluate, if there is some relation in atopic dermatitis patients at the age 14 years and older who suffer from food allergy to common food allergens to other allergic diseases and parameters as bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. Materials and Methods: Complete dermatological and allergological examination was performed; these parameters were examined: food allergy (to wheat flour, cow milk, egg, peanuts and soy, the occurrence of bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. The statistical evaluation of the relations among individual parameters monitored was performed. Results: Food allergy was altogether confirmed in 65 patients (29% and these patients suffer significantly more often from bronchial asthma and allergic rhinitis. Persistent atopic dermatitis lesions and positive data in family history about atopy are recorded significantly more often in patients with confirmed food allergy to examined foods as well. On the other hand, the onset of atopic dermatitis under 5 year of age is not recorded significantly more often in patients suffering from allergy to examined foods. Conclusion: Atopic dermatitis patients suffering from food allergy suffer significantly more often from allergic rhinitis, bronchial asthma, persistent eczematous lesions and have positive data about atopy in their family history.
Rod, N H; Kristensen, T S; Lange, Peter; Prescott, E; Diderichsen, Finn
of adult-onset asthma, allergic rhinitis, atopic dermatitis, and asthma/bronchitis medication. METHODS: Participants (n = 9785) from the Copenhagen City Heart Study, Denmark, free of atopic disorders at baseline in 1981-1983 were asked questions on stress intensity and frequency. They were followed...
Bonfim, Camila Barreto; dos Santos, Darci Neves; Barreto, Maurício Lima
This study aims to describe the types of intrafamilial violence perpetrated against children according to living conditions, family factors, and child characteristics, and to identify the association between types of intrafamilial violence and asthma symptoms in atopic and non-atopic children. A cross-sectional study was carried out with 1,370 caregivers as part of the Social Changes, Asthma and Allergy in Latin America (SCAALA) study, conducted in 2006 in Brazil. The study population was sel...
Palmer, Colin N A; Irvine, Alan D; Terron-Kwiatkowski, Ana;
Atopic disease, including atopic dermatitis (eczema), allergy and asthma, has increased in frequency in recent decades and now affects approximately 20% of the population in the developed world. Twin and family studies have shown that predisposition to atopic disease is highly heritable. Although...
Thomsen, Simon F; Ulrik, Charlotte S; Kyvik, Kirsten O;
The susceptibility to develop atopic dermatitis can be attributed both to genetic and environmental causes. We estimated the relative impact of genetic and environmental factors in the etiology of atopic dermatitis in a population-based sample of twins. From the birth cohorts of 1953-1982 who were......?" Latent factor models of genetic and environmental influences were fitted to the observed data using maximum likelihood methods. The overall lifetime prevalence of atopic dermatitis was 7.3%. A cotwin of an affected identical twin had a sevenfold increased risk of atopic dermatitis compared with a...... dermatitis both in male and female patients (p = 0.98). The estimates were adjusted for age. The susceptibility to develop atopic dermatitis is attributable to mainly genetic differences between people. However, differences in environmental exposures also are of importance....
Thomsen, Simon F; Ulrik, Charlotte S; Kyvik, Kirsten O;
The susceptibility to develop atopic dermatitis can be attributed both to genetic and environmental causes. We estimated the relative impact of genetic and environmental factors in the etiology of atopic dermatitis in a population-based sample of twins. From the birth cohorts of 1953-1982 who were......?" Latent factor models of genetic and environmental influences were fitted to the observed data using maximum likelihood methods. The overall lifetime prevalence of atopic dermatitis was 7.3%. A cotwin of an affected identical twin had a sevenfold increased risk of atopic dermatitis compared with a...... dermatitis both in male and female patients (p = 0.98). The estimates were adjusted for age. The susceptibility to develop atopic dermatitis is attributable to mainly genetic differences between people. However, differences in environmental exposures also are of importance...
Linneberg, Allan; Simonsen, Jacob B; Petersen, Janne;
BACKGROUND: Atopic dermatitis (AD) often develops in infancy as the first manifestation of the atopic phenotype. Wheezing is also common in infancy, but it is less clear whether infant wheezing should be considered as an atopic phenotype. If infant wheeze and AD share a common aetiology, this would...... indicate that infant wheezing is an atopic phenotype. OBJECTIVE: To investigate whether potential risk factors for infant wheeze and AD have similar effects on these 2 phenotypes, indicating a common etiology. METHODS: A total of 34.793 mother-child pairs enrolled in the Danish National Birth Cohort were......-feeding, number of older siblings, day care attendance, and pets in the home. CONCLUSION: The majority of risk factors had differential effects on infant wheeze and AD indicative of a different etiology. Infant wheezing does not seem to be etiologically linked to the epidemic of atopic disease, and infant...
Paulsen, Evy; Andersen, Klaus Ejner
Background. An association between Compositae sensitization and atopic dermatitis has been suggested on the basis of case reports and clinical studies. Objectives. To describe the characteristics of sensitization in Compositae-allergic patients with current and/or past atopic dermatitis. Patients....../materials/methods. Consecutive Compositae-sensitive patients were selected for analysis if they had a history of (i) present and/or past atopic dermatitis or (ii) childhood flexural eczema or (iii) childhood eczema of any kind and a positive prick test result. Results. Fifty-one persons (35 females and 16 males) were included...... of non-atopics, except that dandelion was an important allergen in children. Cobalt allergy was the most frequent other contact allergy, occurring in 37%. Conclusions. Persons with current or past atopic dermatitis may become sensitized to Compositae at any age, both occupationally and non...
Olesen, Anne Braae; Andersen, G.; Jeppesen, D.L.;
Atopic dermatitis is a common skin disorder of unknown aetiology with peak incidence in early childhood. The disease is associated with peripheral T-cell accumulation in the skin. The thymus is a key organ of the cellular immune response early in life. We hypothesized that atopic dermatitis is...... associated with an unbalanced establishment of the peripheral T-lymphocyte system. This cross-sectional study was performed to compare thymus sizes in patients with atopic dermatitis and healthy controls. Thirty-seven children with current atopic dermatitis were enrolled and compared with 29 healthy controls....... An interview and medical examination were performed by one doctor, an ultrasound scan was performed within 3 days of the examination, and the thymus index, a marker of thymus size, was measured. The thymus index was on average 32% higher (95% CI 3%-67%) in children with active atopic dermatitis...
Baumgartner-Nielsen, Jane; Vestergaard, Christian; Thestrup-Pedersen, K.;
exhibit a condition in their skin resembling atopic dermatitis. GITR also exists in a soluble form, and increased levels of this lead to decreased levels of GITRL and thereby increased Treg activity. We have measured the levels of GITR and GITRL in plasma from atopic dermatitis patients and found it not...... pathogenesis of atopic dermatitis and the migration of Tregs and skin-homing T-cells. Immunohistochemistry showed GITR and GITRL were present in few dermal cells of both patients with atopic dermatitis, and normal healthy volunteers, and often locali zed in close proximity to each other. Since regulatory T......-cells are localized in the vicinity of GITRL-expressing cells in atopic dermatitis skin, the GITR/GITRL interaction may serve to perpetuate the inflammation locally....
Eichenfield, Lawrence F; Tom, Wynnis L; Chamlin, Sarah L; Feldman, Steven R; Hanifin, Jon M; Simpson, Eric L; Berger, Timothy G; Bergman, James N; Cohen, David E; Cooper, Kevin D; Cordoro, Kelly M; Davis, Dawn M; Krol, Alfons; Margolis, David J; Paller, Amy S; Schwarzenberger, Kathryn; Silverman, Robert A; Williams, Hywel C; Elmets, Craig A; Block, Julie; Harrod, Christopher G; Smith Begolka, Wendy; Sidbury, Robert
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in the management and care of AD, providing updated and expanded recommendations based on the available evidence. In this first of 4 sections, methods for the diagnosis and monitoring of disease, outcomes measures for assessment, and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed. PMID:24290431
Full Text Available Background and Design: Atopic dermatitis is a chronic, inflammatory skin disease characterized by itchy skin lesions. Since adolescents are intensely interested in their physical appearance, chronic skin diseases in this period can adversely affect the development of self esteem. Atopic dermatitis is a skin disease that affects the appearance and there is an heightened attention to the body image in adolescence which is an important period of time in the development of self-esteem. Therefore, we aimed to investigate self-esteem and dermatological quality of life in adolescents with atopic dermatitis. Materials and Methods: Thirty-three patients with atopic dermatitis and 33 healthy controls were included in the study. The Piers-Harris Children’s Self-Concept Scale and the Children’s Dermatology Life Quality Index (CDLQI were used for determining self-esteem and quality of life. The Scoring of Atopic Dermatitis (SCORAD Index was used to assess the severity of atopic dermatitis. Results: It was found that patient group had lower self-esteem than healthy controls according to the Piers-Harris Children’s Self-Concept Scale. A statistically significant difference was observed in happiness/satisfaction and anxiety subscale scores between the patients and healthy controls while there was no significant difference between the other sub-scale scores. Mean value of dermatological quality of life in patients with atopic dermatitis was significantly lower than in healthy controls. A moderate negative correlation was found between self-esteem and CDLQI scores among adolescents with atopic dermatitis. Discussion: This study results have shown that self-esteem and dermatological quality of life were adversely affected in adolescents with atopic dermatitis irrespective of gender. These patients should be examined psychiatrically besides dermatological examination and treatment. We suggest that improvement will be observed in self-esteem and quality of
Full Text Available Background The clinical syndrome of atopy is associated with the production of immunoglobulin E (IgE antigenic stimulation as part of a type I hypersensitivity reaction. Since early prevention is regarded as an important cornerstone in the management of atopic diseases, the identification of reliable markers such as IgE and interlukin 4 (IL-4 in detecting individuals at risk are of major interest. Objective To determine whether cord blood IgE and IL-4 levels can be used as an predictor of atopy in newborns with a family history of atopic diseases. Methods We conducted a cross-sectional study on healthy-term newborns in the neonatal ward at R.D. Kandou Hospital from june to August 2010. A total of 50 healthy newborn in atopic and non-atopic groups were examined for cord blood IgE and IL-4 levels. Result The mean cord blood IL-4 levels in the atopic and non-atopic groups were 0.1 ug/mL (SD 0.08 and 0.1 ug/mL (SD 0.16 (P=0.359, respectively. The mean cord blood IgE levels in the atopic and non-atopic groups were 2.2 IU/mL (SD 1.98 and 0.5 IU/mL (SD 0.29 (P<0.001, respectively. A point-biserial correlation coefficient analysis showed no significant correlation between IL-4 levels and family history of atopic disease (rpb=0.54 Conclusions to distinguish newborns with a family history of atopic diseases from those without. [Paediatr Indones. 2011;51:12-6].
Full Text Available Effective atopic eczema (AE control not only improves quality of life but may also prevent the atopic march. The Royal College of General Practitioners’ (RCGP curriculum does not currently provide specific learning outcomes on AE management. We aimed to gain consensus on learning outcomes to inform curriculum development. A modified Delphi method was used with questionnaires distributed to gather the views of a range of health care professionals (HCPs including general practitioners (GPs, dermatologists, dermatology nurses and parents of children with AE attending a dedicated paediatric dermatology clinic. Ninety-one questionnaires were distributed to 61 HCPs and 30 parents; 81 were returned. All agreed that learning should focus on the common clinical features, complications and management of AE and the need to appreciate its psychosocial impact. Areas of divergence included knowledge of alternative therapies. Parents felt GPs should better understand how to identify, manage and refer severe AD and recognized the value of the specialist eczema nurse. Dermatologists and parents highlighted inconsistencies in advice regarding topical steroids. This study identifies important areas for inclusion as learning outcomes on AE management in the RCGP curriculum and highlights the importance of patients and parents as a valuable resource in the development of medical education.
Eller, Esben; Kjaer, Henrik Fomsgaard; Høst, Arne; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten
The aim was to describe the relapsing pattern, sensitization and prognosis of atopic dermatitis (AD) in the first 6 yr in a population-based, prospective birth cohort. The DARC cohort includes 562 children with clinical examinations, specific-IgE and skin prick test at all follow-ups. All children were examined for the development of AD using Hanifin-Rajka criteria and for food hypersensitivity by oral challenges. Severity of AD was measured by objective SCORing Atopic Dermatitis (SCORAD). Point-prevalence of AD peaked at 18 months of age (10%) and decreased at 36 and 72 months to slightly below 7%. The 6-yr cumulative incidence was 22.8% and sensitization was found in 43% of children with AD. It was predominately sensitization to foods, however shifting toward inhalant allergens with age. Sensitization at >or=2 follow-ups affected severity, whereas short-term sensitization at one follow-up does not. Children with early, non-IgE mediated (intrinsic) AD outgrew more often their eczema; however if they develop persistent AD, they remain intrinsic. Early long-term sensitization worsens the prognosis, but 38% of all children have a debut later than 18 months of age. Boys had earlier onset of AD than girls. The large number of follow-ups gives a detailed picture of the relapsing pattern and shows that the relapses occur independently of time of onset. We could not establish any clear correlation between elimination diets and AD duration nor severity. PMID:19788539
Full Text Available Annalisa Patrizi, Beatrice Raone, Giulia Maria RavaioliDepartment of Specialized, Diagnostic and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, ItalyAbstract: Atopic dermatitis (AD is a common chronic inflammatory skin disease that can affect all age groups. It is characterized by a relapsing course and a dramatic impact on quality of life for patients. Environmental interventions together with topical devices represent the mainstay of treatment for AD, in particular emollients, corticosteroids, and calcineurin inhibitors. Systemic treatments are reserved for severe cases. Phototherapy represents a valid second-line intervention in those cases where non-pharmacological and topical measures have failed. Different forms of light therapy are available, and have showed varying degrees of beneficial effect against AD: natural sunlight, narrowband (NB-UVB, broadband (BB-UVB, UVA, UVA1, cold-light UVA1, UVA and UVB (UVAB, full-spectrum light (including UVA, infrared and visible light, saltwater bath plus UVB (balneophototherapy, Goeckerman therapy (coal tar plus UVB radiation, psoralen plus UVA (PUVA, and other forms of phototherapy. In particular, UVA1 and NB-UVB have gained importance in recent years. This review illustrates the main trials comparing the efficacy and safety of the different forms of phototherapy. No sufficiently large randomized controlled studies have been performed as yet, and no light modality has been defined as superior to all. Parameters and dosing protocols may vary, although clinicians mainly refer to the indications included in the American Academy of Dermatology psoriasis guidelines devised by Menter et al in 2010. The efficacy of phototherapy (considering all forms in AD has been established in adults and children, as well as for acute (UVA1 and chronic (NB-UVB cases. Its use is suggested with strength of recommendation B and level of evidence II. Home phototherapy can also be performed
Full Text Available BACKGROUND: Atopic diseases, including allergic rhinitis, allergic dermatitis and asthma, are common diseases with a prevalence of 30-40% worldwide and are thus of great global public health importance. Allergic inflammation may influence the immunity against infections, so atopic individuals could be susceptible to respiratory infections. No previous population-based study has addressed the relation between atopy and respiratory infections in adulthood. We assessed the relation between atopic disease, specific IgE antibodies and the occurrence of upper and lower respiratory infections in the past 12 months among working-aged adults. METHODS AND FINDINGS: A population-based cross-sectional study of 1008 atopic and non-atopic adults 21-63 years old was conducted. Information on atopic diseases, allergy tests and respiratory infections was collected by a questionnaire. Specific IgE antibodies to common aeroallergens were measured in serum. Adults with atopic disease had a significantly increased risk of lower respiratory tract infections (LRTI; including acute bronchitis and pneumonia with an adjusted risk ratio (RR 2.24 (95% confidence interval [CI] 1.43, 3.52 and upper respiratory tract infections (URTI; including common cold, sinusitis, tonsillitis, and otitis media with an adjusted RR 1.55 (1.14, 2.10. The risk of LRTIs increased with increasing level of specific IgE (linear trend P = 0.059. CONCLUSIONS: This study provides new evidence that working-aged adults with atopic disease experience significantly more LRTIs and URTIs than non-atopics. The occurrence of respiratory infections increased with increasing levels of specific IgE antibodies to common aeroallergens, showing a dose-response pattern with LRTIs. From the clinical point of view it is important to recognize that those with atopies are a risk group for respiratory infections, including more severe LRTIs.
Leticia Rodrigues Parrilha
Full Text Available ABSTRACTPurpose:To evaluate the effectiveness of topical 1% cyclosporine eye drops diluted in either of the two vehicles-olive and linseed oil-and that of the oils themselves in treating experimentally-induced keratoconjunctivitis sicca (KCS in rabbits.Methods:KCS was induced in 25 New Zealand rabbits using 1% atropine sulfate eye drops for 7 days before treatment and throughout the treatment period (12 weeks. The rabbits were divided into five groups: one control (C group without KCS induction and four treatment groups in which KCS was induced and treated topically with olive oil (O, linseed oil (L, cyclosporine in olive oil (CO, and cyclosporine in linseed oil (CL. The animals were evaluated using Schirmer tear test 1 (STT, the fluorescein test (FT, tear-film break-up time (TBUT, the rose bengal test (RBT, and histopathological analysis.Results:Values of STT and TBUT significantly decreased 1 week post-induction (p<0.05 and were similar to initial values after the 4th week of treatment, in all groups. After KCS induction, there was significantly less corneal damage in group L than in group CL, as assessed FT and RBT. Histopathology demonstrated that Groups L and CL presented less edema and corneal congestion. There was no significant difference in the goblet cell density (cells/mm2 between the groups (p=0.147.Conclusion:Cyclosporine diluted in olive oil or linseed oil was effective in the treatment of KCS, although it had better efficacy when diluted in linseed oil. Linseed oil presented better effectiveness, whether associated or not, than olive oil. These results may contribute to the creation of novel topical ophthalmic formulations for KCS treatment in future.
Miniello, Vito Leonardo; Brunetti, Luigia; Tesse, Riccardina; Natile, Miria; Armenio, Lucio; Francavilla, Ruggiero
We measured the concentration of interferon-gamma and interleukin-4 in the exhaled breath condensate of children with atopic and nonallergic dermatitis receiving a probiotic supplementation (Lactobacillus reuteri ATCC 55730) or placebo for 8 weeks. We demonstrated that the levels of these cytokines increased and decreased respectively only in atopic subjects receiving active treatment. Our data suggest that the oral administration of a specific probiotic strain in patients with atopic dermatitis can modulate in vivo the cytokine pattern at a different site from intestine. PMID:20639717
Czarnowicki, Tali; Krueger, James G; Guttman-Yassky, Emma
Atopic dermatitis is the most common chronic inflammatory skin disease. Its pathogenesis combines barrier defects, immune dysregulation, and increased skin infections; however, the relative contribution of each of these components is yet to be determined. Uninvolved atopic dermatitis skin also displays broad immune and barrier abnormalities, which highlights a role for proactive treatment strategy. The residual disease genomic profile that accompanies clinical resolution provides further support for proactive treatment approaches. Although intrinsic and extrinsic atopic dermatitis subtypes share a common clinical phenotype, they show some important differences in their Th22/Th17 cytokine profile, which opens the door for personalized specific therapeutics for each disease category. PMID:25017523
Hogan, Mary Beth; Peele, Kathy; Wilson, Nevin W.
Atopic dermatitis can be due to a variety of causes from nonatopic triggers to food allergy. Control of egress of water and protection from ingress of irritants and allergens are key components of cutaneous barrier function. Current research suggests that a degraded barrier function of the skin allows the immune system inappropriate access to environmental allergens. Epidermal aeroallergen exposure may allow sensitization to allergen possibly initiating the atopic march. Further research into connections between epidermal barrier function and possible allergen sensitization will be important to undertake. Future clinical trials focused on skin barrier protection may be of value as a possible intervention in prevention of the initiation of the atopic march. PMID:22619686
Andersen, Peter Hundevadt; Bindslev-Jensen, C; Mosbech, H;
Detergent enzymes may cause skin irritation and occasionally hypersensitivity reactions. The potential hazards of these enzymes have led some physicians to advise atopic dermatitis patients against the use of enzyme-enriched detergents. A three-phased randomised, double-blind, cross-over experiment...... statistical differences in any of the primary or secondary parameters comparing treatment and placebo periods. Our data therefore seem to exclude that atopic dermatitis may exacerbate during 1 month's exposure to enzyme-enriched detergents. Since no significant irritant capacity was detected in atopic...... dermatitis patients, it is unlikely that consumers with "normal skin" will experience any skin discomfort when enzyme-enriched detergents are used....
Hollander, Peter; Rostgaard, Klaus; Smedby, Karin E;
reactivity. Tumor Epstein-Barr virus (EBV) status was determined for 498 patients. Odds ratios with 95% confidence intervals were calculated using logistic regression analysis. Rheumatoid arthritis was associated with a higher risk of HL (odds ratio (OR) = 2.63; 95% confidence interval (CI): 1.47, 4......Results from previous investigations have shown associations between the risk of Hodgkin lymphoma (HL) and a history of autoimmune and atopic diseases, but it remains unknown whether these associations apply to all types of HL or only to specific subtypes. We investigated immune diseases and the...... risk of classical HL in a population-based case-control study that included 585 patients and 3,187 controls recruited from October 1999 through August 2002. We collected information on immune diseases through telephone interviews and performed serological analyses of specific immunoglobulin E...
Fowler, Joseph F
Colloidal oatmeal suspensions are currently available in bath soaps, shampoos, shaving gels, and moisturizing creams, and several studies have been conducted that demonstrate the efficacy and safety of colloidal oatmeal for the treatment of inflammatory skin conditions. The diverse chemical polymorphism of oats translates into numerous clinical utilities for atopic dermatitis (AD) and eczema. Avenanthramides are the principle polyphenolic antioxidants in oats, and they have been shown to assuage inflammation in murine models of contact hypersensitivity and neurogenic inflammation and also reduce pruritogen-induced scratching in a murine itch model. Moreover, avenanthramides are a potent antioxidant. This paper will discuss various studies that have found colloidal oatmeal compounds to be beneficial in the treatment of AD and also as adjunctive treatments for AD. PMID:25607551
Bandier, Josefine; Johansen, Jeanne Duus; Petersen, Lars Jelstrup;
BACKGROUND: The acidic pH of the skin plays a role in antimicrobial defense by regulating the bacterial skin flora and aspects of barrier. Filaggrin is a co-factor in maintaining a low skin pH because of its degradation into acidic amino acids. Accordingly, lack of filaggrin due to filaggrin...... mutations may influence skin pH. OBJECTIVE: We aimed to determine the epidermal pH in different groups stratified by filaggrin mutations and atopic dermatitis. Further, we investigated the changes in pH according to severity of mutational status among patients with dermatitis, irrespective of skin condition....... METHODS: pH was measured with a multiprobe system pH probe (PH 905), and the study population was composed of 67 individuals, who had all been genotyped for 3 filaggrin mutations (R501X, 2282del4, R2447X). RESULTS: We found no clear pattern in relation to filaggrin mutation carrier status. Individuals...
Full Text Available Increased plasma histamine levels were associated with significantly lowered diamine and type B monoamine oxidase activities in platelet-rich plasma of atopic eczema (AE patients. The diamine oxidase has almost normal cofactor levels (pyridoxal phosphate and Cu2+ but the cofactor levels for type B monoamine oxidase (flavin adenine dinucleotide and Fe2+ are lowered. The biogenic amines putrescine, cadaverine, spermidine, spermine, tyramine and serotonin in the sera, as well as dopamine and epinephrine in EDTA-plasma were found to be normal. It is unlikely, therefore, that these amines are responsible for the decreased activities of monoamine and diamine oxidase in these patients. The most likely causative factors for the inhibition of the diamine oxidase are nicotine, alcohol, food additives and other environmental chemicals, or perhaps a genetic defect of the diamine oxidase.
Jung, Thomas; Stingl, Georg
Recent insights into the relevance of the epidermal barrier function and its interaction with components of the innate and adaptive immune responses in patients with atopic dermatitis (AD) give rise to a number of novel potential treatment options. In particular, the identification of loss-of-function mutations in the barrier protein filaggrin and of a diminished expression of certain antimicrobial peptides in AD skin stimulates new concepts to think beyond the T(H)1/T(H)2 paradigm. This review will focus on these most recent discoveries and will discuss new and corresponding proof-of-concept trials in patients with AD. It will further speculate on novel ways to restore the homeostasis among the 3 major components in AD skin suspected to be clinically relevant. PMID:18992925
Sokolova, Anna; Smith, Saxon D
Atopic dermatitis (AD) is a chronic relapsing inflammatory disease of the skin and is the most common paediatric dermatological condition. While no cure is available, it can be treated effectively if adherence to a therapeutic plan is maintained. Poor adherence to treatment is common in AD and can lead to treatment failure, which has significant impacts on the patient, family and society. A comprehensive literature search was conducted to identify factors that contribute to poor treatment adherence in childhood AD and to identify possible strategies to remedy these. Identified factors leading to poor treatment adherence include: complexity of treatment regimen, lack of knowledge, impaired quality of life, dissatisfaction with treatment strategies, infrequent follow up, corticosteroid phobia and the use of complementary and alternative medicine. Effective strategies to increase treatment adherence include: caregiver education and utilisation of education adjuncts, optimisation of the patient/caregiver-clinician relationship, early and frequent follow up and improvement of patient and caregiver quality of life. PMID:25817780
Lynch, M D; Sears, A; Cookson, H; Lew, T; Laftah, Z; Orrin, L; Zuckerman, M; Creamer, D; Higgins, E
Coxsackievirus A6 (CV-A6) is an emerging pathogen that has in recent years been associated with atypical hand, foot and mouth disease. This manifests as a generalized papular or vesicular eruption, which may be associated with fever and systemic disturbance. We report a series of six children presenting to a single centre in the UK with disseminated CV-A6 infection on a background of atopic dermatitis (AD). Our patients exhibited a widespread papular or vesicular eruption in association with exacerbation of AD. Several of our cases mimicked eczema herpeticum, but the extent was more generalized, and individual lesions were discrete rather than clustered and were less circumscribed in character. This series highlights that CV-A6 infection may be encountered in the UK, and should be considered in the differential diagnosis of an acute exacerbation of AD, particularly in children. PMID:25677678
Williams, Michael R; Gallo, Richard L
Atopic dermatitis (AD) is a common skin disease that affects a large proportion of the population worldwide. The incidence of AD has increased over the last several decades along with AD's burden on the physical and psychological health of the patient and family. However, current advances in understanding the mechanisms behind the pathophysiology of AD are leading to a hopeful outlook for the future. Staphylococcus aureus (S. aureus) colonization on AD skin has been directly correlated to disease severity but the functions of other members of the skin bacterial community may be equally important. Applying knowledge gained from understanding the role of the skin microbiome in maintaining normal skin immune function, and addressing the detrimental consequences of microbial dysbiosis in driving inflammation, is a promising direction for development of new treatments. This review discusses current preclinical and clinical research focused on determining how the skin microbiome may influence the development of AD. PMID:26404536
Linneberg, a; Petersen, Janne; Grønbæk, M;
BACKGROUND: There is evidence that antenatal factors play a role in the development of atopic dermatitis (AD). However, little is known about the effects of maternal lifestyle factors during pregnancy on the risk of AD in the offspring. OBJECTIVE: To investigate the effect of alcohol consumption......, time of onset, and doctor's diagnosis of AD in the offspring was obtained by interview at 18 months of age. The effect of alcohol consumption during pregnancy on the incidence of AD was analysed by Cox regression allowing for different effects of alcohol before (early infancy) and after 2 months (60...... days) of age. RESULTS: Alcohol during pregnancy was associated with a significant and dose-dependent increased risk of AD in early infancy. This effect was mainly seen in high-risk infants (two parents with allergic disease). Thus, the highest risk of AD in early infancy was seen in high-risk infants...
Linneberg, A; Petersen, Janne; Grønbaek, M;
BACKGROUND: There is evidence that antenatal factors play a role in the development of atopic dermatitis (AD). However, little is known about the effects of maternal lifestyle factors during pregnancy on the risk of AD in the offspring. OBJECTIVE: To investigate the effect of alcohol consumption......, time of onset, and doctor's diagnosis of AD in the offspring was obtained by interview at 18 months of age. The effect of alcohol consumption during pregnancy on the incidence of AD was analysed by Cox regression allowing for different effects of alcohol before (early infancy) and after 2 months (60...... days) of age. RESULTS: Alcohol during pregnancy was associated with a significant and dose-dependent increased risk of AD in early infancy. This effect was mainly seen in high-risk infants (two parents with allergic disease). Thus, the highest risk of AD in early infancy was seen in high-risk infants...
Full Text Available Pavel V Chernyshov Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine Abstract: Atopic dermatitis (AD is one of the most common skin diseases. Prevalence of AD is highest in childhood. Because of chronicity and often visible lesions, AD may lead to stigmatization and problems with self-perception. However, problems of self-perception and stigmatization in AD children are poorly studied. Literature data on general tendencies of children’s development, clinical course, and epidemiologic tendencies of AD in different age groups make it possible to highlight three main periods in the formation of self-perception and stigmatization. The first period is from early infancy till 3 years of age. The child’s problems in this period depend on parental exhaustion, emotional distress, and security of the mother–child attachment. The child’s AD may form a kind of vicious circle in which severe AD causes parental distress and exhaustion that in turn lead to exacerbation of AD and psychological problems in children. The second period is from 3 till 10 years of age. During this period, development of AD children may be influenced by teasing, bullying, and avoiding by their peers. However, the majority of children in this age group are very optimistic. The third period is from 10 years till adulthood. Problems related to low self-esteem are characteristic during this period. It is important to identify children with AD and their parents who need psychological help and provide them with needs-based consultation and care. Appropriate treatment, medical consultations, and educational programs may help to reduce emotional problems in AD children and their parents. Keywords: atopic dermatitis, stigmatization, self-perception, quality of life, children, pediatric dermatology, skin disease
Høst, A; Husby, S; Hansen, L G;
cross-over design the atopic and non-atopic mothers alternated their intake of milk between homogenized and unhomogenized milk each week. On day 7, in each week, consecutive milk samples were taken before and 4, 8, 12 and 24 hr after a single ingestion of 500 ml of homogenized or unhomogenized milk......Human milk samples (n = 300) were collected during a 3-week period from 10 healthy mothers and from 10 atopic mothers, all with healthy, solely breast-fed infants. The milk samples were analysed by an enzyme-linked immunosorbent assay (ELISA) for the content of bovine beta-lactoglobulin (BLG). In a....... Detectable amounts of BLG (0.9-150 micrograms/l, median value 4.2 micrograms/l) were measured in 19/20 of the mothers (95%), in 9 of 10 atopic mothers and in all 10 of 10 non-atopic mothers. No correlation was found between the type of milk preparation (homogenized or unhomogenized) and the presence of BLG...
Bodin, Lennart; Andersson, K.; Bønløkke, Jakob Hjort;
-atopic with nasal histamine hyperreactivity, 13 were non-atopic, and 12 were atopic. Subjective ratings of symptoms and general health were registered four times during four 6-h exposure sessions. Six symptom intensity indices were constructed. The nasal hyperreactive group had a high and time......-dependent increase of mucous membrane irritations, whereas the atopic group had a low and stable rate of irritations with exposure time, close to the reference group (P = 0.02 for differences between the groups with respect to time under exposure for Weak Inflammatory Responses and P = 0.05 for Irritative Body...... Perception, significance mainly because of the nasal hyperreactive group). Exposure to dust, with or without glucan or aldehydes, showed increased discomfort measured by the index for Constant Indoor Climate, and dust with glucan had a similar effect for the index for Lower Respiratory Effects. For...
Hammer-Helmich, Lene; Linneberg, Allan; Thomsen, Simon Francis;
AIM: To determine the prevalence of asthma, atopic eczema and hay fever among children in different age groups and examine the associations with parental socioeconomic position. METHODS: A cross-sectional health survey of four complete birth-cohorts in the municipality of Copenhagen was conducted...... educational level, whereas asthma and hay fever were associated with low educational level. No association with household income was found........ Children aged 11 and 15 years and parents of children aged 3 and 6 years completed questionnaires on symptoms and diseases. Data were linked to national registers on demographics and socioeconomic position measured as education, employment and income. In total, 9720 children/parents responded (50...... a decreased risk of atopic eczema and eczema symptoms. There was no independent association between household income and any of the outcomes. CONCLUSIONS: The prevalence of asthma and hay fever, but not atopic eczema, increased with increasing age. Atopic eczema was associated with high parental...
Full Text Available Kaposi’s varicelliform eruption is a widespread viral infection frequently caused by herpes simplex virus types 1 and 2, and less frequently Coxsackie A-16 and vaccinia virus superimposed on a pre-existing dermatosis. It is often associated with atopic dermatitis. The topical immunomodulator pimecrolimus have proven effective in managing atopic dermatitis. Reported adverse effects are infrequent; however, cutaneous infections are potential complications of its application. Kaposi’s varicelliform eruption is the most important problem in treating patients with atopic dermatitis with pimecrolimus. Even though the causative effect of this topical immunomodulator remains unclear, patients should be thought to recognise herpes simplex virus infection and stop application to prevent the spreading of the infection. Herein we report a child with atopic dermatitis who developed Kaposi’s varicelliform eruption during treatment with pimecrolimus because of its rare occurence
Thorsteinsdottir, Sunna; Thyssen, Jacob P; Stokholm, Jakob;
BACKGROUND: While the etiopathogenesis of atopic dermatitis is complex and poorly understood, neonatal exposures are important for disease occurrence. However, the effect of dog exposure on the risk of atopic dermatitis is unresolved. OBJECTIVE: We investigated whether domestic dog exposure...... affected the risk of atopic dermatitis in children during the first 3 years of life. METHODS: Copenhagen prospective studies on asthma in childhood (COPSAC) are ongoing prospective clinical birth cohort studies. Data from 411 children born to mothers with asthma (COPSAC2000 ), and 700 unselected children...... (COPSAC2010 ) were analyzed following the same protocols at the same research site. Atopic dermatitis was diagnosed prospectively according to the Hanifin-Rajka criteria. Parental history of asthma, eczema or rhinitis was defined by self-reported physician diagnosis. In COPSAC2000, maternal specific serum...
Halkjær, Liselotte Brydensholt; Loland, Lotte; Buchvald, Frederik F;
OBJECTIVES: To describe the development of atopic dermatitis (AD) during the first 3 years of life and identify the localization of the early skin lesions that predicts the development of AD. DESIGN: Prospective, longitudinal, birth cohort study of children born to mothers with a history of asthma....... PARTICIPANTS: A total of 411 infants were enrolled in the cohort; 55 had incomplete follow-up and were excluded from certain analyses. MAIN OUTCOME MEASURES: Atopic dermatitis was defined based on the criteria of Hanifin and Rajka, and severity was assessed by the SCORAD (Scoring Atopic Dermatitis) index...... best predicted AD at age 3 years. CONCLUSIONS: Atopic dermatitis begins at the scalp, forehead, ear, and neck in a balaclava-like pattern. Eczema at the arms and joints provides the highest predictive value for the development of AD at age 3 years. This may be used for early prediction and intervention...
Thyssen, J P; McFadden, J P; Kimber, I
Atopic dermatitis and allergic contact dermatitis are both common skin diseases having an immune pathogenesis. There has been considerable interest about their inter-relationships with regard to altered susceptibility. Recent investigations have shed new light on this important question, and in...... this article, we explore whether there is evidence that atopic dermatitis affects the risk of contact sensitization and allergic contact dermatitis. The use of topical products to treat xerotic and inflamed skin in atopic dermatitis often results in a higher prevalence of sensitization to, for example......, fragrances and other ingredients in emollients. Moreover, the prevalence of metal allergy seems to be increased, probably due to compromised chelation of the metals in the stratum corneum of patients with atopic dermatitis. However, conversely, the T-helper cell 2 bias that characterizes immune responses in...
Mørtz, Charlotte G; Lauritsen, J M; Bindslev-Jensen, C;
BACKGROUND: Atopic diseases are common in children and adolescents. However, epidemiological knowledge is sparse for hand eczema and allergic contact dermatitis in this age group. Furthermore, no population-based studies have evaluated the prevalence of atopic diseases and hand and contact...... dermatitis in the same group of adolescents. OBJECTIVES: To assess prevalence measures of atopic dermatitis (AD), asthma, allergic rhinitis and hand and contact dermatitis in adolescents in Odense municipality, Denmark. METHODS: The study was carried out as a cross-sectional study among 1501 eighth grade...... associated. A considerable number of adolescents still suffers from AD, and a considerable sex difference was noted for hand eczema and allergic contact dermatitis. Nickel allergy and perfume allergy were the major contact allergies. In the future this cohort of eighth grade school children will be followed...
Gabriele Di Lorenzo
Full Text Available The value of CD30 and the soluble circulating fragment of CD30 (sCD30 for atopic dermatitis (AD remains unclear. In particular, little is known about the effects of age, duration of disease and Scoring Atopic Dermatitis index (SCORAD on the levels of serum sCD30 in patients affected by AD. In the present study, we have analysed serum sCD30 levels of adult patients affected by AD. The study's population includes 18 non-smoking outpatients, with a diagnosis of AD. As a control group we studied 18 non-atopic subjects from laboratory staff, matched for sex and age. These subjects had no history of AD, urticaria or seasonal or perennial rhinitis or asthma, and had negative skin prick test to a panel of allergens.
İjlal Erturan; Evrim Aktepe; Didem Didar Balcı; Mehmet Yıldırım; Yonca Sönmez; Ali Murat Ceyhan
Background and Design: Atopic dermatitis is a chronic, inflammatory skin disease characterized by itchy skin lesions. Since adolescents are intensely interested in their physical appearance, chronic skin diseases in this period can adversely affect the development of self esteem. Atopic dermatitis is a skin disease that affects the appearance and there is an heightened attention to the body image in adolescence which is an important period of time in the development of self-esteem. Therefore,...
Fariba Jaffary; Gita Faghihi; Arghavan Mokhtarian; Sayed Mohsen Hosseini
Background: The pathogenesis of atopic dermatitis (AD) remains to be determined; recently a possible change in the immune system with production of immunoglobulins is proposed. As vitamin E is a potent antioxidant, with the ability to decrease the serum levels of immunoglobulin E (IgE) in atopic patients, we aimed to evaluate the effect of oral vitamin E on treatment of AD. Materials and Methods: This randomized, double-blind, placebo-controlled trial comprised seventy participants with mild-...
Trak-Fellermeier, María Angélica
It was hypothesized that high fat consumption, specifically from polyunsaturated fatty acids, may be positively related to atopic disease prevalence. On the other hand, antioxidants constituents of the diet may exert a protective effect against disorders related to the immune system. The aim of the present cross-sectional study was to assess the relationship between dietary intake of selected foods, fatty acids, and dietary antioxidants with atopic disease prevalence in adul...
@@ 异位性皮炎(atopic dermatitis,AD)又名异位性湿疹(atopic eczama),特征为具有遗传过敏性湿疹临床表现,常伴哮喘、枯草热、过敏性皮炎湿疹的家族倾向,对异种蛋白质过敏,血清中IgE值高,血液中嗜酸性粒细胞增多.
Leopold, Christine; Arts, Danielle; Fröschl, Barbara
Health political background: In developed countries 2.5% of the population - mainly children - are affected by atopic dermatitis. During the past few years its prevalence amongst school children has risen decisively and now lies between 8% to 16%. It is the most frequent chronic skin disease amongst school-aged children. Scientific background: Current methods of treating atopic dermatitis among children focus on containing and preventing the illness’s further progression. Preventing dry skin,...
Treatment and, ultimately prevention of complex diseases such as atopic diseases, should start with the identification of individuals at risk for developing (an) atopic disease(s). Gene expression profiles, that is, whether a gene is expressed as mRNA, can reflect both genetic and environmental factors. We explored gene expression profiles in children with wheezing symptoms. Children who persist to wheeze after the age of three are at risk of developing asthma, but recognition of these persis...
Background In 1993 extremely high levels of birch pollen were recorded in Stockholm, Sweden. This provided an opportunity to evaluate the effects of aeroallergen exposure on the early immune response. Objective To assess the influence of exposure to birch pollen during pregnancy and early infancy, on the allergen-specific IgE- and IgG4-antibody (ab) response and development of atopic disease in children. Methods A total of 970 children with atopic heredity and born in ...
Jarmila Čelakovská; Ettler, K; K Ettlerová; J Vaněčková
Background: Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Aims and Objectives: Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. Materials and Methods: The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hype...
Eyerich, Kilian; Huss-Marp, Johannes; Darsow, Ulf; Wollenberg, Andreas; Foerster, Stefanie; Ring, Johannes; Behrendt, Heidrun; Traidl-Hoffmann, Claudia
Introduction: Eczematous reactions to type I allergy-inducing antigens are documented in a subgroup of patients with atopic eczema. Yet, the underlying immunological mechanisms are not well understood. Material and Methods: To delineate the effect of native pollen grains on human skin of healthy and atopic individuals we performed patch tests (atopy patch test with native pollen grains, PPT). Nickel patch tests (NPT) served as an established model of contact dermatitis. Skin site biopsies wer...
Knudsen, Thomas Bøllingtoft; Thomsen, Simon Francis; Ulrik, Charlotte Suppli; Fenger, Mogens; Nepper-Christensen, Steen; Backer, Vibeke
.56-3.94), p < 0.001. This was observed both for atopic asthma OR = 2.41, 95% CI (1.25-4.64), p = 0.007, non-atopic asthma, OR = 2.35, 95% CI (1.14-4.83), p = 0.02, and house dust mite (HDM) sensitive airway hyperresponsiveness, OR = 3.00, 95% CI (1.44-6.24), p = 0.002. Rhinitis and pollen allergy were not...
Yin, ZhiQiang; Xu, Jiali; Luo, Dan
Tacrolimus ointment and pimecrolimus cream have proved to be suitable for the treatment of atopic dermatitis. We conducted a meta-analysis of the efficacy, adverse events/withdrawal of tacrolimus versus pimecrolimus in the treatment of atopic dermatitis. According to our meta-analysis, 0.1% tacrolimus was more effective than 1% pimecrolimus in the treatment of adult patients and moderate to very severe pediatric patients, and more 0.1% mild pediatric patients treatal with pimecrolimus withdre...
Filiz Canpolat; Hatice Akpınar; Fatma Eskioğlu
Kaposi’s varicelliform eruption is a widespread viral infection frequently caused by herpes simplex virus types 1 and 2, and less frequently Coxsackie A-16 and vaccinia virus superimposed on a pre-existing dermatosis. It is often associated with atopic dermatitis. The topical immunomodulator pimecrolimus have proven effective in managing atopic dermatitis. Reported adverse effects are infrequent; however, cutaneous infections are potential complications of its application. Kaposi’s varicellif...
Carlsen, B C; Thyssen, J P; Menné, T;
The phenotypic traits of people with the filaggrin mutation (FLG) genotype and atopic dermatitis (AD) are still under elucidation, and the association with concomitant AD and contact allergy (CA) has not previously been examined.......The phenotypic traits of people with the filaggrin mutation (FLG) genotype and atopic dermatitis (AD) are still under elucidation, and the association with concomitant AD and contact allergy (CA) has not previously been examined....
Platts-Mills, T.A.; Mitchell, E.B.; Rowntree, S.; Heymann, P.W.; Chapman, M.D.
Patients with atopic dermatitis have IgE antibodies to common environmental antigens, both foods and inhalants. Such antibodies are probably relevant and exposure to the corresponding antigens can give rise to eczema. Nevertheless, the mechanisms involved and the role of other etiologies, e.g. contact reactions, remain to be elucidated. Patients with atopic dermatitis should have comprehensive evaluations to determine the role of environmental antigens.
@@ Background:A subset of common chronic skin condition demonstrates severe atopic dermatitis that is refractory to conventional treatment with topical steroids.The patients on atopic dermatitis (AD)using the Ou-kou (黄膏;a novel herbal ointment)has been shown improved skin condition and better quality of life (QOL).Objective and Methods:This study aimed to show the effect, in mental and skin conditions, of the administration of Ou- kou on atopic dermatitis patients.