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Sample records for atopic keratoconjunctivitis akc

  1. Topical cyclosporine for atopic keratoconjunctivitis.

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    González-López, Julio J; López-Alcalde, Jesús; Morcillo Laiz, Rafael; Fernández Buenaga, Roberto; Rebolleda Fernández, Gema

    2012-09-12

    Atopic keratoconjunctivitis (AKC) is a chronic ocular surface non-infectious inflammatory condition that atopic dermatitis patients may suffer at any time point in the course of their dermatologic disease and is independent of its degree of severity. AKC is usually not self resolving and it poses a higher risk of corneal injuries and severe sequelae. Management of AKC should prevent or treat corneal damage. Although topical corticosteroids remain the standard treatment for patients with AKC, prolonged use may lead to complications. Topical cyclosporine A (CsA) may improve AKC signs and symptoms, and be used as a corticosteroid sparing agent. To determine the efficacy and gather evidence on safety from randomised controlled trials (RCTs) of topical CsA in patients with AKC. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to July 2012), EMBASE (January 1980 to July 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to July 2012), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to July 2012), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en), the IFPMA Clinical Trials Portal (http://clinicaltrials.ifpma.org/no_cache/en/myportal/index.htm) and Web of Science Conference Proceedings Citation Index- Science (CPCI-S). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 9 July 2012. We also handsearched the following conference proceedings: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, International Council of Opthalmology and Societas

  2. Clinical Usefulness of Monitoring Expression Levels of CCL24 (Eotaxin-2) mRNA on the Ocular Surface in Patients with Vernal Keratoconjunctivitis and Atopic Keratoconjunctivitis

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    Yukiko Shiraki; Jun Shoji; Noriko Inada

    2016-01-01

    Purpose. This study aimed to evaluate the clinical efficacy of using expression levels of CCL24 (eotaxin-2) mRNA on the ocular surface as a biomarker in patients with vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). Methods. Eighteen patients with VKC or AKC (VKC/AKC group) and 12 control subjects (control group) were enrolled in this study. The VKC/AKC clinical score was determined by objective findings in patients by using the 5-5-5 exacerbation grading scale. All su...

  3. The differences of tear function and ocular surface findings in patients with atopic keratoconjunctivitis and vernal keratoconjunctivitis.

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    Hu, Y; Matsumoto, Y; Dogru, M; Okada, N; Igarashi, A; Fukagawa, K; Tsubota, K; Fujishima, H

    2007-08-01

    The pathogenesis of the ocular surface disease in atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) has not been fully understood. We tried to clarify the differences in the ocular surface status in patients with AKC, VKC, and healthy control subjects. Twenty-four eyes of 12 AKC patients, 12 eyes of six VKC patients, and 20 eyes of 10 normal control subjects were studied. The subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time (BUT), vital staining of the ocular surface, conjunctival impression and brush cytology. Impression cytology samples underwent periodic acid Schiff staining for goblet cell density, squamous metaplasia grading, and immunohistochemical staining for MUC1, 2, 4, and 5AC. Brush cytology specimens underwent staining for inflammatory cell counting and Real Time PCR for MUC1, 2, 4, and 5AC mRNA expression. The mean BUT, corneal sensitivity, and conjunctival goblet cell density values in AKC patients were significantly lower compared with VKC patients and control subjects. The squamous metaplasia grades in eyes with AKC were significantly higher compared to eyes with VKC and controls. The inflammatory cell response in brush cytology specimens was different between patients with AKC and VKC. Eyes with AKC showed significantly higher MUC1, 2 and 4 and lower MUC5AC mRNA expression compared to eyes with VKC. Differences of the infiltrates, higher level of tear instability, lower corneal sensitivity, up-regulation of MUC1, 2, and 4, and down regulation of MUC5AC were important differential features of the ocular surface disease in AKC compared with VKC.

  4. Clinical Usefulness of Monitoring Expression Levels of CCL24 (Eotaxin-2) mRNA on the Ocular Surface in Patients with Vernal Keratoconjunctivitis and Atopic Keratoconjunctivitis.

    Science.gov (United States)

    Shiraki, Yukiko; Shoji, Jun; Inada, Noriko

    2016-01-01

    Purpose. This study aimed to evaluate the clinical efficacy of using expression levels of CCL24 (eotaxin-2) mRNA on the ocular surface as a biomarker in patients with vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). Methods. Eighteen patients with VKC or AKC (VKC/AKC group) and 12 control subjects (control group) were enrolled in this study. The VKC/AKC clinical score was determined by objective findings in patients by using the 5-5-5 exacerbation grading scale. All subjects underwent modified impression cytology and specimens were obtained from the upper tarsal conjunctiva. Expression levels of CCL24 (eotaxin-2) mRNA on the ocular surface were determined using real-time reverse transcription polymerase chain reaction. Results. The VKC group was divided into two subgroups, depending on the clinical score: the active stage subgroup with 100 points or more of clinical scores and the stable stage subgroup with 100 points or less. CCL24 (eotaxin-2) mRNA expression levels in the active VKC/AKC stage subgroup were significantly higher than those in the stable VKC/AKC subgroup and the control group. Clinical scores correlated significantly with CCL24 (eotaxin-2) mRNA expression levels in the VKC group. Conclusions. CCL24 (eotaxin-2) mRNA expression levels on the ocular surface are a useful biomarker for clinical severity of VKC/AKC.

  5. Evaluation of lipid oxidative stress status and inflammation in atopic ocular surface disease

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    Wakamatsu, Tais H.; Ayako, Igarashi; Takano, Yoji; Matsumoto, Yukihiro; Ibrahim, Osama M.A.; Okada, Naoko; Satake, Yoshiyuki; Fukagawa, Kazumi; Shimazaki, Jun; Tsubota, Kazuo; Fujishima, Hiroshi

    2010-01-01

    Background Although the oxidative stress status in atopic skin disease has been reported to be elevated, there are still no studies related to the status of oxidative stress in atopic ocular surface disease. The purpose of this study was to evaluate the ocular surface lipid oxidative stress status and inflammation in atopic keratoconjunctivitis (AKC) patients and normal subjects. Methods Twenty eight eyes of 14 patients (9 males, 5 females) with AKC and 18 eyes of 9 age and sex matched (4 males and 5 females) normal healthy controls were examined in this prospective study. The severity of atopic dermatitis (AD) was scored by the SCORing Atopic Dermatitis (SCORAD) index. All subjects underwent Schirmer test, tear film break up time (BUT), fluorescein/Rose Bengal stainings, tear collection, and brush cytology from the upper palpebral conjunctiva. The brush cytology samples were stained with Diff-Quik for differentiation of inflammatory cells and immunohistochemistry (IHC) staining with HEL (hexanoyl-lysine) and 4-HNE (4-hydroxy-2-nonenal) to study lipid oxidation. HEL and cytokine (interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ)) levels were measured by enzyme-linked immunosorbent assay (ELISA) from tear samples of AKC patients and control subjects. Toluidine Blue and IHC staining with HEL, 4-HNE and cluster of differentiation 45 (CD45) were performed on papillary samples of AKC patients. This study was conducted in compliance with the “Declaration of Helsinki.” Results The tear stability and vital staining scores were significantly worse in eyes of AKC patients (ptears of AKC patients compared to controls. Papillary specimens also revealed many CD45 inflammatory cells as well as many cells positively stained with HEL and 4-HNE in IHC. A strong significant linear positive correlation between conjunctival inflammation and epithelial lipid oxidative stress status was observed

  6. Vernal keratoconjunctivitis.

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    Bonini, S; Coassin, M; Aronni, S; Lambiase, A

    2004-04-01

    Vernal keratoconjunctivitis (VKC) is an allergic eye disease that especially affects young boys. The most common symptoms are itching, photophobia, burning, and tearing. The most common signs are giant papillae, superficial keratitis, and conjunctival hyperaemia. Patients with VKC frequently have a family or medical history of atopic diseases, such as asthma, rhinitis, and eczema. However, VKC is not associated with a positive skin test or RAST in 42-47% of patients, confirming that it is not solely an IgE-mediated disease. On the basis of challenge studies as well as immunohistochemical and mediator studies, a Th2-driven mechanism with the involvement of mast cells, eosinophils, and lymphocytes has been suggested. Th2 lymphocytes are responsible for both hyperproduction of IgE (interleukin 4, IL-4) and for differentiation and activation of mast cells (IL-3) and eosinophils (IL-5). Other studies have demonstrated the involvement of neural factors such as substance P and NGF in the pathogenesis of VKC, and the overexpression of oestrogen and progesterone receptors in the conjunctiva of VKC patients has introduced the possible involvement of sex hormones. Thus, the pathogenesis of VKC is probably multifactorial, with the interaction of the immune, nervous, and endocrine systems. The clinical management of VKC requires a swift diagnosis, correct therapy, and evaluation of the prognosis. The diagnosis is generally based on the signs and symptoms of the disease, but in difficult cases can be aided by conjunctival scraping, demonstrating the presence of infiltrating eosinophils. Therapeutic options are many, in most cases topical, and should be chosen on the basis of the severity of the disease. The most effective drugs, steroids, should however be carefully administered, and only for brief periods, to avoid secondary development of glaucoma.A 2% solution of cyclosporine in olive oil or in castor oil should be considered as an alternative. The long-term prognosis of

  7. Vernal keratoconjunctivitis

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    Bernadetha Shilio

    2005-03-01

    Full Text Available Why is allergic eye disease a problem for eye workers?Why is allergic eye disease, and vernal keratoconjunctivitis (VKC in particular, a problem for eye workers and patients in hot climates?

  8. Dermatoceratoconjuntivite atópica em pacientes do Ambulatório de Dermatologia Infanto-Juvenil em centro de referência Atopic keratoconjunctivitis in patients of the pediatric dermatology ambulatory in a reference center

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    Bernardo Kaplan Moscovici

    2009-12-01

    ção oftalmológica de rotina desses pacientes, visto que nenhum dos pacientes de nosso estudo estavam em acompanhamento oftalmológico prévio.PURPOSE: To evaluate the frequency of atopic keratoconjunctivitis, its symptoms and changes in patients of Pediatric Dermatology Service of "Santa Casa de Misericordia de São Paulo" Hospital with a previous diagnosis of atopic dermatitis. METHODS: Fifty-two patients with atopic dermatitis under 16 years old (mean age 8.9 ± 4.1 between 2 and 16 years old were evaluated through a protocol of questions and assessment of signs and symptoms. The signs and symptoms were graded from 0 (absent to 4 (highest intensity, and in some cases only as present or not. The analysis was descriptive and statistical, with a 5% significance level. RESULTS: The frequency of atopic keratoconjunctivitis was 76.9% among the 52 patients with atopic dermatitis, including atopic conjunctivitis (26.7% and atopic blepharitis (50.2%. Atopic dermatitis is more frequent in female patients and atopic conjunctivitis in male. Age was practically the same in both groups. The most frequent symptoms were red eye and itching, especially in the atopic conjunctivitis group. Itching was the most intense symptom and was present in all patients of the atopic conjunctivitis group. Blepharitis and papillae were the most common signs. Other signs were less frequent. The tear break-up time was changed in most patients. CONCLUSIONS: The prevalence of atopic keratoconjunctivitis was 76.9% in patients with atopic dermatitis. Itching was the most frequent symptom, followed by red eye, in patients with atopic conjunctivitis. Blepharitis and papillae were the most frequent signs in patients with atopic conjunctivitis. Due to the increasing prevalence of atopic dermatitis in children, it would be prudent to perform a routine ophthalmologic evaluation of these patients. From the patients evaluated in this study, none had been previously monitored with ophthalmological exams.

  9. [Vernal keratoconjunctivitis].

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    Pleyer, U; Leonardi, A

    2015-02-01

    Vernal keratoconjunctivitis (VKC) is a bilateral, usually seasonally recurrent inflammation of the conjunctiva. Clinically characteristic findings are tarsal giant conjunctival papillae (> 1 mm) and/or limbal gelatinous changes (Trantas dots). The underlying etiology and pathophysiology of VKC remains unclear; however, clinical findings and immunohistochemical studies suggest a complex, both IgE-dependent and IgE-independent immune-mediated etiology. Several predisposing conditions include endocrine, genetic, neurogenic, environmental and socioeconomic risk factors. Mast cell stabilizers, antihistamines and topical corticosteroids are often used during acute flare-ups in VKC; however this approach is unsatisfactory for controlling severe cases and avoiding recurrences. Immunomodulatory agents, such as cyclosporin A and tacrolimus are promising alternative agents for long-term management. In most children the clinical course of VKC is self-limiting and may disappear following puberty; however, some VKC patients will face sight-threatening complications which are mainly due to corneal involvement and iatrogenic damage caused by prolonged corticosteroid treatment.

  10. A comprehensive review on vernal keratoconjunctivitis with emphasis on proteomics.

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    Pattnaik, Lolly; Acharya, Laxmikanta

    2015-05-01

    Allergic conjunctivitis presents as a spectrum of different clinical entities, such as perennial allergic conjunctivitis, seasonal allergic conjunctivitis, atopic keratoconjunctivitis and vernal keratoconjunctivitis. Vernal keratoconjunctivitis (VKC) is a disorder that is often associated with allergens and is seen during the spring season. Herein, we focused on vernal keratoconjunctivitis (VKC) and reviewed its epidemiology, clinical presentations, ocular associations, available treatment options, and the progressive understanding of its histopathological features; we have also systematically elaborated on the various studies on proteomics. Initial theories of a solely IgE-mediated mechanism have been replaced by those considering IgE and non-IgE mechanisms. Developments in basic and clinical research will open novel diagnostic approaches for the early detection and cure of the disease. Copyright © 2015. Published by Elsevier Inc.

  11. Tear levels of IL-16 in vernal keratoconjunctivitis

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    Onur Çatak

    2013-09-01

    Full Text Available Objective: Vernal keratoconjunctivitis is more common inchildren and young adults having an atopic background.The aim of the present study was to determine the interleukin-16 (IL-16 levels in tear fluids of patients withvernal keratoconjunctivitis (VKC.Methods: Tear fluid samples were collected from 20patients with VKC and 10 healthy subjects. Tear fluidsamples were collected with microcapillary tubes for hematocritat the lateral canthus of patients in the supineposition without any anesthesia. Tear levels of IL-16 weremeasured by ELISA kit.Results: The mean levels of IL-16 among the patients(514±135 pg/ml was significantly higher than amongcontrols (358±139 pg/ml (p=0.04.Conclusions: These results considered that IL-16 havesignificant effect on the pathogenetic process of vernalkeratoconjunctivitis.Key words: Interleukin-16, vernal keratoconjunctivitis,enzyme-linked immunosorbent assay

  12. OCULAR MANIFESTATIONS OF ATOPIC DERMATITIS- AN OBSERVATIONAL STUDY IN A TERTIARY CARE CENTRE IN WESTERN ODISHA

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    Swati Samikshya

    2017-08-01

    Full Text Available BACKGROUND Atopic dermatitis (AD also known as atopic eczema, is an allergic condition with hereditary predisposition. It mostly presents with intensely itchy skin, raised, splotchy lesions anywhere throughout the body. AD is most commonly seen in younger age group, the severity increases with increasing age. It is a chronic allergic condition, having both dermatologic as well as ocular manifestations. Ocular manifestations and its complications of AD are proven to be potentially morbid. The aim of this study was to evaluate the frequencies, prevalence and pattern of ocular manifestations in patients with Atopic Dermatitis in our Tertiary eye care center in Western Odisha, so that early diagnosis and treatment of symptoms can be effectively done to prevent complications. MATERIALS AND METHODS A Hospital based observational study of Ocular manifestations in 80 cases of Atopic Dermatitis was done over 12 months. To study the frequency of ocular symptoms and its complications, a study group comprising of 49 males and 31 females were examined thoroughly. Associated ocular signs, anterior segment of eye and fundus were examined. RESULTS Atopic keratoconjunctivitis (AKC having the maximum contribution (38.8% followed by severe blepharoconjunctivitis (20.3% was found in our study. Lid involvement appeared as thickening, scaling and Dennie Morgan folds, while conjunctival changes were seen in form of severe follicular and moderate to severe papillary reactions with limbal thickening. Cobblestone appearance of papillae were typically found along with papillary hypertrophy. The ocular abnormalities were mostly found in the age group of 0-10 years with an average duration of suffering from AD of >1 year. The ocular manifestations in our case group were not significantly associated with visual impairment or any serious morbidity. CONCLUSION Atopic dermatitis is a chronic allergic condition which when presents as ocular manifestations presents mostly with

  13. Vernal keratoconjunctivitis: atopy and autoimmunity.

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    Zicari, A M; Nebbioso, M; Lollobrigida, V; Bardanzellu, F; Celani, C; Occasi, F; Cesoni Marcelli, A; Duse, M

    2013-05-01

    Vernal Keratoconjunctivitis (VKC) is a rare chronic ocular inflammatory disease and it mainly affects boys in the first decade of life. Although it is a self-limiting disease, patients may present many phases characterized by an exacerbation of inflammatory symptoms with a consequent decline of the quality of life. define the clinical and immunological profile of patients affected by VKC and investigate their familiar history of autoimmune disorders and their autoimmunity pattern. 28 children were enrolled (20 males, 71%) aged between 4 and 14 years of life affected by VKC. Family history of allergic and immunological diseases was collected for each patient. In particular, it was asked whether some components of their families were affected by Hashimoto's thyroiditis, type I diabetes, psoriasis or rheumatoid arthritis and Systemic Lupus Erythematosus (SLE). All VKC children underwent a serological evaluation of anti-nuclear antibodies (ANA). A family history of immunological disorders was found in 46% of patients, 28% of Hashimoto's thyroiditis, 14% of type I diabetes, 14% of psoriasis, and 1 of Systemic Lupus Erythematosus. Furthermore, 35% of patients was ANA positive and they corresponded to patients with a higher ocular score and with the most important clinical symptoms. the detection of ANA positivity and of a familiar history of autoimmune disorders in a high percentage of children with VKC may help us to better understand the association of this ocular inflammatory disease with systemic autoimmune disorders and atopic condition.

  14. Clinical grading of vernal keratoconjunctivitis.

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    Bonini, Stefano; Sacchetti, Marta; Mantelli, Flavio; Lambiase, Alessandro

    2007-10-01

    The purpose of the present review is to provide an overview on the clinical features of vernal keratoconjunctivitis on the basis of cases series presented in the literature. Furthermore, a new grading system of vernal keratoconjunctivitis based on the severity of the disease is proposed. Different treatment options are discussed based on the clinical grade of vernal keratoconjunctivitis. Recent epidemiological studies on the demographic, clinical and immunologic features of vernal keratoconjunctivitis are presented. The efficacy and complications of treatments are described. Diagnosis and treatment of patients is a challenge for ophthalmologists as no precise diagnostic criteria have been established, the pathogenesis is unclear, and antiallergic treatments are often unsuccessful. This review describes old and new concepts of vernal keratoconjunctivitis diagnosis and treatment: the clinical features, the diagnostic criteria, the common features between this and other ocular allergies and the therapeutic strategies. On the basis of this knowledge, a new grading system is introduced based on clinical signs and symptoms of ocular surface inflammation. This new grading of vernal keratoconjunctivitis may help clinicians and researchers to classify disease activity and to establish a common agreement for treatments.

  15. Pathogenesis of Vernal Keratoconjunctivitis and Associated Factors.

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    Nebbioso, Marcella; Zicari, Anna Maria; Celani, Camilla; Lollobrigida, Valeria; Grenga, Roberto; Duse, Marzia

    2015-01-01

    To investigate the role of some variables, including allergy and autoimmunity, in the pathogenesis of vernal keratoconjunctivitis (VKC). The VKC is a chronic and often severe form of bilateral keratoconjunctivitis. Usually, it begins during the first decade and disappears during the end of the second decade of life. 26 patients with VKC were selected. The diagnosis was performed by the ophthalmologist through a score based on ocular signs and subjective symptoms before and after administration of 1% cyclosporine A (Cy) eyedrops. Each variable was graded: 0 = absent; 1 = mild; 2 = moderate; 3 = severe. Patients with a total score ≥7 were included in the study. Blood samples were collected at the initial time for the determination of autoimmunity by total IgE and antinuclear antibodies (ANA). A Skin Prick Test (SPT) was performed on each patient to common inhalants and food allergens. 53.8% of the children resulted atopic. The most important allergens were house dust mites and grasses. 46.1% of the patients showed total IgE >100 UI/ml and 30.8% had ANA positivity at the first determination. The photophobia occurred in 42.3% of children, most frequently with respect to other symptoms like secretion or tearing (30.8%), foreign body sensation (15.4%), itching and conjunctival hyperemia (11.5%). Fortunately all children improved their symptoms after Cy eyedrop therapy. Moreover, there was an elevated percentage (30.8%) of children with ANA positivity compared with the values in the general pediatric population. Despite the fact that it is a non-specific autoantibody, its high presence in a population of children with VKC may have an important role in clarifying etiopathogenesis and chronic inflammation.

  16. [Vernal keratoconjunctivitis in children].

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    Oraszewska-Matuszewska, Bronisława; Pieczara, Ewa; Sameochowiec-Donocik, Elibieta; Filipek, Erita

    2005-01-01

    To evaluate the course of palpebral type of vernal keratoconjunctivitis (VKC) and relation of the number of recurrences per year, to patients age and to estimate the frequency of irreversible corneal transparency changes and visual acuity decrease. There were 34 eyes of 17 children, 13 boys (76.4%) included 2 brothers and 4 girls. The age of patients was from 5 to 14 years, mean 9.1. All patients were hospitalized because of pathological corneal changes. Follow up from 2 to 13 years (mean 8.4). The number of recurrences ranged from 2 to 5 per year and there was not correlation between age of children and frequency of episodes. We have observed punctate keratopathy (79.14% of cases) and corneal ulcers (26.5% of cases). In 25 eyes of 13 patients cryocoagulation and/or excision of giant palpebral papillae were done. Visual acuity ranged from 0.01 to 1.0 and mean value before treatment was 0.879 +/- 0.09 and after 0.884 +/- 0.10. The difference was not statistically significant (p = 0.878). (1) The course of VKC is recurrent, the number of recurrences per year does not depend on the age of patients, but is correlated with giant papillae of palpebral conjunctiva presence. (2) Large papillae should be excised, in order to make the healing of cornea quicker. (3) Permanent visual function decreasing is not frequent because partial leucoma is localized at the periphery of cornea.

  17. Management of vernal keratoconjunctivitis.

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    Leonardi, Andrea

    2013-12-01

    Vernal keratoconjunctivitis (VKC) is a relatively rare, chronic form of ocular allergy that can potentially cause severe visual complications. Affecting mainly children and young adults, it is an IgE- and T cell-mediated disease, leading to a chronic inflammation in which eosinophil, lymphocyte and structural cell activation are involved. Treatment of VKC requires a multiple approach that includes conservative measures and pharmacologic treatment. Patients and parents should be made aware of the long duration of disease, its chronic evolution and possible complications. Treatment should be based on the duration and frequency of symptoms and the severity of corneal involvement. Mast cell stabilizers and antihistamines have been proven to be effective for the treatment of mild to moderate forms of VKC. In the most severe cases, topical steroids can be used as rescue medication to reduce conjunctival and corneal inflammation. Immunomodulators that have been investigated for VKC treatment include topical ocular preparations of cyclosporine A and tacrolimus. Topical cyclosporine A has been proven to be effective in the long-term treatment of VKC, significantly improving signs and symptoms without significant side effects.

  18. Vernal keratoconjunctivitis: an update.

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    De Smedt, Stefan; Wildner, Gerhild; Kestelyn, Philippe

    2013-01-01

    Vernal keratoconjunctivitis (VKC) is a bilateral, usually seasonally recurrent, allergic inflammation of the conjunctiva, characterised by limbal gelatinous hypertrophy and/or upper tarsal giant conjunctival papillae. Although rare in temperate regions, it represents an important cause of hospital referral in many parts of Africa and Asia. Clinical and immunohistochemical studies suggest that IgE-dependent (type I allergic) and IgE-independent (type IV allergic) mechanisms are involved in the immunopathogenesis of VKC, in which various inflammatory cells, including different T cell subpopulations play an active role via a cascade of chemical mediators. Endocrine, genetic, neurogenic, environmental and socioeconomic risk factors have been identified. However, its aetiology and pathophysiology remain unclear. The clinical course of this disease is usually benign and self-limiting, but a minority of patients will face very debilitating and sight threatening complications. Topical corticosteroids are often used during flare-ups in combination with mast cell stabilizers as maintenance treatment for VKC. However this management is unsatisfactory in controlling severe cases and avoiding recurrences. Non-steroidal immune modulators such as ciclosporin A and tacrolimus are promising alternatives, but tolerance to these agents needs to be improved and production costs reduced. The purpose of this review is to give an update on its epidemiology, immunopathogenesis and management.

  19. Listeria monocytogenes endophthalmitis following keratoconjunctivitis

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    Shoughy SS

    2014-01-01

    Full Text Available Samir S Shoughy,1 Khalid F Tabbara1–31The Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia; 2Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3The Wilmer Ophthalmological Institute of The Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Endophthalmitis due to endogenous or exogenous bacteria is a rare infection of the eye. We report a case of endophthalmitis following Listeria monocytogenes keratoconjunctivitis in a 27-year-old healthy white male presenting with hand motion visual acuity, right eye mucopurulent conjunctivitis, elevated intraocular pressure, and pigmented hypopyon 6 months post-keratectomy. The conjunctivitis was unresponsive to a 5-day course of topical tobramycin eye drops, and the patient developed keratitis with pain that progressed to endophthalmitis after 21 days. Diagnostic B-scan revealed vitreous exudates. Intraocular fluid specimen showed Gram-positive organisms and the aqueous culture grew penicillin-/aminoglycoside-sensitive L. monocytogenes. The patient was given intravitreal and systemic vancomycin and ceftazidime. The eye was unresponsive to intravenous penicillin and gentamicin; the anterior chamber progressively flattened and developed phthisis bulbi. L. monocytogenes keratoconjunctivitis may lead to bacterial endophthalmitis. Prompt culture and early antibiotic therapy are recommended.Keywords: conjunctivitis, L. monocytogenes, endophthalmitis

  20. Atopic dermatitis

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis

    2014-01-01

    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....

  1. Akcīzes nodoklis un tā administrēšana Latvijas Republikā

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    Gertnere, Inga

    2014-01-01

    Akcīzes nodokļa ieņēmumi veido nozīmīgu valsts budžeta ieņēmumu daļu. Ar akcīzes nodokli apliekamās preces ir paaugstināta riska preces, kas ir īpaši pakļautas krāpnieciskiem darījumiem, kontrabandai. Diplomdarbā „Akcīzes nodoklis un tā administrēšana Latvijas Republikā” darba autores mērķis ir izpētīt akcīzes nodokļa lomu un administrēšanu Latvijas Republikā, izdarot secinājumus, izstrādāt priekšlikumus akcīzes nodokļa administrēšanas uzlabošanai. Diplomdarbs sastāv no 3 nodaļām. Dar...

  2. Corneal complications of vernal keratoconjunctivitis.

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    Solomon, Abraham

    2015-10-01

    Vernal keratoconjunctivitis (VKC) is a severe bilateral chronic allergic inflammatory disease of the ocular surface. In most of the cases, the disease is limited to the tarsal conjunctiva and to the limbus. However, in the more severe cases, the cornea may be involved, leading to potentially sight threatening complications. Prompt recognition of these complications is crucial in the management of VKC, which is one of the most severe ocular allergic diseases. A vicious cycle of inflammation occurs as a result of a set of reciprocal interactions between the conjunctiva and the cornea, which results in damage to the corneal epithelium and corneal stoma, and to the formation of shield ulcers and plaques, infectious keratitis, keratoconus, scarring, and limbal stem cell deficiency. These corneal complications can cause permanent decrease or loss of vision in children suffering from VKC. Corneal complications in VKC are the result of an on-going process of uncontrolled inflammation. Proper recognition of the corneal complications in VKC is crucial, as most of these can be managed or prevented by a combination of medical and surgical measures.

  3. Dry Eye in Vernal Keratoconjunctivitis

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    Villani, Edoardo; Strologo, Marika Dello; Pichi, Francesco; Luccarelli, Saverio V.; De Cillà, Stefano; Serafino, Massimiliano; Nucci, Paolo

    2015-01-01

    Abstract The purpose of this comparative cross-sectional study was to investigate the use of standardized clinical tests for dry eye in pediatric patients with active and quiet vernal keratoconjunctivitis (VKC) and to compare them with healthy children. We recruited 35 active VKC, 35 inactive VKC, and 70 age-matched control healthy subjects. Each child underwent a complete eye examination, including visual analog scale symptoms assessment, biomicroscopy, fluorescein break-up time (BUT), corneal fluorescein and conjunctival lissamine green staining, corneal esthesiometry, Schirmer test with anesthetic, and meibomian glands inspection and expression. Active VKC patients showed significantly increased symptoms and signs of ocular surface disease, compared with the other 2 groups. Inactive VKC patients, compared with control subjects, showed increased photophobia (P < 0.05; Mann-Whitney U test), conjunctival lissamine green staining and Schirmer test values, and reduced BUT and corneal sensitivity [P < 0.05 by analysis of variance (ANOVA) least significant difference posthoc test for BUT and Schirmer; P < 0.001 by Mann-Whitney U test for lissamine green staining and corneal sensitivity]. Our results confirm the association between VKC and short-BUT dry eye. This syndrome seems to affect the ocular surface in quiescent phases too, determining abnormalities in tear film stability, epithelial cells integrity, and corneal nerves function. The very long-term consequences of this perennial mechanism of ocular surface damage have not been fully understood yet. PMID:26496269

  4. Topical tacrolimus for the treatment of severe allergic keratoconjunctivitis in children.

    Science.gov (United States)

    Liendo, Vera Lucia; Vola, Maria Eugenia; Barreiro, Telma Pereira; Wakamatsu, Tais Hitomi; Gomes, José Álvaro Pereira; Santos, Myrna Serapião Dos

    2017-01-01

    Administration of eye drops containing antihistamines or sodium cromoglycate and its derivatives for the treatment of allergic keratoconjunctivitis is often insufficient and usually requires the addition of corticosteroids. However, the risk of complications, such as glaucoma and cataract, limits the use of corticosteroids to short courses, resulting in inadequate long-term treatment response. Immunosuppressive drugs have been considered as a valid alternative to steroids for atopic keratoconjunctivitis and vernal keratoconjunctivitis. This study aimed to evaluate the use of topical tacrolimus (TCL) in improving the clinical signs of severe allergic keratoconjuctivitis in children. Patients with severe allergic keratoconjunctivitis associated with corneal epitheliopathy, gelatinous limbal infiltrates, and/or papillary reaction, along with a history of recurrences and resistance to conventional topical anti-allergy agents, were included in this open clinical trial. Patients were treated with 0.03% TCL ointment for ocular use. A severity score ranging from 0 to 9, with 9 being the highest and 0 being the lowest, was assigned based on signs observed on biomicroscopy prior to and following TCL treatment. Analyses included 66 eyes of 33 patients. After a mean follow-up period of 13 months (range, 12-29 months), TCL treatment significantly decreased the mean symptom score severity for the right (from 5.56 ± 1.18 to 2.76 ± 1.5; p<0.001) and left (from 5.94 ± 1.16 to 2.86 ± 1.64; p<0.001). Topical TCL was effective and significantly improved the clinical signs of allergic keratoconjuctivitis in children. Thus, it is a potential new option for severe and challenging cases of ocular allergy.

  5. Topical tacrolimus for the treatment of severe allergic keratoconjunctivitis in children

    Directory of Open Access Journals (Sweden)

    Vera Lucia Liendo

    Full Text Available ABSTRACT Purpose: Administration of eye drops containing antihistamines or sodium cromoglycate and its derivatives for the treatment of allergic keratoconjunctivitis is often insufficient and usually requires the addition of corticosteroids. However, the risk of complications, such as glaucoma and cataract, limits the use of corticosteroids to short courses, resulting in inadequate long-term treatment response. Immunosuppressive drugs have been considered as a valid alternative to steroids for atopic keratoconjunctivitis and vernal keratoconjunctivitis. This study aimed to evaluate the use of topical tacrolimus (TCL in improving the clinical signs of severe allergic keratoconjuctivitis in children. Methods: Patients with severe allergic keratoconjunctivitis associated with corneal epitheliopathy, gelatinous limbal infiltrates, and/or papillary reaction, along with a history of recurrences and resistance to conventional topical anti-allergy agents, were included in this open clinical trial. Patients were treated with 0.03% TCL ointment for ocular use. A severity score ranging from 0 to 9, with 9 being the highest and 0 being the lowest, was assigned based on signs observed on biomicroscopy prior to and following TCL treatment. Results: Analyses included 66 eyes of 33 patients. After a mean follow-up period of 13 months (range, 12-29 months, TCL treatment significantly decreased the mean symptom score severity for the right (from 5.56 ± 1.18 to 2.76 ± 1.5; p<0.001 and left (from 5.94 ± 1.16 to 2.86 ± 1.64; p<0.001. Conclusion: Topical TCL was effective and significantly improved the clinical signs of allergic keratoconjuctivitis in children. Thus, it is a potential new option for severe and challenging cases of ocular allergy.

  6. uv keratoconjunctivitis vs. established dose effect relationships

    Energy Technology Data Exchange (ETDEWEB)

    Gulvady, N.U.

    1976-08-01

    A patient who received a uv dose to his eyes 11 times greater than the photokeratitic threshold of Pitts and 4/sup 1///sub 2/ times the photokeratitic threshold as found by Leach. The patient had severe keratoconjunctivitis for 3 days and did not develop any keratitis.

  7. Vernal Keratoconjunctivitis in Kashmir: A temperate zone.

    Science.gov (United States)

    Sofi, Rayees Ahmad; Mufti, Asmat

    2016-12-01

    The objective of this study was to observe the clinical features of patients with vernal keratoconjunctivitis attending the Outpatient Department of a mobile eye unit, Directorate of Health Services, Jammu and Kashmir over a period of 1 year. The greater prevalence of VKC is seen in the regions with hot, humid climate, and higher load of airborne allergens. The clinical profile of this disease seems to have geographical variation. The study was conducted in the mobile eye unit, Directorate of Health Services, Kashmir, a comparatively cooler area. All the patients with vernal keratoconjunctivitis who presented to the OPD during this period were examined. The diagnosis of vernal keratoconjunctivitis was based on typical history, clinical features, and examination. All the patients with the complaints of itching, watering, and photophobia were examined. After proper history, clinical features, and ocular examination under slit lamp, the data were recorded for patients who were diagnosed with vernal keratoconjunctivitis. Of all the patients who had allergic ocular disorders, a total of 212 patients were diagnosed as cases with vernal keratoconjunctivitis. This is a non-interventional study, and the ethical clearance was obtained from the regulatory board of the hospital. The study abides by the tenets laid down in the declaration of Helsinki. During this 1-year period, 212 vernal keratoconjunctivitis patients were examined, of whom 155 (73 %) were males and 57 (27 %) were females. As per the age group, 40 % (85) of patients were in the age group of 11-15 years. 93 % (197) of patients had bilateral disease, and 7 % (15) had unilateral. It was seen that 75 % (159) had seasonal attack. Different types of disease were observed: 77 % (163) had bulbar disease, 7 % (15) had palpebral, and 16 % (34) had mixed disease. During this period, we noticed that VKC led to complications also. It was seen that 3 % (6) of patients had steroid induced glaucoma, 5 % (11) had

  8. ouova. Akce

    African Journals Online (AJOL)

    dustbin, plastic bag, and metal dust bin). According to the responses of the households, the number of days in which the solid waste was kept in the storage containes before disposal showed that 32. (58.2%) of the house holds kept for three. 57.14% is not being washed after the solid days, 17 (30.9%) for two days, and 6.

  9. Serum Vitamin D Levels in Children with Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Bozkurt, Banu; Artac, Hasibe; Ozdemir, Hulya; Ünlü, Ali; Bozkurt, Mete Kaan; Irkec, Murat

    2016-10-24

    To evaluate serum 25-hydroxyvitamin D [25(OH)D3] levels of vernal keratoconjunctivitis (VKC) children. A total of 62 non-atopic healthy children (64.5% male, mean age 10.79 ± 3.3 years) and 29 VKC children (75.9%, mean age 12.17 ± 2.7 years) were included in the study. Serum 25(OH)D3 levels measured by HPLC were compared between the two groups and a p value of <0.05 was considered as statistically significant. The mean serum 25(OH)D3 level of VKC group was significantly lower than in the control group (11.02 ± 5.16 ng/mL and 15.99 ± 7.36 ng/mL, respectively) (p = 0.002). Severe vitamin D deficiency (<10 ng/mL) was detected in 48.3% of VKC children and 22.6% of the controls (p = 0.017). Time spent outdoors during daylight was higher in the control group (229.5 ± 101.2 min) compared with the VKC group (160.7 ± 65.9 min) (p = 0.008), and showed a significant correlation with serum 25(OH)D3 levels (Spearman rho = 0.812) (p<0.001). Children with VKC should be evaluated for vitamin D deficiency, which might occur secondary to sun avoidance.

  10. Atopic dermatitis - children - homecare

    Science.gov (United States)

    Infantile eczema; Dermatitis - atopic children; Eczema - atopic - children ... child's provider what kind is right for your child. Atopic dermatitis is usually treated with medicines placed directly on ...

  11. Atopic dermatitis

    DEFF Research Database (Denmark)

    Haagerup, Annette; Bjerke, Torbjørn; Schiøtz, Peter Oluf

    2004-01-01

    to focus on this phenotype, and specific susceptibility genes remain to be found. To identify candidate regions holding genes for atopic dermatitis we performed a genome-scan in Danish affected sib-pair families containing sib-pairs matching a phenotype definition of both clinical atopic dermatitis...... and confirmed specific allergy. The scan was undertaken using 446 microsatellite markers and non-parametric linkage results were obtained from the MAPMAKER/SIBS computer program. We found evidence of linkage to three candidate regions in chromosomes 3p (MLS=2.14), 4p (MLS=2.00) and 18q (MLS=2.25), one of which...

  12. Bacteriological Investigation of Infectious Keratoconjunctivitis in Norwegian Sheep

    Directory of Open Access Journals (Sweden)

    Hofshagen M

    2004-03-01

    Full Text Available Contagious keratoconjunctivitis is a rather common disease in Norwegian sheep. Since the knowledge of its aetiology is limited, the present study was performed to determine the microorganisms involved. Local veterinarians throughout the country collected conjunctival swabs from both sick (n = 43 and healthy (n = 42 sheep on 15 farms with outbreaks of ovine keratoconjunctivitis, and further from healthy sheep (n = 50 on 17 farms not showing any signs of conjunctival disease. All samples were cultivated for bacteria and mycoplasma. Listeria monocytogenes was isolated from 3 cases (1% in one single herd. Staphylococcus aureus (5%, Corynebacterium spp. (2% and Escherichia coli (4% were isolated only in herds with keratoconjunctivitis, but from both sick and healthy animals. Moraxella (Branhamella ovis was isolated from 28% of sampled animals in affected herds and from 10% of sampled animals in healthy herds. The corresponding numbers for Moraxella spp. were 9%/12%, for Pseudomonas spp. 7%/8%, for Staphylococcus spp. 22%/22%, for Bacillus spp. 12%/14%, for Micrococcus spp. 6%/2% and for Streptococcus/Enterococcus spp. 2%/2%. Mycoplasma conjunctivae was isolated from 16 animals with keratoconjunctivitis (37% and from 3 animals without clinical signs (7% in farms with keratoconjunctivitis. In farms without clinical signs of keratoconjunctivitis, M. conjunctivae was isolated in 4 animals (8%. To our knowledge, this is the first time M. conjunctivae has been isolated in Norway. Other predisposing agents found were Moraxella (Branhamella ovis and Listeria monocytogenes. The etiological importance of different microorganisms in ovine keratoconjunctivitis seems to vary; some are probably only present as secondary invaders. Other possible causes of ovine keratoconjunctivitis in Norway, such as Chlamydia psittaci, remain to be investigated.

  13. Severe vernal keratoconjunctivitis successfully treated with subcutaneous omalizumab.

    Science.gov (United States)

    de Klerk, Timothy A; Sharma, Vibha; Arkwright, Peter D; Biswas, Susmito

    2013-06-01

    A 12-year-old boy with severe mixed limbal and palpebral vernal keratoconjunctivitis experienced persistent ocular symptoms despite treatment with topical corticosteroids or cyclosporine. Signs and symptoms resolved completely with monthly subcutaneous omalizumab, an immunomodulating biologic agent. To our knowledge, this is the first report of its use as a monotherapy agent to treat vernal keratoconjunctivitis. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  14. BILATERAL STEROID INDUCED GLAUCOMA IN VERNAL KERATOCONJUNCTIVITIS

    Directory of Open Access Journals (Sweden)

    Bangal Surekha V, Bankar Mahima S, Bhandari Akshay J, Kalkote Prasad R

    2015-01-01

    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.

  15. Vitiligo in association with vernal keratoconjunctivitis.

    Science.gov (United States)

    Kumar, Sunil; Al Khars, Wajeeha

    2016-01-01

    Vernal keratoconjunctivitis (VKC) is a chronic allergic inflammation of ocular surface involving the tarsal and/or bulbar conjunctiva. Signs of VKC are confined to the conjunctiva and cornea. The skin of the lid remains uninvolved. Here we report a case of 17 year-old male suffering from VKC who develops vitiligo of lid skin and lash poliosis. All ocular and systemic causes of localized skin and lash depigmentation were excluded in our patient by thorough clinical examination and investigations. During regular follow-up for two-year patient did not develop any ocular and systemic illness presenting as vitiligo and poliosis. We believe that VKC was the most possible etiology of Vitiligo of lid and lash poliosis in this patient.

  16. The usefulness of measuring tear periostin for the diagnosis and management of ocular allergic diseases.

    Science.gov (United States)

    Fujishima, Hiroshi; Okada, Naoko; Matsumoto, Kenji; Fukagawa, Kazumi; Igarashi, Ayako; Matsuda, Akio; Ono, Junya; Ohta, Shoichiro; Mukai, Hideki; Yoshikawa, Mamoru; Izuhara, Kenji

    2016-08-01

    Chronic ocular allergic diseases such as vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are accompanied by serious comorbidities; however, the underlying pathogenesis remains obscure. Furthermore, diagnosing conjunctival lesions in patients with atopic dermatitis and estimating the severity in AKC are important for the treatment of ocular allergic diseases. We addressed whether periostin, a novel mediator and biomarker in allergic inflammation, is involved in the pathogenesis of ocular allergic diseases and whether periostin can be a biomarker for these diseases. We investigated tear periostin in patients with seasonal allergic conjunctivitis (SAC), VKC, and AKC and allergic patients without conjunctivitis and compared it with tear IL-13 and serum periostin. Furthermore, in patients with AKC, we measured tear periostin before and after topical treatment with tacrolimus. Tears from patients with ocular allergic disease showed significantly high periostin levels than did tears from allergic patients without conjunctivitis and from patients with AKC, VKC, and SAC in descending order. Tear periostin was associated with serious comorbidities such as large papilla formation and corneal damage in AKC, although both tear IL-13 and serum periostin had little to no such abilities. Furthermore, after topical tacrolimus treatment, tear periostin tended to decrease in most patients with AKC along with their clinical improvement. Periostin produced in conjunctival tissues stimulated by IL-13 may contribute to the pathogenesis of ocular allergic diseases. Furthermore, tear periostin can be potentially applied as a biomarker to diagnose conjunctivitis in allergic patients and to evaluate disease severity as well as the efficacy of treatments in AKC. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Watson Wade

    2011-11-01

    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.

  18. Tacrolimus Ointment for Treatment of Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Al-Amri, Abdulrahman M; Mirza, Aleem Gulzar; Al-Hakami, Ahmed Mossa

    2016-01-01

    To evaluate the safety and efficacy of tacrolimus 0.1% ointment for the treatment of refractory vernal keratoconjunctivitis (VKC). This prospective, nonrandomized case series enrolled 20 patients (40 eyes) with severe VKC, who were treated with tacrolimus 0.1% ointment. The mean age of the patients was 18.25 ± 4.2 years (range, 9-31 years). Each patient completed a follow-up period of at least 24 months. The main outcome measure was the clinical response to treatment. Significant improvements in clinical signs and symptoms were achieved in all patients 6 weeks after starting treatment with topical tacrolimus. Treatment was gradually reduced, with increasing intervals between applications. VKC recurred in all patients who attempted to discontinue treatment. No additional medications were required and no significant changes in visual acuity or refraction were documented. Five patients discontinued treatment due to a severe burning sensation and were excluded from the study. Tacrolimus, 0.1% ointment, is a safe and effective treatment for VKC refractory to standard treatment and may be used as a substitute for steroid treatments used to controlled disease activity. However, adverse effects could cause poor patient compliance.

  19. [Atopic dermatitis].

    Science.gov (United States)

    Wüthrich, B

    1994-01-01

    Atopic dermatitis (AD) is a multifactorial skin disease with a chronic or a chronic-relapsing course which often starts during infancy. The persistence rate of AD after the puberty is certainly higher than mostly assumed. 60% of the patients also develop respiratory atopies as hay fever or bronchial asthma. The etiology of this distressing skin condition is still obscure, but an immunological disturbance of the T-cell immune response is most probably implicated in its pathogenesis. The demonstration of IgE-bearing epidermal Langerhans cells with high-affinity receptors for IgE opens up new perspectives in its pathophysiology. As no efficient treatment of AD is known and a symptomatic treatment, local with emolients, corticosteroids and/or disinfectants as well as internal with antihistamines, is often difficult and unsatisfactory, prevention is of particular importance. The efficacy of prolonged breast-feeding, a strict prohibition of cow milk, egg, fish--during the first six months of life--and of keeping pets as well as a consequent treatment against house-dust mites can reduce the incidence of AD in 'at risk' children with a family history of atopy. Besides symptomatic treatment a substitution of essential fatty acids, a UV therapy and a climate therapy are other possible approaches in the management of such patients.

  20. Tacrolimus in Corticosteroid-Refractory Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Chatterjee, Samrat; Agrawal, Deepshikha

    2016-11-01

    To evaluate the efficacy of 0.03% tacrolimus in the treatment of corticosteroid-refractory vernal keratoconjunctivitis (VKC). This open-label study enrolled 30 patients with VKC who were not responding to topical corticosteroid treatment for at least 4 weeks. All patients were treated with 0.03% tacrolimus eye ointment 3 times daily, 0.05% ketotifen eye drops twice daily, and preservative-free artificial tears. Symptoms (itching, redness, watering, discharge, burning, and photophobia) and signs (conjunctival injection, papillae, cobblestone papillae, limbal inflammation, or hypertrophy and corneal epithelial staining) were graded on a 4-point scale at enrolment, after 4 weeks, and at the end of treatment period, which was at 12 weeks. Composite scores for symptoms and signs were computed by summing individual scores. Treatment failure was denoted if additional treatment with corticosteroids were required. The composite scores for symptoms (10.8, 3.8, 3.4) and signs (8.7, 4.7, 4.0) in 23 patients showed a statistically significant (P < 0.05) improvement from baseline to the 4- and 12-week visits. Among the signs, upper tarsal papilla showed improvement only at 12 weeks, but the scores for giant cobblestone papillae did not reach statistically significant reduction even at 12 weeks. There was improvement in visual acuity at 12 weeks, although it was not statistically significant (P = 0.05). Treatment failure was recorded in 17% patients. The only adverse effect reported was transient stinging sensation lasting for a few days. Tacrolimus 0.03% was apparently safe and effective in treating patients with steroid-refractory VKC. A small subset of patients may still require supplemental topical corticosteroids for resolution of their symptoms.

  1. Vernal keratoconjunctivitis-like disease in adults.

    Science.gov (United States)

    Leonardi, Andrea; Lazzarini, Daniela; Motterle, Laura; Bortolotti, Massimo; Deligianni, Velika; Curnow, S John; Bonini, Stefano; Fregona, Iva A

    2013-05-01

    To identify clinical, demographic, immunologic, and health-related quality-of-life data from a cohort of vernal keratoconjunctivitis (VKC) patients with the onset of the disease after puberty (VKC-like disease). Retrospective, observational case series. Forty-nine patients with late-onset VKC-like disease from among 600 consecutive VKC patients. History of disease, test results for allergen sensitivity, signs and symptoms, impact of disease on work productivity, health-related quality of life, and treatment satisfaction were assessed. In addition, multiplex bead analysis for Th1/Th2 cytokines were carried out in tear samples from 20 VKC patients (10 adults and 10 children) and from 10 normal subjects. A family history of allergy was positive in only 28% and positive prick test results were present in 55% of the 49 VKC-like adult patients. Based on typical signs and symptoms, 48% were affected by the limbal form, 33% were affected by the tarsal form, and 19% were affected by the mixed form. Corneal ulcer complicated the disease in only 2 adult patients. Although the disease was not considered a limiting factor for work, productivity was reduced by 26% and social activities were reduced by 31% during active flare-ups. No significant differences were found in tear cytokine pattern production between VKC in children and VKC in adults. A late onset VKC-like disease can appear in young adults with signs and symptoms similar to those in pediatric disease, but with less corneal involvement. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Tear ferning in normal dogs and dogs with keratoconjunctivitis sicca ...

    African Journals Online (AJOL)

    This study evaluates tear ferning as an ancillary technique for the evaluation of the canine tear film in normal eyes and eyes affected by keratoconjunctivitis sicca (KCS). Thirty dogs with KCS and 50 control dogs with normal tear film were evaluated with a full ophthalmoscopic examination and a Schirmer tear test type 1 ...

  3. Topographic corneal changes in patients with vernal keratoconjunctivitis.

    Science.gov (United States)

    Dantas, Paulo Elias Correa; Alves, Milton Ruiz; Nishiwaki-Dantas, Maria Cristina

    2005-01-01

    To carry out a case-control clinical study in patients with vernal keratoconjunctivitis, aiming at information about the anterior corneal curvature and visual performance using a quantitative corneal descriptor analyzer (Holladay Diagnostic Summary). We examined 342 eyes of 171 patients divided into 2 groups. Group 1 with 142 eyes of 71 patients with a clinical diagnosis of vernal keratoconjunctivitis (cases) and Group 2 with 200 eyes of 100 patients (controls) from the Department of Ophthalmology/"Santa Casa" of São Paulo. Patients were submitted to a complete examination and corneal topography with a quantitative corneal surface contour descriptor (Holladay Diagnostic Summary). Clinical and topographic criteria were established to diagnose keratoconus in both groups. The frequency of patients with a clinical diagnosis of keratoconus associated with vernal keratoconjunctivitis in Group 1 was 9.85% (7 patients). According to topographic criteria, the frequency in Group 1 was 22.53% (16 patients). In Group 2, no patient presented biomicroscopic, refratometric or topographic characteristics of keratoconus. All studied topographic variables, including corneal asphericity, presented statistical significance (pvernal keratoconjunctivitis. Visual performance is compromised by aberrations and changes in corneal asphericity and other topographic variables.

  4. Hyposensitization in the treatment of resistant cases of vernal keratoconjunctivitis.

    Science.gov (United States)

    Mahdy, Reda A; Nada, Waled M; Shahien, Ezzat A; Boghdadi, Ghada A; Marei, Ayman A

    2010-09-01

    The study evaluated the treatment of resistant cases of vernal keratoconjunctivitis by hyposensitization resulting from intradermal skin reactions of different allergens. This prospective study was carried out in the Department of Ophthalmology and the Department of Microbiology and Immunology, Zagazig University, and included 36 patients with bilateral vernal keratoconjunctivitis that was resistant to topical corticosteroids and antihistaminic drugs. Patients were subjected to intradermal skin reactions to different allergens after stoppage of the medication. Subcutaneous injections of different allergens were administered in addition to topical vasoconstrictor and antihistaminic eye drops for different durations of 12, 18, and 24 months. The study revealed that most of the patients were sensitive to pollens (65%), house dust (55%), and tobacco smoke (40%). Among 36 total patients who received different doses of allergens, 10 of 20 patients showed marked improvement following a 24-month treatment period, with a 50% success rate. Another 3 of 9 patients showed marked improvement following an 18-month treatment period, with a 33.3% success rate. The use of intradermal skin reactions to determine the sensitivity for different stimulating allergens in resistant cases of vernal keratoconjunctivitis was conclusive. Treatment by hyposensitization using prepared vaccines had an acceptable success rate especially in patients treated for 24 months. Future studies will be needed to determine how effective this treatment is with other allergens and for longer durations of hyposensitization. Additional immunologic studies will be essential for developing a strategy of management of resistance in such cases of resistant vernal keratoconjunctivitis.

  5. Lacrimomimetic effect of lopieal cyclosporins A in canine keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Carlos Horário Lightowler

    1993-12-01

    Full Text Available The authors make a description of the results attained with the topical use of keratoconjunctivitis sicca. In all treated cases they observed an increase in the values of the Schirmer tear test marked improvement of the eyes and furthermore an attenuation of the melanic pigment deposited on the cornea.

  6. Prevalence of Keratoconjunctivitis Sicca among adults in Abia State ...

    African Journals Online (AJOL)

    Keratoconjunctivitis Sicca (KSC) is autoimmune inflammation process that occurs mostly in middle age and in older population. It has been shown to occur due ... in the elderly and middle aged. Eye care practitioners are thus encouraged to take proper case history in order to diagnose KCS whenever the case is presented.

  7. Atopic dermatitis: professional orientation.

    Science.gov (United States)

    Frimat, Paul; Boughattas, Wided; Even, Dorothée

    2015-01-01

    Atopic dermatitis is often exacerbated by the working environment. In order to reduce the risk of allergy, young people must receive better medical guidance when they choose a career. This is all the more relevant for young atopic patients.

  8. Challenging Treatment of Ocular Surface Squamous Neoplasia in Patients with Atopic Disease.

    Science.gov (United States)

    Zhang, Lily; Mercado, Carolina; Galor, Anat; Holland, Edward J; Wang, Gaofeng; Karp, Carol L

    2017-11-30

    Few studies have described ocular surface squamous neoplasia (OSSN) and its association with atopic diseases and there is no consensus on the course of OSSN in atopic patients. We thereby report three patients with atopy and OSSN. Retrospective case series. Three male patients with mean age of 73 presented with OSSN and history of atopy treated with immunosuppressant therapy. Their histories included atopic dermatitis and keratoconjunctivitis. All patients had treatment complicated by multiple surgeries, recurrences, or advanced disease. The patients initially received medical treatment with topical interferon-alpha-2b (IFNα2b). However, all the patients had recurrences and required modification of treatment including topical 5-fluorouracil (5-FU). We report on three patients with a history of atopy whose OSSN presentation and course was challenging. Overall, our cases responded better to topical 5-fluorouracil compared to topical interferon-alpha-2b, but recurrences were common. These patients may benefit from more aggressive and long-term treatment.

  9. Itch in Atopic Dermatitis.

    Science.gov (United States)

    Kido-Nakahara, Makiko; Furue, Masutaka; Ulzii, Dugarmaa; Nakahara, Takeshi

    2017-02-01

    Chronic itch in inflammatory skin diseases, such as atopic dermatitis, markedly diminishes the quality of life of affected individuals. Comprehensive progress has been made in understanding itch signaling and associated mediators in the skin, dorsal root ganglia, spinal cord, and central nervous system, which may amplify or suppress atopic itch. Conventional therapies for atopic dermatitis are capable of reducing atopic itch; however, most patients are not satisfied with the antipruritic capacity of conventional treatments. Exploring itch pathways and mechanisms may lead to novel therapeutic approaches for atopic itch. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Allergens in atopic dermatitis.

    Science.gov (United States)

    Dai, Y-S

    2007-12-01

    Allergens play an essential role in atopic dermatitis, either intrinsic or extrinsic. They provoke cutaneous inflammation via IgE-dependent and cell-mediated immune reactions. Food allergens have a well-known contribution to disease activity of atopic dermatitis, especially in infants and young children. However, the importance of inhaled allergens is still under investigation. For clinical implication, identification of individualized allergens is an ideal strategy for better control of atopic dermatitis and avoidance of atopic march. The aim of this article is to discuss the common allergens in atopic dermatitis (AD), the specificity and sensitivity of laboratory tests for allergens, and the clinical effect of various preventions.

  11. Evaluation of FcεRl-binding serum IgE in patients with ocular allergic diseases

    Directory of Open Access Journals (Sweden)

    Satoru Matsumoto

    1999-01-01

    Full Text Available We evaluated high-affinity receptor for IgE (FcεRI- binding serum IgE in patients with atopic keratoconjunctivitis (AKC; n=31 and with seasonal allergic conjunctivitis (SAC; n=13 by enzyme-linked immunosorbent assay (ELISA using a recombinant soluble form of the human FcεRIα ectodomain (soluble α. The quantities of FcεRI-binding IgE are compared with those of total IgE measured by a conventional sandwich ELISA. Both of the quantities of FcεRI-binding and total IgE in AKC were significantly larger than those in SAC (P<0.001. In contrast, the proportion of FcεRI- binding IgE (FcεRI-binding IgE/total IgE; % in SAC was significantly larger than that in AKC (P <0.001, although significant reverse correlation was observed between the proportion of FcεRI-binding IgE and total IgE in both AKC and SAC. Significantly, a higher proportion of FcεRI-binding IgE in SAC than that in AKC may reflect the differences in pathologic states of AKC and SAC that are caused by a disparity in immune responses in these diseases.

  12. Atopic dermatitis, atopic eczema, or eczema?

    DEFF Research Database (Denmark)

    Kantor, R; Thyssen, J P; Paller, A S

    2016-01-01

    terms for AD. METHODS: A systematic review of the MEDLINE, EMBASE, and LILACS (1945-2016) for the terms AD, atopic eczema (AE), and multiple other eczematous disorders. RESULTS: In MEDLINE, 33 060 were identified, of which 21 299 (64.4%) publications used the term 'AD', 15 510 (46.9%) 'eczema', and only...... 2471 (7.5%) AE. Most of these publications used the term AD (82.0%) or eczema (70.8%) without additional nomenclature; only 1.2% used AE alone. Few publications used the terminology 'childhood eczema', 'flexural eczema', 'infantile eczema', 'atopic neurodermatitis', or 'Besnier's prurigo'. AD...... was rarely used until the late 1970s, after which it became the most commonly used of the three terms and continuously increased until 2015. Atopic eczema decreased between 2008 and 2015. Atopic dermatitis was the most commonly used term in studies across almost all publication types, languages, and journals...

  13. Brimonidine allergy presenting as vernal-like keratoconjunctivitis.

    Science.gov (United States)

    Shah, Aparna A; Modi, Yasha; Thomas, Benjamin; Wellik, Sarah R; Galor, Anat

    2015-01-01

    To report a brimonidone-induced allergic reaction that mimicked a limbal form of vernal keratoconjunctivitis in the setting of background ocular surface toxicity. A 78-year-old male with a history of primary open angle glaucoma presented with symptoms of unilateral blurry vision, irritation, and redness shortly after starting brimonidine exclusively in the right eye. Examination revealed injected palpebral and bulbar conjunctiva, diffuse punctate epithelial erosion and discrete, non-staining corneal limbal infiltrates superiorly. Given the unilateral presentation, the patient was diagnosed with an allergic limbal keratoconjunctivitis secondary to bromonidine. Shortly after discontinuing the brimonidine, there was full resolution of the corneal limbal infiltrates. The punctate epithelial erosions and tear film abnormalities remained. Direct medication allergy and ocular surface disease are two distinct entities that often co-exist. Distinguishing between the two entities, sometimes by trial and error, is critical in the management of these patients.

  14. Clinical presentation of vernal keratoconjunctivitis in Bharatpur Medical College

    Directory of Open Access Journals (Sweden)

    Polina Dahal

    2015-11-01

    Full Text Available Background & Objectives: To evaluate the different clinical presentation of Vernal Keratoconjunctivitis (VKC in our context.Materials & Methods: Ninety diagnosed VKC patients attending the outpatient department of College of Medical Sciences from 1st March 2014 to 1st June 2015 were enrolled in the study.Results: The study revealed male predominance (83.33%. Commonly occurring symptoms were itching (100% and redness (80%. Commonest sign was tarsal papillae (100%. Conjunctival hyperemia was seen in 94.1% cases and 180 eyes of 90 cases showed Vernal Keratoconjunctivitis.Conclusion: The clinical presentation of VKC patients in our context are very much similar to the findings of the other study done in Nepal and other parts of the world. Commonly occurring symptoms are itching, redness and commonly occurring signs are tarsal papillae and conjunctival hyperemia.JCMS Nepal. 2015; 11(2:17-19

  15. Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Nikhil S Gokhale

    2012-01-01

    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.

  16. Kingella kingae Keratitis in a Child with Underlying Vernal Keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Salim Nurul-Laila

    2017-01-01

    Full Text Available Kingella kingae had rarely been reported as a causative organism for corneal ulcer and had not been described before in vernal keratoconjunctivitis (VKC. Generally regarded as commensals of respiratory tract particularly in young children, it had however been isolated from the corneal ulcer scraping of both adult and children. We report a case of bacterial ulcer with isolation of Kingella kingae from the corneal scraping in a young child with underlying VKC.

  17. Kingella kingae Keratitis in a Child with Underlying Vernal Keratoconjunctivitis

    OpenAIRE

    Salim Nurul-Laila; Khai-Siang Chai; Ahmad Tajudin Liza-Sharmini; Ismail Shatriah

    2017-01-01

    Kingella kingae had rarely been reported as a causative organism for corneal ulcer and had not been described before in vernal keratoconjunctivitis (VKC). Generally regarded as commensals of respiratory tract particularly in young children, it had however been isolated from the corneal ulcer scraping of both adult and children. We report a case of bacterial ulcer with isolation of Kingella kingae from the corneal scraping in a young child with underlying VKC.

  18. Kingella kingae Keratitis in a Child with Underlying Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Nurul-Laila, Salim; Chai, Khai-Siang; Liza-Sharmini, Ahmad Tajudin; Shatriah, Ismail

    2017-01-01

    Kingella kingae had rarely been reported as a causative organism for corneal ulcer and had not been described before in vernal keratoconjunctivitis (VKC). Generally regarded as commensals of respiratory tract particularly in young children, it had however been isolated from the corneal ulcer scraping of both adult and children. We report a case of bacterial ulcer with isolation of Kingella kingae from the corneal scraping in a young child with underlying VKC.

  19. Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis

    Science.gov (United States)

    Gokhale, Nikhil S; Samant, Rohini; Sharma, Vishnu

    2012-01-01

    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. PMID:22569387

  20. Atopic dermatitis -- self-care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000418.htm Atopic dermatitis - self-care To use the sharing features on ... skin disorder characterized by scaly and itchy rashes. Atopic dermatitis is the most common type. Atopic dermatitis is ...

  1. Recent Patents and Emerging Therapeutics in the Treatment of Allergic Conjunctivitis

    Science.gov (United States)

    Mishra, Gyan P.; Tamboli, Viral; Jwala, Jwala; Mitra, Ashim K.

    2011-01-01

    Ocular allergy is an inflammatory response of the conjunctival mucosa that also affects the cornea and eyelids. Allergic conjunctivitis includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and giant papillary conjunctivitis (GPC). In general, allergic conditions involve mast cell degranulation that leads to release of inflammatory mediators and activation of enzymatic cascades generating pro-inflammatory mediators. In chronic ocular inflammatory disorders associated with mast cell activation such as VKC and AKC constant inflammatory response is observed due to predominance of inflammatory mediators such as eosinophils and Th2-generated cytokines. Antihistamines, mast-cell stabilizers, non-steroidal anti-inflammatory agents, corticosteroids and immunomodulatory agents are commonly indicated for the treatment of acute and chronic allergic conjunctivitis. In recent years newer drug molecules have been introduced in the treatment of allergic conjunctivitis. This article reviews recent patents and emerging therapeutics in the treatment of allergic conjunctivitis. PMID:21171952

  2. Primary Sjögren's syndrome and keratoconjunctivitis sicca: Diagnostic methods, frequency and social disease aspects

    DEFF Research Database (Denmark)

    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...

  3. VERNAL KERATOCONJUNCTIVITIS IN SCHOOL CHILDREN IN NORTH BANGALORE: AN EPIDEMIOLOGICAL AND CLINICAL EVALUATION

    OpenAIRE

    Ashwini; Dhatri; Rajeev

    2015-01-01

    OBJECTIVE: To describe the demographic profile, clinical presentation and health seeking behaviour in children with vernal keratoconjunctivitis in north Bangalore. MATERIALS AND METHODS: Cross sectional survey of school children conducted between Feb 2014 to May 2014. Children were interviewed using a questionnaire on Vernal keratoconjunctivitis related symptoms. Children received a full eye examination including vision using snellen chart, slit lamp examination and fundus...

  4. Comorbidities of Atopic Dermatitis

    DEFF Research Database (Denmark)

    Andersen, Yuki M F; Egeberg, Alexander; Skov, Lone

    2017-01-01

    PURPOSE OF REVIEW: In this review article, we summarize the current evidence about atopic dermatitis (AD)-associated comorbidities, beyond the traditional atopic and allergic conditions. RECENT FINDINGS: Patients with AD may have an increased risk of cardiovascular diseases, certain malignancies...

  5. Atopic dermatitis 2017

    DEFF Research Database (Denmark)

    No, Daniel J; Amin, Mina; Egeberg, Alexander

    2018-01-01

    Novel and innovative treatment options for atopic dermatitis (AD) are underway. The recent advancements in understanding AD are reminiscent of the progress made in psoriasis research over a decade ago.......Novel and innovative treatment options for atopic dermatitis (AD) are underway. The recent advancements in understanding AD are reminiscent of the progress made in psoriasis research over a decade ago....

  6. Akcīzes nodokļa ietekme uz alkoholisko dzērienu un tabakas patēriņu Latvijā

    OpenAIRE

    Sergejeva, Jeļena

    2012-01-01

    Maģistra darba tēma ir „Akcīzes nodokļa ietekme uz alkoholisko dzērienu un tabakas patēriņu Latvijā”. Autore: Jeļena Sergejeva. Akcīzes nodokļa ieņēmumi no alkoholiskiem dzērieniem un tabakas izstrādājumiem aizņem būtisku daļu no valsts kopbudžeta, tomēr šīs preces ir kaitīgas veselībai. Valstij iedzīvotāju labā ir jāierobežo šis produktu patēriņš, bet ierobežošana atspoguļosies gan uz valsts ieņēmumiem, gan uz nelegālo tirdzniecību. Darbā tiek pētīti pret smēķēšanu vērstie nacionālie s...

  7. New Finding in Vernal Keratoconjunctivitis: Splendore-Hoeppli Phenomenon.

    Science.gov (United States)

    Soleimani, Mohammad; Tabatabaei, Seyed Ali; Mirshahi, Reza; Nozarian, Zohreh; Jabbarvand Behrbouz, Mahmoud

    2016-06-01

    To report 2 cases of Splendore-Hoeppli phenomenon, a rare histopathologic observation, as a late clinical finding in vernal keratoconjunctivitis (VKC). We report the cases of 2 young women with subconjunctival nodules as a manifestation of Splendore-Hoeppli phenomenon with a history of severe VKC. After eliminating other conditions causing such a reaction, both patients were treated using frequent topical corticosteroid, plus topical cyclosporine 2% in one of patient. Complete resolution was observed in both patients. The Splendore-Hoeppli phenomenon could be a part of VKC manifestations.

  8. Clinical trial with 2% sodium cromoglycate (Opticrom) in vernal keratoconjunctivitis.

    Science.gov (United States)

    El Hennawi, M

    1980-01-01

    An open assessment study was carried out during the summer of 1972 in which 2% sodium cromoglycate eyedrops were evaluated in the treatment of patients with vernal keratoconjunctivitis. A highly significant number of patients found the eyedrops effective, while a marked improvement was recorded in mild and moderate cases; in severe cases or in acute exacerbations additional steroid therapy was recommended. Sodium cromoglycate eyedrops were found to be as effective as Decadron and superior to Antistin-Privine. Furthermore SCG eyedrops could replace or reduce local steroid therapy in vernal keratoconjuntivitis and so avert the possible rise in ocular tension caused by steroids. PMID:6775687

  9. Extrinsic and idiopathic vernal keratoconjunctivitis? Two cases with dissimilar immunopathology.

    Science.gov (United States)

    Zavaro, A; Baryishak, Y R; Samra, Z; Sompolinsky, D

    1983-01-01

    Two clinically similar cases of vernal keratoconjunctivitis with dissimilar immunological data are reported. One patient had strikingly elevated IgE levels in both serum and tears, and his tear fluid contained specific IgE antibodies to a number of allergens. Conjunctival scrapings and peripheral blood samples showed marked eosinophilic reactions. The other patient showed normal values for tear and serum IgE; no IgE type antibodies to allergens were detected; and no local or systemic eosinophilic reactions were observed. The immunopathogenesis of these cases is discussed. PMID:6639909

  10. Atopic dermatitis in children.

    Science.gov (United States)

    Strathie Page, Sarah; Weston, Stephanie; Loh, Richard

    2016-05-01

    Atopic dermatitis is a frequent reason for presentation to general practice. A large number of children are affected by this condition and its treatment can cause significant anxiety for parents. The role of the general practitioner (GP) is to provide advice and allay concerns regarding conventional and alternative treatments. The aim of this article is to provide an overview of atopic dermatitis management in children in the general practice setting. This article also reviews when it is necessary to refer to specialists, the evidence for management and the link to allergies. Prescribing topical steroids to young children with atopic dermatitis involves a thorough understanding of this condition. Achieving treatment compliance partly involves providing adequate explanation to parents in order to reduce their concerns regarding the long-term side effects of topical corticosteroids. Making GPs confident and knowledgeable about atopic dermatitis will make the interaction between the practitioner, families and children more rewarding.

  11. Supratarsal injection of triamcinolone for severe vernal keratoconjunctivitis in children

    Directory of Open Access Journals (Sweden)

    Alexandre Xavier da Costa

    Full Text Available ABSTRACT Purpose: To evaluate the use of supratarsal injection of triamcinolone acetonide in severe vernal keratoconjunctivitis (VKC in children. Methods: Patients included in this open clinical trial were those with severe VKC-associated with keratitis, gelatinous limbal infiltrates, and/or giant papillae, with a history of recurrence and resistance to conventional topical antiallergic agents. Patients were treated with a supratarsal injection of 20 mg triamcinolone acetonide. Results: Analysis included 27 injections in 23 eyes of 17 patients with severe allergic keratoconjunctivitis. Mean age was 12.3 (range: 7-19 years. Mean follow-up time was 39.3 months (SD=19.21. In the 17 patients, the disease was successfully controlled for an average of 3.6 months (range: 1-16, during which allergy symptoms and signs were significantly improved, with complete resolution of lid edema and conjunctival chemosis, significant decline of pannus and keratitis, and reduction of giant papillae size. Conclusion: Treatment of severe, acute VKC in children with supratarsal injection of 20 mg triamcinolone acetonide showed satisfactory results and was well tolerated by patients; it may therefore constitute a safe option for severe and challenging cases. While full disease remission was not achieved, a significant improvement was found in ocular allergy symptoms and signs, with a reduction in the frequency of acute recurrences.

  12. Supratarsal injection of triamcinolone for severe vernal keratoconjunctivitis in children.

    Science.gov (United States)

    Costa, Alexandre Xavier da; Gomes, José Álvaro Pereira; Marculino, Leonardo Guedes Candido; Liendo, Vera Lucia; Barreiro, Telma Pereira; Santos, Myrna Serapião Dos

    2017-06-01

    To evaluate the use of supratarsal injection of triamcinolone acetonide in severe vernal keratoconjunctivitis (VKC) in children. Patients included in this open clinical trial were those with severe VKC-associated with keratitis, gelatinous limbal infiltrates, and/or giant papillae, with a history of recurrence and resistance to conventional topical antiallergic agents. Patients were treated with a supratarsal injection of 20 mg triamcinolone acetonide. Analysis included 27 injections in 23 eyes of 17 patients with severe allergic keratoconjunctivitis. Mean age was 12.3 (range: 7-19) years. Mean follow-up time was 39.3 months (SD=19.21). In the 17 patients, the disease was successfully controlled for an average of 3.6 months (range: 1-16), during which allergy symptoms and signs were significantly improved, with complete resolution of lid edema and conjunctival chemosis, significant decline of pannus and keratitis, and reduction of giant papillae size. Treatment of severe, acute VKC in children with supratarsal injection of 20 mg triamcinolone acetonide showed satisfactory results and was well tolerated by patients; it may therefore constitute a safe option for severe and challenging cases. While full disease remission was not achieved, a significant improvement was found in ocular allergy symptoms and signs, with a reduction in the frequency of acute recurrences.

  13. Corneal Complications And Visual Impairment In Vernal Keratoconjunctivitis Patients.

    Science.gov (United States)

    Arif, Abdus Salam; Aaqil, Bushra; Siddiqui, Afsheen; Nazneen, Zainab; Farooq, Umer

    2017-01-01

    Vernal kerato-conjunctivitis (VKC) is an infrequent but serious form of allergic conjunctivitis common in warm and humid areas where air is rich in allergens. It affects both eyes asymmetrically. Although VKC is a self-limiting disease but visions affecting corneal complications influence the quality of life in school children. The aim of this study was to list the corneal complications due to this condition and to find out the extent of visual impairment among VKC patients. This cross-sectional study was conducted in the department of Ophthalmology, Benazir Bhutto Shaheed Hospital on 290 eyes of diagnosed cases of VKC. The diagnosis of VKC was made on the basis of history and examination. Visual acuity was recorded using Snellen's notation and visual impairment was classified according to World Health Organization classification for visual disabilities. The mean age of presentation was 10.83±6.13 years. There were 207 (71.4%) males and 83 (28.6%) females. Corneal scarring was observed in 59 (20.3%) eyes. Keratoconus was found to be in 17 (5.9%) eyes. Shield ulcer was detected in 09 (3.1%) eyes while 07 (2.4%) eyes had corneal neovascularization. Majority of the patients with visual loss had corneal scarring and the complication that led to severe visual loss in most of the eyes was Keratoconus. Vernal kerato-conjunctivitis in the presence of corneal complications is a sight threatening disease and can lead to severe visual impairment.

  14. Safety and efficacy of lodoxamide in vernal keratoconjunctivitis.

    Science.gov (United States)

    Das, Dial; Khan, Moosa; Gul, Ali; Alam, Raffique

    2011-03-01

    To observe the safety and efficacy of topical Lodoxamide eye drops in patients with diagnosed vernal keratoconjunctivitis (VKC). This study was conducted at Department of Pharmacology and Therapeutics, BMSI, JPMC, Karachi in collaboration with Department of Ophthalmology, JPMC, Karachi, from April to October, 2009. A total of forty patients with diagnosed vernal keratoconjunctivitis were selected and enrolled consecutively from the out patient department (OPD) of Ophthalmology. Each patient received two drops of Lodoxamide eye drops topically in each eye four times daily. Patients were examined with a torch and slit lamp at baseline and follow-up visits. Out of 40 patients included, 39 completed the study and there was a significant effect of the drug on symptoms and signs of the disease. At the end of the study, 38 (97.4%) were cured, with few side effects. The cure criteria was based on patient's history of becoming symptom-free and resolution of ocular signs. Topical lodoxamide eye drops, when used for treatment of VKC, are effective with fewer adverse effects.

  15. Conjunctival Inclusion Cysts in Long-standing Chronic Vernal Keratoconjunctivitis

    Science.gov (United States)

    Lee, Seung-Won; Lee, Seung-Chan

    2007-01-01

    Purpose To report a case of conjunctival inclusion cysts on the corneal limbus of a patient with chronic vernal keratoconjunctivitis during 16 months' follow up Methods The patient was a 26 year old male without any specific history of surgery or trauma. Giant papillae, shield ulcers, and Horner-Trantas dots were detected. During the 16 month follow-up, Sodium cromoglycate eye drops and Prednisolone acetate 1% eye drops were given 3 times a day. During this period, conjunctival cysts were detected on the corneal limbus in both eyes. In spite of improvement of the corneal and conjunctival conditions, the conjunctival cysts did not seem to show any specific changes. For relief of foreign body sensation, excision of the conjunctival cysts and giant papillae of the left eye and histopathologic examination of the specimen was performed. Results On histopathological examination, the conjunctival cysts consisted of nonkeratinizing stratified epithelial cells filled with PAS-positive mucous substance. Inflammatory cells were not found in the vicinity. Conclusions Conjunctival inclusion cysts can be seen as an atypical finding of long-standing vernal keratoconjunctivitis. Mechanical friction between the giant papillae and conjunctiva may be a factor in inducing the formation of the conjunctival cysts. PMID:18063892

  16. Flexural eczema versus atopic dermatitis.

    Science.gov (United States)

    Jacob, Sharon E; Goldenberg, Alina; Nedorost, Susan; Thyssen, Jacob P; Fonacier, Luz; Spiewak, Radoslaw

    2015-01-01

    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 cannot be assumed as atopic without further testing. Patch testing should at least be considered in cases of chronic or recurrent eczema regardless of the working diagnosis.

  17. Therapy of atopic eczema

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2006-10-01

    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. [1]. 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

  18. Dry Eye in Vernal Keratoconjunctivitis: A Cross-Sectional Comparative Study

    National Research Council Canada - National Science Library

    Villani, Edoardo; Strologo, Marika Dello; Pichi, Francesco; Luccarelli, Saverio V; De Cillà, Stefano; Serafino, Massimiliano; Nucci, Paolo

    2015-01-01

    The purpose of this comparative cross-sectional study was to investigate the use of standardized clinical tests for dry eye in pediatric patients with active and quiet vernal keratoconjunctivitis (VKC...

  19. Prevalence and associated factors of vernal keratoconjunctivitis among children in Gondar city, Northwest Ethiopia

    OpenAIRE

    Hayilu, Dereje; Legesse,Kbrom; Lakachew, Natinael; Asferaw, Mulusew

    2016-01-01

    Background Vernal keratoconjunctivitis (VKC) is a common cause of ocular morbidity in children in warm dry climates such as Sub?Saharan Africa and accounts for about 3?% of serious ophthalmic cases in tropical countries. The purpose of this study was to assess the prevalence and associated factors of vernal keratoconjunctivitis among children living in Gondar City, Ethiopia. Methods A Cross Sectional Design study was carried out in 737 children under the age of 18?years in Gondar City from Ap...

  20. The Use of Bandage Contact Lenses in Adenoviral Keratoconjunctivitis.

    Science.gov (United States)

    Uçakhan, Ömür; Yanik, Özge

    2016-11-01

    To evaluate the safety and efficacy of the use of the bandage contact lenses (BCLs) in adenoviral keratoconjunctivitis-related ocular surface problems. Fifteen eyes of 15 consecutive patients presenting at the Ankara University Medical Center, Cornea and Contact Lens Service, and requiring BCL use for adenoviral keratoconjunctivitis-related ocular surface problems were enrolled. Visual acuity, slitlamp examination findings, indication and duration of the BCL use, the total follow-up, and any adjuvant medication were recorded. All patients were followed regarding the success of treatment and adverse effects associated with BCL use. The average age at the time of presentation was 26.8±15.5 years. The major reasons for BCL use included epithelial defect (7 eyes), filamentous keratopathy (5 eyes), epithelial edema (1 eyes), and filamentous keratopathy together with epithelial defect (2 eyes). After the first appearance of conjunctivitis symptoms, the mean time to BCL application was 9.0±3.9 days. The mean duration of contact lens wear was 9.9±6.5 days, and the mean follow-up was 26.4±15.8 days. Preservative-free artificial tears and topical antibiotics were used in all cases. Besides, topical ganciclovir 0.15% gel (8 eyes), topical 0.4% povidone-iodine solution (9 eyes), and topical steroids (11 eyes) were used in various combinations. At the end of the follow-up period, the mean visual acuity improved from 0.23±0.32 logMAR units (∼0.6 Snellen line) to 0.0l±0.04 logMAR units (∼1.0 Snellen line) (P=0.042). No sight-threatening complication related to contact lens wear was encountered. Adjuvant use of BCLs seems to be safe and effective in the treatment of adenoviral keratoconjunctivitis-related ocular surface problems. Close follow-up and prophylactic use of topical antibiotics are rationalistic for prevention of secondary infections.

  1. Tear levels of macrophage migration inhibitory factor in vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Onur Çatak

    2013-06-01

    Full Text Available Objective: The pathogenesis of vernal keratoconjunctivitis(VKC is not fully understood and cannot be explainedonly with type I hypersensitivity reaction. The aim of thisstudy was to determine the Macrophage migration inhibitoryfactor (MIF levels in tear fluids of patients with VKC.Methods: Tear fluid samples were collected with microcapillarytubes for hematocrit at the lateral canthus ofpatients in the supine position without any anesthesia.Tear levels of MIF were measured by ELISA kit. Tear fluidsamples were collected from 10 healthy subjects and 20patients with VKC.Results: Tear levels of MIF in patients with VKC weresignificantly higher than those in controls (p<0,001.Conclusion: These results suggested that MIF may havesignificant effect on the pathogenetic process of VKC. JClin Exp Invest 2013; 4 (2: 195-198Key words: Macrophage migration inhibitory factor, vernalkeratoconjunctivitis, ELISA

  2. Impact of Vernal Keratoconjunctivitis on School Children in Egypt.

    Science.gov (United States)

    Marey, Hatem M; Mandour, Sameh S; El Morsy, Osama A; Farahat, Hassan G; Shokry, Shaimaa M

    2017-01-01

    To evaluate the prevalence of vernal keratoconjunctivitis (VKC) and its impact on school children in Egypt. A total of 3,706 students from six randomly selected schools of Menoufia were included where 126 had symptoms according to the VKC related symptoms questionnaire. Selected children were referred to a hospital for further assessment. The mean age of included children was 8.79±31.87 years, with a VKC prevalence of 3.3%, and male-to-female ratio of 2.3:1. The most frequently reported symptoms were ocular itching, followed by burning sensation, tearing, red eye, discharge, and photophobia. Signs vary between mild and severe cases; however, all cases had a negative impact on school attendance and performance. The prevalence of VKC differs according to the age group of included cases and the local temperature of the study area. School attendance, performance, lifestyle, and social activities were negatively affected by VKC.

  3. Treatment of asymmetrical vernal keratoconjunctivitis with supratarsal corticosteroid injection.

    Science.gov (United States)

    Thanathanee, Onsiri; Bhoomibunchoo, Chavakij; Suwan-apichon, Olan

    2014-11-19

    A 6-year-old Thai girl presented with itching, redness and copious discharge in both eyes. Slit-lamp biomicroscopy of the left eye revealed cobblestone papillae with marked ptosis while in the right eye only small papillae were observed. Punctuate epithelial keratitis was noted only in the left eye. There were no associated factors for giant papillary conjunctivitis (ie, suture or contact lens). The cobblestone papillae in the left eye persisted after maximal topical and oral antiallergic medications. Two doses of supratarsal corticosteroid (20 mg of triamcinolone acetonide) injection without any topical or oral antiallergic medications were undertaken in the left eye 1 month apart. Cobblestone papillae and punctate epithelial erosion (including allergic symptoms) were completely recovered. There was no recurrence after 18 months of follow-up. This case report indicates that using supratarsal corticosteroid injection by itself in recalcitrant vernal keratoconjunctivitis provides promising results. 2014 BMJ Publishing Group Ltd.

  4. Flexural eczema versus atopic dermatitis

    DEFF Research Database (Denmark)

    Jacob, Sharon E; Goldenberg, Alina; Nedorost, Susan

    2015-01-01

    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...

  5. Protein Linked to Atopic Dermatitis

    Science.gov (United States)

    ... Research Matters January 14, 2013 Protein Linked to Atopic Dermatitis Normal skin from a mouse (left) shows no ... that lack of a certain protein may trigger atopic dermatitis, the most common type of eczema. The finding ...

  6. New insights into atopic dermatitis

    National Research Council Canada - National Science Library

    Leung, Donald Y M; Boguniewicz, Mark; Howell, Michael D; Nomura, Ichiro; Hamid, Qutayba A

    2004-01-01

    Atopic dermatitis is a chronic inflammatory skin disease associated with cutaneous hyperreactivity to environmental triggers and is often the first step in the atopic march that results in asthma and allergic rhinitis...

  7. Vernal keratoconjunctivitis: a severe allergic eye disease with remodeling changes.

    Science.gov (United States)

    Vichyanond, Pakit; Pacharn, Punchama; Pleyer, Uwe; Leonardi, Andrea

    2014-06-01

    Vernal keratoconjunctivitis (VKC) is an unusually severe sight-threatening allergic eye disease, occurring mainly in children. Conventional therapy for allergic conjunctivitis is generally not adequate for VKC. Pediatricians and allergists are often not familiar with the severe clinical symptoms and signs of VKC. As untreated VKC can lead to permanent visual loss, pediatric allergists should be aware of the management and therapeutic options for this disease to allow patients to enter clinical remission with the least side effects and sequelae. Children with VKC present with severe ocular symptoms, that is, severe eye itching and irritation, constant tearing, red eye, eye discharge, and photophobia. On examination, giant papillae are frequently observed on the upper tarsal conjunctiva (cobblestoning appearance), with some developing gelatinous infiltrations around the limbus surrounding the cornea (Horner-Trantas dot). Conjunctival injections are mostly severe with thick mucus ropy discharge. Eosinophils are the predominant cells found in the tears and eye discharge. Common therapies include topical antihistamines and dual-acting agents, such as lodoxamide and olopatadine. These are infrequently sufficient and topical corticosteroids are often required for the treatment of flare ups. Ocular surface remodeling leads to severe suffering and complications, such as corneal ulcers/scars. Other complications include side effects from chronic topical steroids use, such as increased intraocular pressure, glaucoma, cataract and infections. Alternative therapies for VKC include immunomodulators, such as cyclosporine A and tacrolimus. Surgery is reserved for those with complications and should be handled by ophthalmologists with special expertise. Newer research on the pathogenesis of VKC is reviewed in this article. Vernal keratoconjunctivitis is a very important allergic eye disease in children. Complications and remodeling changes are unique and can lead to blindness

  8. Japanese Guideline for Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Ichiro Katayama

    2011-01-01

    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 2009 (ADGL2009” prepared by the Atopic Dermatitis Guidelines Advisory Committee, Japanese Society of Allergology in principle.

  9. Omalizumab for atopic dermatitis

    DEFF Research Database (Denmark)

    Holm, Jesper Grønlund; Agner, Tove; Sand, Carsten

    2017-01-01

    Omalizumab is a recombinant humanized monoclonal antibody targeting the high-affinity Fc receptor of IgE, registered for the treatment of chronic spontaneous urticaria and severe allergic asthma. We present a case series of nine patients with atopic dermatitis (AD) treated off-label with omalizumab...

  10. Detection of equine herpesvirus in horses with idiopathic keratoconjunctivitis and comparison of three sampling techniques.

    Science.gov (United States)

    Hollingsworth, Steven R; Pusterla, Nicola; Kass, Philip H; Good, Kathryn L; Brault, Stephanie A; Maggs, David J

    2015-09-01

    To determine the role of equine herpesvirus (EHV) in idiopathic keratoconjunctivitis in horses and to determine whether sample collection method affects detection of EHV DNA by quantitative polymerase chain reaction (qPCR). Twelve horses with idiopathic keratoconjunctivitis and six horses without signs of ophthalmic disease. Conjunctival swabs, corneal scrapings, and conjunctival biopsies were collected from 18 horses: 12 clinical cases with idiopathic keratoconjunctivitis and six euthanized controls. In horses with both eyes involved, the samples were taken from the eye judged to be more severely affected. Samples were tested with qPCR for EHV-1, EHV-2, EHV-4, and EHV-5 DNA. Quantity of EHV DNA and viral replicative activity were compared between the two populations and among the different sampling techniques; relative sensitivities of the sampling techniques were determined. Prevalence of EHV DNA as assessed by qPCR did not differ significantly between control horses and those with idiopathic keratoconjunctivitis. Sampling by conjunctival swab was more likely to yield viral DNA as assessed by qPCR than was conjunctival biopsy. EHV-1 and EHV-4 DNA were not detected in either normal or IKC-affected horses; EHV-2 DNA was detected in two of 12 affected horses but not in normal horses. EHV-5 DNA was commonly found in ophthalmically normal horses and horses with idiopathic keratoconjunctivitis. Because EHV-5 DNA was commonly found in control horses and in horses with idiopathic keratoconjunctivitis, qPCR was not useful for the etiological diagnosis of equine keratoconjunctivitis. Conjunctival swabs were significantly better at obtaining viral DNA samples than conjunctival biopsy in horses in which EHV-5 DNA was found. © 2015 American College of Veterinary Ophthalmologists.

  11. Prevalence and associated factors of vernal keratoconjunctivitis among children in Gondar city, Northwest Ethiopia.

    Science.gov (United States)

    Hayilu, Dereje; Legesse, Kbrom; Lakachew, Natinael; Asferaw, Mulusew

    2016-09-29

    Vernal keratoconjunctivitis (VKC) is a common cause of ocular morbidity in children in warm dry climates such as Sub-Saharan Africa and accounts for about 3 % of serious ophthalmic cases in tropical countries. The purpose of this study was to assess the prevalence and associated factors of vernal keratoconjunctivitis among children living in Gondar City, Ethiopia. A Cross Sectional Design study was carried out in 737 children under the age of 18 years in Gondar City from April to May 2015. Basic ophthalmic examination was performed using a 3x magnifying loop and torch light and a pretested and structured questionnaire was completed. The association between vernal keratoconjunctivitis and factors such as socio-economic, demographic, and environmental status, and history of allergic disease in affected children and their family members was examined using logistic regression multivariate analysis. The prevalence of vernal keratoconjunctivitis was 5.8 % (95 % CI: 4.14, 7.53) (43/737) and mixed type VKC was the most frequent form which was found in 35 out of 43 cases (81.4 %). The following were positively associated with vernal keratoconjunctivitis: use of kerosene/firewood for cooking (AOR = 6.25 (95 % CI: 1.61, 25)), child dust exposure (AOR = 10.0 (95 % CI: 4.16, 20.0)), child history of non-ocular allergic diseases (AOR = 4.0 (95 % CI: 1.92, 8.33)), family history of non-ocular allergic diseases (AOR = 3.57(95 % CI: 1.39, 9.09). There is a high prevalence of vernal keratoconjunctivitis in this region. The use of kerosene/firewood for cooking, child dust exposure, and non-ocular allergic disease in the child or their family were statistically significant risk factors for vernal keratoconjunctivitis.

  12. A simplified quantitative method for assessing keratoconjunctivitis sicca from the Sjögren's Syndrome International Registry

    DEFF Research Database (Denmark)

    Whitcher, John P; Shiboski, Caroline H; Shiboski, Stephen C

    2010-01-01

    To describe, apply, and test a new ocular grading system for assessing keratoconjunctivitis sicca (KCS) using lissamine green and fluorescein.......To describe, apply, and test a new ocular grading system for assessing keratoconjunctivitis sicca (KCS) using lissamine green and fluorescein....

  13. Inclusion keratoconjunctivitis ('pink eye') in sheep. A proposal for a new name for chlamydial keratoconjunctivitis in sheep and comment on recent clinical trials.

    Science.gov (United States)

    Bogaard, A E

    1984-09-01

    The cytoplasmatic inclusion bodies, which, in 1931, Coles discovered in the corneal cells of sheep suffering from contagious keratoconjunctivitis are now considered to be the reticulate bodies of a chlamydia, Colesiota conjunctivae (synonym: Chlamydia psittaci ovis). According to the postulates of Koch Colesiota conjunctivae is a primary cause of contagious keratoconjunctivitis in sheep, but the clinical picture is complex and is a result of the interaction between the infecting chlamydiae, host resistance factors, and secondary infections caused by opportunistic bacterial ocular pathogens. The clinical syndrome might also be caused by other micro-organisms, such as Mycoplasma conjunctivae or environmental factors, such as dust. However, in these cases, cytoplasmatic inclusion bodies cannot be found in the corneal cells of diseased eyes. To differentiate chlamydial keratoconjunctivitis from keratoconjunctivitis due to other causes, it is proposed to include in the name the laboratory findings typical for this disease: Sheep Inclusion Keratoconjunctivitis. Chlamydia are Gram-negative bacteria, which are obligate intracellular parasites. Prolonged treatment seems to be required to eradicate chlamydiae from a host and antibiotics must reach intracellular levels that are higher than their minimum inhibitory concentration for chlamydiae. Tetracyclines are the drugs of choice. This means that for a microbiological cure, diseased sheep must be injected several times a day for a week or more. Because the disease is usually self-limiting and economic losses are considered low, this seems unnecessary and control of the disease by local treatment of secondary infections seems sufficient. However, this will not prevent spreading of the disease in a herd and relapses may occur.

  14. Prevention of atopic dermatitis

    OpenAIRE

    Williams, Hywel C.; Chalmers, Joanne R; Simpson, Eric L.

    2012-01-01

    Atopic dermatitis now affects one in five children, and may progress to asthma and hay fever. In the absence of effective treatments that influence disease progression, prevention is a highly desirable goal. The evidence for most existing disease prevention strategies, such as avoidance of allergens and dietary interventions, has been unconvincing and inconsistent. Fresh approaches to prevention include trying to induce tolerance to allergens in early life, and enhancing the defective skin ba...

  15. Immunology of atopic dermatitis.

    Science.gov (United States)

    Piloto Valdés, L J; Valdés Sánchez, A F; Gómez Echevarría, A H

    1988-01-01

    Thirty-two adult patients with atopic dermatitis were studied at the Allergology Service of the "Hnos. Ameijeiras" Clinical Surgical Hospital. The diagnosis was established following the criteria of Hanifin and Lobitz. A detailed medical history was written for the patients; the study of some immunological parameters, such as the serum immunoglobulin quantification, delayed skin tests with a battery of antigens, and the spontaneous rosette-test, was also carried out. Almost all the patients showed serum IgE values above 150 UI, by means of the ELISA test modified by C.E.N.I.C. The mean values of the spontaneous rosette-test were low; this was more noticeable during the exacerbation period of the lesions. Candida sp, Mantoux and Streptokinase-Streptodornase antigens showed negative results in a high proportion of patients with atopic dermatitis, in relation with the control group. In atopic dermatitis, there are humoral disorders of immunity; this was demonstrated in our group by increased values of IgE and cellular disorders due to skin anergy, and to a low percentage of rosette forming cells; this does not allow to state that these phenomena have an active participation in the etiopathogenesis of this entity.

  16. The efficacy of topical interferon alpha 2b treatment in refractory vernal keratoconjunctivitis.

    Science.gov (United States)

    Turan-Vural, Ece; Acar, Banu Torun; Acar, Suphi

    2012-04-01

    This study aimed to investigate the efficacy and safety of a 2-month topical interferon alpha 2b treatment in patients with refractory vernal keratoconjunctivitis. Twelve (10 male, 2 female) patients with refractory vernal keratoconjunctivitis received topical treatment with one million IU/mL interferon alpha 2b 4 times a day for 2 months. Symptom and ophthalmological examination scores were assessed at baseline and during follow-up. No significant complications or side effects associated with the use of topical interferon alpha 2b were observed. Symptom scores for itching, tearing, photophobia, and total symptom score, and objective scores for corneal lesion, hyperemia, chemosis, papillary hypertrophy, secretion, and total examination score significantly improved during the 2-month treatment. Improvements were maintained after discontinuation of the treatment for most parameters. Topical interferon alpha 2b treatment seems to offer a safe and effective alternative for the treatment of refractory vernal keratoconjunctivitis for a brief period.

  17. An outbreak of epidemic keratoconjunctivitis at an outpatient ophthalmology clinic

    Directory of Open Access Journals (Sweden)

    Timothy J Doyle

    2010-12-01

    Full Text Available Epidemic keratoconjunctivitis (EKC is an acute eye infection caused by adenovirus. We investigated an outbreak of EKC at an outpatient ophthalmology practice in the context of a suspected community wide increase in EKC activity. A site visit was made to the facility reporting the outbreak. A line list was created of patients clinically diagnosed with EKC at the practice during the previous 5 months. A questionnaire was faxed to all other licensed ophthalmologists in the county regarding recent EKC activity in their facility. Descriptive data analyses were conducted. The outbreak facility reported 37 patients clinically diagnosed with EKC during the previous 5 months. In addition, the single ophthalmologist at the practice also had symptoms compatible with EKC during the outbreak period. Specimens were collected on 4 patients and all were positive for adenovirus serotype 8. Forty percent of ophthalmologists surveyed in the county saw at least one EKC patient in the previous 3 months, and 20% reported a perceived increase in EKC activity in recent months over normal seasonal patterns. The outbreak at the facility likely began as part of a widespread community increase in EKC that may have been amplified at the facility through nosocomial transmission. Medical providers experiencing increases in EKC activity above seasonally expected norms should contact their public health department for assistance with etiologic diagnoses and outbreak control.

  18. Orbital Inflammation Developing from Epidemic Keratoconjunctivitis in an Adult

    Directory of Open Access Journals (Sweden)

    Sung In Kim

    2013-08-01

    Full Text Available Introduction: We report a rare case of epidemic keratoconjunctivitis (EKC that developed into an orbital inflammation in an adult. Case Presentation: A 67-year-old Korean man, who had been diagnosed with EKC and treated for conjunctival injection and chemosis in the right eye for 4 days, was referred to Oculoplastics as orbital cellulitis was suspected. At the point of referral, clinical features such as decreased visual acuity, severe eyelid swelling, chemosis, follicles, corneal edema, limitations in lateral eye movement, and diplopia were observed in the right eye. Orbital cellulitis was suspected according to orbital computed tomography scan images, but there was no response to systemic antibiotics. Systemic steroid was administered instead, and then his symptoms and signs started to improve. The final diagnosis of this patient was orbital inflammation related to EKC based on the facts that there was no response to antibiotics, that he presented with contralateral symptoms and signs, that pseudomembrane formation occurred in both eyes, and that the symptoms resolved completely after 2 weeks. Conclusion: Clinicians need to consider the possibility of orbital inflammation developing from EKC, even in an adult patient, and treat the patient properly if the EKC symptoms and signs, such as conjunctival injection and follicles, are accompanied with symptoms and signs similar to orbital cellulitis.

  19. An Update on the Therapeutic Approach to Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Esposito, Susanna; Fior, Giulia; Mori, Alessandro; Osnaghi, Silvia; Ghiglioni, Daniele

    2016-10-01

    Vernal keratoconjunctivitis (VKC) is an inflammatory disease of the ocular surface. It commonly occurs in the first decade of life, has a wide geographical distribution, and usually occurs in warm, dry areas. The pathogenesis of VKC seems to have an immune, nervous, and endocrine basis. The most common eye symptoms are itching, discharge, tearing, eye irritation, redness of the eyes, and photophobia. Although VKC generally has a good prognosis, the lack of clarity regarding the origin of the disease makes treatment a challenge for pediatricians and ophthalmologists. The purpose of this review is to discuss the pathogenesis, clinical features, and diagnostic criteria in VKC, with a focus on its therapeutic management. The selection of a therapeutic scheme from the many available options is based on clinical features and the personal preferences of both physicians and patients. Due to the lack of uniform grading of disease severity, there is no worldwide consensus on first-line and second-line therapeutic approaches. The choice of treatment for long-term moderate to severe VKC includes topical cyclosporine or tacrolimus. Further data are needed to define the minimal effective concentration and the safety of these drugs in eye drops and to clarify the diagnosis of VKC in patients who require these drugs. Finally, while promising newly discovered drugs are expected to enter into clinical practice, further studies on their efficacy and safety are required.

  20. Vernal keratoconjunctivitis with giant papillae on the inferior tarsal conjunctiva.

    Science.gov (United States)

    Asada, Yosuke; Ebihara, Nobuyuki; Funaki, Toshinari; Yokoi, Norihiko; Murakami, Akira; Matsuda, Akira

    2014-01-01

    In vernal keratoconjunctivitis (VKC), giant papillae are commonly observed on the superior tarsal conjunctiva. We found 3 cases of giant papillae on the inferior tarsal conjunctiva, and diagnosed them as being VKC based on their clinical and histopathological features. Three patients with inferior tarsal giant papillae were studied. In 2 patients, the giant papillae were resected for therapeutic purposes. Immunohistochemical analysis was carried out by indirect immunofluorescent staining using anti-CD3, anti-CD20, anti-CD35 antibodies. In all 3 patients, giant papilla formation was observed on the inferior lid margin. Clusters of CD20 B lymphocytes with CD35 follicular dendritic cells, and CD3 marginal zone T lymphocytes, common features of lymphoid neogenesis, were observed. In 2 patients, typical giant papillary formation was also observed on the superior tarsal conjunctiva. In all the patients, topical dexamethasone and tacrolimus treatments were found to be effective. The giant papillae of VKC can occur not only on the superior tarsal conjunctiva but also on the inferior tarsal conjunctiva. The possibility of the presence of giant papillae on the inferior tarsal conjunctiva should be considered in the clinical examination of patients with VKC.

  1. Assessment of corneal alterations by confocal microscopy in vernal keratoconjunctivitis.

    Science.gov (United States)

    Nebbioso, Marcella; Zicari, Anna Maria; Lollobrigida, Valeria; Marenco, Marco; Duse, Marzia

    2015-01-01

    Vernal keratoconjunctivitis (VKC) is a bilateral chronic, seasonally exacerbated inflammation of the ocular surface that especially affects male children and young boys. To evaluate the corneal microscopic features of patients affected by VKC and to assess whether some corneal changes were associated with specific ocular symptoms and/or signs. 20 children aged between 4 and 14 years were enrolled. All patients underwent corneal confocal microscopy by Confoscan CS3 (Nidek). 350 images of the central cornea of each eye were obtained with a ×40 noncontact lens 3,5 micron gap in automode. Some alterations of the sub-basal and stromal corneal nerves were detected. These alterations were more evident in patients with higher severity of photophobia. On the other hand, there were scarce other signs of the anterior segment of the eye. Our preliminary findings show that there is another group of patients affected by VKC, characterized by an intense photophobia caused by corneal damage and without other significant ocular alterations. Therefore confocal microscopy may be useful for an early identification of corneal alterations before the onset of severe ocular symptoms and to set an appropriate therapeutic management.

  2. Effect of Topical Cyclosporine in grading of Vernal keratoconjunctivitis.

    Directory of Open Access Journals (Sweden)

    Dr Krupali Raol

    2017-06-01

    Full Text Available Background & Objective: To evaluate efficacy of topical aqueous solution of 0.05% cyclosporine in first time diagnosed vernal keratoconjunctivitis (VKC including palpebral, bulbar and mixed form. Methods: 25 patients of VKC received CsA 0.05% aqueous ophthalmic solution in a dosage of one drop every 12 hours in both eyes for 6 months. Follow up visits (day 1, 2 weeks, 1 month, 2 months, 3 months and 6 months. Five symptoms were evaluated and six clinical signs were charted. Total objective score of 13 or more over atleast 3 variables was included (CART – scoring system. Results: Comparison of 1st Day with 2 weeks score showed no significant effect in the score value (t=0.90, df = 24, p<0.1. 1st Day with 3rd month score showed maximum effect in the score value (t = 35.76, df = 24, p<0.0001. 3rd month with 6th month score showed sustained effect of cyclosporine showing no major change in the score line (t test, t = 1.80, df = 24, p <0.05. Conclusion: Topical application of a 0.05% CsA aqueous solution has been shown to be effective in the treatment of patients with VKC. CsA could be an important alternative to steroid treatment.

  3. Ocular complications of severe vernal keratoconjunctivitis (VKC) in Yemen.

    Science.gov (United States)

    Al-Akily, Saleh A; Bamashmus, Mahfouth A

    2011-07-01

    The objective of this study was to assess the ocular complications and visual loss among patients with severe vernal keratoconjunctivitis (VKC). Four hundred and thirty-one patients with VKC seen at Ibn Al-Haitham Eye Center were the study group. This is a retrospective non-comparative observational study between 01 January 2002 and 31 December 2002. Visual acuity was measured with the standard Snellen visual acuity chart and for children under 5 years of age Kay pictures were used. Visual impairment was assessed by means of the World Health Organization criteria for visual disabilities. Cases with severe VKC that developed ocular complications leading to blindness and severe visual impairment were analyzed. The majority of VKC patients were males (75.9%) with a male:female ratio of 3.1:1. A total of 68 (15.7%) patients (54 boys and 14 girls) had severe VKC. The ocular findings among 20 patients with severe VKC that led to blindness and severe visual impairment included keratoconus (7); steroid-induced cataract (5), central corneal scars (5) and steroid-induced glaucoma (3). Two of the keratoconus cases developed acute hydrops. Severe VKC in developing countries including Yemen is a potentially blinding disease. Visual loss may be due to keratoconus and corneal scars, as well as complications of the unsupervised use of topically administered corticosteroids.

  4. Ocular complications of severe vernal keratoconjunctivitis (VKC) in Yemen☆

    Science.gov (United States)

    Al-Akily, Saleh A.; Bamashmus, Mahfouth A.

    2011-01-01

    Objectives The objective of this study was to assess the ocular complications and visual loss among patients with severe vernal keratoconjunctivitis (VKC). Methods Four hundred and thirty-one patients with VKC seen at Ibn Al-Haitham Eye Center were the study group. This is a retrospective non-comparative observational study between 01 January 2002 and 31 December 2002. Visual acuity was measured with the standard Snellen visual acuity chart and for children under 5 years of age Kay pictures were used. Visual impairment was assessed by means of the World Health Organization criteria for visual disabilities. Cases with severe VKC that developed ocular complications leading to blindness and severe visual impairment were analyzed. Results The majority of VKC patients were males (75.9%) with a male:female ratio of 3.1:1. A total of 68 (15.7%) patients (54 boys and 14 girls) had severe VKC. The ocular findings among 20 patients with severe VKC that led to blindness and severe visual impairment included keratoconus (7); steroid-induced cataract (5), central corneal scars (5) and steroid-induced glaucoma (3). Two of the keratoconus cases developed acute hydrops. Conclusion Severe VKC in developing countries including Yemen is a potentially blinding disease. Visual loss may be due to keratoconus and corneal scars, as well as complications of the unsupervised use of topically administered corticosteroids. PMID:23960939

  5. Infrared ocular thermography in dogs with and without keratoconjunctivitis sicca.

    Science.gov (United States)

    Biondi, Flávia; Dornbusch, Peterson T; Sampaio, Manuella; Montiani-Ferreira, Fabiano

    2015-01-01

    Infrared thermography was used to measure temperature differences of the corneal surface between nasal and temporal limbus regions and central cornea of normal dogs and dogs with keratoconjunctivitis sicca (KCS), in order to establish temperature values in normal canine eyes and in patients with decreased Schirmer tear tests (STT) values. Dogs investigated were all either patients seen at the Veterinary Teaching Hospital of Federal University of Paraná or normal dogs that belonged to the same institution. STT were performed in all eyes. A total of 40 control eyes (STT ≥15 mm/min) and 20 eyes with low STT values (STT ≤14 mm/min) were examined. The mean STT value for eyes with normal STT values was 22.9 ± 3.9 mm/min (mean ± standard deviation), and the mean STT value for eyes with low STT value was 7.2 ± 4.8 mm/min. The mean corneal temperature was significantly lower in eyes with low STT values than in control eyes (P popular ancillary test for the diagnoses of ocular surface disorders. © 2013 American College of Veterinary Ophthalmologists.

  6. Vitamin D levels in children affected by vernal keratoconjunctivitis.

    Science.gov (United States)

    Zicari, Anna Maria; Cafarotti, Arianna; Occasi, Francesca; Lollobrigida, Valeria; Nebbioso, Marcella; Pecorella, Irene; De Castro, Giovanna; Spalice, Alberto; Loffredo, Lorenzo; Villa, Maria Pia; Duse, Marzia

    2017-02-01

    Vernal keratoconjunctivitis (VKC) is a chronic and often severe bilateral conjunctivitis. VKC etiology still remains unclear although endocrine, genetic, neurogenic and environmental factors have been implicated. Vitamin D is a fat-soluble prohormone whose main function is the regulation of calcium and phosphate metabolism. The aim of this study was to evaluate serum vitamin D in children affected by VKC compared to the healthy children and investigate the relationship between its levels and disease severity. A total of 110 children, 47 affected by VKC, aged between 5 and 12 years were enrolled at the Department of Pediatrics, Division of Allergy and Immunology, "Sapienza" University of Rome. Used as controls were 63 healthy children with negative skin prick test (SPT), without allergic, ocular and systemic disease. Serum samples were obtained in April from all the children included in the study. Vitamin D dosage was repeated in October in 20 patients after therapy and in 20 controls. A conjunctival scraping was performed in all children affected by VKC. Children affected by VKC had lower vitamin D levels compared to healthy controls and we found an increase in vitamin D levels after therapy with cyclosporine eye drops 1% although this increase was lower than that of healthy controls. Moreover we found significant correlations between vitamin D level and the severity of the disease. The study shows that children affected by VKC have lower vitamin D levels when compared to healthy controls and highlights a significant correlation between its levels and disease severity.

  7. Microbiome and pediatric atopic dermatitis.

    Science.gov (United States)

    Powers, Claire E; McShane, Diana B; Gilligan, Peter H; Burkhart, Craig N; Morrell, Dean S

    2015-12-01

    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. © 2015 Japanese Dermatological Association.

  8. Can atopic dermatitis be prevented?

    Science.gov (United States)

    Gómez-de la Fuente, E

    2015-05-01

    Atopic dermatitis has become a health problem in our setting due to its rising prevalence, impact on quality of life, associated costs, and role in the progression to other atopic diseases. Furthermore, atopic dermatitis has no definitive cure and therefore preventive measures are important. In this article, we review the latest advances in both primary prevention (reduction of the incidence of atopic dermatitis) and secondary prevention (reduction of associated morbidity and reduction of the atopic march). We analyze the different preventive strategies available, including modification of the immune system through microbial exposure, induction of immune tolerance through antigen exposure, and restoration of skin barrier function to halt the atopic march. Dermatologists need to be familiar with these strategies in order to apply them where necessary and to accurately inform patients and their relatives to prevent misguided or inappropriate actions. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  9. Atopic asthmatic subjects but not atopic subjects without ...

    Science.gov (United States)

    BACKGROUND: Asthma is a known risk factor for acute ozone-associated respiratory disease. Ozone causes an immediate decrease in lung function and increased airway inflammation. The role of atopy and asthma in modulation of ozone-induced inflammation has not been determined. OBJECTIVE: We sought to determine whether atopic status modulates ozone response phenotypes in human subjects. METHODS: Fifty volunteers (25 healthy volunteers, 14 atopic nonasthmatic subjects, and 11 atopic asthmatic subjects not requiring maintenance therapy) underwent a 0.4-ppm ozone exposure protocol. Ozone response was determined based on changes in lung function and induced sputum composition, including airway inflammatory cell concentration, cell-surface markers, and cytokine and hyaluronic acid concentrations. RESULTS: All cohorts experienced similar decreases in lung function after ozone. Atopic and atopic asthmatic subjects had increased sputum neutrophil numbers and IL-8 levels after ozone exposure; values did not significantly change in healthy volunteers. After ozone exposure, atopic asthmatic subjects had significantly increased sputum IL-6 and IL-1beta levels and airway macrophage Toll-like receptor 4, Fc(epsilon)RI, and CD23 expression; values in healthy volunteers and atopic nonasthmatic subjects showed no significant change. Atopic asthmatic subjects had significantly decreased IL-10 levels at baseline compared with healthy volunteers; IL-10 levels did not significa

  10. Atopic Dermatitis and Homeopathy

    Directory of Open Access Journals (Sweden)

    Lawrence Chukwudi Nwabudike

    2012-07-01

    Full Text Available Introduction: Atopic dermatitis (AD is a chronic, relapsing disorder of the skin associated with allergen sensitization and impaired barrier function. There is often a family history of pruritic skin disease or asthma.Materials and Methods: Three cases of atopic dermatitis treated with homeopathy are presented. Case 1 is a case of a 22-year-old female, with AD since early childhood, which had not responded to standard topical therapy. She received several homeopathic medicines, with transitory effect until she finally received the medicine Aurum metallicum, at M potency. At present, 1 year after cessation of treatment, she remains lesion-free. Case 2 is a case of a 10-month-old baby with a an 8-month history of itchy rash and poor sleep, that had failed to respond to treatment. The patient was given the homeopathic medicine Lachesis at C30 potency and responded. The rashes receded and the patient was able to sleep better at night. Case 3 is a case of an 11-month-old boy with a 3-month history of itchy rash, diagnosed as having AD and treated with topical steroids. After 3 months of unsuccessful treatment, the patient was brought in for homeopathic therapy. He received the homeopathic medicine Lachesis, at C30 potency. He improved under this treatment and is currently lesion-free, 6 months after cessation of treatment.Conclusions: Three cases of atopic dermatitis that failed to respond to treatment were given homeopathic therapy and responded adequately. The patients remained free of lesions even after cessation of treatment.

  11. Analysis on tacrolimus efficacy in the treatment of vernal keratoconjunctivitis

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    Xin Zhang

    2014-04-01

    Full Text Available AIM: To evaluate the curative effects of tacrolimus on vernal keratoconjunctivitis(VKC. METHODS: A double-blind, randomized, placebo-controlled trial.Sixteen ambulatory patients from department of ophthalmology in West China Hospital of Sichuan University were randomly divided into drug treatment group and control group. Patients in treatment group were treated with tacrolimus eye drops, and control group with the basic placebo eye drops. Observation period of the trial was 28 days after taking the drops. The signs and symptoms were recorded and marked respectively. Total variation of ocular signs before or after therapy was main therapeutic index but subjective symptoms were the secondary index. RESULTS: Comparison in groups: there were significant differences on the scores of signs and symptoms before and after medication. After the drug treatment group, consciousness of each period symptom score was lower than before the medication, and over time, symptom score gradually reduced, the difference was statistically significant, but the control group after the medication had no statistically significant differences between different periods. Compared between the groups: There were no significant differences of subjective symptoms and signs before and after medication at the first review, but there were statistically significant differences during the other two reviews. Score variation(scores before or after medicationhad no significant differences in the first review but had it in the following two times.CONCLUSION:Tacrolimus can be used to improve the signs and symptoms of VKC, especially for the severe patients who are nonresponse to the anti-anaphylaxis drops. Tacrolimus can be quick and excellent to improve the effects, so it can be applied into clinic.

  12. Corneal biochemical features of patients with vernal keratoconjunctivitis.

    Science.gov (United States)

    Emre, Sinan; Başer, Esin; Oztürk, Bilge; Zorlu, Sibel; Uzun, Ozgür; Gülhan, Ceren

    2013-02-01

    Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, seasonally exacerbated, allergic inflammation of the ocular surface, involving bulbar and ⁄ or tarsal conjunctiva and cornea. The ocular response analyzer (ORA) measures corneal biomechanical properties in vivo by monitoring and analyzing the corneal behavior when its structure is submitted to a force induced by an air jet. This study was designed to examine corneal biomechanical properties and intraocular pressure in patients with VKC, and to compare with control eyes. ORA measurements were performed on the both eyes of 26 patients with VKC (group I) and 14 healthy children who served as the control group (group II). Corneal hysteresis (CH), corneal resistance factor (CRF) and intraocular pressure [Goldmann correlated (IOPg) and corneal compensated (IOPcc)] were recorded with ORA. Mean age of patients with VKC and control groups were 11.3 ± 5.8 and 10.6 ± 1.9 years for groups I and II respectively. Mean (± SD) of the CH and CRF readings were 10.1 ± 1.6 versus 10.5 ± 1.6 (p > 0.05) and 9.5 ± 1.7 versus 10.8 ± 1.7 mmHg (p 0.05) in groups I and II respectively. Statistical analysis revealed significant differences for CRF and IOPg between the study groups. The mean CRF and IOPg values of patients with VKC were lower than those of controls. According to the results of our study, one can conclude that corneal biomechanical property, CRF, could be different in VKC patients compared to normals.

  13. Management of Atopic Hand Dermatitis

    DEFF Research Database (Denmark)

    Halling-Overgaard, Anne-Sofie; Zachariae, Claus; Thyssen, Jacob P

    2017-01-01

    This article provides an overview of clinical aspects of hand eczema in patients with atopic dermatitis. Hand eczema can be a part of atopic dermatitis itself or a comorbidity, for example, as irritant or allergic contact dermatitis. When managing hand eczema, it is important to first categorize...

  14. [Atopic dermatitis: pathophysiology update].

    Science.gov (United States)

    Taieb, Alain

    2012-03-01

    Atopic dermatitis (AD) is very common in industrialized countries, where it affects 15% to 30% of children and 2% to 10% of adults. AD has a complex determinism, combining environmental influences and genetic predisposition, hitherto dominated by an immunological perspective, particularly after the discovery of associated high IgE serum levels. DA is a possible mode of onset of asthma, allergic rhinitis and food allergies, resulting in the poorly understood "atopic march". The discovery of mutations in the filaggrin gene, a key protein for stratum corneum maturation, have refocused attention on the skin and operated a Copernican revolution in our understanding of this group of disorders. AD has become a prototype of inflammatory epithelial barrier diseases. The epidermal barrier has three major elements: the stratum corneum, which provides an air-liquid barrier, tight junctions in the granular layer (liquid-liquid barrier), and Langerhans cells that capture antigens (immunological barrier). Better knowledge of the molecular events underlying epidermal barrier function and its dysfunction in AD should lead to ways of preventing and eventually curing this group of disorders.

  15. Genomic identification of human vaccinia virus keratoconjunctivitis and its importance as a laboratory-acquired infection

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    Zahra Movahedi Motlagh

    2016-01-01

    Full Text Available Context: Vaccinia virus (VACV is a member of orthopoxvirus genus of the family Poxviridae. VACVs are enveloped, double-stranded DNA viruses. Several species of this family, for example, molluscum contagiosum, smallpox, deerpox, horsepox, rabbitpox, and VACVs may cause conjunctivitis. Aims: Given the high incidence of keratoconjunctivitis in Iran (approximately 3.6%-53.9% and insufficient clinical diagnostic measures, laboratory tests for detection of its causes and determination of accurate keratoconjunctivitis/conjunctivitis prevalence due to different pathogens are essential. Settings and Design: In this research, conjunctival samples collected from 100 patients with keratoconjunctivitis signs were referred to an eye hospital of Iran. Subjects and Methods: After DNA extraction, polymerase chain reaction (PCR was carried out for detection of VACV. PCR-positive products were further subjected to DNA sequencing. Statistical Analysis Used: The results were analyzed using Chi-square test. Results: In this study, 28% of the samples were positive and a statistically significant relationship obtained between working in medical or research laboratories and VACV prevalence (P < 0.05. Conclusions: This study showed a high rate of VACV keratoconjunctivitis, and therefore, further studies for its prevention and control are necessary.

  16. Alpha-1 Antitrypsin, a Diagnostic and Prognostic Marker of Vernal Keratoconjunctivitis

    OpenAIRE

    Ahsan, Akif; Salman, Khushtar A; Alam, Sana; Siddiqui, Anwar H.; Naeem, Syed Shariq; Ahmad, Aquil; Khan, Iqbal M

    2014-01-01

    Introduction: A major chunk of ocular allergies in humans involve the conjunctiva, of which Vernal Keratoconjunctivitis (VKC) appears to be more common. VKC, a chronic allergic conjunctivitis, frequently affects young males and is characterized by intense inflammation of the limbal and/or tarsal conjunctiva. The etiology and immuno-pathogenesis of VKC still remain unclear.

  17. Limbal Pseudoepitheliomatous Hyperplasia Mimicking Ocular Surface Squamous Neoplasia in Palpebral Vernal Keratoconjunctivitis

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    Chintan Malhotra

    2013-01-01

    Full Text Available Purpose. Pseudoepitheliomatous hyperplasia at the limbus can mimic an ocular surface squamous neoplasia. It is an uncommon manifestation of vernal keratoconjunctivitis and has been reported previously in limbal VKC. It, however, has not been reported as a manifestation in the palpebral form of the disease and needs to be kept in the differential diagnosis of a limbal mass lesion in vernal keratoconjunctivitis. Case Report. We report the case of a 24 year old male patient having palpebral VKC and presenting with a papillomatous limbal mass with focal areas of keratinization mimicking an ocular surface squamous neoplasia. An excision biopsy was performed, and the specimen sent for histopathologywhich revealed features of pseudoepitheliomatous hyperplasia with no evidence of dysplasia or malignant transformation. The subepithelium revealed a dense plasma-rich inflammation. Discussion. We report this relatively uncommon presentation of limbal pseudoepitheliomatous hyperplasia mimicking an ocular surface squamous neoplasia in palpebral vernal keratoconjunctivitis. Wide excision as is required for an ocular surface neoplasia may thus be avoided if this entity is recognized in vernal keratoconjunctivitis.

  18. A Severe Aspect of Pediatric Ocular Allergy to Recognize: Vernal Keratoconjunctivitis

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    Hande Taylan Þekeroðlu

    2012-09-01

    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.

  19. Limbal pseudoepitheliomatous hyperplasia mimicking ocular surface squamous neoplasia in palpebral vernal keratoconjunctivitis.

    Science.gov (United States)

    Malhotra, Chintan; Jain, Arun K; Thapa, Bikram

    2013-01-01

    Purpose. Pseudoepitheliomatous hyperplasia at the limbus can mimic an ocular surface squamous neoplasia. It is an uncommon manifestation of vernal keratoconjunctivitis and has been reported previously in limbal VKC. It, however, has not been reported as a manifestation in the palpebral form of the disease and needs to be kept in the differential diagnosis of a limbal mass lesion in vernal keratoconjunctivitis. Case Report. We report the case of a 24 year old male patient having palpebral VKC and presenting with a papillomatous limbal mass with focal areas of keratinization mimicking an ocular surface squamous neoplasia. An excision biopsy was performed, and the specimen sent for histopathologywhich revealed features of pseudoepitheliomatous hyperplasia with no evidence of dysplasia or malignant transformation. The subepithelium revealed a dense plasma-rich inflammation. Discussion. We report this relatively uncommon presentation of limbal pseudoepitheliomatous hyperplasia mimicking an ocular surface squamous neoplasia in palpebral vernal keratoconjunctivitis. Wide excision as is required for an ocular surface neoplasia may thus be avoided if this entity is recognized in vernal keratoconjunctivitis.

  20. High-mobility group box-1 (HMGB-1) and serum soluble receptor for advanced glycation end products (sRAGE) in children affected by vernal keratoconjunctivitis.

    Science.gov (United States)

    Zicari, Anna Maria; Zicari, Alessandra; Nebbioso, Marcella; Mari, Emanuela; Celani, Camilla; Lollobrigida, Valeria; Cesoni Marcelli, Azzurra; Occasi, Francesca; Duse, Marzia

    2014-02-01

    Vernal keratoconjunctivitis (VKC) is a chronic disease affecting conjunctiva even though the immunopathogenetic mechanisms underlying this inflammation are unclear. The aim of our study is to investigate serum levels of HMGB1 and circulating sRAGE in children affected by VKC before and after treatment with cyclosporine A (CsA) eye drops and in a group of healthy children. Twenty-four children affected by VKC aged between 5 and 12 yrs of life were enrolled at the Department of Pediatrics, Division of Allergy and Immunology, 'Sapienza' University of Rome. Twenty-four healthy children without atopy, ocular, and systemic disease, cross-matched for sex and age to patients affected by VKC, represented the controls. All children affected by VKC were treated with CsA 1% eye drops for 4 wks, and blood samples were collected before and 2 wks after the end of treatment while the controls underwent to a single blood sample at the time of enrollment. Serum basal levels of HMGB1 and sRAGE were higher in children with VKC when compared with controls while, in patients affected by VKC, no difference was detected between atopic and non-atopic, and between ANA-positive and ANA-negative children. A significant reduction in serum HMGB1 and sRAGE levels was detected after the therapy while CsA serum levels were negative. Our study gives a support to the definition of VKC as a systemic inflammation in which HMGB1 and its soluble receptors could play a role. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Tartrazine in atopic eczema.

    Science.gov (United States)

    Devlin, J; David, T J

    1992-01-01

    Multiple double blind placebo controlled challenges with tartrazine 50 mg (three challenges) and glucose placebo (three challenges) were performed in 12 children with atopic eczema aged 1 to 6 years. The children were selected on the basis of severity (regular clinic attenders) and a parental history that tartrazine provoked worsening of the eczema. In only one patient did the three tartrazine challenge periods correspond with the highest symptom scores or the highest physician observer scores, and the probability of this occurring by chance in one or more patients out of 12 was 0.46. In this sample we were unable to confirm intolerance to tartrazine in 11 out of 12 patients. PMID:1626990

  2. Microbiome in atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Wollina U

    2017-02-01

    Full Text Available Uwe Wollina Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany Abstract: Atopic dermatitis (AD is a common chronic inflammatory skin disease affecting ~10–20% of the general population. AD is characterized by disturbances in epidermal barrier function and hyperactive immune response. Recently, changes in the skin and intestinal microbiome have been analyzed in more detail. The available data suggest a link between disturbed skin microbiome and course of the disease. Flares of the disease are associated with an expansion of Staphylococcus aureus on lesional skin and a substantial loss of biodiversity in skin microbiome. Staphylococci exoproteins and superantigens evoke inflammatory reactions in the host. Skin microbiome includes superficial stratum corneum that is affected by environmental factors such as exposure to germs and cleansing. Available evidence argues for a link between epidermal barrier impairment and disturbances in skin microbiome in AD. In contrast to skin microbiome, intestinal microbiome seems to become stabilized after infancy. There is also a significant heritable component for intestinal microbiome. The microbial taxa, relative percentages and quantities vary remarkably between the different parts of the intestinal tract. Early intestinal microbial colonization may be a critical step for prevention of further development of AD. Skin barrier-aimed topical treatments help to develop a neo-microbiome from deeper compartments. Probiotics, prebiotics and synbiotics have been investigated for the treatment of AD, but further investigations are needed. Targeted treatment options to normalize skin and intestinal microbiome in AD are under investigation. Keywords: atopic dermatitis, microbiome, staphylococci, skin, intestine, antimicrobial peptides

  3. Retrospective Study: Atopic Dermatitis in Childhood

    OpenAIRE

    Sihaloho, Kristina; Indramaya, Diah Mira

    2017-01-01

    Background: Atopic dermatitis is a chronically and relapsing inflammatory skin disease affecting individuals with atopic history or their families. Atopic dermatitis affects all ageswith percentage 15-30% in children and 1-2% in adults. Chronic pruritus, skin infection, sleep disorder, and growth disorder are signs and symptomps commonly found in childhood atopic dermatitis. Evaluation of the profile and management of DA were needed to improve the management of atopic dermatitis. Purpose:To e...

  4. Difficult to control atopic dermatitis

    NARCIS (Netherlands)

    U. Darsow (U.); A. Wollenberg (A.); D. Simon; A. Taieb; T. Werfel; A.P. Oranje (Arnold); C. Gelmetti (C.); Ã. Svensson (Ãke); M. Deleuran (M.); A.M. Calza; F. Giusti; J. Lübbe (Jann); S. Seidenari (Stefania); J. Ring (J.)

    2013-01-01

    textabstractDifficult 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

  5. Atopic dermatitis in adolescence

    Directory of Open Access Journals (Sweden)

    Giampaolo Ricci

    2011-12-01

    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.

  6. Vernal keratoconjunctivitis: culmination of management using immunosuppression, surgical and prosthetic therapy over quarter century.

    Science.gov (United States)

    Das, Shilpa; Pasari, Anand S; Sangwan, Virender S

    2016-11-23

    A 22-year-old male patient presented in 1988 with active vernal keratoconjunctivitis. He was treated with topical mast cell stabilisers and corticosteroids. Chronic inflammation despite topical treatment necessitated oral immunosuppressants. Active disease came under control with this; however, the patient gradually developed limbal stem cell deficiency. He underwent bilateral pannus resection with amniotic membrane transplantation that resulted in improved ocular surface. In 2007, patient was found to have significant bilateral posterior subcapsular cataracts and underwent bilateral cataract surgery with intraocular lens implantation with good visual outcome. In 2016, he was provided with scleral lens prosthetic device, which further improved vision. At last follow-up, more than 25 years after his initial visit, his visual acuity was 20/25 in both eyes with a stable surface. With a comprehensive approach using immunosuppression, surgical therapy and scleral lens prosthetic device, chronic vernal keratoconjunctivitis can be well managed as illustrated in this case. 2016 BMJ Publishing Group Ltd.

  7. Efficacy of topical 0.05% cyclosporine treatment in children with severe vernal keratoconjunctivitis.

    Science.gov (United States)

    Çoban-Karataş, Müge; Özkale, Yasemin; Altan-Yaycıoğlu, Rana; Sızmaz, Selçuk; Pelit, Aysel; Metindoğan, Sevda; Cantürk-Uğurbaş, Sılay; Aydın-Akova, Yonca

    2014-01-01

    We aimed to determine the efficacy of topical cyclosporine in children with vernal keratoconjunctivitis refractory to topical mast cell stabilizer and antihistamine therapy. Thirty-one patients, 24 boys and 7 girls younger than 16 years of age, were included in the study. All patients were scored on a four-point scale from 0 to 3 for symptoms and signs. Each patient received topical cyclosporine 0.05% emulsion (Restasis, Allergan Inc., Irvine, CA, USA) four times daily in addition to preservative-free artificial tears and was followed for 6 months. The data was recorded before the initiation of treatment (day 0) and at the 1st, 3rd, and 6th months following treatment. After six months of treatment, severity of all symptoms and signs showed a statistically significant decrease (pvernal keratoconjunctivitis in children.

  8. Measure of keratoconus progression in patients with vernal keratoconjunctivitis using scanning slit topography.

    Science.gov (United States)

    Taneja, Mukesh; Ashar, Jatin N; Mathur, Anurag; Vaddavalli, Pravin K; Rathi, Varsha; Sangwan, Virender; Murthy, Somashiela

    2013-02-01

    To document topographic changes using Orbscan in patients with keratoconus and vernal keratoconjunctivitis over 1 year. Retrospective analysis of clinical and Orbscan data of 22 eyes of 11 patients with keratoconus and VKC with follow up over 1 year period was done. The parameters studied included patients demographics, clinical features, visual acuity, refraction and Orbscan IIz. The changes in various Orbscan parameters were studied over the 1-year period. Mean age was 14±4.1 years. 20 eyes had clinical keratoconus, while 2 had forme fruste keratoconus. 8 eyes of 22 showed evident progression (>1 diopter change in mean simulated (sim) K over 12 months). There was no significant difference in the visual acuity or clinical features over follow up. In patients with progression, statistically significant change (pvernal keratoconjunctivitis and keratoconus. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  9. Measurement of the B$0\\atop{d}$ lifetime using B$0\\atop{d}$ → J/ΨK$0\\atop{S}$ decays at D0

    Energy Technology Data Exchange (ETDEWEB)

    Balm, Paul Wijnand [Univ. of Amsterdam (Netherlands)

    2004-12-08

    This thesis describes a measurement of the B$0\\atop{d}$ lifetime in the decay to (J/ΨK$0\\atop{S}$), using 114 pb-1 of data collected by the D0 experiment at the Tevatron from October 15, 2002, to June 10, 2003. The measurement is motivated by the tests of the Standard Model that it makes possible. These include tests of Heavy Quark Effective Theory predicting B-meson lifetimes, and of the complex phase in the CKM-matrix as the source of CP-violation in B$0\\atop{d}$ decays to (J/ΨK$0\\atop{S}$).

  10. Chronic keratoconjunctivitis with dermatitis as a presenting sign of child abuse.

    Science.gov (United States)

    Moore, Daniel B; Herlihy, Erin P; Weiss, Avery H

    2012-04-01

    A 13-month-old girl presented with chronic keratoconjunctivitis with dermatitis. She was initially diagnosed with corneal abrasion and mild preseptal cellulitis and was treated with topical and oral antibiotics. After failing to respond to standard therapy, she was eventually identified as a victim of abuse. We discuss key findings that could have provoked earlier recognition. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  11. Systematic approach to managing vernal keratoconjunctivitis in clinical practice: Severity grading system and a treatment algorithm

    OpenAIRE

    Gokhale, Nikhil S

    2016-01-01

    Vernal keratoconjunctivitis is an ocular allergy that is common in the pediatric age group. It is often chronic, severe, and nonresponsive to the available treatment options. Management of these children is difficult and often a dilemma for the practitioner. There is a need to simplify and standardize its management. To achieve this goal, we require a grading system to judge the severity of inflammation and an algorithm to select the appropriate medications. This article provides a simple and...

  12. Direct fluorescent antibody assay and polymerase chain reaction for the detection of Chlamydia trachomatis in patients with vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Maria Cristina Nishiwaki-Dantas

    2011-01-01

    Full Text Available OBJECTIVES: To identify Chlamydia trachomatis via polymerase chain reaction and a direct fluorescent antibodyassay in patients with vernal keratoconjunctivitis while comparing the efficacies of both tests for detectingChlamydia trachomatis in these conditions. METHODS: Conjunctival scraping samples were obtained from 177 patients who were divided into two groups: avernal keratoconjunctivitis group (group A and a control group (group B. The polymerase chain reaction and adirect fluorescent antibody assay were performed. Sensitivity, specificity, receiver operating characteristic curves,and areas under the curve were calculated for both tests in groups A and B. Receiver operating characteristic curveswere plotted using a categorical variable with only two possible outcomes (positive and negative. RESULTS: Statistical analysis revealed a significant association between vernal keratoconjunctivitis and Chlamydia trachomatis infection detected by a direct fluorescent antibody assay with high sensitivity and specificity. Allpatients in group A with positive polymerase chain reactions also presented with positive direct fluorescentantibody assays. CONCLUSION: The association between vernal keratoconjunctivitis and Chlamydia trachomatis infection wasconfirmed by positive direct fluorescent antibody assays in 49.4% of vernal keratoconjunctivitis patients and bypositive polymerase chain reactions in 20% of these patients. The direct fluorescent antibody assay detectedChlamydia trachomatis in a higher number of patients than did the polymerase chain reaction. Although thediagnosis of trachoma is essentially clinical, the disease may not be detected in vernal keratoconjunctivitis patients.Due to the high frequency of chlamydial infection detected in patients with vernal keratoconjunctivitis, we suggestconsidering routine laboratory tests to detect Chlamydia trachomatis in patients with severe and refractory allergicdisease.

  13. Direct fluorescent antibody assay and polymerase chain reaction for the detection of Chlamydia trachomatis in patients with vernal keratoconjunctivitis.

    Science.gov (United States)

    Nishiwaki-Dantas, Maria Cristina; de Abreu, Mariza Toledo; de Melo, Cynthia Mendonça; Romero, Ivana Lopes; Neto, Rubens Belfort Matos; Dantas, Paulo Elias Correa

    2011-01-01

    To identify Chlamydia trachomatis via polymerase chain reaction and a direct fluorescent antibody assay in patients with vernal keratoconjunctivitis while comparing the efficacies of both tests for detecting Chlamydia trachomatis in these conditions. Conjunctival scraping samples were obtained from 177 patients who were divided into two groups: a vernal keratoconjunctivitis group (group A) and a control group (group B). The polymerase chain reaction and a direct fluorescent antibody assay were performed. Sensitivity, specificity, receiver operating characteristic curves, and areas under the curve were calculated for both tests in groups A and B. Receiver operating characteristic curves were plotted using a categorical variable with only two possible outcomes (positive and negative). Statistical analysis revealed a significant association between vernal keratoconjunctivitis and Chlamydia trachomatis infection detected by a direct fluorescent antibody assay with high sensitivity and specificity. All patients in group A with positive polymerase chain reactions also presented with positive direct fluorescent antibody assays. The association between vernal keratoconjunctivitis and Chlamydia trachomatis infection was confirmed by positive direct fluorescent antibody assays in 49.4% of vernal keratoconjunctivitis patients and by positive polymerase chain reactions in 20% of these patients. The direct fluorescent antibody assay detected Chlamydia trachomatis in a higher number of patients than did the polymerase chain reaction. Although the diagnosis of trachoma is essentially clinical, the disease may not be detected in vernal keratoconjunctivitis patients. Due to the high frequency of chlamydial infection detected in patients with vernal keratoconjunctivitis, we suggest considering routine laboratory tests to detect Chlamydia trachomatis in patients with severe and refractory allergic disease.

  14. Prospective, multicenter demographic and epidemiological study on vernal keratoconjunctivitis: a glimpse of ocular surface in Italian population.

    Science.gov (United States)

    Lambiase, Alessandro; Minchiotti, Simona; Leonardi, Andrea; Secchi, A G; Rolando, Maurizio; Calabria, Giovanni; Orsoni, Jelka; Zola, Enrica; Ferreri, Giuseppe; Aragona, Pasquale; Reibaldi, Alfredo; Chisari, Giorgio; Bonini, Stefano

    2009-01-01

    To evaluate the frequency and epidemiological features of vernal keratoconjunctivitis (VKC) in Italy. a specific electronic clinical chart for vernal keratoconjunctivitis was created to standardize: 1) medical history; 2) diagnostic criteria; 3) signs and symptoms; and 4) treatments. This study involved 6 Italian referral centers for ocular surface diseases: between March 2005 and March 2006, all referred patients were included, clinical data collected and statistically examined. The mean age of the vernal keratoconjunctivitis population (n = 156) was 13.8 +/- 8.8 with 64.1% of subjects under 14 years of age and a male/female ratio of 3.5:1. Among VKC patients, 48.7% showed associated systemic allergic diseases. Only 32.1% of patients were positive for RAST and/or prick test. The limbal form (53.8%) was the most frequent subtype of vernal keratoconjunctivitis. Approximately 9% of patients showed a severe form of vernal keratoconjunctivitis. At the first visit patients were treated with: multiple action or mast cell stabilizer eye drops (58.1% and 41.3% of cases, respectively), topical corticosteroids alone (0.6%) or in association (26.8% of cases). All patients used topical steroids at least once in the studied year. Systemic antihistamine therapy was used by 25.6% of patients. In this cohort, 32.7% of patients required two or more examinations per year for exacerbations of their symptoms. Vernal keratoconjunctivitis is a severe ocular condition that mainly affects young males. Vernal keratoconjunctivitis is characterized by different clinical features and therapeutic responses, suggesting the need for a standardized therapeutic approach on the basis of a grading of disease severity.

  15. Subcutaneous allergen-specific immunotherapy versus topical treatment in vernal keratoconjunctivitis.

    Science.gov (United States)

    Mahdy, Reda Abdel Rahman; Nada, Waled M; Marei, Ayman A

    2012-05-01

    The study evaluated the treatment of cases with vernal keratoconjunctivitis by subcutaneous allergen-specific immunotherapy (SCIT) versus topical treatment according to clinical improvement and total serum immunoglobulin (Ig) E. Prospective randomized study. The study included 64 patients with bilateral vernal keratoconjunctivitis. Cases were divided into 2 groups: group 1, 32 patients who were subjected to topical treatment; and group 2, 32 patients who were subjected to intradermal skin reactions to different allergens. Prepared subcutaneous injections of different allergens were administered. Follow-up was performed to detect criteria of improvement according to clinical data and total serum IgE. The study revealed that the treatment by SCIT was more effective in improving the clinical symptoms and reducing the serum IgE than topical treatment because there was a greater reduction in symptoms in group 1 of immunotherapy (72%) than in group 2 of medical treatment (59%) (P vernal keratoconjunctivitis by SCIT was more effective than topical treatment in improving the clinical symptoms and reducing the total serum IgE.

  16. Atopic and non-atopic sensitivity in a large bakery.

    Science.gov (United States)

    Popescu, I G; Ulmeanu, V; Murariu, D

    1981-01-01

    Flour is an allergen which can sensitize either by the digestive or the inhalatory route, particularly those who work with this product. Factors involved occupational four-induced asthma also include various insects and their excreta, fungi and dermato-farinae. In this study, 1303 subjects from a number of bakeries were studied. They underwent allergological investigation by means of prick-tests with allergens and respiratory function tests for those with bronchial asthma. Also studied is the relationship with atopic syndromes or atopic family history.

  17. Dermatitis, atopic on the legs (image)

    Science.gov (United States)

    ... are caused by an inherited allergic condition called atopic dermatitis. Many of these areas have been scratched until ... infection triggering and perpetuating the problem. In adults, atopic dermatitis frequently involves the body creases, such as inside ...

  18. Dermatitis, atopic on the arms (image)

    Science.gov (United States)

    This person has inherited allergic skin inflammation (atopic dermatitis) on the arms. Red (erythematous), scaly plaques can be seen on the inside of the elbows (antecubital fossa). In adults, atopic dermatitis usually ...

  19. Twin Studies of Atopic Dermatitis

    DEFF Research Database (Denmark)

    Elmose, Camilla; Thomsen, Simon Francis

    2015-01-01

    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...... was 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...

  20. Multidrug-resistant bacteria induce recurrent keratoconjunctivitis in a patient with common variable immunodeficiency: case report and literature review.

    Science.gov (United States)

    Chao, Jiang; Yumei, Zhou; Zhiqun, Wang; Yang, Zhang; Xuguang, Sun

    2013-11-01

    We present a case study regarding a patient with recurrent keratoconjunctivitis that presented as an initial manifestation of common variable immunodeficiency (CVID). We describe a case and review the recent relevant medical literature. A 33-year-old male had recurrent keratoconjunctivitis induced by multidrug-resistant bacteria. Topical vancomycin treatment was effective, but infection recurred when the vancomycin treatment was stopped. The patient was transferred to the Department of Medicine to rule out potential systemic immune diseases and was finally diagnosed with CVID. Intravenous immunoglobulin (IVIG) was administered, and the patient was followed up monthly without any recurrence of infection to date. IVIG will be administered monthly for the patient's lifetime. Keratoconjunctivitis is a CVID-associated manifestation, sometimes appearing as the first presentation. CVID should be considered when unexplained recurrent conjunctival and/or corneal bacterial infections are observed. Topical therapy is not sufficient to treat this infection and IVIG is necessary.

  1. Atopic eczema in school children

    African Journals Online (AJOL)

    AC, Hay RJ. Validation of the UK diagnostic criteria for Atopic dermatitis in a population setting. BR J Dermatol. 1996;135:12~7. \\ 6. International Study of Asthma and. Allergies in Childhood (ISAAC) Manual. Munster: University of Munster; 1992. 7. Jose I. Figueroa, L-Claire F, Aynalem A,. Rod J Hay, Pediatric Dermatology.

  2. Evolving Concepts in Atopic Dermatitis.

    Science.gov (United States)

    Sidbury, Robert; Khorsand, Kate

    2017-07-01

    Tremendous advances have been made in the field of atopic dermatitis in the past 5 years. We will explore developments in burden of disease, co-morbidities, pathogenesis, prevention, and management. The tremendous burden moderate to severe atopic dermatitis (AD) places on families from a medical, psychosocial, and financial perspective has been characterized. Epidemiologic studies have identified intriguing new associations beyond the well-characterized "atopic march" of food allergies, asthma, and hay fever. Studies of primary prevention have gained traction including the remarkable impacts of early emollient therapy. Basic advances have simultaneously elucidated the nature of atopic inflammation, setting the stage for an explosion of new potential therapeutic targets. After a fallow period of nearly 15 years without a substantial therapeutic advance, this year has already seen two new FDA-approved treatments for AD. AD has a tremendous impact on quality of life with an underappreciated burden of disease; there are important newly described co-morbidities including ADHD and anemia; new insights into etio-pathogenesis have paved the way for novel topical therapies like crisaborole, and new systemic interventions like dupilumab.

  3. Psychological interventions in atopic dermatitis

    NARCIS (Netherlands)

    Jaspers, Jan P. C.

    Atopic dermatitis is a common skin disease that places a large burden on patients and their families. It is characterized as a chronic inflammatory disease that most commonly begins in early childhood. Prevalence is high, especially in children, and increases in western countries. Originally,

  4. Genetics Home Reference: atopic dermatitis

    Science.gov (United States)

    ... DY. Filaggrin mutations associated with skin and allergic diseases. N Engl J Med. 2011 Oct 6;365(14):1315-27. doi: 10.1056/NEJMra1011040. Review. Citation on PubMed Liang Y, Chang C, Lu Q. The Genetics and Epigenetics of Atopic Dermatitis-Filaggrin and Other Polymorphisms. Clin ...

  5. Severe vernal keratoconjunctivitis requiring trabeculectomy with mitomycin C for corticosteroid-induced glaucoma.

    Science.gov (United States)

    Ang, Marcus; Ho, Ching-Lin; Tan, Donald; Chan, Cordelia

    2012-01-01

    To describe clinical features of severe vernal keratoconjunctivitis with steroid response in Asian children and risk factors for glaucoma filtration surgery. Retrospective non-controlled, comparative case series. Patients with severe vernal keratoconjunctivitis seen at a single centre over 6 years. Clinical features, symptoms and treatment modalities were recorded for patients (i) diagnosed with severe VKC (clinical grade ≥ 3); (ii) had >2 recordings of increased intraocular pressures of >21 mmHg; (iii) and a minimum follow-up period of 1 year post-presentation. Corticosteroid-induced glaucoma requiring trabeculectomy with mitomycin-C. Six patients (eight eyes) of 36 patients required trabeculectomy/mitomycin-C. All were male. Mean age of disease onset was 9.3 ± 4.5 years for a mean duration of 6.08 ± 3.5 years. Mean intraocular pressures increase from baseline was 29.0 ± 8.2 mmHg and all required >2 anti-glaucoma medications. The main risk factor for trabeculectomy was a greater increase in intraocular pressures from baseline (odds ratio 1.3; 95% confidence interval, 1.0-1.5; P = 0.011), which was independent of potential confounders such as type and duration of corticosteroid use. Comparing eyes pre- and post-trabeculectomy, all improved in clinical severity of vernal keratoconjunctivitis (mean clinical grade improvement 2.1; 95% confidence interval, 1.3-3.0; P < 0.001) and reduced dependence on topical corticosteroids for mean duration of 22.5 ± 15.3 months. In our study, patients with a 'greater steroid response', that is, higher increase in intraocular pressures from baseline are associated with a 30% higher risk toftrabeculectomy. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  6. Childhood chronic anterior uveitis associated with vernal keratoconjunctivitis (VKC: successful treatment with topical tacrolimus. Case series

    Directory of Open Access Journals (Sweden)

    Taddio Andrea

    2011-11-01

    Full Text Available Abstract Uveitis treatment involves topical corticosteroids along with cycloplegic-mydriatics. Particularly severe cases may require systemic corticosteroids and immunosuppressive drugs. Vernal keratoconjunctivitis (VKC treatment consists of a brief period of topical corticosteroids and/or cyclosporine. In patients refractory to traditional treatment, the use of 0.1% topical ophtalmic FK- 506 (tacrolimus ointment has been occasionally reported. This is the first report of the coexistence of uveitis and VKC. The documented response to topical tacrolimus eyedrop of uveitis and VKC is also of interest, in particular since to our knowledge there are no published reports on its clinical use in uveitis.

  7. Surgical management and immunohistochemical study of corneal plaques in vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Hsiu-Yi Lin

    2013-09-01

    Full Text Available Two children with shield ulcer in vernal keratoconjunctivitis unresponsive to steroid therapy received plaque removal by superficial keratectomy, followed by amniotic membrane transplantation (AMT. Hematoxylin and eosin staining of the excised corneal specimen revealed a thick layer of eosinophilic material attached to the Bowman's layer. These deposits were positive for eosinophil granule major basic protein, as confirmed by an immunohistochemical study. The shield ulcer healed after the amniotic membrane was removed. No recurrent corneal plaque developed, although corneal opacity complicated in both cases. Lamellar keratectomy with AMT offers an effective management by removing the cytotoxic plaques and protecting the denuded stroma from deposition of inflammatory debris.

  8. Systematic approach to managing vernal keratoconjunctivitis in clinical practice: Severity grading system and a treatment algorithm.

    Science.gov (United States)

    Gokhale, Nikhil S

    2016-02-01

    Vernal keratoconjunctivitis is an ocular allergy that is common in the pediatric age group. It is often chronic, severe, and nonresponsive to the available treatment options. Management of these children is difficult and often a dilemma for the practitioner. There is a need to simplify and standardize its management. To achieve this goal, we require a grading system to judge the severity of inflammation and an algorithm to select the appropriate medications. This article provides a simple and practically useful grading system and a stepladder algorithm for systematic treatment of these patients. Use of appropriate treatment modalities can reduce treatment and disease-related complications.

  9. Systematic approach to managing vernal keratoconjunctivitis in clinical practice: Severity grading system and a treatment algorithm

    Directory of Open Access Journals (Sweden)

    Nikhil S Gokhale

    2016-01-01

    Full Text Available Vernal keratoconjunctivitis is an ocular allergy that is common in the pediatric age group. It is often chronic, severe, and nonresponsive to the available treatment options. Management of these children is difficult and often a dilemma for the practitioner. There is a need to simplify and standardize its management. To achieve this goal, we require a grading system to judge the severity of inflammation and an algorithm to select the appropriate medications. This article provides a simple and practically useful grading system and a stepladder algorithm for systematic treatment of these patients. Use of appropriate treatment modalities can reduce treatment and disease-related complications.

  10. Childhood chronic anterior uveitis associated with vernal keratoconjunctivitis (VKC): successful treatment with topical tacrolimus. Case series

    Science.gov (United States)

    2011-01-01

    Uveitis treatment involves topical corticosteroids along with cycloplegic-mydriatics. Particularly severe cases may require systemic corticosteroids and immunosuppressive drugs. Vernal keratoconjunctivitis (VKC) treatment consists of a brief period of topical corticosteroids and/or cyclosporine. In patients refractory to traditional treatment, the use of 0.1% topical ophtalmic FK- 506 (tacrolimus) ointment has been occasionally reported. This is the first report of the coexistence of uveitis and VKC. The documented response to topical tacrolimus eyedrop of uveitis and VKC is also of interest, in particular since to our knowledge there are no published reports on its clinical use in uveitis. PMID:22047067

  11. Vernal keratoconjunctivitis in the black child and its response to therapy.

    Science.gov (United States)

    Dahan, E; Appel, R

    1983-01-01

    A clinical study of vernal keratoconjunctivitis in black children in Southern Africa was conducted to report on the peculiar, predominantly limbal form of the disease, and to test its response to therapy. Pigmented and thickened limbal conjunctiva gave the disease its typical appearance. In severe cases these lesions were encroaching on to the cornea and threatened sight. Placebo had no effect on the course of the disease. Topical steroids and sodium cromoglycate were equally effective. A combination of steroids and SCG proved particularly effective in treating severe cases, indicating a possible synergistic effect of the 2 drugs. Images PMID:6412738

  12. First observation of the decay $\\bar{B}$$0\\atop{s}$ →; D$+\\atop{s}$ K and measurement of B($\\bar{B}$$0\\atop{s}$ →; D$±\\atop{s}$K)/Br($\\bar{B}$$0\\atop{s}$→; D$+\\atop{s}$ π-)

    Energy Technology Data Exchange (ETDEWEB)

    Muelmenstaedt, Johannes [Univ. of California, Berkeley, CA (United States)

    2007-01-01

    We present the first observation of the decay $\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ K and measure the relative branching fraction of $\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ K to $\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ π-. The measurement of the relative branching fraction is performed by applying a fit in invariant mass and specific ionization to 1.2 fb-1 of Ds(φπ)X data collected with the CDF II detector in pp collisions at √s = 1.96 TeV at the Fermilab Tevatron collider. We measure B($\\bar{B}$$0\\atop{s}$ → D± s K∓¢/B($\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ π-) = 0.107±0.019(stat)±0.008(sys). The statistical significance of the $\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ K signal is 7.9σ. To cross-check our analysis method, we also measure B($\\bar{B0}$ → D+K-)/B($\\bar{B0}$ → D+π-) and B($\\bar{B0}$ → D*+K-)/B($\\bar{B0}$ → D*+π-) and verify that our results are in agreement with the world average.

  13. The history of atopic dermatitis.

    Science.gov (United States)

    Kramer, Owen N; Strom, Mark A; Ladizinski, Barry; Lio, Peter A

    Fred Wise (1881-1950) and Marion Sulzberger (1895-1983) are often credited with introducing the term atopic dermatitis to dermatology in 1933. This definition was based on atopy, a term first created by Arthur Coca (1875-1959) and Robert Cooke (1880-1960) in 1923, when they recognized an association between allergic rhinitis and asthma. Despite its recent introduction into our medical lexicon, historical precursors of atopic dermatitis date back to at least as early as 69-140 ce. In this contribution, we highlight both the prominent individuals credited with shaping the disorder into our current interpretation and the suspected historical precursors of this disease and reported treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Childhood Atopic Dermatitis in Taiwan.

    Science.gov (United States)

    Wang, I-Jen; Wang, Jiu-Yao; Yeh, Kuo-Wei

    2016-04-01

    The prevalence of atopic dermatitis (AD) appears to have increased dramatically over the past decades. It is generally believed that such rapid increase in prevalence cannot be explained fully by genetic factors. Environmental factors might play a role in such an increment. Children with AD are most likely to suffer considerable school absences, family stress, and health care expenditures. Because the onset of AD occurs relatively early in life, identification of early life risk factors and early management for AD to prevent the development of atopic march are of critical importance. However, there is still no consensus on coordinated prevention and management for AD in Taiwan. In this review, we discuss the specific risk factors of AD and important results of recent articles on AD from Taiwan. The management and prevention strategies of AD for Asian skin are also discussed. Copyright © 2016. Published by Elsevier B.V.

  15. Childhood Atopic Dermatitis in Taiwan

    Directory of Open Access Journals (Sweden)

    I-Jen Wang

    2016-04-01

    Full Text Available The prevalence of atopic dermatitis (AD appears to have increased dramatically over the past decades. It is generally believed that such rapid increase in prevalence cannot be explained fully by genetic factors. Environmental factors might play a role in such an increment. Children with AD are most likely to suffer considerable school absences, family stress, and health care expenditures. Because the onset of AD occurs relatively early in life, identification of early life risk factors and early management for AD to prevent the development of atopic march are of critical importance. However, there is still no consensus on coordinated prevention and management for AD in Taiwan. In this review, we discuss the specific risk factors of AD and important results of recent articles on AD from Taiwan. The management and prevention strategies of AD for Asian skin are also discussed.

  16. [From atopic dermatitis to asthma].

    Science.gov (United States)

    Businco, L; Marziali, M; Furcolo, G; Meglio, P

    1997-10-01

    Atopic dermatitis (AD) is the most common chronic skin disorder in infancy and childhood and is the main hallmark of atopic constitution. The disease is multifactorial, and although genetic predisposition is certainly a prerequisite, a number of environmental factors modulate the phenotypic expression of AD. The majority of affected children shows IgE sensitisation towards a large variety of foods and aeroallergens. Since at least 1600, it has been recognized that patients with AD have a high predisposition to develop asthma. Recent epidemiological studies show that AD is commonly seen in individuals from families with a history of asthma. In addition, in population where asthma is uncommon, AD is also uncommon. The sex distribution of AD and asthma is the same, with boys affected significantly more often by these two atopic diseases and in similar proportions. The ETAC project (Early Treatment of the Atopic Child) is a large multicenter, multi-national, double blind, placebo controlled, randomised trial. The main objective of the study is to stop the progression from AD to asthma in young children with AD using early therapeutic intervention with Cetirizine and the second objective is to investigate the main risk factors for the onset of asthma. The results of this study indicate that exposure to potent allergens such as cat or mite significantly increased the risk of sensitisation to these allergens. Prolonged breast feeding was associated with a lowest sensitisation rate to cow milk proteins and to egg. Therefore environmental factors seem to play a crucial role in IgE sensitisation in children with AD.

  17. Immune response to Varicella vaccine in children with atopic dermatitis compared to non-atopic controls

    OpenAIRE

    Schneider, Lynda; Weinberg, Adriana; Boguniewicz, Mark; Taylor, Patricia; Oettgen, Hans; Heughan, Lisa; Zaccaro, Daniel; Armstrong, Brian; Holliday, Aaron; Leung, Donald Y. M.

    2010-01-01

    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.

  18. Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis in the cavalier King Charles spaniel.

    Science.gov (United States)

    Barnett, K C

    2006-09-01

    To record a previously unreported congenital and hereditary condition affecting the eyes and skin in the cavalier King Charles spaniel. Nineteen cases (13 litters) were investigated, with particular reference to eye and skin clinical signs. In addition, five generation pedigrees were obtained and studied from all cases with the exception of one. The eye signs were due to keratoconjunctivitis sicca, a common ocular disease in the dog, but rarely of congenital origin. The skin signs were of an ichthyosiform dermatosis; ichthyosis being a rare skin disease in the dog. In human beings, ichthyosis is a similar disease, mainly inherited and with a neonatal onset, and sometimes accompanied by other developmental defects. In the cavalier King Charles spaniel, the coat abnormality was noted at birth by the breeders as a 'curly coat', with deterioration of the skin signs as the animal became adult. These two conditions occurring together in this breed is well recognised by some breeders but rarely by the veterinary profession. Successful treatment is not possible, although some improvement, particularly of the keratoconjunctivitis sicca, can be obtained. The probable hereditary nature of the condition is an important factor for control.

  19. ORAL DIETHYLCARBAMAZINE AS ADJUVANT THERAPY IN REFRACTORY VERNAL KERATOCONJUNCTIVITIS - A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Roopashree

    2015-10-01

    Full Text Available PURPOSE: To evaluate the role of oral diethylcarbamazine as an adjuvant therapy in refractory vernal keratoconjunctivitis associated with eosinophilia. MATERIALS AND METHODS: Twenty four patients with bilateral refractory severe vernal keratoconjunctivitis (VKC and eosinophilia were included in the prospective study. The average age of patients was 8.25 years (range 3 to 14 years including 18 males (75% and 6 females (25%. The absolute eosinophil count (AEC in these pa tients was on an average 1065.79 cells/μL (range 530 to 3120 cells/μL. All the patients were given oral diethylcarbamazine (DEC as an adjuvant therapy for refractory VKC. RESULTS: At an average follow up of 7.2 months (range 6 to 11 months, only 2 cases (8.3% had recurrent exacerbation of VKC. Signs and symptoms of VKC improved significantly with remission in all the patients within 3 months. Absolute eosinophil count repeated after 3 months of starting DEC was on an average 376.25 cells/μL (range 200 t o 950 cells/μL. There was a statistically significant reduction in eosinophilia following oral DEC at p<0.0001. CONCLUSION: Oral DEC effectively reduces eosinophilia seen in refractory VKC. It is a cost effective and safe alternative as an adjuvant in ref ractory VKC with good clinical response

  20. [Follow-up study on patients with vernal keratoconjunctivitis undergoing topical 0.1% tacrolimus treatment].

    Science.gov (United States)

    Harada, Natsuko; Inada, Noriko; Ishimori, Akiko; Shoji, Jun; Sawa, Mitsuru

    2014-04-01

    A retrospective study for evaluating the clinical course of patients with vernal keratoconjunctivitis (VKC) treated with topical tacrolimus ophthalmic suspension 0.1% (Tacrolimus). Subjects were 30 patients (24 men and 6 women) with VKC who were treated with a combined therapy of Tacrolimus and antiallergic ophthalmic solution, and could be followed up for six months. The subjects were divided into two groups: 1. A conversion treatment group in which Tacrolimus was substituted for a steroid ophthalmic solution [21 patients; average age 14.7 +/- 9.44 years (mean +/- SD)] and 2. An additional treatment group receiving Tacrolimus and anti-allergic ophthalmic solution [9 patients; average age 28.2 +/- 7.31 years (mean +/- SD)]. The therapeutic effects of the patients were evaluated chronologically using the ocular clinical score according to the papillae-limbus-cornea grading score and eosinophil cationic protein (ECP) levels in tears. Papillae-limbus-cornea grading scores were significantly decreased from 8 (median) points at instillation initiation to 5 points at the first month after initiation of Tacrolimus treatment (p vernal keratoconjunctivitis was remarkable at one month after instillation initiation. For evaluating the effect of treatment and diagnosing exacerbation in VKC treated with Tacrolimus, a follow-up examination using clinical indexes such as the papillae-limbus-cornea grading score and ECP levels in tears is beneficial.

  1. Maternal mental health and social support: effect on childhood atopic and non-atopic asthma symptoms

    OpenAIRE

    Dos Santos, LM; Dos Santos, DN; Rodrigues,LC; Barreto,ML

    2011-01-01

    : BACKGROUND: Atopic and non-atopic asthma have distinct risk factors and immunological mechanisms, and few studies differentiate between the impacts of psychosocial factors on the prevalence of these disease phenotypes. The authors aimed to identify whether the effect of maternal mental health on prevalence of asthma symptoms differs between atopic and non-atopic children, taking into account family social support. METHODS: This is a cross-sectional study of 1013 children participating in th...

  2. Precipitins to dietary proteins in atopic eczema.

    Science.gov (United States)

    Barnetson, R S; Drummond, H; Ferguson, A

    1983-12-01

    Precipitating antibodies to foods have been assayed in three groups of patients with atopy. Forty-five per cent of patients with atopic eczema and IgE-mediated food allergy had precipitins to foods in their serum compared with only 15% of patients with atopic eczema without evidence of food allergy, and 16% of patients with atopic asthma and/or rhinitis. It is likely that this results from increased intestinal permeability in the group with eczema and food allergy.

  3. Effects of Atopic Syndrome on Keratoconus.

    Science.gov (United States)

    Shajari, Mehdi; Eberhardt, Emanuel; Müller, Michael; Al Khateeb, Ghada; Friderich, Stefan; Remy, Matthias; Kohnen, Thomas

    2016-11-01

    To evaluate the effects of atopic syndrome on manifestations of keratoconus. In this retrospective study, we reviewed patient files and data generated by Scheimpflug imaging of 670 eyes of 434 keratoconus patients. Patients were divided into a study group consisting of patients suffering from atopic syndrome (110 eyes of 75 patients), namely allergic asthma, atopic dermatitis, and/or allergic rhinitis, and a control group of patients without known atopic syndrome (560 eyes of 359 patients). We found a significant difference with the mean age being 36.1 ± 11.7 for the control group, 32.8 ± 9.6 for the atopic group (P = 0.002) with 1 atopic trait, and 30.4 ± 7.5 for patients with 2 or more atopic traits (P = 0.002). No statistically significant differences were found in the mean corrected distance visual acuity, corneal pachymetry, minimum relative pachymetric progression (RPImin), mean refraction, keratoconus index, anterior chamber depth and volume, Kmax, and location of Kmax in relation to the corneal apex. However, we found a significantly higher corneal density for the anterior 120 μm of the cornea in the atopic group (control: 20.74 ± 4.68, atopic group: 21.92 ± 4.65 P = 0.016). Keratoconus patients suffering from atopic syndrome were significantly younger but showed no topographical changes except in corneal densitometry compared with keratoconus patients without an atopic disease. This suggests atopic syndrome is a factor, which can trigger earlier manifestation of keratoconus.

  4. Japanese guidelines for atopic dermatitis 2017

    Directory of Open Access Journals (Sweden)

    Ichiro Katayama

    2017-04-01

    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 2015 (ADGL2015” 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 2016” together with those for other allergic diseases.

  5. Japanese Guideline for Atopic Dermatitis 2014

    Directory of Open Access Journals (Sweden)

    Ichiro Katayama

    2014-01-01

    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.

  6. Epidemiology and natural history of atopic diseases

    DEFF Research Database (Denmark)

    Thomsen, Simon F

    2015-01-01

    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 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...

  7. Clinical management of atopic dermatitis: practical highlights and updates from the atopic dermatitis practice parameter 2012.

    Science.gov (United States)

    Lio, Peter A; Lee, Margaret; LeBovidge, Jennifer; Timmons, Karol G; Schneider, Lynda

    2014-01-01

    Atopic dermatitis is a challenging condition for clinicians and patients. Recent advances were documented in the Atopic Dermatitis Practice Parameter 2012, and we want to provide clinicians with key points from the Atopic Dermatitis Practice Parameter 2012. In this article, we highlight the evidence-based therapy of atopic dermatitis as well as provide practical tips for clinicians and families. An updated review of immunopathology provides a firm basis for patient education and therapy. We also review clinical diagnosis and ways to improve quality of life for patients with atopic dermatitis. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Patient Burden of Atopic Dermatitis.

    Science.gov (United States)

    Sibbald, Cathryn; Drucker, Aaron M

    2017-07-01

    Atopic dermatitis is associated with significant patient burden, with impacts from symptoms and visible physical manifestations of the disease. Consequences include detrimental effects on quality of life (QoL), sleep, self-esteem, interpersonal relationships, participation in leisure and sports, and attendance or performance at school or work. Patients also spend a significant amount of time on treatments and care. Worsening severity of disease appears to be associated with a higher risk of impaired QoL, and pharmacologic and educational interventions that improve disease severity appear to, for the most part, simultaneously improve QoL. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. News from dendritic cells in atopic dermatitis.

    Science.gov (United States)

    Schäkel, Knut; Hänsel, Anja

    2011-10-01

    Dendritic cells are essential for the generation of innate and adaptive immune responses, which makes them stay on center stage when studying the immuno pathogenesis of atopic dermatitis. This review will discuss recent findings on the role of dendritic cells subsets in atopic dermatitis and will report novel findings on how the microenvironment conditions dendritic cells to fuel atopic dermatitis. Several microenvironmental factors characteristic for atopic dermatitis and with direct relevance for the disease have been defined. We now increasingly understand how thymic stromal lymphopoietin and histamine contribute to the disease by modulating the function of dendritic cells. We have learned much about the pathogenesis of atopic dermatitis by the studies on inflammatory dendritic epidermal cells. However, the current analysis on the functional and phenotypic heterogeneity of dendritic cells in eczematous skin lesions may lead to the definition of additional dendritic cell types relevant in the pathogenesis of atopic dermatitis. In this respect, it appears interesting to further discuss the parallels and differences in atopic dermatitis and psoriasis. Understanding the heterogeneity of dendritic cells and their functional alteration by local factors in the inflamed skin will provide essential clues to the immunopathogenesis of atopic dermatitis.

  10. Contact allergy in children with atopic dermatitis

    DEFF Research Database (Denmark)

    Simonsen, A B; Johansen, J D; Deleuran, M

    2017-01-01

    The importance of contact allergy in children with atopic dermatitis is frequently debated. Previously, patients with atopic dermatitis were believed to have a reduced ability to produce a type IV immunological response. However, this belief has been challenged and authors have highlighted the risk...... of underestimating and overlooking allergic contact dermatitis in children with atopic dermatitis. Several studies have been published aiming to shed light on this important question but results are contradictory. To provide an overview of the existing knowledge, we systematically reviewed studies that report...... frequencies of positive patch test reactions in children with atopic dermatitis. We identified 436 manuscripts of which 31 met the inclusion criteria. Although the literature is conflicting, it is evident that contact allergy is a common problem in children with atopic dermatitis....

  11. The Atopic March. A Literature Review

    Directory of Open Access Journals (Sweden)

    Juan F. Salazar-Espinosa

    2015-10-01

    Full Text Available The atopic march is defined as the progression of atopic diseases, generally during childhood, such as atopic dermatitis, asthma, allergic rhinitis and food allergies. The main risk factors for developing these atopic diseases include genetics, aeroallergens, food allergens, late food introduction to the infant, and living in developing countries. The immunologic contributors to this problem include the Th2 response, epigenetics, and lack of certain factors like thymic stromal lymphopoietin (TSLP and filaggrin. As a whole, the therapeutic approach has been changing during recent years because of the discovery of new factors involved in this problem. This article explains the definition of atopic march, the immunological pathway, clinical features, epidemiology and therapeutic approaches to create a context for the broader understanding of this important condition.

  12. Atopic dermatitis in Tunisian schoolchildren.

    Science.gov (United States)

    Amouri, Meriem; Masmoudi, Abderahmen; Borgi, Nozha; Rebai, Ahmed; Turki, Hamida

    2011-01-01

    The prevalence of atopic dermatitis (AD) is low in North Africa. We describe the epidemiology of this atopic condition among school children in Tunisia. We conducted a Cross-sectional survey study of 5 to 6-year-old schoolchildren from 21 primary schools of Sfax. The diagnosis of AD was based on the U.K. Working Party diagnostic criteria. A questionnaire including these criteria and some risk factors of AD was issued to the children. All children were examined by one dermatologist. Among the 1617 examined children, ten had AD giving a one-year prevalence of 0.65%. The overall sex ratio was 2.33. The disease occurred before the age of 2 years in 3 children. Pure AD without concomitant respiratory allergies was noted in 3 cases. One first-degree family member with atopy was at least noted in seven children. The strongest associated factor was the presence of AD in at least one parent and maternal age at the time of the child birth. Nor breast-feeding neither environmental characteristics of the house did correlate with AD. The prevalence of AD in Tunisian schoolchildren is low but comparable to those of other developing countries. Family history of atopy and maternal age at the birth time was the most important associated factors.

  13. Adenovirus-related epidemic keratoconjunctivitis outbreak at a hospital-affiliated ophthalmology clinic.

    Science.gov (United States)

    Muller, Matthew P; Siddiqui, Naureen; Ivancic, Rose; Wong, David

    2018-01-02

    Adenovirus-associated epidemic keratoconjunctivitis (A-EKC) is a cause of large and prolonged outbreaks in ophthalmology clinics and can result in substantial morbidity. A-EKC outbreaks are often the result of contaminated ophthalmologic equipment, surfaces, or hands. Contaminated multidose eye drops are also a likely culprit, but few prior studies provide clear epidemiologic evidence that adenovirus transmission resulted from contamination of eye drops. We describe an A-EKC outbreak at a large, hospital-affiliated eye clinic that affected 44 patients. The unique epidemiology of the outbreak provides strong evidence that contaminated multidose dilating eye drops resulted in adenovirus transmission. Removal of multidose eye medication from the clinic, combined with case finding, enhanced infection control and enhanced environmental cleaning, led to rapid control of the outbreak. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Boston type 1 keratoprosthesis for severe blinding vernal keratoconjunctivitis and Mooren's ulcer.

    Science.gov (United States)

    Basu, Sayan; Taneja, Mukesh; Sangwan, Virender S

    2011-06-01

    Indications for the Boston keratoprosthesis differ throughout the world depending on the prevailing regional causes of end-stage corneal disease. We report the short term anatomical and functional outcomes of the Boston type 1 keratoprosthesis for severe bilaterally blinding vernal keratoconjunctivitis and Mooren's ulcer. A retrospective chart review was conducted of 2 patients who underwent several unsuccessful ocular surface reconstruction procedures before Boston type 1 keratoprosthesis implantation. The anatomical and visual outcomes of the Boston type 1 keratoprosthesis at 1 year of follow-up were assessed clinically and by anterior segment optical coherence tomography imaging. The keratoprosthesis was retained in both the eyes at 1 year postoperatively with a best-corrected visual acuity of 20/30 in both patients. To our knowledge this is the first report of successful Boston keratoprosthesis implantation for these two unusual indications.

  15. Outcomes and Rationale of Excision and Mucous Membrane Grafting in Palpebral Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Iyer, Geetha; Agarwal, Shweta; Srinivasan, Bhaskar

    2017-10-13

    To report outcomes of mucous membrane grafting (MMG) for refractory giant papillae in vernal keratoconjunctivitis. Eleven eyes of 6 patients having giant papillae and recurrent shield ulcers refractory to topical medications, cryotherapy, and supratarsal steroid injections and shave excision of papillae underwent surgical resection of the giant papillae with MMG. Average occurrence of shield ulcers was twice per eye per year before the procedure with 50% of eyes having steroid-induced cataract and glaucoma. No recurrence of the shield ulcer in any eye was observed over a mean follow-up period of 38.2 (range 9-106) months. The papillae recurred beyond the graft junction in one eye. Surgical excision of refractory giant papillae followed by MMG does have its advantages in reducing their corneal complications, and it should be considered early in the management of exuberant refractory giant papillae.

  16. Surgical management and immunohistochemical study of corneal plaques in vernal keratoconjunctivitis.

    Science.gov (United States)

    Lin, Hsiu-Yi; Yeh, Po-Ting; Shiao, Cheng-Shiang; Hu, Fung-Rong

    2013-09-01

    Two children with shield ulcer in vernal keratoconjunctivitis unresponsive to steroid therapy received plaque removal by superficial keratectomy, followed by amniotic membrane transplantation (AMT). Hematoxylin and eosin staining of the excised corneal specimen revealed a thick layer of eosinophilic material attached to the Bowman's layer. These deposits were positive for eosinophil granule major basic protein, as confirmed by an immunohistochemical study. The shield ulcer healed after the amniotic membrane was removed. No recurrent corneal plaque developed, although corneal opacity complicated in both cases. Lamellar keratectomy with AMT offers an effective management by removing the cytotoxic plaques and protecting the denuded stroma from deposition of inflammatory debris. Copyright © 2012. Published by Elsevier B.V.

  17. Vernal keratoconjunctivitis in an Israeli group of patients and its treatment with sodium cromoglycate.

    Science.gov (United States)

    Baryishak, Y R; Zavaro, A; Monselise, M; Samra, Z; Sompolinsky, D

    1982-01-01

    Vernal keratoconjunctivitis (VKC) is usually considered as an allergic eye disorder of type I, and in most therapeutic trials it has been shown to yield to topical treatment with sodium cromoglycate. This has been confirmed in the present study of VKC patients from Israel. However, some of the cases seemed not to benefit from this treatment. In a survey of IgE levels in VKC patients in Israel tear IgE levels were significantly increased in 63.5%, but in 29% of the patients both tear and blood IgE levels were normal to low. The possibility that some of the cases diagnosed as VKC might have another cause than IgE-mediated atopy is discussed. Images PMID:6800400

  18. The role of Chlamydia pneumoniae in the etiology of keratoconjunctivitis sicca (KCS).

    Science.gov (United States)

    Krásny, Jan; Hrubá, Dana; Netuková, Magdalena

    2014-01-01

    The authors aimed to show the possible relationship between keratoconjunctivitis sicca (KCS) and Chlamydia pneumonia from the point of view of clinical and microbiological diagnostics. 94 adult patients were treated for follicular conjunctivitis with symptoms of KCS with possible Chlamydia pneumoniae etiology. The diagnosis of a chlamydial infection is based on the serological positivity of chlamydia antibodies and is further based on the antigen positivity in conjunctival imprint preparations. Patients were treated with azithromycin for a period of 12 days. The reciprocal relationship between chlamydial infection and ocular symptoms was proved at 21 patients (22%). Ninety% of patients showed positive anti-Chlamydia pneumoniae IgA and/or IgM with positivity in 80%, including anti-LSP IgA and/or IgM antibodies. This finding was in correlation with the medium to strongly positive finding of anti-cHSP60 IgG. In two patients, this infection was confirmed by the positivity of Chlamydia pneumoniae DNA in peripheral leucocytes. The test group (100 healthy persons) showed 69% negative finding of anti-Chlamydia pneumoniae antibodies or only positive anamnestic antibodies (IgG) and 31% positive antibodies IgA or IgM without clinical sings. This study indicated the possible relationship between KCS and Chlamydia pneumoniae in the course of simultaneous clinical signs of follicular conjunctivitis. KCS is a consequence of the action of local infection at the surface of the conjunctiva. It also indicated the necessity of simultaneous evaluation of microbiological findings and the clinical picture in consideration of overall antibiotic treatment in view of the high antibody background of Chlamydia pneumoniae in the adult population in the Czech Republic. The authors aimed to show the possible relationship between the keratoconjunctivitis sicca and Chlamydia pneumoniae based on results of the two studies. Some patents on conjunctivitis are also briefly described in this article.

  19. Search for rare decays of the B$0\\atop{s}$ meson with the DØ experiment

    Energy Technology Data Exchange (ETDEWEB)

    Bernhard, Ralf Patrick [Univ. of Zurich, Irchel (Switzerland)

    2005-10-01

    This document presents the searches for the flavour-changing neutral current decays B$0\\atop{s}$ → μ+μ- and B$0\\atop{s}$s → φμ+μ- . A data set with integrated luminosity of 300 pb-1 of proton-antiproton collisions at √ s = 1 . 96 TeV collected with the DØ detector in Run II of the FERMILAB Tevatron collider is used. The former decay mode is particularly sensitive to supersymmetric extensions of the Standard Model. For the latter mode, a measurement of the branching ratio could validate the prediction of the Standard Model. In the absence of an apparent signal, a limit on the branching fraction B(B$0\\atop{s}$ → μ+μ-) can be computed by normalising the upper limit on the number of events in the B$0\\atop{s}$ signal region to the number of reconstructed B ± → J/ψ K ± events. An upper limit on the branching fraction of B(B$0\\atop{s}$ → μ+ μ- ) ≤ 3.7 × 10-7 at a 95% CL is obtained. This limit can be used to constrain models beyond the Standard Model. In models where the lightest supersymmetric particle is considered to be a dark matter candidate the limit aids in restricting the dark matter scattering cross section on nucleons. For the decay B$0\\atop{s}$ → φμ+μ- also no signal has been observed and an upper limit on the branching ratio normalised to B$0\\atop{s}$ → J/ψ φ events of B$0\\atop{s}$ B(B$0\\atop{s}$ → φ μ+ μ-)/B(B$0\\atop{s}$→J/ψφ) < 4 . 4 × 10-3 at a 95% CL is obtained. In addition, the rare decay B$0\\atop{s}$ → ψ (2 S ) φ has been observed. To measure a branching ratio, the B$0\\atop{s}$ → J/ψ φ mode was used for normalisation, while B± → ψ (2S) K± and B± → J/ψ K± modes were used as control samples. The relative branching ratio has been measured to be B(B$0

  20. Use of textiles in atopic dermatitis: care of atopic dermatitis.

    Science.gov (United States)

    Ricci, G; Patrizi, A; Bellini, F; Medri, M

    2006-01-01

    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

  1. Gastrointestinal disorders in children with atopic dermatitis.

    Science.gov (United States)

    Rokaite, Rūta; Labanauskas, Liutauras

    2005-01-01

    The aims of this study were to analyze the peculiarities of allergies to food; to determine gastrointestinal disorders, endoscopic signs of mucosal damage and histological lesions of the mucosa and to establish their relation to the extent of atopic dermatitis and its degree of severity. A total of 164 children (86 boys and 78 girls) suffering only from atopic dermatitis were examined. Atopic dermatitis was diagnosed using standard diagnostic criteria; extent of disease (the Basic Clinical Scoring System (BCSS)) and the severity (Scoring Atopic Dermatitis (SCORAD) index), total serum IgE levels were determined; skin prick and patch tests with the main food allergens were performed. Using questionnaire gastrointestinal disorders with the symptoms of atopic dermatitis were ascertained. In children with atopic dermatitis suffering from chronic dyspepsia esophagealgastroduodenoscopy was performed and biopsy samples from the antrum of the stomach and duodenum were taken. The age of patients ranged from 6 months to 18 years. According to extent of atopic dermatitis and degree of severity localized, mild atopic dermatitis prevailed. Analysis of the changes in total Ig E levels showed different degree of sensitization of the children examined. Considering the type of allergic reaction, immediate-type allergic reactions dominated only in 11.6% of children with atopic dermatitis, whereas delayed-type allergic reactions manifested in 44.5% of children. No food allergy was present in one-fifth of children with atopic dermatitis. One hundred four (63.4%) children complained of gastrointestinal disorders. Of these 104 patients, 17 children (mean age 6.9 years) who underwent esophagealgastroduodenoscopy with biopsy had no pathology; however, histological examination of mucosa revealed eosinophilic infiltration in the gastric antrum and duodenum in three children. The most common gastrointestinal disorders are: abdominal pain vomiting, diarrhea, abdominal distention, and

  2. Maternal mental health and social support: effect on childhood atopic and non-atopic asthma symptoms.

    Science.gov (United States)

    Marques dos Santos, Letícia; Neves dos Santos, Darci; Rodrigues, Laura Cunha; Barreto, Maurício Lima

    2012-11-01

    Atopic and non-atopic asthma have distinct risk factors and immunological mechanisms, and few studies differentiate between the impacts of psychosocial factors on the prevalence of these disease phenotypes. The authors aimed to identify whether the effect of maternal mental health on prevalence of asthma symptoms differs between atopic and non-atopic children, taking into account family social support. This is a cross-sectional study of 1013 children participating in the Social Change Allergy and Asthma in Latin America project. Psychosocial data were collected through a household survey utilising Self-Reporting Questionnaire and Medical Outcome Study Social Support Scale. Socioeconomic and wheezing information was obtained through the questionnaire of the International Study of Allergy and Asthma in Childhood, and level of allergen-specific IgE was measured to identify atopy. Polytomous logistic regression was used to estimate the association between maternal mental health, social support and atopic and non-atopic wheezing. Effect modification was evaluated through stratified polytomous regression according to social support level. Maternal mental disorder had the same impact on atopic and non-atopic wheezing, even after adjusting for confounding variables. Affective, material and informational supports had protective effects on non-atopic asthma, and there is some evidence that social supports may act as a buffer for the impact of maternal mental disorder on non-atopic wheezing. Poor maternal mental health is positively associated with wheezing, independent of whether asthma is atopic or non-atopic, but perception of high levels of social support appears to buffer this relationship in non-atopic wheezers only.

  3. Family management of childhood atopic dermatitis.

    Science.gov (United States)

    Son, Hae Kyoung; Kim, Dong Hee; Lee, Hyejung; Kim, Heejung; Chung, Kyoungmee; Kim, Hee-Soon

    2018-02-22

    To identify the variables that affect family management of childhood atopic dermatitis and establish a prediction model based on Bandura's self-efficacy theory. Atopic dermatitis is a chronic recurrent skin disease and common health problem in childhood. It is necessary to use an approach that includes parental factors when considering the effective management of childhood atopic dermatitis. A cross-sectional study design. A convenience sample, comprising 168 Korean mothers caring for a child with atopic dermatitis under the age of 13, was recruited from the pediatric outpatient departments of two general hospitals in Seoul, South Korea. Data were collected using structured self-reported questionnaires including severity, antecedents, effort, self-efficacy and family management of childhood atopic dermatitis from 1 November 1 2015 - 28 February 28 2016. Descriptive statistics regarding the participants and variables were examined and data were analyzed using structural equation modeling. The hypothetical model had an adequate fit to the data, indicating that severity, antecedents, effort and self-efficacy influenced family management of childhood atopic dermatitis. These results suggest that strategies to support children with atopic dermatitis and their family should consider the influence of such variables. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  4. Clinical and allergological analysis of ocular manifestations of sick building syndrome.

    Science.gov (United States)

    Saeki, Yusuke; Kadonosono, Kazuaki; Uchio, Eiichi

    2017-01-01

    The disease concept of sick building syndrome (SBS) is still unclear. Ocular mucous membrane irritation is one of the major symptoms of SBS. However, the immunological aspects of the ocular complications of SBS are not yet clarified. The clinical and allergological aspects of SBS cases with ocular disorders with special reference to allergic conjunctival diseases (ACD) were analyzed, especially with respect to local immunological features. Twelve cases of SBS with ocular findings and 49 cases of ACD (allergic conjunctivitis [AC], atopic keratoconjunctivitis [AKC], and vernal keratoconjunctivitis [VKC]) for comparison were evaluated. The clinical findings in SBS and ACD were scored, and tear film breakup time (BUT) was measured. Cytokine (interferon-γ [IFN-γ], interleukin [IL]-2, IL-4, IL-5, IL-6, IL-8, and IL-13) concentrations in tears were analyzed by cytometric bead arrays. Eosinophil count in peripheral blood, total IgE in serum, and multiple allergen simultaneous test (MAST) for antigen-specific IgE were also measured. In SBS, conjunctival lesions were observed in all cases, and corneal abnormalities were found in two-thirds of the cases. Limbal lesions were observed in 2 pediatric cases. Mean serum total IgE level in SBS was significantly higher than that in AC; however, it was significantly lower than that in AKC and VKC. Eosinophil count in peripheral blood and number of positive allergens in MAST were significantly lower in SBS than in AKC and VKC. Significant elevation of tear IL-4 was observed in SBS and ACD. However, in contrast to ACD, elevation of other cytokines in tears was not observed in SBS. Mean tear BUT in SBS was in the normal range. From these results, SBS is thought to be partially induced by an allergic response. However, clinical dissociation of the ocular clinical findings and local immunological features in tear cytokines may suggest that SBS belongs to a different entity from ACD.

  5. Difficult to control atopic dermatitis

    Science.gov (United States)

    2013-01-01

    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

  6. Management of Children with Atopic Dermatitis: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Masoud Golpour

    2016-11-01

    Full Text Available Context Atopic dermatitis is a chronic, relapsing skin disorder that affects all ages including infancy and childhood. There are many proved and unproved treatments for atopic dermatitis. Evidence Acquisition Data sources of this narrative review included studies about pediatric atopic dermatitis with the following keywords, pediatric, atopic dermatitis, immunity, acute, chronic, pruritic inflammatory skin disorder, infancy, childhood, diagnosis, management and treatment. All of the articles were written in English language with full text on management or treatment. Results Innate and adaptive immune system involved atopic dermatitis. Major characteristics of atopic dermatitis include pruritus, chronic or relapsing lesions and personal or family history of atopic disease. There is no specific treatment for atopic dermatitis. The treatment included rehydration, emollients, topical steroid, calcineurin inhibitors and immunosuppressant. Crisaborole topical ointment, a PDE4 anti-inflammatory topical agent (phase three of the research could be effective in atopic dermatitis. Conclusions Avoidance from trigger factors and emollients are basic treatments of atopic dermatitis.

  7. Comparison of atopic cough with cough variant asthma: is atopic cough a precursor of asthma?

    OpenAIRE

    Fujimura, M; Ogawa, H.; Nishizawa, Y.; Nishi, K.

    2003-01-01

    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 ...

  8. Search for B$0\\atop{s}$ oscillations at D0

    Energy Technology Data Exchange (ETDEWEB)

    Bose, Tulika [Columbia Univ., New York, NY (United States)

    2006-01-01

    Measurement of the B$0\\atop{s}$ oscillation frequency via B$0\\atop{s}$ mixing analyses provides a powerful constraint on the CKM matrix elements. A search for B$0\\atop{s}$ oscillations was performed using data collected by the DØ detector during the period 2002-2005 at the Fermilab Tevatron. Approximately 610 pb-1 of data was analyzed to reconstruct a large set of B0 s mesons in different semileptonic decay modes. Opposite-side flavor tagging algorithms that were tested on semileptonic B0 d decays with the measurement of the B$0\\atop{d}$ mixing frequency were used to determine the initial state flavor of the reconstructed B0 s meson. No significant signal for any particular value of the oscillation frequency was found. A 95% confidence level limit on the B$0\\atop{s}$ oscillation frequency Δms > 7.3 ps-1 and a sensitivity of 9.5 ps-1 were obtained.

  9. Qualitative vs. quantitative atopic dermatitis criteria

    DEFF Research Database (Denmark)

    Andersen, R M; Thyssen, J P; Maibach, H I

    2016-01-01

    This review summarizes historical aspects, clinical expression and pathophysiology leading to coining of the terms atopy and atopic dermatitis, current diagnostic criteria and further explore the possibility of developing quantitative diagnostic criteria of atopic dermatitis (AD) based on the imp......This review summarizes historical aspects, clinical expression and pathophysiology leading to coining of the terms atopy and atopic dermatitis, current diagnostic criteria and further explore the possibility of developing quantitative diagnostic criteria of atopic dermatitis (AD) based...... phenomenon. Specific pheno- and endotypes are now emerging potentially enabling us to better classify patients with AD, but the influence of these on the diagnosis of AD is so far unclear. Few diagnostic models use quantitative scoring systems to establish AD cases from normal population, which, however, may...

  10. A study of atopic diseases in Basrah

    African Journals Online (AJOL)

    STORAGESEVER

    2008-11-19

    Allergic and Asthma diseases center) under clinician supervision to diagnosis atopic diseases for both sex and various age group depending on minor and major criteria for each disease. (Hollingsworth et al., 2005; Sheikh, 2004; ...

  11. Atopic dermatitis in the domestic dog.

    Science.gov (United States)

    Pucheu-Haston, Cherie M

    2016-01-01

    Dogs may develop a syndrome of spontaneous, inflammatory, pruritic dermatitis that shares many features with human atopic dermatitis, including a young age of onset, characteristic lesion distribution, immunoglobulin E sensitization to common environmental allergen sources, and evidence of epidermal barrier dysfunction. There are also several important differences between canine and human atopic dermatitis. Although dogs may suffer from multiple-organ hypersensitivity syndromes, there is no evidence that this species experiences the progressive evolution from cutaneous to respiratory allergy characteristic of the human atopic march. Despite the presence of epidermal barrier derangement, there is no significant association between canine atopic dermatitis and mutations in filaggrin. Finally, treatment of canine disease relies much less heavily on topical therapy than does its human counterpart, while allergy testing and allergen-specific immunotherapy provide an often essential component of effective clinical management of affected dogs. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Skin absorption through atopic dermatitis skin

    DEFF Research Database (Denmark)

    Halling-Overgaard, A-S; Kezic, S; Jakasa, I

    2017-01-01

    Patients with atopic dermatitis have skin barrier impairment in both lesional and non-lesional skin. They are typically exposed to emollients daily and topical anti-inflammatory medicaments intermittently, hereby increasing the risk of developing contact allergy and systemic exposed to chemicals...... ingredients found in these topical preparations. We systematically searched for studies that investigated skin absorption of various penetrants, including medicaments, in atopic dermatitis patients, but also animals with experimentally induced dermatitis. We identified 40 articles, i.e. 11 human studies...... examining model penetrants, 26 human studies examining atopic dermatitis drugs and 3 animal studies. We conclude that atopic dermatitis patients have nearly two-fold increased skin absorption when compared to healthy controls. There is a need for well-designed epidemiological and dermato...

  13. When does atopic dermatitis warrant systemic therapy?

    DEFF Research Database (Denmark)

    Simpson, Eric L; Bruin-Weller, Marjolein; Flohr, Carsten

    2017-01-01

    BACKGROUND: Although most patients with atopic dermatitis (AD) are effectively managed with topical medication, a significant minority require systemic therapy. Guidelines for decision making about advancement to systemic therapy are lacking. OBJECTIVE: To guide those considering use of systemic ...

  14. Emerging therapies for atopic dermatitis: JAK inhibitors.

    Science.gov (United States)

    Cotter, David G; Schairer, David; Eichenfield, Lawrence

    2018-03-01

    The Janus kinase-signal transducer and activator of transcription pathway is a conserved master regulator of immunity and myeloproliferation. Advanced understanding of this pathway has led to development of targeted inhibitors of Janus kinases (Jakinibs). As a class, JAK inhibitors effectively treat a multitude of hematologic and inflammatory diseases. Given such success, use of JAK inhibitors for mitigation of atopic dermatitis is under active investigation. Herein, we review the evolving data on the safety and efficacy of JAK inhibitors in treatment of atopic dermatitis. Although it is still early in the study of JAK inhibitors for atopic dermatitis, evidence identifies JAK inhibitors as effective alternatives to conventional therapies. Nonetheless, multiple large safety and efficacy trials are needed before widespread use of JAK inhibitors can be advocated for atopic dermatitis. Copyright © 2017. Published by Elsevier Inc.

  15. Soluble interleukin 2 receptor in atopic eczema.

    OpenAIRE

    Colver, G. B.; Symons, J A; Duff, G. W.

    1989-01-01

    OBJECTIVE--To determine whether serum soluble interleukin 2 receptor concentrations are related to disease activity in atopic eczema. DESIGN--Single cohort longitudinal study with controls. SETTING--Outpatient and general medicine departments in secondary referral centre. PATIENTS--Of 15 patients aged 17-57 with severe atopic eczema, all with acute exacerbations of disease, 13 were admitted to hospital and two treated as outpatients until the skin lesions had resolved or greatly improved. Nin...

  16. [Atopic dermatitis in children. New aspects].

    Science.gov (United States)

    Schnopp, C; Mempel, M

    2015-04-01

    Atopic dermatitis in childhood is controlled by adaequate topical treatment in the majority of cases. Severe manifestations, recurrent superinfections, associated food allergy and psychosocial aspects of a chronic disease in childhood need special consideration. Furthermore, prevention is an important issue in this age group. The following article focuses on new aspects with repercussions on the management of childhood atopic dermatitis and possible implications for the future.

  17. Probiotics and Atopic Dermatitis in Children

    OpenAIRE

    Gian Vincenzo Zuccotti; Chiara Mameli; Valentina Fabiano; Fabio Meneghin

    2012-01-01

    There is increasing interest in the potential beneficial role of probiotic supplementation in the prevention and treatment of atopic diseases in children. Probiotics are defined as ingested live microorganisms that, when administered in an adequate amount, confer a health benefit to the host. They are mainly represented by Lactobacilli and Bifidobacteria. Several epidemiological data demonstrate that intestinal microflora of atopic children is different from the one of healthy children. Many ...

  18. Common Allergens in Patients with Atopic Dermatitis

    OpenAIRE

    Bonyadi, MR. (PhD; Ezzati, F. (MSc

    2014-01-01

    Background and objective: Being exposed to different allergens, followed by the production of specific IgE, has an important role in causing atopic dermatitis, recognizing the allergens and applying immunotherapy for treatment. We aimed to determine the frequency of common allergens in the patients suffering from atopic dermatitis. Material and Methods: In this descriptive- analytical study the serum level of total IgE and frequency of specific IgE were measured by Immunoblotting method again...

  19. Gene-environment interaction in atopic diseases

    DEFF Research Database (Denmark)

    Kahr, Niklas; Naeser, Vibeke; Stensballe, Lone Graff

    2015-01-01

    stratified by exposure status showed no significant change in the heritability of asthma according to the identified risk factors. CONCLUSION: In this population-based study of children, there was no evidence of genetic effect modification of atopic diseases by several identified early-life risk factors....... The causal relationship between these risk factors and atopic diseases may therefore be mediated via mechanisms different from gene-environment interaction....

  20. Lifetime difference in the B$0\\atop{s}$ system from untagged B$0\\atop{s}$ → J/ΨΦ decay at √s= 1.96 TeV at D0 detector

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, Avdhesh [Tata Inst. of Fundamental Research (TIFR), Mumbai (India)

    2006-01-01

    In this dissertation, they present a study of the untagged decay of B$0\\atop{s}$ → J/ΨΦ, the final state of which is a superposition of the CP-even and CP-odd states. Within the framework of the standard model (SM), to a good approximation, the two CP eigenstates of the (B$0\\atop{s}$, $\\bar{B}$$0\\atop{s}$) system are equivalent to mass eigenstates. The data collected by the D0 detector between June 2002 to August 2004 (an integrated luminosity of approximately 450 pb-1) has been used for the analysis presented in this thesis. From a simultaneous fit to the B$0\\atop{s}$ candidate mass, lifetime, and the angular distribution of the decay products, they obtain the CP-odd fraction in the final state at production time to be 0.16 ±} 0.10(stat) ± 0.02(syst). The average lifetime of the (B$0\\atop{s}$, $\\bar{B}$$0\\atop{s}$) system is measured to be 1.39$+0.13\\atop{-0.16}$(stat)$+0.01\\atop{-0.02}$(syst) ps, with the relative width difference between the heavy and light mass eigenstates, Δγ/$\\bar{γ}$ = (γLH)/$\\bar{γ}$ = 0.24$+0.16\\atop{-0.38}$(stat)$+0.03\\atop{-0.04}$(syst). With the additional constraint from the world average of the B$0\\atop{s}$ lifetime measurements using semileptonic decays, they find average lifetime of the (B$0\\atop{s}$, $\\bar{B}$$0\\atop{s}$) system 1.39 ± 0.06 ps with Δγ/$\\bar{γ}$ = 0.25$+0.14\\atop{-0.15}$. They have also done B0 lifetime measurement for its analogous decay mode to J/Ψ}K*. With this measurement they get B0 lifetime 1.530 ± 0.043(stat) ± 0.023(syst) ps. Using above results, they get 0.91 ± 0.09(stat) ± 0.003(syst), for the ratio of the B$0\\atop{s}$ and B0 lifetimes ($\\bar{γ}$(B$0\\atop{s}$)/γ(B0)). These measurements are consistent with the predictions of SM within the measurement uncertainty.

  1. ATOPIC DERMATITIS: NEW ASPECTS OF TREATMENT

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    D. Sh. Macharadze

    2013-01-01

    Full Text Available Atopic dermatitis is a chronic inflammatory cutaneous disease, which demands a prolonged treatment. A modern views on the main approaches to treatment of atopic dermatitis in children and adults are analyzed in this article. The treatment is based on the permanent use of emollients in order to achieve an anti-inflammatory effect — topical calcineurin inhibitors (tacrolimus and pimecrolimus, and short courses (5 days of topical corticosteroids during relapses. For the 10-year period of topical calcineurin inhibitors usage in treatment of atopic dermatitis a great amount of experimental and clinical data have been accumulated. Two the most important changes and additions in the treatment of atopic dermatitis in recent times were related to a new hypothesis of proactive therapy with the use of topical tacrolimus and closing of «black box» warnings, associated to malignization risk due to the long-term usage of topical calcineurin inhibitors. Since atopic dermatitis is characterized by relapsing course, nowadays topical tacrolimus should be considered the most appropriate treatment approach, both in adults and children. The results of investigations confirmed more than 6-times decrease in relapse rate, as well as the significant improvement of quality of life, when the above-mentioned treatment scheme is used, both in children and adults.Key words: children, atopic dermatitis, emollients, treatment, tacrolimus.

  2. Effects of examination stress on psychological responses, sleep and allergic symptoms in atopic and non-atopic students.

    Science.gov (United States)

    Jernelöv, Susanna; Höglund, Caroline Olgart; Axelsson, John; Axén, Jennie; Grönneberg, Reidar; Grunewald, Johan; Stierna, Pontus; Lekander, Mats

    2009-01-01

    Recent findings indicate that atopics may be more vulnerable to stress than non-atopics. However, the roles of psychological well-being and sleep in this presumed increased sensitivity are not known. To investigate the effects of a brief naturalistic stressor on psychological responses, sleep, and allergic symptoms and to compare those responses between atopic and non-atopic individuals. We assessed atopic and non-atopic students during a period without and during a period with examinations. For both atopic and non-atopic students, tension, anxiety, and depression deteriorated in response to examination, as did sleep latency and sleep quality. Overall, atopics were more tense, had more anxiety, longer sleep latencies, and were less well rested than non-atopics. Non-atopic students rose from bed later during the examination period. In response to examination, atopic students reported increased frequency of stress behaviors (e.g., eating fast), while decreased stress behaviors were reported by non-atopic students. Allergic symptoms were not affected. Atopic students were worse off in aspects of psychological well-being and sleep, but displayed only partly stronger responses to a stressor compared to non-atopic students. In spite of a broad negative response to examination, allergic symptoms were not affected.

  3. Probiotics and infantile atopic eczema

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    Akelma AZ

    2015-09-01

    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

  4. Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis

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    Ang M

    2012-08-01

    Full Text Available Marcus Ang,1 Seng-Ei Ti,1 Raymond Loh,1 Sonal Farzavandi,1 Rongli Zhang,2 Donald Tan,1 Cordelia Chan11Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, SingaporeBackground: We describe clinical characteristics and risk factors for corticosteroid response in children with severe vernal keratoconjunctivitis (VKC.Design: Retrospective, noncontrolled, comparative case series.Participants: Patients from three tertiary centers in Singapore.Methods: We reviewed patients with severe VKC (clinical grade > 2 who were on topical steroid therapy, with a minimum follow-up period of 1 year post-presentation. Logistic regression was used to determine risk factors for corticosteroid response.Main outcome measure: Corticosteroid response was defined as intraocular pressure (IOP>21 mmHg (three consecutive readings, or a rise of more than 16 mmHg from baseline, after commencement of steroid therapy in the absence of other possible causes of raised IOP.Results: Forty-one of 145 (28.3% patients developed a corticosteroid response, of which eight (5.5% progressed to glaucoma. The overall mean age of onset of VKC was 9.9 ± 4.4 years. Longer duration of corticosteroid use (OR, 5.06; 95% CI: 1.04–25.56; P = 0.45 and topical dexamethasone 0.01% (OR, 2.25; 95% CI: 1.99–5.08; P = 0.40 were associated with corticosteroid response. Mixed type of VKC (OR, 9.76; 95% CI: 3.55–26.77; P < 0.001, the presence of limbal neovascularization of ≥ three quadrants (OR, 6.33; 95% CI: 2.36–16.97; P < 0.001, and corneal involvement (OR, 3.51; 95% CI: 1.31–9.41; P = 0.012 were significant clinical risk factors after adjusting for potential confounders such as age, sex, ethnicity, duration, and type of corticosteroid used.Conclusion: Children on long-term oral corticosteroids with severe, mixed-type VKC and corneal involvement are more likely to develop corticosteroid response, and may require early treatment to prevent progression to glaucoma

  5. Efficacy and safety of low-dose topical tacrolimus in vernal keratoconjunctivitis

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    Shoughy SS

    2016-04-01

    Full Text Available Samir S Shoughy,1 Mahmoud O Jaroudi,1 Khalid F Tabbara1–3 1The Eye Center and The Eye Foundation for Research in Ophthalmology, 2Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Wilmer Ophthalmological Institute of the Johns Hopkins University School of Medicine, Baltimore, MD, USA Objective: The objective of this study was to evaluate the efficacy and safety of topical low-dose tacrolimus (0.01% solution in patients with vernal keratoconjunctivitis (VKC. Patients and methods: A total of 62 consecutive patients with VKC refractory to conventional treatment were included retrospectively. Tacrolimus 0.01% ophthalmic solution was administered to patients twice daily after discontinuation of all previous topical medications. The duration of treatment ranged from 1 month to 29 months. The clinical symptoms of itching, redness, foreign body sensation, and discharge and the clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots, and superficial punctate keratopathy were graded as 0 (normal, 1+ (mild, 2+ (moderate, or 3+ (severe. Assessment was carried out before initiation of therapy and on the last visit after treatment. Results: There were 62 patients with VKC comprising 49 male and 13 female patients. The median age was 12 years (range: 5–47 years. The mean visual acuity improved from 20/30 to 20/25 following treatment. There was statistically significant improvement in symptoms of itching (P<0.001, redness (P<0.001, foreign body sensation (P<0.001, and discharge (P<0.001. Statistically significant improvement was also observed in clinical signs of conjunctival hyperemia (P<0.001, limbal infiltration (P<0.001, Trantas dots (P<0.001, superficial punctate keratopathy (P<0.001, and conjunctival papillary hypertrophy (P<0.001. The solution form of tacrolimus was well tolerated. None of the patients developed elevation of intraocular pressure

  6. Atopic dermatitis phenotypes and the need for personalized medicine

    Science.gov (United States)

    Cabanillas, Beatriz; Brehler, Ann-Christin; Novak, Natalija

    2017-01-01

    Purpose of review To describe recent developments in therapies which target the molecular mechanisms in atopic dermatitis. Recent findings Current advances in the understanding of the molecular basis of atopic dermatitis are leading to the stratification of different atopic dermatitis phenotypes. New therapies offer the option to target-specific molecules involved in the pathophysiology of atopic dermatitis. Current new therapies under investigation aim to modulate specific inflammatory pathways associated with distinctive atopic dermatitis phenotypes, which would potentially translate into the development of personalized, targeted-specific treatments of atopic dermatitis. Summary Despite the unmet need for well tolerated, effective, and personalized treatment of atopic dermatitis, the current standard treatments of atopic dermatitis do not focus on the individual pathogenesis of the disease. The development of targeted, phenotype-specific therapies has the potential to open a new promising era of individualized treatment of atopic dermatitis. PMID:28582322

  7. Case Report of Restoration of the Corneal Epithelium in a Patient with Atopic Keratoconjunctivitis Resulting in Amelioration of Ocular Allergic Inflammation

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    Ken Fukuda

    2010-01-01

    Discussion: This case suggests that loss of corneal epithelial integrity likely exacerbates conjunctival allergic inflammation and that restoration or maintenance of the barrier function of the corneal epithelium may be one of the important targets for the treatment of severe ocular allergic diseases.

  8. Wheeze in children : the impact of parental education on atopic and non-atopic symptoms

    NARCIS (Netherlands)

    de Meer, Gea; Reijneveld, Sijmen A.; Brunekreef, Bert

    There is conflicting evidence for the relationship between parental socioeconomic position and their children's asthma. The aim of this study was to investigate relationships between parental education and respiratory symptoms in their children, distinguishing atopic and non-atopic symptoms. A

  9. Wheeze in children: the impact of parental education on atopic and non-atopic symptoms.

    NARCIS (Netherlands)

    de Meer, G.; Reijneveld, S.A.; Brunekreef, B.

    2010-01-01

    There is conflicting evidence for the relationship between parental socioeconomic position and their children's asthma. The aim of this study was to investigate relationships between parental education and respiratory symptoms in their children, distinguishing atopic and non-atopic symptoms. A

  10. [Food allergy in atopic dermatitis].

    Science.gov (United States)

    Wichmann, K; Heratizadeh, A; Werfel, T

    2012-04-01

    Food allergy predominantly affects children rather than adult patients with atopic dermatitis (AD). Early sensitization to foods has been found to be significantly associated with AD. Three different patterns of clinical reactions to food allergens in AD patients exist: i. immediate-type reaction, ii. isolated late-type reaction, iii. combined reaction (i. + ii.). While in children allergens from cow's milk, hen's egg, soy, wheat, fish, peanut or tree nuts are mostly responsible for allergic reactions, birch-pollen related food allergens seem to play a major role in adolescent and adults with AD in Central and Northern Europe. Defects of the epidermal barrier function seem to facilitate the development of sensitization to allergens following epicutaneous exposure. The relevance of defects of the gut barrier as well as genetic characteristics associated with an increased risk for food allergy remain to be further investigated. Numerous studies focus on prevention strategies which include breast-feeding or feeding with hydrolyzed milk substitute formula during the first 4 months of life.

  11. Emerging drugs for atopic dermatitis.

    Science.gov (United States)

    Ong, Peck Y

    2009-03-01

    Atopic dermatitis (AD) is the most common chronic inflammatory skin disease, affecting 10-20% of children and 2% of adults worldwide. Preventive treatment of AD consists of daily skin hydration and emollient therapy; but the majority of patients still require symptomatic treatment with topical corticosteroids and/or topical calcineurin inhibitors, both of which may be associated with potential long-term side effects. With increasing evidence supporting the role of skin barrier defects in the pathogenesis of AD, there is also a parallel increase in medications that claim to assist barrier repair. The current review discusses some exciting results with these medications, as well as the challenges that lie ahead of them. While barrier repair treatments offer some promise, there continues to be a need for safer anti-inflammatory medications. Some of these medications under investigation are phosphodiesterase-4 inhibitors, urocanic acid oxidation products and IL-4/IL-13 receptor blockers. The review also discusses anti-staphylococcal treatments including nanocrystalline silver cream, silver and antimicrobial-coated fabrics, and anti-itch treatments including mu-opiod receptor antagonists, chymase inhibitors and cannabinoid receptor agonists. These medications may become an integral part of AD therapy.

  12. Study of B$0\\atop{s}$ Mixing at the D-Zero Detector at Fermilab Using the Semi-leptonic Decay B$0\\atop{s}$ → D$-\\atop{s}$ μ+v X

    Energy Technology Data Exchange (ETDEWEB)

    Anzelc, Meghan [Northwestern Univ., Evanston, IL (United States)

    2008-06-01

    B$0\\atop{s}$ mixing studies provide a precision test of Charge-Parity violation in the Standard Model. A measurement of Δms constrains elements of the CKM quark rotation matrix [1], providing a probe of Standard Model Charge-Parity violation. This thesis describes a study of B$0\\atop{s}$ mixing in the semileptonic decay B$0\\atop{s}$ → Ds- μ+vX, where Ds- → Φπ-, using data collected at the D-Zero detector at Fermi National Accelerator in Batavia, Illinois. Approximately 2.8 fb-1 of data collected between April 2002 and August 2007 was used, covering the entirety of the Tevatron's RunIIa (April 2002 to March 2006) and part of RunIIb (March 2006-August 2007). Taggers using both opposite-side and same-side information were used to obtain the flavor information of the Bs0 meson at production. The charge of the muon in the decay B$0\\atop{s}$ → Ds-μ+vX was used to determine the flavor of the B$0\\atop{s}$ at decay. The B$d\\atop{0}$ mixing frequency, Δmd, was measured to verify the analysis procedure. A log-likelihood calculation was performed, and a measurement of Δms was obtained. The final result was Δms = 18.86 ± 0.80(stat.) ± 0.37(sys.) with a significance of 2.6σ.

  13. Japanese guidelines for atopic dermatitis 2017.

    Science.gov (United States)

    Katayama, Ichiro; Aihara, Michiko; Ohya, Yukihiro; Saeki, Hidehisa; Shimojo, Naoki; Shoji, Shunsuke; Taniguchi, Masami; Yamada, Hidekazu

    2017-04-01

    Given the importance of appropriate diagnosis and appropriate assessment of cutaneous symptoms in treatment of atopic dermatitis, the basics of treatment in this guideline are composed of (1) investigation and countermeasures of causes and exacerbating factors, (2) correction of skin dysfunctions (skin care), and (3) pharmacotherapy, as three mainstays. These are based on the disease concept that atopic dermatitis is an inflammatory cutaneous disease with eczema by atopic diathesis, multi-factorial in onset and aggravation, and accompanied by skin dysfunctions. These three points are equally important and should be appropriately combined in accordance with the symptoms of each patient. In treatment, it is important to transmit the etiological, pathological, physiological, or therapeutic information to the patient to build a favorable partnership with the patient or his/her family so that they may fully understand the treatment. This guideline discusses chiefly the basic therapy in relation to the treatment of this disease. The goal of treatment is to enable patients to lead an uninterrupted social life and to control their cutaneous symptoms so that their quality of life (QOL) may meet a satisfactory level. 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 2015 (ADGL2015)" 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 2016" together with those for other allergic diseases. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  14. Increased Incidence of Thyroid Dysfunction and Autoimmunity in Patients with Vernal Keratoconjunctivitis

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    Stefano Stagi

    2014-01-01

    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.

  15. Increased incidence of thyroid dysfunction and autoimmunity in patients with vernal keratoconjunctivitis.

    Science.gov (United States)

    Stagi, Stefano; Pucci, Neri; Di Grande, Laura; de Libero, Cinzia; Caputo, Roberto; Pantano, Stefano; Mattei, Ivan; Mori, Francesca; de Martino, Maurizio; Novembre, Elio

    2014-01-01

    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.

  16. Low dose Mitomycin-C in severe vernal keratoconjunctivitis: A randomized prospective double blind study

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    Jain Arun

    2006-01-01

    Full Text Available Purpose: To study the efficacy and safety of low dose topical Mitomycin C (MMC in severe Vernal keratoconjunctivitis (VKC. Design: Placebo controlled double masked randomized clinical trial. Materials and Methods: Twenty-eight patients with severe VKC were randomly assigned to receive either topical MMC (0.01% (n=17 or distilled water (n=11 three times daily for a period of two weeks. Signs and symptoms were recorded on day of presentation and at the end of treatment period (2 weeks. Mann Whitney test was used to analyze the signs and symptoms in the two groups. Results: No statistically significant difference was observed in terms of severity of symptoms at presentation. At two weeks patients in the MMC group showed significant decrease in tearing, foreign body sensation, discharge, hyperemia, punctate keratitis, limbal edema and trantas spots. No adverse effect of MMC was observed. Conclusion: Short term low dose topical MMC is an effective and safe drug to control acute exacerbations in patients of severe VKC refractory to conventional treatment.

  17. Dry Eye in Vernal Keratoconjunctivitis: A Cross-Sectional Comparative Study.

    Science.gov (United States)

    Villani, Edoardo; Strologo, Marika Dello; Pichi, Francesco; Luccarelli, Saverio V; De Cillà, Stefano; Serafino, Massimiliano; Nucci, Paolo

    2015-10-01

    The purpose of this comparative cross-sectional study was to investigate the use of standardized clinical tests for dry eye in pediatric patients with active and quiet vernal keratoconjunctivitis (VKC) and to compare them with healthy children.We recruited 35 active VKC, 35 inactive VKC, and 70 age-matched control healthy subjects. Each child underwent a complete eye examination, including visual analog scale symptoms assessment, biomicroscopy, fluorescein break-up time (BUT), corneal fluorescein and conjunctival lissamine green staining, corneal esthesiometry, Schirmer test with anesthetic, and meibomian glands inspection and expression.Active VKC patients showed significantly increased symptoms and signs of ocular surface disease, compared with the other 2 groups. Inactive VKC patients, compared with control subjects, showed increased photophobia (P < 0.05; Mann-Whitney U test), conjunctival lissamine green staining and Schirmer test values, and reduced BUT and corneal sensitivity [P < 0.05 by analysis of variance (ANOVA) least significant difference posthoc test for BUT and Schirmer; P < 0.001 by Mann-Whitney U test for lissamine green staining and corneal sensitivity].Our results confirm the association between VKC and short-BUT dry eye. This syndrome seems to affect the ocular surface in quiescent phases too, determining abnormalities in tear film stability, epithelial cells integrity, and corneal nerves function. The very long-term consequences of this perennial mechanism of ocular surface damage have not been fully understood yet.

  18. Tacrolimus eye drops as monotherapy for vernal keratoconjunctivitis: a randomized controlled trial.

    Science.gov (United States)

    Müller, Eduardo Gayger; Santos, Myrna Serapião Dos; Freitas, Denise; Gomes, José Álvaro Pereira; Belfort, Rubens

    2017-06-01

    To assess the efficacy of monotherapy using tacrolimus eye drops versus sodium cromoglycate for the treatment of vernal keratoconjunctivitis (VKC). Randomized double-masked controlled trial comparing the efficacy of tacrolimus 0.03% eye drops t.i.d. (Group 1) with sodium cromoglycate 4% eye drops t.i.d. (Group 2) for the symptomatic control of VKC at days 0, 15, 30, 45, and 90 of follow-up. Visual acuity, intraocular pressure, and other complications were evaluated to assess safety and side effects. In total, 16 patients were included, with 8 enrolled in each group. Two patients from Group 2 were excluded from the analysis at days 45 and 90 because of corticosteroid use. Most patients were male (81.8%) and presented with limbal VKC (56.3%). There were statistically significant differences in favor of tacrolimus in the following severity scores: itching at day 90 (p=0.001); foreign body sensation at day 15 (p=0.042); photophobia at day 30 (p=0.041); keratitis at day 30 (p=0.048); and limbal activity at days 15 (p=0.011), 30 (p=0.007), and 45 (p=0.015). No relevant adverse effects were reported, except for a burning sensation with tacrolimus, though this did not compromise treatment compliance. Treatment with tacrolimus was superior to sodium cromoglycate when comparing severity scores for symptoms of itching, foreign body sensation, and photophobia, as well as for signs of limbal inflammatory activity and keratitis.

  19. In vivo confocal microscopy of meibomian glands and palpebral conjunctiva in vernal keratoconjunctivitis

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    Qiaoling Wei

    2015-01-01

    Full Text Available Purpose: To investigate the correlations between conjunctival inflammatory status and meibomian gland (MG morphology in vernal keratoconjunctivitis (VKC patients by using in vivo confocal microscopy (CM. Materials and Methods: Nineteen VKC patients (7 limbal, 7 tarsal, and 5 mixed forms and 16 normal volunteers (controls were enrolled. All subjects underwent CM scanning to obtain the images of upper palpebral conjunctiva and MGs. Inflammatory cell (IC density in palpebral conjunctival epithelial and stromal layers, Langerhans cell (LC density at lid margins and the stroma adjacent to the MG, and MG acinar unit density (MGAUD were recorded. The longest and shortest diameters of MG acinar were measured. The Kruskal-Wallis test was used to compare the parameter differences whereas the Spearman′s rank correlation analysis was applied to determine their correlations. Results: Among all groups, no significant statistical differences were found in epithelial and stromal IC densities, mean values of MG acinar unit densities, or longest and shortest diameters. Both LC parameters in the tarsal-mixed groups were significantly higher than those in the limbal and control groups. All LC densities of VKC patients showed a positive correlation with MGAUD and shortest diameter. Conclusions: In VKC patients, the conjunctival inflammatory status could be associated with the MG status. In vivo CM is a noninvasive, efficient tool in the assessment of MG status and ocular surface.

  20. Mean platelet volume and neutrophil to lymphocyte ratio in patients with vernal keratoconjunctivitis

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    Bilal Elbey

    2015-03-01

    Full Text Available Objective: It was aimed to investigate the neutrophil, eosinophil, lymphocyte, platelet count, neutrophil to lymphocyte ratio (NLR and mean platelet volume (MPV in patients with vernal keratoconjunctivitis (VKC. Methods: The medical records of the VKC patients who admitted to ophthalmology polyclinic were evaluated. Age and sex matched control group was consisted with patients without any systemic or ocular disease except strabismus. Age and gender of all participants were recorded. Hemogram parameters such as mean platelet volume (MPV, neutrophil, eosinophil, lymphocyte, platelet count, NLR were measured by automatized analyzer. Data were compared between the groups. Results: Thirty patients and 30 control subjects were studied. There were no significant differences with respect to age and gender between groups. The mean MPV and NLR values were higher but not statistically significant in VKC group compared to control group (p=0.19, p=0.16, respectively. Conclusion:The results of the current study demonstrated that MPV and NLR values were not associated with VKC. Higher MPV and NLR results in patients with VKC although the differences were not reach statistically significances may suggest that MPV and NLR may be auxiliary parameter.J Clin Exp Invest 2015; 6 (1: 40-43

  1. Supratarsal injection of corticosteroids in the treatment of refractory vernal keratoconjunctivitis.

    Directory of Open Access Journals (Sweden)

    Singh S

    2001-01-01

    Full Text Available PURPOSE: To study and compare the efficacy of supratarsal injection of dexamethasone sodium phosphate, triamcinolone acetonide and hydrocortisone sodium succinate in treating refractory vernal keratoconjunctivitis (VKC. METHODS: Prospective randomized, double-masked, case control trial, including 90 eyes of 45 patients with refractory VKC. Both eyes of each patient were randomly assigned to receive supratarsal injection of one of three compounds under study: dexamethasone sodium phosphate (2 mg, triamcinolone acetonide (10.5 mg, and hydrocortisone sodium succinate (50 mg. RESULTS: All the three drugs were equally effective with no statistically significant difference in the time of resolution of cobblestone papillae, lid oedema, conjunctival discharge and chemosis, Tranta′s dots and shield ulcers. There was no statistically significant difference in the severity and rate of recurrence of disease following supratarsal injection of all the three drugs. But recurrence of disease to same severity was seen within 6 months of injection in all cases irrespective of compounds used. CONCLUSION: Supratarsal injection of corticosteroids is very effective for temporary suppression of severe inflammation associated with VKC.

  2. Quiescent and Active Tear Protein Profiles to Predict Vernal Keratoconjunctivitis Reactivation.

    Science.gov (United States)

    Micera, Alessandra; Di Zazzo, Antonio; Esposito, Graziana; Sgrulletta, Roberto; Calder, Virginia L; Bonini, Stefano

    2016-01-01

    Vernal keratoconjunctivitis (VKC) is a chronic recurrent bilateral inflammation of the conjunctiva associated with atopy. Several inflammatory and tissue remodeling factors contribute to VKC disease. The aim is to provide a chip-based protein analysis in tears from patients suffering from quiescent or active VKC. This study cohort included 16 consecutive patients with VKC and 10 controls. Participants were subjected to clinical assessment of ocular surface and tear sampling. Total protein quantification, total protein sketch, and protein array (sixty protein candidates) were evaluated. An overall increased Fluorescent Intensity expression was observed in VKC arrays. Particularly, IL1β, IL15, IL21, Eotaxin2, TACE, MIP1α, MIP3α, NCAM1, ICAM2, βNGF, NT4, BDNF, βFGF, SCF, MMP1, and MMP2 were increased in quiescent VKC. Of those candidates, only IL1β, IL15, IL21, βNGF, SCF, MMP2, Eotaxin2, TACE, MIP1α, MIP3α, NCAM1, and ICAM2 were increased in both active and quiescent VKC. Finally, NT4, βFGF, and MMP1 were highly increased in active VKC. A distinct "protein tear-print" characterizes VKC activity, confirming some previously reported factors and highlighting some new candidates common to quiescent and active states. Those candidates expressed in quiescent VKC might be considered as predictive indicators of VKC reactivation and/or exacerbation out-of-season.

  3. Long-term use of 0.003% tacrolimus suspension for treatment of vernal keratoconjunctivitis.

    Science.gov (United States)

    Al-Amri, Abdulrahman Mohammed; Fiorentini, Sandra Flavia; Albarry, Maan A; Bamahfouz, Ashjan Yousef

    2017-01-01

    To evaluate the safety and efficacy of 0.003% tacrolimus suspension for the treatment of refractory vernal keratoconjunctivitis (VKC). This prospective study included 40 eyes of 20 patients with severe VKC. After discontinuing all other medications, patients were treated with varying doses of 0.003% tacrolimus suspension. All were followed for at least 24 months. Changes in signs and symptoms after treatment were evaluated; adverse events were assessed. The clinical response to the treatment was the most important measurement to achieve the conclusion. The mean age of the patients was 15.7 ± 1.4 years. Two patients discontinued treatment due to severe burning sensation and were excluded from the study. Significant improvements in all signs and symptoms, including itching, foreign body sensation, papillae, and Trantas dots, were seen in all patients 6 weeks after starting topical tacrolimus. Itching was the first symptom to improve. Treatment was gradually reduced, and intervals were increasing between applications. Recurrence occurred in all patients who attempted to discontinue treatment. No additional medications were required to provide relief, and no significant changes in visual acuity or refraction were seen. The safety and efficacy of 0.003% Tacrolimus suspension treatment for refractory VKC were achieved and it can be considered a useful option instead of steroids, despite the poor compliance in few patients due its adverse effects.

  4. Effect of vernal keratoconjunctivitis on vitreous depth in patients with keratoconus.

    Science.gov (United States)

    Cingü, Abdullah Kürşat; Kaya, Savaş; Çınar, Yasin; Şahin, Muhammed; Türkçü, Fatih Mehmet; Yüksel, Harun; Murat, Mehmet; Çaça, İhsan

    2015-05-01

    The aim of this study was to comparatively evaluate the vitreous depth (VD) of keratoconic eyes in patients with or without vernal keratoconjunctivitis (VKC). Eighty eyes of 80 consecutive keratoconus (KC) patients and 40 emmetropic control subjects were enrolled. KC patients were divided into two groups according to accompanying VKC (VKC-KC group and KC group). Mean outcome measures were best-corrected visual acuity (BCVA), spherical equivalent (SE), mean keratometry (Km), intraocular pressure (IOP), and axial length (AL) and its components. The eyes with the highest Km were selected for statistical analysis for each participant. There were 50, 30, and 40 patients in the VKC-KC group, KC group, and control group respectively. The KC group and VKC-KC group were similar in BCVA, SE, Km, CCT, ACD, LT, and IOP (p>0.05). The mean ACD was significantly lower in the control group when compared with the KC group and VKC-KC group. The mean AL and VD were significantly higher in VKC-KC group than those of KC group and the control group, whereas similar in KC and control groups (p>0.05). In the current study we showed that VKC-associated KC patients have significantly longer AL and VD when compared with KC patients without VKC. Posterior segment elongation in VKC-KC group may be associated with the type IV collagen destruction due to chronic longstanding inflammation in VKC patients.

  5. Topographic corneal changes in children with vernal keratoconjunctivitis: A report from Kathmandu, Nepal.

    Science.gov (United States)

    Gautam, Vijay; Chaudhary, Meenu; Sharma, Ananda Kumar; Shrestha, Gauri Shankar; Rai, Pooja Gautam

    2015-12-01

    The present study was conducted to determine corneal topographic characteristics of children with vernal keratoconjunctivitis (VKC) and compare the corneal topographic indices in VKC subjects with normal subjects In the hospital based comparative study, 115 consecutive subjects with VKC and 102 age and sex matched normal subjects were selected for the videokeratography with NIDEK ophthalmic operating system. Keratoconus-like topography was determined based on the expert classifier system. Other assessments included visual acuity testing with LogMAR chart, slit lamp biomicroscopy, dilated fundus examination, measurement of central corneal thickness and intraocular pressure. Topographic indices were analyzed and compared using unpaired t-test among different groups. Sensitivity and specificity was estimated by the ROC curve. Among 115 subjects with VKC, males comprised of 86 subjects (66.1%) and mean age of presentation was 10.9 (SD 4.9) years with mixed VKC in 56.5%. Keratoconus-like topography was present in 13 subjects (11.3%). The keratoconus predictiv index (sensitivity 92.3%, specificity 98.5%), the opposite sectoral index (sensitivity 84.6%; specificity 93.2%), the differential sectoral index (sensitivity 92.3%; specificity 90.8%) were found to be signficantly associated with VKC subjects having keratoconus-like topography. A high prevalence of keratoconus-like topography was observed in patients with VKC. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. In vivo confocal microscopy of meibomian glands and palpebral conjunctiva in vernal keratoconjunctivitis.

    Science.gov (United States)

    Wei, Qiaoling; Le, Qihua; Hong, Jiaxu; Xiang, Jun; Wei, Anji; Xu, Jianjiang

    2015-04-01

    To investigate the correlations between conjunctival inflammatory status and meibomian gland (MG) morphology in vernal keratoconjunctivitis (VKC) patients by using in vivo confocal microscopy (CM). Nineteen VKC patients (7 limbal, 7 tarsal, and 5 mixed forms) and 16 normal volunteers (controls) were enrolled. All subjects underwent CM scanning to obtain the images of upper palpebral conjunctiva and MGs. Inflammatory cell (IC) density in palpebral conjunctival epithelial and stromal layers, Langerhans cell (LC) density at lid margins and the stroma adjacent to the MG, and MG acinar unit density (MGAUD) were recorded. The longest and shortest diameters of MG acinar were measured. The Kruskal-Wallis test was used to compare the parameter differences whereas the Spearman's rank correlation analysis was applied to determine their correlations. Among all groups, no significant statistical differences were found in epithelial and stromal IC densities, mean values of MG acinar unit densities, or longest and shortest diameters. Both LC parameters in the tarsal-mixed groups were significantly higher than those in the limbal and control groups. All LC densities of VKC patients showed a positive correlation with MGAUD and shortest diameter. In VKC patients, the conjunctival inflammatory status could be associated with the MG status. In vivo CM is a noninvasive, efficient tool in the assessment of MG status and ocular surface.

  7. Is there is an association between the presence of Staphylococcus species and occurrence of vernal keratoconjunctivitis?

    Science.gov (United States)

    Al-Hakami, Ahmed M; Al-Amri, Abdulrahaman; Abdulrahim, Ihab; Hamid, Mohamed E

    2015-01-01

    The aim of this study was to identify the association of normal bacterial flora with vernal keratoconjunctivitis (VKC) occurrence in VKC and non-VKC groups. Conjunctival specimens were collected from 18 VKC patients and 22 healthy controls, cultured and identified following standard methods. The association between the presence of bacteria and occurrence of VKC was analyzed using Chi square statistic. Comparable bacterial growth was observed in VKC (77.8%) as well as control group (77.2%) (p = 0.970). Analysis of individual bacterial revealed that Staphylococcus aureus was detected more frequently in VKC (27.78% vs. 4.55% in control, p = 0.041) and Staphylococcus epidermidis was found much more commonly in the control eyes (45.45% in control vs. 5.56% in VKC, p = 0.005). An aggravating role of S. aureus colonization in the occurrence of VKC, and a possible role of S. epidermidis against the occurrence of VKC were concluded.

  8. Effect of lodoxamide and disodium cromoglycate on tear eosinophil cationic protein in vernal keratoconjunctivitis

    Science.gov (United States)

    Leonardi, A.; Borghesan, F.; Avarello, A.; Plebani, M.; Secchi, A.

    1997-01-01

    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 measurement were performed, and ocular signs and symptoms evaluated.
RESULTS—While statistically significant changes did not occur after DSCG therapy, mean tear ECP increased from 343 (SD 363) µg/l to 571 (777) µg/l due to marked elevation in six eyes. The clinical score in DSCG eyes did not improve. After lodoxamide therapy, both clinical signs and symptoms, and tear ECP levels (560 (756) µg/l to 241 (376) µg/l) decreased significantly (p<0.0001 and p<0.01, respectively). Compared with DSCG treatment, lodoxamide was more effective in reducing signs and symptoms (p<0.005). ECP levels were significantly correlated with signs, symptoms, corneal involvement, and number of eosinophils in tears (p<0.0001).
CONCLUSIONS—In patients with VKC, lodoxamide significantly reduced ECP tear levels, and thus, eosinophil activation, and was more effective than DSCG in reducing clinical signs and symptoms.

 PMID:9135403

  9. Serum levels of IL-17 in patients with vernal keratoconjunctivitis: a preliminary report.

    Science.gov (United States)

    Zicari, A M; Nebbioso, M; Zicari, A; Mari, E; Celani, C; Occasi, F; Tubili, F; Duse, M

    2013-05-01

    Vernal Keratoconjunctivitis (VKC) is a chronic and often severe form of bilateral tarsal and/or bulbar conjunctivitis. The purpose of the present study is to measure the Interleukin-17 (IL-17) serum levels in children with VKC evaluating the role of the systemic inflammation in patients affected by VKC. Fifteen patients were enrolled with VKC aged between 6 and 10 years of life. Serum were obtained from the peripheral blood samples collected from all the children included in the study to evaluate serum level of IL-17. Serum levels of IL-17 were significantly higher in patients with VKC than in healthy controls (10.3 ± 9.36 pg/ml vs. 3.3 ± 6.20 pg/ml respectively; p < 0.04). The presence of a significantly higher level of IL-17 in patients with VKC suggests a possible role of this cytokine in the pathogenesis of VKC. Further studies on larger samples of patients are warranted to confirm These findings in order to identify new possible therapeutic targets.

  10. Surgical resection and amniotic membrane transplantation for treatment of refractory giant papillae in vernal keratoconjunctivitis.

    Science.gov (United States)

    Guo, Ping; Kheirkhah, Ahmad; Zhou, Wei-wei; Qin, Lei; Shen, Xiao-li

    2013-06-01

    The aim of this study was to evaluate the outcome of surgical resection and amniotic membrane transplantation (AMT) for treatment of refractory symptomatic giant papillae in vernal keratoconjunctivitis (VKC). This is a retrospective study of 13 eyes of 9 patients with refractory giant papillae associated with corneal shield ulcer and/or punctate epithelial erosions who underwent surgical resection of the papillae combined with AMT to cover the tarsal conjunctival defect. During 14.2 ± 4.2 months of postoperative follow-up, smooth tarsal conjunctival surface was achieved in all cases, with no recurrence of the giant papillae in any eye. Corneal shield ulcers and punctate epithelial erosions healed within 2 weeks after surgery and did not recur during the follow-up. Best-corrected visual acuity improved from 0.26 ± 0.21 logarithm of the minimum angle of resolution preoperatively to 0.02 ± 0.04 logarithm of the minimum angle of resolution postoperatively (P = 0.01). Three patients experienced recurrence of VKC symptoms, but without giant papillae, which could be well controlled by topical medications. Surgical resection combined with AMT is an effective procedure for treatment of refractory giant papillae in patients with VKC.

  11. Demographic and clinical profile of vernal keratoconjunctivitis at a tertiary eye care center in India.

    Science.gov (United States)

    Saboo, Ujwala S; Jain, Manish; Reddy, Jagadesh C; Sangwan, Virender S

    2013-09-01

    To study the demographic and clinical profile of patients with vernal keratoconjunctivitis (VKC) at a tertiary eye care center in India. Retrospective chart analysis of 468 patients of VKC seen from January 2006 to December 2006. Mean age at presentation was 12 years. Majority of the patients had mixed pattern disease (72%). Chronic perennial disease was seen in 36% patients. Personal or family history of allergies was noted in 5% patients. Severe disease based on clinical grading was present in 37% patients. Moderate to severe vision loss was seen in 12% of total population. Persistent disease beyond 20 years of age was found in 12% patients. VKC-related complications such as corneal scarring (11%), shield ulcer (3%), keratoconus (6%), and limbal stem cell deficiency (1.2%) were seen. Treatment-related complications like corticosteroid-induced cataract and glaucoma were seen in 6% and 4% of patients, respectively. Clinical pattern of VKC seen in the tropical climate of India is essentially similar to that seen in other tropical countries. Few distinct features that we noted represent chronic perennial disease, low association with atopy, and higher propensity for disease and treatment-related complications.

  12. Cytological and immunohistochemical study of the limbal form of vernal keratoconjunctivitis by the replica technique.

    Science.gov (United States)

    el Asrar, A M; Geboes, K; Missotten, L; Emarah, M H; Maudgal, P C; Desmet, V

    1987-01-01

    The cellular composition of the inflammatory infiltrate present in 13 patients with the limbal form of vernal keratoconjunctivitis was examined in the conjunctival scrapings and the limbic replicas by means of Giemsa stain and immunohistochemistry. Conjunctival scrapings showed the presence of mast cells, lymphocytes, plasma cells, polymorphonuclear leucocytes, and very few basophils in all the specimens. Eosinophils were present in only four scrapings. The superficial epithelium of the limbic lesion and the adjacent cornea and conjunctiva was studied by the replica technique. The limbic lesion area showed the presence of necrotic epithelial cells mixed with inflammatory cells, including eosinophils, mast cells, lymphocytes, plasma cells, and polymorphonuclear leucocytes and very few basophils. Most of the inflammatory cells were HLA-DR+. Many OKT6+ cells were present, indicating the presence of Langerhans cells. T-lymphocytes including a few helper/inducer cells and many suppressor/cytotoxic cells, were detected in the infiltrate. In addition many B-lymphocytes were observed. These findings suggest that other immune mechanisms in addition to type 1 reaction are involved in the pathogenesis of the disease. Images PMID:3318919

  13. Epidemiological and virological features of epidemic keratoconjunctivitis due to new human adenovirus type 54 in Japan.

    Science.gov (United States)

    Kaneko, Hisatoshi; Suzutani, Tatsuo; Aoki, Koki; Kitaichi, Nobuyoshi; Ishida, Susumu; Ishiko, Hiroaki; Ohashi, Tsutomu; Okamoto, Shigeki; Nakagawa, Hisashi; Hinokuma, Rikutaro; Asato, Yoshimori; Oniki, Shinobu; Hashimoto, Teiko; Iida, Tomohiro; Ohno, Shigeaki

    2011-01-01

    New human adenovirus (HAdV)-54 causes epidemic keratoconjunctivitis (EKC) and is virologically close to and has occasionally been detected as HAdV-8. Taking HAdV-54 into account, we re-determined HAdV type in EKC samples to determine its epidemiology in Japan, and examined the virological features of HAdV-54. HAdV type was re-determined in 776 conjunctival swabs from Japan and 174 from six other countries, obtained between 2000 and 2009. Using 115 HAdV strains obtained before 1999, trends regarding HAdV-8 and HAdV-54 were also determined. In addition, immunochromatography (IC) kit features, DNA copy numbers and viral isolation of HAdV-54 in samples were evaluated. Recently, HAdV-37 and HAdV-54 have been the major causative types of EKC in Japan. HAdV-54 has been isolated each year since 1995, whereas HAdV-8 has become less common since 1997, although it remains the most common cause of EKC in the six other countries investigated where HAdV-54 is yet to be detected. HAdV-54 is comparable to other EKC-related HAdV types in terms of IC kit sensitivity and DNA copy numbers, although HAdV-54 grows more slowly on viral isolation. EKC due to HAdV-54 can result in epidemics; therefore, it should be accurately diagnosed and monitored as an emerging infection worldwide.

  14. Mixing and CP violation in the B$0\\atop{s}$ meson system at CDF; Mélange et violation de CP dans le système des mésons B$0\\atop{s}$ à CDF

    Energy Technology Data Exchange (ETDEWEB)

    Di Giovanni, Gian Piero [Univ. of Paris VI-VII (France)

    2008-01-01

    The two analyses presented in the thesis, the B$0\\atop{s}$ mixing analysis and the B$0\\atop{s}$ → J/ψφ angular analysis, share most of the technical implementations and features. Thus, my choice was to pursue in parallel the common aspects of the analyses, avoiding, whenever possible, repetitions. Each Chapter is split in two parts, the first one dedicated to the B$0\\atop{s}$ mixing analysis and the second one describing the angular analysis on the B$0\\atop{s}$ → J/ψφ decay mode. They are organized as follows. In Chapter 1 we present the theoretical framework of the B$0\\atop{s}$ neutral mesons system. After a general introduction on the Standard Model, we focus on the quantities which are relevant to the Δms measurement and the CP violation phenomena, underlying the details concerning the study of pseudo-scalar to vector vector decays, P → VV, which allow to carry out an angular analysis. A discussion on the implication of the measurements performed in the search of physics beyond the Standard Model is presented. The accelerator facilities and the CDF-II detector are reported in Chapter 2. While describing the detector, more emphasis is given to the components fundamental to perform B physics analyses at CDF. The Chapter 3 is focused on the reconstruction and selection of the data samples. The Chapter starts with a description of the on-line trigger requirements, according to the B$0\\atop{s}$ sample considered, followed by the offline selection criteria implemented to reconstruct B$0\\atop{s}$ semileptonic and hadronic decays, fully and partially reconstructed, for the B$0\\atop{s}$ mixing analysis, as well as the B$0\\atop{s}$ → J/ψφ decay mode for the angular analysis. The subsequent Chapter 4 is dedicated to the revision of the technical ingredients needed in the final analyses. The B$0\\atop{s}$ mixing elements are firstly described. The methodology historically used in the oscillation searches, the 'amplitude scan', is here

  15. Probiotics and Atopic Dermatitis in Children

    Directory of Open Access Journals (Sweden)

    Gian Vincenzo Zuccotti

    2012-07-01

    Full Text Available There is increasing interest in the potential beneficial role of probiotic supplementation in the prevention and treatment of atopic diseases in children. Probiotics are defined as ingested live microorganisms that, when administered in an adequate amount, confer a health benefit to the host. They are mainly represented by Lactobacilli and Bifidobacteria. Several epidemiological data demonstrate that intestinal microflora of atopic children is different from the one of healthy children. Many literature data show that probiotics may modulate the intestinal microflora composition and may have immunomodulatory effect. Based on this hypothesis, probiotics are supposed to confer benefits to allergic diseases. Administration of probiotics when a natural population of indigenous intestinal bacteria is still developing could theoretically influence immune development by favoring the balance between Th1 and Th2 inflammatory responses. For this reason, some studies have evaluated the potential impact of probiotics supplementation in the prevention of atopic dermatitis, with contrasting results. Clinical improvement in immunoglobulin (IgE-sensitized (atopic eczema following probiotic supplementation has been reported in some published studies and the therapeutic effects of probiotics on atopic dermatitis seemed to be encouraging. However, as far as the usefulness of probiotics as a prevention strategy is concerned, results are still inconclusive. In fact, the clinical benefits of probiotic therapy depend upon numerous factors, such as the type of bacteria, dosing regimen, delivery method and other underlying host factors, such as age and diet. More studies are still needed to definitively prove the role of probiotics in the treatment of allergic eczema.

  16. Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.

    Science.gov (United States)

    Kantor, R; Thyssen, J P; Paller, A S; Silverberg, J I

    2016-10-01

    The lack of standardized nomenclature for atopic dermatitis (AD) creates unnecessary confusion for patients, healthcare providers, and researchers. It also negatively impacts accurate communication of research in the scientific literature. We sought to determine the most commonly used terms for AD. A systematic review of the MEDLINE, EMBASE, and LILACS (1945-2016) for the terms AD, atopic eczema (AE), and multiple other eczematous disorders. In MEDLINE, 33 060 were identified, of which 21 299 (64.4%) publications used the term 'AD', 15 510 (46.9%) 'eczema', and only 2471 (7.5%) AE. Most of these publications used the term AD (82.0%) or eczema (70.8%) without additional nomenclature; only 1.2% used AE alone. Few publications used the terminology 'childhood eczema', 'flexural eczema', 'infantile eczema', 'atopic neurodermatitis', or 'Besnier's prurigo'. AD was rarely used until the late 1970s, after which it became the most commonly used of the three terms and continuously increased until 2015. Atopic eczema decreased between 2008 and 2015. Atopic dermatitis was the most commonly used term in studies across almost all publication types, languages, and journals. Atopic dermatitis is the most commonly used term and appears to be increasing in popularity. Given that eczema is a nonspecific term that describes the morphological appearance of several forms of dermatitis, we strongly suggest the use of a more specific term, AD, in publications, healthcare clinician training, and patient education. Support from researchers, reviewers, and editors is key to success. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Correction of pancreatic insufficiency in young children with atopic dermatitis

    National Research Council Canada - National Science Library

    Solodovnichenko, I.G; Voloshina, L.G; Babadzhanyan, E.N; Savitskaya, E.V

    2016-01-01

    ...% of patients with atopic dermatitis. Objective: evaluation of the effectiveness of the enzyme mini-tableted Ermital 10,000 for the compensation of pancreatic insufficiency in children with atopic dermatitis...

  18. Hyperlinearity in atopic dermatitis, on the palm (image)

    Science.gov (United States)

    This picture shows a manifestation of atopic dermatitis on the palm. Individuals with atopic dermatitis characteristically have increased numbers and depth of skin lines (hyperlinearity) on the palms with little ...

  19. Typical and atypical clinical appearance of atopic dermatitis.

    Science.gov (United States)

    Silverberg, Nanette B

    Atopic dermatitis is a complex, systemic inflammatory disorder associated with a variety of clinical features. The original criteria of Hanifin and Rajka include major criteria and a list of about two dozen minor criteria however, even the minor criteria do not include some features of atopic dermatitis noted less commonly but still seen with some frequency. This contribution first reviews the common clinical appearance of atopic dermatitis in infancy, childhood, and adulthood, as well as the less typical appearances, including lichenoid atopic dermatitis; juvenile plantar dermatosis; nummular-type atopic dermatitis; follicular atopic dermatitis; alopecia of atopic dermatitis; eczema coxsackium; and psoriasiform, perineal, and lip licker's dermatitis. The clinician will be able to recognize and treat rarer forms of atopic dermatitis and incorporate this into their daily practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Ocular effects of long term use of topical steroids among children and adolescents with vernal keratoconjunctivitis: a prospective observational study.

    Science.gov (United States)

    Mandal, Radhakrishna; Maiti, Prasenjit; Sasmal, Nirmal Kumar; Sinha, Nirmalya; Gupta, Aninda; Das, Kali Sankar; Biswas, Mukul Chandra

    2011-10-01

    Topical steroids were often irrationally used on long term basis for quick relief from ocular discomfort of inflammatory eye conditions like vernal keratoconjunctivitis in spite of their well known deleterious ocular effects. The present study was undertaken to determine the ocular effects of long term use of topical steroids among the patients with vernal keratoconjunctivitis and also to evaluate the ocular responses after withdrawal of steroids. The prospective observational study was carried out in a tertiary eye care centre of West Bengal. A total 150 referred patients of vernal keratoconjunctivitis, those used topical steroids for more than a month were included in the study. A complete set of ophthalmic examinations including measurement of intra-ocular pressure and visual acuity was carried out during registration. After withdrawal of steroids, the patients were followed-up periodically and finally evaluated after 8 weeks for any Improvement of Intra-ocular pressure and best corrected visual acuity. The data was analysed by SPSS 12.0.1 software package. Proportions were used for Interpretation. Paired t-test was used for comparison between two proportions (before and after withdrawal of steroids) and p-value <0.05 was considered as the level of significance. Though ropy mucus discharge with minimal conjunctival involvement was found the most common (74.7%) ocular manifestation, grave consequences like glaucoma was also evident among 8.7% of the study participants. Significant improvements (p<0.05) were observed for both reduction of intra-ocular pressure and visual acuity after 8 weeks of withdrawal of topical steroids. Topical steroids should be used cautiously with periodic ophthalmic examinations including intra-ocular pressure.

  1. Wheeze in children: the impact of parental education on atopic and non-atopic symptoms.

    Science.gov (United States)

    de Meer, Gea; Reijneveld, Sijmen A; Brunekreef, Bert

    2010-08-01

    There is conflicting evidence for the relationship between parental socioeconomic position and their children's asthma. The aim of this study was to investigate relationships between parental education and respiratory symptoms in their children, distinguishing atopic and non-atopic symptoms. A cross-sectional survey among 3262 elementary school children (age 8-13) was performed; data on parental education were obtained for 3213 children. Parents completed a questionnaire on their child's allergic and respiratory symptoms, and potential explanatory variables including family history, indoor environment, and the child's medical history. Subsets of children were tested for atopy (n = 1983), lung function (n = 2325), and airway hyperresponsiveness (AHR) (n = 880). Logistic regression was used to assess relationships of health outcomes with parental education. A high parental education was associated with an increased risk of atopic sensitization to indoor allergens (OR 1.31, 95% CI 1.02; 1.69). Studied explanatory variables did not influence the relationship. In contrast, a high parental education protected children from wheeze (OR 0.77, 95% CI 0.61; 0.97). This only applied to non-atopic wheeze (OR 0.65, 95% CI 0.43; 0.99) and not to atopic wheeze (OR 0.89, 95% CI 0.60; 1.31). The protection from non-atopic wheeze in children of highly educated parents declined after adjustment for household smoking and breastfeeding (OR 0.96, 95% CI 0.58; 1.57). Similar results were observed for non-atopic and atopic rhinitis. We conclude that children from highly educated parents are protected from non-atopic respiratory symptoms, which is largely explained by a lower rate of household smoking and a higher rate of breastfeeding.

  2. Immunological mechanisms in atopic dermatitis : clinical and experimental studies

    OpenAIRE

    Tengvall Linder, Maria

    1998-01-01

    The aim of the study was to investigate immunological mechanisms in atopic dermatitis. Serum IgE levels are elevated in 80% of atopic dermatitis patients and CD4+ T cells and environmental allergens are known to be of importance in the pathogenesis of the disease. It was therefore of interest to further elucidate the role of these factors in atopic dermatitis. Cyclosporin A (CSA) was used as a tool for exploring the pathogenesis of atopic dermatitis, with emphasis on the...

  3. A clinical study to assess the efficacy of Triyushnadi Anjana in Kaphaja Abhishyanda with special reference to vernal keratoconjunctivitis.

    Science.gov (United States)

    Dhiman, K S; Sharma, Gunjana; Singh, Shailender

    2010-10-01

    Vernal keratoconjunctivitis / spring catarrh is a variety of exogenous allergic conjunctivitis, which is a very troublesome ocular disease of childhood and in the adolescent age group. The child suffers from intense itching, grittiness, discharge, redness, lacrimation, photophobia, and so on, thereby, decreasing his learning hours. The troublesome features are aggravated in the spring season / hot climate that lasts for years together and rarely persists after adolescence. Mast cell stabilizers, topical Nonsteroidal anti-inflammatory drugs (NSAIDs), and steroids are the available treatment options that too with symptomatic relief and potential side effects, which limits the long-term use of these medicines. The clinical picture of vernal keratoconjunctivitis / spring catarrh is very similar to Kaphaja Abhishyanda, and Triyushnadi Anjana Bhaishajya Ratnavali (B.R.), and its treatment was clinically tried on the patients attending the Netra Roga OPD of the R.G. Government P.G. Ayurveda College Hospital at Paprola (H.P.). A proper protocol and performa was adopted with strict inclusion and exclusion criteria. In the first phase, a pilot study was conducted on 38 clinically diagnosed patients with vernal keratoconjunctivitis, and it gave 100% relief in photophobia, foreign body (FB) sensation, and lacrimation, with marked relief in other features. Encouraged by this pilot work, Triyushnadi Anjana (TA) and 2% sodium cromoglycate (mast cell stabilizer) eye drops in the second-phase clinical trial on 32 patients were tried clinically to evaluate the comparative efficacy. In the second clinical trial, the patients were randomly divided into two groups and Group I was given sodium cromoglycate 2% eye drops and Group II was given TA. The outcome of this study verified the results of the first phase pilot study, and on comparison of the results of the two groups in the second clinical study it was observed that the TA-treated group showed better results. Transient irritation

  4. Sweat mechanisms and dysfunctions in atopic dermatitis.

    Science.gov (United States)

    Hendricks, Aleksi J; Vaughn, Alexandra R; Clark, Ashley K; Yosipovitch, Gil; Shi, Vivian Y

    2018-02-01

    Skin barrier dysfunction is inherent to atopic dermatitis (AD), causing dryness, irritation, and increased permeability to irritants, allergens and pathogens. Eccrine sweat functions as part of the skin's protective barrier. Variations in sweat responses have been observed in patients with AD, and altered sweat composition and dynamics are under-recognized as important factors in the disease cycle. This review discusses the role that sweat plays in the pathogenesis of AD, examines evidence on abnormal sweat composition, secretion, and neuro-immune responses to sweat in atopic skin, and highlights the value of sweat management. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  5. Evidence-based treatment of atopic eczema in general practice

    African Journals Online (AJOL)

    banzi

    of atopic eczema in general practice. Atopic eczema is a common chronic condition characterised by dry, itchy skin associated with flares and remissions. .... atopy. This effect is lessened in the general population and neg- ligible in children without first- order atopic relatives. Breast- feeding should be strongly rec-.

  6. Probiotic bacteria for prevention of atopic diseases: design and application

    NARCIS (Netherlands)

    Niers, L.E.M.

    2009-01-01

    Atopic diseases such as (atopic) eczema, food allergy, asthma, and allergic rhinitis are common diseases. The cumulative incidence during childhood is estimated to be 20 to 30%. In countries with a so called ‘’Western lifestyle’’ an increase in the prevalence of atopic diseases has been observed

  7. Treatment of superior limbic keratoconjunctivitis with a large-diameter contact lens and Botulium Toxin A.

    Science.gov (United States)

    Chun, Yeoun Sook; Kim, Jae Chan

    2009-08-01

    To evaluate the effect of a large-diameter (16-20 mm) hydrogel contact lens (CL) or an injection of Botulinum Toxin A to Riolan muscle for the treatment of superior limbic keratoconjunctivitis (SLK). Eight eyes from 8 patients were fitted with large-diameter CL for 7 days. The clinical improvement and changes of fluorescein and rose bengal staining were examined on the day of diagnosis and 3, 7, 14, and 30 days after the CL was fitted. Three eyes showing symptoms of recurrence of SLK within 1 month after removal of the CL and 2 eyes with complications related to CL were treated with an injection of Botulinum Toxin A to pretarsal orbicularis muscle, Riolan. The changes of symptoms and vital stains were also evaluated on day 7 and 1, 2, 3, and 6 months after the injection. The mean age was 48 +/- 13.5 years, and the group consisted of 6 females and 2 males. Dry eye syndrome and horizontal conjunctival corrugation were found in all 8 patients, superior conjunctivochalasis in 5 patients, and floppy eyelid syndrome in 2 patients. Complete resolution after more than 1 month with CL only was seen in 3 eyes (37.5%). Clinical symptoms improved in 4.62 days and vital staining in 10.75 days after fitting of the CL. Superficial punctuate keratopathy related to CL occurred in 3 eyes (37.5%). Five eyes (62.5%) that were treated with botulinum showed distinct improvement within 7 days after the injection, and the effect was maintained for 2-7 months. The fitting of large-diameter CL can be considered for the treatment of acute severe symptoms of SLK for a short time. An injection of Botulinum toxin to the Riolan muscle can effectively and rapidly resolve the symptoms associated with SLK, and its effect of maintenance was a mean of 4 months.

  8. Very Low Prevalence of Keratoconus in a Large Series of Vernal Keratoconjunctivitis Patients.

    Science.gov (United States)

    Caputo, Roberto; Versaci, Francesco; Pucci, Neri; de Libero, Cinzia; Danti, Gioia; De Masi, Salvatore; Mencucci, Rita; Novembre, Elio; Jeng, Bennie H

    2016-12-01

    To evaluate the prevalence of keratoconus (KC) and other corneal abnormalities by means of videokeratography and tomography in a large series of patients affected by vernal keratoconjunctivitis (VKC). Cross-sectional study. Setting: Single-center children's hospital. A total of 651 consecutive patients with VKC and a control group of 500 were prospectively recruited between May 1, 2012 and September 30, 2013, with a minimum follow-up of 12 months. All patients were evaluated by means of a Scheimpflug camera combined with a Placido corneal topographer. Keratoconus, suspected keratoconus, or its absence were determined in each patient. The corneal symmetry index of front (SIf) and back curvature (SIb), shape indices, and thicknesses were compared between the 2 groups. Prevalence of keratoconus and corneal indices modifications. Five out of 651 patients (0.77%) demonstrated topographic signs of KC. Two of them were bilateral. All patients were older than 7 years of age, and the mean age was 11.54 years. Four other patients (0.61%) were classified as KC suspects by the screening program. Of 304 patients older than 11 years (mean age 14.4 years), 4 (1.32%) were found to have KCN, and 4 (1.32%) were KC suspects. The corneal indices of patients in the VKC group were extremely similar to those in the control group. (P > .05). The prevalence of KC in our patient population, compared with previous reports in the literature, is much lower. The similar corneal indices in both groups suggest the absence of permanent corneal deformation due to VKC. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Efficacy and safety of low-dose topical tacrolimus in vernal keratoconjunctivitis.

    Science.gov (United States)

    Shoughy, Samir S; Jaroudi, Mahmoud O; Tabbara, Khalid F

    2016-01-01

    The objective of this study was to evaluate the efficacy and safety of topical low-dose tacrolimus (0.01%) solution in patients with vernal keratoconjunctivitis (VKC). A total of 62 consecutive patients with VKC refractory to conventional treatment were included retrospectively. Tacrolimus 0.01% ophthalmic solution was administered to patients twice daily after discontinuation of all previous topical medications. The duration of treatment ranged from 1 month to 29 months. The clinical symptoms of itching, redness, foreign body sensation, and discharge and the clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots, and superficial punctate keratopathy were graded as 0 (normal), 1+ (mild), 2+ (moderate), or 3+ (severe). Assessment was carried out before initiation of therapy and on the last visit after treatment. There were 62 patients with VKC comprising 49 male and 13 female patients. The median age was 12 years (range: 5-47 years). The mean visual acuity improved from 20/30 to 20/25 following treatment. There was statistically significant improvement in symptoms of itching (P<0.001), redness (P<0.001), foreign body sensation (P<0.001), and discharge (P<0.001). Statistically significant improvement was also observed in clinical signs of conjunctival hyperemia (P<0.001), limbal infiltration (P<0.001), Trantas dots (P<0.001), superficial punctate keratopathy (P<0.001), and conjunctival papillary hypertrophy (P<0.001). The solution form of tacrolimus was well tolerated. None of the patients developed elevation of intraocular pressure, cataract, or infectious keratitis. Low-dose topical tacrolimus 0.01% solution is effective and safe in the management of patients with refractory VKC.

  10. Evaluation of keratoconus by videokeratography in subjects with vernal keratoconjunctivitis (VKC

    Directory of Open Access Journals (Sweden)

    MR Shoja

    2006-07-01

    Full Text Available BACKGROUND: To assess demographic variables and the incidence of keratoconus in patients with VKC and to evaluate the characteristics of Vernal Keratoconjunctivitis (VKC associated with keratoconus. METHODS: One hundred and fifty patients with VKC were studied at Ophthalmology Department of Shaheed Sadoughi medical center between October 2004 and June 2005. Both eyes of VKC patients were evaluated by Orbscan topography for the diagnosis of keratoconus. Corneal topography maps were examined with modified Robinowitz-McDonnell test. The characteristics of VKC were recorded in keratoconus patients. RESULTS: The study included 93 male and 57 female subjects. The patients mean age was 13.07 ± 4.71 (range 8-24 years. The clinical forms of VKC were as follows: 45.2% mixed, 38% palpebral and 16.7% limbal types. Fifty four (36% of 150 subjects with VKC had complications of pseudogerontoxon, punctate keratitis and shield ulcer. Eighty-four eyes (42 subjects of 150 patients with VKC were detected as having keratoconus by videokeratography maps (28%. There were 27 males and 15 females in keratoconus group. 16.7% of the eyes had mild, 33.3% had moderate and 50% had severe keratoconus. Eyes with severe keratoconus presented at younger age (12.7 ± 3.35 years than moderate keratoconus (18.3 ± 2.15 years. Keratoconus was more common in male gender, long-standing disease, mixed and palpebral VKC. CONCLUSION: Screening of keratoconus subjects with corneal topography allows early detection and management of keratoconus. The higher incidence of keratoconus in our study is due to videokeratography study of early keratoconus. KEYWORDS: VKC, videokeratography, keratoconus.

  11. Alpha-1 antitrypsin, a diagnostic and prognostic marker of vernal keratoconjunctivitis.

    Science.gov (United States)

    Ahsan, Akif; Salman, Khushtar A; Alam, Sana; Siddiqui, Anwar H; Naeem, Syed Shariq; Ahmad, Aquil; Khan, Iqbal M

    2014-05-01

    A major chunk of ocular allergies in humans involve the conjunctiva, of which Vernal Keratoconjunctivitis (VKC) appears to be more common. VKC, a chronic allergic conjunctivitis, frequently affects young males and is characterized by intense inflammation of the limbal and/or tarsal conjunctiva. The etiology and immuno-pathogenesis of VKC still remain unclear. Alpha-1 antitrypsin (AAT), a member of serine proteinase inhibitor (SERPIN) superfamily, is an acute phase protein whose concentration in blood increases in response to inflammation. AAT deficiency is one of the many factors that may be involved in several abnormalities such as liver disease, emphysema, inflammatory joint diseases and inflammatory eye diseases. In the present study, the role played by this protein in VKC was analyzed in a selective case/control study to assess its diagnostic and prognostic value. The case control study included 50 patients of VKC reporting to Ophthalmology out patient department (OPD). Age and sex matched 40 healthy subjects served as control. Serum AAT level of both the cases and controls were evaluated and compared. Moreover the serum AAT levels of the patients at presentation were compared with their serum AAT level after three weeks post treatment. Levels of AAT in the serum of VKC patients at presentation (2.80 ± 0.42 mg/ml) were significantly higher as compared to controls (2.31 ± 0.21 mg/ml) whereas no significant difference was observed between the serum level of post treatment VKC patients (2.48 ± 0.26 mg/ml) and controls. AAT is a potent acute phase protein whose concentration rises significantly in VKC, irrespective of the age and sex of the patient. Moreover, the serum level of AAT declined significantly post treatment; therefore it might be used as a prognostic marker.

  12. Corneal backward scattering and higher-order aberrations in children with vernal keratoconjunctivitis and normal topography.

    Science.gov (United States)

    Chan, Tommy C Y; Wong, Emily S; Chan, Jason C K; Wang, Yumeng; Yu, Marco; Maeda, Naoyuki; Jhanji, Vishal

    2017-11-01

    To investigate the corneal backward scattering and higher-order aberrations (HOAs) in children with vernal keratoconjunctivitis (VKC) and normal topography. Thirty-six eyes of 22 patients with VKC and 54 eyes of 34 normal subjects were included. All participants had clear cornea, absence of dry eyes and a normal corneal tomography. Scheimpflug imaging was used to measure corneal backward scattering in zones centred on the corneal apex (central 2-mm zone and paracentral 2- to 6-mm zone), and HOAs were compared between VKC and normal control. The mean age of participants was 12.0 ± 4.1 years in VKC group and 11.2 ± 4.1 years in control group (p = 0.339). There was no significant intergroup difference in mean keratometry, astigmatism and apex pachymetry (p ≥ 0.076). Total corneal backscatter was higher in the VKC group compared to the control group (p ≤ 0.012). Anterior and posterior cornea displayed a higher level of backward scattering in the VKC group (p < 0.001 for anterior; p ≤ 0.048 for posterior). Patients with VKC exhibited higher total HOAs and coma (p ≤ 0.036). There were significant correlations between total anterior HOAs and backward scattering measured at the central (r = 0.500; p = 0.032) and paracentral zones (r = 0.470; p = 0.024) for VKC. The current study showed optical quality changes in patients with clear corneas and quiescent VKC. An increase in corneal backward scattering and HOAs was noted in patients with VKC as compared to normal patients. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  13. Deep Anterior Lamellar Keratoplasty in Keratoconic Patients with versus without Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Feizi, Sepehr; Javadi, Mohammad Ali; Javadi, Fatemeh; Jafarinasab, Mohammad Reza

    2015-01-01

    To compare the clinical outcomes of deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC) versus those without VKC. In this retrospective comparative study, records of 262 eyes with keratoconus (Group 1) and 28 keratoconic eyes with VKC (Group 2) that had undergone DALK were compiled. Reviewed parameters included length of follow-up, best-corrected visual acuity (BCVA), refractive error, complications and cumulative graft survival. Mean duration of follow-up was 38.6 ± 20.2 and 34.4 ± 20.9 months in groups 1 and 2, respectively (P = 0.21). Mean post-operative BCVA was 0.19 ± 0.11 and 0.20 ± 0.15 logMAR, in groups 1 and 2 (P = 0.79). BCVA≥20/40 was achieved in 91.6 and 88.5% of eyes in groups 1 and 2, respectively (P = 0.48). Epithelial problems were encountered in 31.3 and 42.9% of operated eyes, respectively (P = 0.16). Vascularization of suture tracts and stitch abscesses were encountered more frequently in the eyes with VKC (P = 0.01 and <0.001, respectively). At the 33-month follow-up examination, rejection-free graft survival rates were 56.0% in group 1 and 33.3% in group 2, with mean durations of 41.0 and 32.1 months, respectively (P = 0.15). Graft survival rates were 98.1% in group 1 and 95.0% in group 2, with mean durations of 88.6 and 88.4 months, respectively (P = 0.74). Clinical outcomes of DALK in keratoconic eyes with VKC were comparable to those in eyes with keratoconus alone. However, complications such as suture tract vascularization and stitch abscesses were more common when VKC coexisted, necessitating closer monitoring.

  14. Identification of human tear fluid biomarkers in vernal keratoconjunctivitis using iTRAQ quantitative proteomics.

    Science.gov (United States)

    Leonardi, A; Palmigiano, A; Mazzola, E A; Messina, A; Milazzo, E M S; Bortolotti, M; Garozzo, D

    2014-02-01

    Understanding and treating vernal keratoconjunctivitis (VKC) has been a challenge because the pathogenesis is unclear and antiallergic therapy often unsuccessful. The aim of the study was to analyze peptide profiles in human tears using mass spectrometry to elucidate compositional differences between healthy subjects and patients affected by VKC. Tears were collected from healthy subjects and VKC patients. Digested samples were treated with iTRAQ (isobaric tag for relative and absolute quantitation). Separation of tryptic peptides was realized using a MicroHPLC interfaced with a microfraction collector. MS and MS/MS mass spectra were performed using a MALDI TOF/TOF 4800 Applied Biosystem spectrometer. Protein Pilot™ software with Paragon™ algorithm v4.1.46 or GPS™ with Mascot engine was used as search engines with SwissProt or IPI human as the databases. A significant number of peptides were examined, and 78 proteins were successfully identified. In all VKC samples, levels of serum albumin, transferrin, and hemopexin were found up to 100 times higher than control tear levels and correlated to the severity of disease. Hemopexin, transferrin, mammaglobin B, and secretoglobin 1D were found significantly over-expressed in VKC samples compared with the control samples. Tear samples from patients treated with topical cyclosporine or corticosteroids showed a dramatic reduction in these protein levels. LC MALDI MS and isobaric tag for relative and absolute quantitation technique may be useful in the quantitative and qualitative characterization of the peptidoma of human tears. These techniques may identify target proteins to be used in the diagnosis and management of VKC and other inflammatory ocular surface conditions. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Efficacy and safety of topical cyclosporine A 0.05% in vernal keratoconjunctivitis.

    Science.gov (United States)

    Yücel, Ozlem Eski; Ulus, Nihal Demir

    2016-09-01

    While corticosteroids are an effective choice of treatment for severe vernal keratoconjunctivitis (VKC), their long-term use is restricted due to side effects. This study was conducted to evaluate the efficacy and safety of topical cyclosporine A (CsA) 0.05% in the treatment of VKC. A total of 30 patients with VKC that was resistant to topical corticosteroids, antihistamines and mast cell stabilisers were treated with topical CsA 0.05%. Patients were evaluated at Weeks 4, 8 and 12 after the initiation of therapy. Symptoms and signs observed before and after treatment were recorded and scores were assigned. Scores for symptoms and signs, the need for topical corticosteroids and ocular side effects were evaluated. At baseline, the median values of the symptom and sign scores were 10.0 (range 5.0-18.0) and 6.0 (range 2.0-13.0), respectively. At Week 4 of treatment with topical CsA 0.05%, the median values of the symptom and sign scores were 3.0 (range 0-14.0) and 3.0 (range 0-8.0), respectively. The reductions in the symptom and sign scores were statistically significant. The reduction in the need for corticosteroid was statistically significant by Week 12 of therapy. No significant side effects were reported. Topical CsA 0.05%, which can help to reduce corticosteroid usage, is an effective and safe alternative for the treatment of resistant VKC. Further studies are needed to determine the optimal duration of therapy and possibility of recurrence.

  16. Microarray-based IgE detection in tears of patients with vernal keratoconjunctivitis.

    Science.gov (United States)

    Leonardi, Andrea; Borghesan, Franco; Faggian, Diego; Plebani, Mario

    2015-11-01

    A specific allergen sensitization can be demonstrated in approximately half of the vernal keratoconjunctivitis (VKC) patients by conventional allergic tests. The measurement of specific IgE in tears using a multiplex allergen microarray may offer advantages to identify local sensitization to a specific allergen. In spring-summer 2011, serum and tears samples were collected from 10 active VKC patients (three females, seven males) and 10 age-matched normal subjects. Skin prick test, symptoms score and full ophthalmological examination were performed. Specific serum and tear IgE were assayed using ImmunoCAP ISAC, a microarray containing 103 components derived from 47 allergens. Normal subjects resulted negative for the presence of specific IgE both in serum and in tears. Of the 10 VKC patients, six resulted positive to specific IgE in serum and/or tears. In three of these six patients, specific IgE was found positive only in tears. Cross-reactivity between specific markers was found in three patients. Grass, tree, mites, animal but also food allergen-specific IgE were found in tears. Conjunctival provocation test performed out of season confirmed the specific local conjunctival reactivity. Multiple specific IgE measurements with single protein allergens using a microarray technique in tear samples are a useful, simple and non-invasive diagnostic tool. ImmunoCAP ISAC detects allergen sensitization at component level and adds important information by defining both cross- and co-sensitization to a large variety of allergen molecules. The presence of specific IgE only in tears of VKC patients reinforces the concept of possible local sensitization. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Tear cytokine levels in vernal keratoconjunctivitis: the effect of topical 0.05% cyclosporine a therapy.

    Science.gov (United States)

    Oray, Merih; Toker, Ebru

    2013-08-01

    The aims of this study were to evaluate the efficacy of topical 0.05% cyclosporine A on clinical signs and symptoms of vernal keratoconjunctivitis (VKC) and to examine its effect on tear cytokine levels. Twenty-one patients with active VKC and 15 healthy volunteers were included. Patients were treated with topical 0.05% cyclosporine A. Symptoms and signs were scored on the day of enrollment and at the end of month 1 and month 3. Tear and serum samples were collected before and on the third month of treatment. Interleukin (IL)-2, soluble IL-2 receptor (sIL-2R), IL-3, IL-4, IL-5, IL-6, IL-9, IL-13, IL-17, eotaxin, tumor necrosis factor alpha (TNF-α), and interferon gamma (IFN-γ) in cell-free tear and serum supernatants were measured by multiplex bead analysis. At the end of month 1 and month 3 with topical 0.05% cyclosporine A treatment, statistically a significant decrease was observed in sign and symptom scores of the patients (P < 0.0001). Tear IL-2, sIL-2R, IL-9, IL-17, IFN-γ, and eotaxin levels in VKC patients were significantly higher than those in controls (P < 0.05). IL-3, IL-4, IL-5, and TNFα levels tended to be higher in VKC patients. There was also statistically significant reduction from before 0.05% cyclosporine A treatment to after treatment in tear levels of IL-4, IL-5, IL-17A, TNFα, IFN-γ, and eotaxin (P < 0.05). IL-2 and sIL-2R levels tended to be lower than pretreatment levels. Topical 0.05% cyclosporine A is effective in alleviating signs and symptoms of VKC patients and shows its effect probably by decreasing the local production of some inflammatory mediators in tears.

  18. Systematic review and meta‐analysis of randomised clinical trials on topical treatments for vernal keratoconjunctivitis

    Science.gov (United States)

    Mantelli, F; Santos, M S; Petitti, T; Sgrulletta, R; Cortes, M; Lambiase, A; Bonini, S

    2007-01-01

    Aims The aim of this study was to assess the efficacy of currently available topical drugs for vernal keratoconjunctivitis (VKC) through a meta‐analysis of randomised clinical trials (RCTs). Methods Twenty‐seven RCTs (n = 2184 eyes) that had evaluated the efficacy of topical drugs for the treatment of VKC were selected according to the set criteria; 10 of these trials were suitable for statistical analysis and were enrolled in the meta‐analysis. Articles published up to December 2005 were identified from the following data sources: Medline, Embase, Lilacs, the Cochrane Controlled Trials Register, and references from relevant articles. Articles in any language published with an English abstract, were screened, and those selected for inclusion were written in English, French, German, Italian, Portuguese or Spanish. The quality of the trials was assessed by the Delphi list. Statistical analysis was performed using STATA® software. Results A significant improvement in all signs and symptoms, except photophobia, was observed after topical treatment for active VKC, independent of the type of treatment. Comparison of the efficacy of different drugs was not possible due to a lack of standardised criteria among studies. Conclusion The currently available topical drugs are effective in treating acute phases of VKC. However, there is a lack of evidence to support the recommendation of one specific type of medication for treating this disorder. There is a need for standard criteria to assess diagnosis and therapy based on severity. There is also a need for RCTs assessing long‐term effects of single drugs to control the disease and to prevent complications. PMID:17588996

  19. Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis.

    Science.gov (United States)

    Ang, Marcus; Ti, Seng-Ei; Loh, Raymond; Farzavandi, Sonal; Zhang, Rongli; Tan, Donald; Chan, Cordelia

    2012-01-01

    We describe clinical characteristics and risk factors for corticosteroid response in children with severe vernal keratoconjunctivitis (VKC). Retrospective, noncontrolled, comparative case series. Patients from three tertiary centers in Singapore. We reviewed patients with severe VKC (clinical grade > 2) who were on topical steroid therapy, with a minimum follow-up period of 1 year post-presentation. Logistic regression was used to determine risk factors for corticosteroid response. Corticosteroid response was defined as intraocular pressure (IOP) >21 mmHg (three consecutive readings), or a rise of more than 16 mmHg from baseline, after commencement of steroid therapy in the absence of other possible causes of raised IOP. Forty-one of 145 (28.3%) patients developed a corticosteroid response, of which eight (5.5%) progressed to glaucoma. The overall mean age of onset of VKC was 9.9 ± 4.4 years. Longer duration of corticosteroid use (OR, 5.06; 95% CI: 1.04-25.56; P = 0.45) and topical dexamethasone 0.01% (OR, 2.25; 95% CI: 1.99-5.08; P = 0.40) were associated with corticosteroid response. Mixed type of VKC (OR, 9.76; 95% CI: 3.55-26.77; P < 0.001), the presence of limbal neovascularization of ≥ three quadrants (OR, 6.33; 95% CI: 2.36-16.97; P < 0.001), and corneal involvement (OR, 3.51; 95% CI: 1.31-9.41; P = 0.012) were significant clinical risk factors after adjusting for potential confounders such as age, sex, ethnicity, duration, and type of corticosteroid used. Children on long-term oral corticosteroids with severe, mixed-type VKC and corneal involvement are more likely to develop corticosteroid response, and may require early treatment to prevent progression to glaucoma.

  20. Management, clinical outcomes, and complications of shield ulcers in vernal keratoconjunctivitis.

    Science.gov (United States)

    Reddy, Jagadesh C; Basu, Sayan; Saboo, Ujwala S; Murthy, Somasheila I; Vaddavalli, Pravin K; Sangwan, Virender S

    2013-03-01

    To assess the clinical outcomes and complications of shield ulcers by various treatment methods. Retrospective, interventional case series. setting: Cornea and anterior segment service of L.V. Prasad Eye Institute, India. study population: One hundred ninety-three eyes of 163 patients clinically diagnosed with vernal keratoconjunctivitis and shield ulcers. intervention: The treatment algorithm was based on the Cameron clinical grading of shield ulcers. Grade 1 ulcers received medical therapy alone. Grade 2 and grade 3 ulcers received either medical therapy alone or medical therapy combined with debridement, amniotic membrane transplantation (AMT), or both. main outcome measures: Re-epithelialization time and best-corrected visual acuity. Grade 1 ulcers were seen in 71 (37%) eyes, grade 2 ulcers were seen in 79 (41%) eyes, and grade 3 ulcers were seen in 43 (22%) eyes. In the grade 1 group, re-epithelialization was seen in 67 (94%) eyes. In the grade 2 group, re-epithelialization was seen in 36 (88%) eyes that received medical treatment, in 20 (95%) eyes that underwent debridement, and in 17 (100%) eyes that underwent AMT. In the grade 3 group, re-epithelialization was seen in only 1 (1.7%) eye that received medical treatment, whereas it was seen in all eyes that underwent debridement and AMT. The mean best-corrected visual acuity after re-epithelialization of the shield ulcer was 20/30, 20/30, and 20/40 in the grade 1, grade 2, and grade 3 groups, respectively. Recurrence and secondary bacterial keratitis were seen in 28 (14.5%) and 20 (10%) eyes, respectively. Grade 1 shield ulcers respond well to medical therapy alone, whereas grade 2 ulcers occasionally may require additional debridement or AMT. Grade 3 ulcers, however, largely are refractory to medical therapy and require debridement and AMT for rapid re-epithelialization. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Use of cyclosporine A and tacrolimus in treatment of vernal keratoconjunctivitis.

    Science.gov (United States)

    Vichyanond, Pakit; Kosrirukvongs, Panida

    2013-06-01

    Vernal keratoconjunctivitis is a sight-threatening inflammatory disease of conjunctiva and cornea. It is frequently observed in young children with the onset usually occurring in the first decade of life. Mild cases of VKC tend to remit with nonspecific and supportive therapy. In contrast, severe cases are usually more protracted with remission/relapse occurring for a prolonged period of time. Although VKC is classified as an allergic eye condition, the role of allergens as an inciting factor is not clear. Pathogenesis of VKC involves roles for IgE, cytokines, chemokines, and inflammatory cells (T and B lymphocytes, mast cells, basophils, neutrophils, and eosinophils) with the release of their granular proteins, proliferation of fibroblasts, and laying down exuberant amounts of collagen fibers in the conjunctival tissue. In severe VKC cases-often of tarsal VKC-diagnostic giant papilla are classically observed on the upper tarsal plate, giving the classic 'cobble-stone' appearance. Corneal ulcer can occur from the effect of eosinophilic granular proteins on corneal epithelium and by physical trauma by intense eye rubbing. Topical corticosteroids, often required for controlling symptoms and signs in severe VKC, can lead to serious ocular complications. Immunomodulators that have been investigated for VKC treatment include topical ocular preparations of cyclosporine A and tacrolimus. Severe VKC responds promptly to topical cyclosporine A and tacrolimus, mostly within 1 month of therapy. Prolonged use of cyclosporine A and tacrolimus in VKC is safe and is tolerated by most patients without significant side effects. Recent investigations on the use of these two agents in VKC are the main purpose of this review. The use of cyclosporine A and tacrolimus are a major breakthrough in treatment for severe VKC, a debilitating allergic eye disease in children.

  2. Histamine H4 receptors in normal conjunctiva and in vernal keratoconjunctivitis.

    Science.gov (United States)

    Leonardi, A; Di Stefano, A; Vicari, C; Motterle, L; Brun, P

    2011-10-01

    While it is known that histamine is the primary mediator of ocular allergy, the presence and distribution of histamine receptors are not well documented in the human eye. Our aim was to evaluate histamine receptor expression in normal and vernal keratoconjunctivitis conjunctiva. Mucosal biopsies were obtained from conjunctiva of healthy donors and from tarsal conjunctiva of vernal patients. Immunostaining and semi-quantitative reverse-transcriptase polymerase chain reaction for H(1), H(2), H(3), and H(4) receptors were performed. Histamine receptor expression was also evaluated in conjunctival cell cultures exposed to histamine, interleukin-4, interleukin-5, interferon-γ and tumor necrosis factor-α. Immunostaining for H(1) and H(2) receptors was slightly positive in normal and over-expressed in vernal tissues. H(3) receptors were rarely present in normal and inflamed conjunctiva. In striking contrast to control tissues, H(4) receptors were highly expressed in all inflamed tissues, particularly by stromal inflammatory cells. Semi-quantitative reverse-transcriptase polymerase chain reaction demonstrated an over-expression of H(1), H(2), and H(4) receptors in vernal vs control tissues. Notably, H(4) receptors were five times more expressed in vernal vs control tissues. In cell cultures, H(2) receptor expression was stimulated eight times the normal levels by interleukin-4 and three times by histamine, but the H(4) receptor was only slightly affected by stimulation with these mediators. Increased expression of H1, and particularly of H(2) and H(4) receptors in vernal keratoconjunctival tissues indicate their important role in the pathogenesis of this disease. H(4) receptors may be a target in the treatment of allergic inflammation. © 2011 John Wiley & Sons A/S.

  3. Genome-wide association study of infectious bovine keratoconjunctivitis in Angus cattle.

    Science.gov (United States)

    Kizilkaya, Kadir; Tait, Richard G; Garrick, Dorian J; Fernando, Rohan L; Reecy, James M

    2013-03-26

    Infectious Bovine Keratoconjunctivitis (IBK) in beef cattle, commonly known as pinkeye, is a bacterial disease caused by Moraxellabovis. IBK is characterized by excessive tearing and ulceration of the cornea. Perforation of the cornea may also occur in severe cases. IBK is considered the most important ocular disease in cattle production, due to the decreased growth performance of infected individuals and its subsequent economic effects. IBK is an economically important, lowly heritable categorical disease trait. Mass selection of unaffected animals has not been successful at reducing disease incidence. Genome-wide studies can determine chromosomal regions associated with IBK susceptibility. The objective of the study was to detect single-nucleotide polymorphism (SNP) markers in linkage disequilibrium (LD) with genetic variants associated with IBK in American Angus cattle. The proportion of phenotypic variance explained by markers was 0.06 in the whole genome analysis of IBK incidence classified as two, three or nine categories. Whole-genome analysis using any categorisation of (two, three or nine) IBK scores showed that locations on chromosomes 2, 12, 13 and 21 were associated with IBK disease. The genomic locations on chromosomes 13 and 21 overlap with QTLs associated with Bovine spongiform encephalopathy, clinical mastitis or somatic cell count. Results of these genome-wide analyses indicated that if the underlying genetic factors confer not only IBK susceptibility but also IBK severity, treating IBK phenotypes as a two-categorical trait can cause information loss in the genome-wide analysis. These results help our overall understanding of the genetics of IBK and have the potential to provide information for future use in breeding schemes.

  4. Genetic polymorphism of the beta-2 adrenergic receptor in atopic and non-atopic subjects.

    Science.gov (United States)

    Potter, P C; Van Wyk, L; Martin, M; Lentes, K U; Dowdle, E B

    1993-10-01

    To investigate a possible genetic basis for reported differences in beta-2 receptor expression in atopic subjects, DNA from 42 atopic children (22 asthmatics and 22 with allergic rhinitis) and 30 non-atopic subjects was Southern blotted and Ban-1 restriction fragment polymorphisms (RFLPS) were studied using a 2.6 kb probe of the human beta-2 receptor gene. Two alleles 3.1 kb and 2.9 kb were identified. Homozygotes and heterozygotes for the two alleles were found with equal frequency in the atopic patients who had asthma and in those who had allergic rhinitis only. The gene frequencies for the upper and lower alleles were 0.45 and 0.55 respectively. Our studies do not provide evidence for an association between a particular polymorphic form of the human beta-2 receptor gene and atopy.

  5. Soluble interleukin 2 receptor in atopic eczema.

    Science.gov (United States)

    Colver, G. B.; Symons, J. A.; Duff, G. W.

    1989-01-01

    OBJECTIVE--To determine whether serum soluble interleukin 2 receptor concentrations are related to disease activity in atopic eczema. DESIGN--Single cohort longitudinal study with controls. SETTING--Outpatient and general medicine departments in secondary referral centre. PATIENTS--Of 15 patients aged 17-57 with severe atopic eczema, all with acute exacerbations of disease, 13 were admitted to hospital and two treated as outpatients until the skin lesions had resolved or greatly improved. Nineteen controls gave single blood samples. INTERVENTIONS--Daily skin dressing with betamethasone valerate (0.025%) and ichthammol paste and tubular dressings. END POINT--Resolution of or considerable improvement in skin lesions. MEASUREMENTS AND MAIN RESULTS--Enzyme linked immunosorbent assays (ELISA) were used to measure serum soluble interleukin 2 receptor concentrations in blood samples taken on admission, at intervals subsequently, and on discharge. Clinical scores of disease activity were also made. Median concentrations on admission were significantly higher (770 U/ml) in the patients than the controls (300 U/ml). Concentrations fell significantly during treatment. In 25 assessments made at different times in 13 patients serum soluble interleukin 2 receptor concentration correlated significantly (R = 0.73) with clinical disease activity. CONCLUSIONS--Cellular immunopathogenic mechanisms contribute to atopic eczema. Immune activation can be measured in atopic eczema by measurements of soluble interleukin 2 receptor, and this should facilitate assessment of response to treatment. PMID:2568868

  6. New Developments in Biomarkers for Atopic Dermatitis

    NARCIS (Netherlands)

    Thijs, Judith L.; Seggelen, Wouter van; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein de; Hijnen, DirkJan

    2015-01-01

    The application of biomarkers in medicine is evolving. Biomarkers do not only give us a better understanding of pathogenesis, but also increase treatment efficacy and safety, further enabling more precise clinical care. This paper focuses on the current use of biomarkers in atopic dermatitis, new

  7. [Atopic dermatitis in children and adults].

    Science.gov (United States)

    Lipozencić, Jasna; Ljubojević, Suzana; Gregurić, Sanja

    2011-01-01

    Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease characterized by itching and typical clinical features, depending on patient age. It is often associated with other atopic diseases such as asthma or allergic rhinitis, resulting from the complex etiology and pathogenesis. It occurs more frequently in people with genetic predisposition for atopic diseases. The intensity and extent of skin lesions (Scoring of Atopic Dermatitis, SCORAD Index) vary significantly among AD patients, depending on whether it is acute or chronic, and there are variations in laboratory parameters, especially immune. In the future, it will be necessary to reach consensus on the new criteria for defining AD instead of the old ones (brought by Hanifin and Rajka 31 years ago). What is needed is effective and safe treatment, and control of the early stages of AD as well as maintaining AD remission. The new therapeutic approach in AD has greatly improved the quality of life of AD patients. As the prevalence of the disease continues to increase, we emphasize the importance of prevention, prompt recognition and optimal treatment of the many patients with AD.

  8. Is atopic dermatitis associated with obesity?

    DEFF Research Database (Denmark)

    Ali, Zarqa; Suppli Ulrik, Charlotte; Agner, Tove

    2018-01-01

    Obesity has been associated with atopic dermatitis (AD), however the results have been conflicting. Our aim was to provide an update on current knowledge from observational studies addressing the possible association between obesity and AD. Systematic literature review was performed by identifying...

  9. Use of systemic corticosteroids for atopic dermatitis

    DEFF Research Database (Denmark)

    Drucker, A M; Eyerich, K; de Bruin-Weller, M S

    2018-01-01

    BACKGROUND: Guidelines discourage the use of systemic corticosteroids for atopic dermatitis (AD), but their use remains widespread. OBJECTIVES: To reach consensus among an international group of AD experts on the use of systemic corticosteroids for AD. METHODS: A survey consisting of statements...

  10. Unbalance of intestinal microbiota in atopic children

    Directory of Open Access Journals (Sweden)

    Candela Marco

    2012-06-01

    Full Text Available Abstract Background Playing a strategic role in the host immune function, the intestinal microbiota has been recently hypothesized to be involved in the etiology of atopy. In order to investigate the gastrointestinal microbial ecology of atopic disease, here we performed a pilot comparative molecular analysis of the faecal microbiota in atopic children and healthy controls. Results Nineteen atopic children and 12 healthy controls aged 4–14 years were enrolled. Stools were collected and the faecal microbiota was characterized by means of the already developed phylogenetic microarray platform, HTF-Microbi.Array, and quantitative PCR. The intestinal microbiota of atopic children showed a significant depletion in members of the Clostridium cluster IV, Faecalibacterium prausnitzii, Akkermansia muciniphila and a corresponding increase of the relative abundance of Enterobacteriaceae. Conclusion Depleted in key immunomodulatory symbionts, the atopy-associated microbiota can represent an inflammogenic microbial consortium which can contribute to the severity of the disease. Our data open the way to the therapeutic manipulation of the intestinal microbiota in the treatment of atopy by means of pharmaceutical probiotics.

  11. Association of atopic dermatitis with smoking

    DEFF Research Database (Denmark)

    Kantor, Robert; Kim, Ashley; Thyssen, Jacob P

    2016-01-01

    BACKGROUND: Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD). OBJECTIVE: We examine the association between AD and exposure to tobacco smoke. METHODS: We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and ...

  12. Autoimmune diseases in adults with atopic dermatitis

    DEFF Research Database (Denmark)

    Andersen, Yuki M F; Egeberg, Alexander; Gislason, Gunnar H.

    2017-01-01

    Background: An increased susceptibility to autoimmune disease has been shown in patients with atopic dermatitis (AD), but data remain scarce and inconsistent. Objective: We examined the co-occurrence of selected autoimmune diseases in adult patients with AD. Methods: Nationwide health registers w...

  13. T-cell inhibitors for atopic dermatitis.

    Science.gov (United States)

    Tidwell, W James; Fowler, Joseph F

    2018-03-01

    The management of atopic dermatitis is changing with the development of novel biologic agents to target specific molecules in the inflammatory cascade. Following the ability of dupilumab has proved its ability to act on the interleukin 4 receptor in treating atopic dermatitis. Thymic stromal lymphopoietin monoclonal antibody (AMG157/MEDI9929) and OX40 blocking antibody (GBR 830) were developed by targeting the same pathway as dupilumab further upstream. The clinical data on the efficacy for these drugs are not yet known. There is some early evidence that AMG157/MEDI9929 attenuates most measures of allergen-induced asthmatic responses. However, there are no public data on its ability to treat atopic dermatitis. In a phase 2a study, GBR 830 showed at least a 50% reduction in the Eczema Area and Severity Index scores of 17 of 23 patients, but it was not sufficiently powered for identification of statistical differences between GBR 830 versus placebo. Although there is potential for these 2 drugs to greatly improve the management of severe atopic dermatitis, significant clinical trials have not yet been completed to prove efficacy, and there are not yet any available phase 3 clinical trials, which are needed to truly evaluate their efficacy in affecting T-cells. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Association between atopic dermatitis and contact sensitization

    DEFF Research Database (Denmark)

    Hamann, Carsten R; Hamann, Dathan; Egeberg, Alexander

    2017-01-01

    BACKGROUND: It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower ...

  15. Atopic dermatitis from adolescence to adulthood in the TOACS cohort

    DEFF Research Database (Denmark)

    Mørtz, Charlotte G; Andersen, K E; Dellgren, C

    2015-01-01

    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...

  16. Efficacy of nedocromil 2% versus fluorometholone 0.1%: a randomised, double masked trial comparing the effects on severe vernal keratoconjunctivitis

    Science.gov (United States)

    Tabbara, K.; Al-Kharashi, S.

    1999-01-01

    AIMS—To compare the efficacy of topical nedocromil 2% with fluorometholone 0.1% in vernal keratoconjunctivitis (VKC).
METHODS—In a double masked random design, 24 patients with severe vernal keratoconjunctivitis were placed at random on nedocromil 2% eye drops in one eye and fluorometholone 0.1% in the fellow eye. At the end of the 2 week treatment period, the patient crossed over the eye drops (if asymptomatic in one eye), or continued with nedocromil sodium in both eyes (if asymptomatic in both eyes). All patients were examined weekly and ocular surface temperature recorded for a period of 6 weeks. 
RESULTS—Improvement in the watering, discharge, conjunctival hyperaemia, papillary hypertrophy, and Trantas' dots was noted in both groups, but overall fluorometholone was significantly more effective than nedocromil. Eyes treated with fluorometholone showed a significant decrease in ocular surface temperature compared with nedocromil treated eyes (p = 0.03).
CONCLUSIONS—Both nedocromil and fluorometholone were effective in ameliorating the signs and symptoms of vernal keratoconjunctivitis. No adverse effects were noted in the nedocromil group.

 Keywords: vernal keratoconjunctivitis; nedocromil; fluorometholone; ocular allergy PMID:10396195

  17. Human adenovirus type 8 epidemic keratoconjunctivitis with large corneal epithelial full-layer detachment: an endemic outbreak with uncommon manifestations

    Directory of Open Access Journals (Sweden)

    Lee YC

    2015-05-01

    Full Text Available Yueh-Chang Lee,1 Nancy Chen,1 I-Tsong Huang,2–4 Hui-Hua Yang,2 Chin-Te Huang,1 Li-Kuang Chen,2–5 Min-Muh Sheu1,6,7 1Department of Ophthalmology, 2Taiwan CDC Collaborating Laboratories of Virology, 3Department of Laboratory Medicine, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan; 4Graduate Institute of Medical Sciences, 5Department of Laboratory Diagnosis, 6Department of Ophthalmology and Visual Science, Tzu-Chi University, Hualien, Taiwan; 7Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan Abstract: Epidemic viral conjunctivitis is a highly contagious disease that is encountered year-round. The causative agents are mainly adenoviruses and enteroviruses. It occurs most commonly upon infection with subgroup D adenoviruses of types 8, 19, or 37. For common corneal involvement of human adenovirus type 8 epidemic keratoconjunctivitis, full-layer epithelial detachment is rarely seen. Herein, we report three cases of epidemic keratoconjunctivitis during an outbreak which manifested as large corneal epithelial full-layer detachment within a few days. The lesions healed without severe sequelae under proper treatment. The unique manifestation of this outbreak may indicate the evolution of human adenovirus type 8. Keywords: EKC, HAdV-8, cornea, virology, epidemic viral conjunctivitis

  18. [Adulthood atopic dermatitis: epidemiology, clinical symptoms, provoking and prognostic factors].

    Science.gov (United States)

    Pónyai, Györgyi; Temesvári, Erzsébet; Kárpáti, Sarolta

    2007-01-07

    The prevalence of atopic diseases, including allergic rhinitis, asthma bronchiale and atopic dermatitis is increasing both in children and adults at different parts of the world. Atopic dermatitis is a chronic inflammatory skin disease affecting mostly children, but the atopic trait continues, not only for later respiratory allergies, but also for skin symptoms in adulthood. In this form dry skin, flexural lichenification, head and neck dermatitis, hand dermatitis are typical. The exact etiology of atopic dermatitis is unknown, in the background interactions of genetical predisposition, skin barrier defects and immunological and environmental factors can be verified. In the complex approach of atopic dermatitis, a pivotal role is ascribed to the evaluation and possibly the elimination of provoking factors, like gender, family structure, clothing, aero-, alimentary and contact allergens, psychosocial stress, migration, infections, and personal home environment. Authors review clinical manifestations, triggering and prognostic factors of the adulthood atopic dermatitis.

  19. Clinical Usefulness of Simultaneous Measurement of the Tear Levels of CCL17, CCL24, and IL-16 for the Biomarkers of Allergic Conjunctival Disorders.

    Science.gov (United States)

    Shoji, Jun; Aso, Hiroshi; Inada, Noriko

    2017-05-01

    This study investigated the clinical usefulness of a multiple tear cytokine/chemokine test by simultaneously determining tear levels of CC chemokine ligand 17 (CCL17)/thymus and activation-regulated chemokine (TARC), CCL24/eotaxin-2, and interleukin-16 (IL-16) for assessing acute and chronic allergic inflammation in allergic conjunctival disorders (ACDs). This study included 37 patients with ACD and 11 healthy adults (controls). Patients with ACDs were divided into the following three groups; patients with allergic conjunctivitis (AC group, n = 17), patients with atopic keratoconjunctivitis (AKC group, n = 6), and patients with vernal keratoconjunctivitis (VKC group, n = 14). Tear samples were collected using the Schirmer I method with a filter paper. Tear levels of CCL17/TARC, CCL24/eotaxin-2, and IL-16 were determined by performing a magnetic bead assay (tear cytokine/chemokine test). Tear levels of eosinophil cationic protein (ECP) were determined by performing enzyme immunoassay. In patients with AC, clinical scores of objective findings and results of the tear cytokine/chemokine test at baseline were compared with those at 7 days after treatment with the histamine H1 receptor antagonist (epinastine) ophthalmic solution. Tear positive rates of CCL17/TARC, CCL24/eotaxin-2, and IL-16 were higher in patients with AC, AKC, and VKC compared with controls. Tear levels of CCL17/TARC, CCL24/eotaxin-2, and IL-16 in patients with AKC and VKC were significantly higher than those in patients with AC. Moreover, tear levels of IL-16 in patients with AC that showed improvement of their clinical score by treatment with epinastine ophthalmic solution decreased significantly after 7 days of the treatment compared with those at baseline. In patients with AKC and VKC, a significant correlation was observed between the tear levels of CCL24/eotaxin-2 and ECP. Simultaneous measurement of the tear levels of CCL17/TARC, CCL24/eotaxin-2, and IL-16 may be a useful test for assessing

  20. Risk factors for atopic and non-atopic asthma in a rural area of Ecuador

    Science.gov (United States)

    Vaca, Maritza; Oviedo, Gisela; Erazo, Silvia; Quinzo, Isabel; Fiaccone, Rosemeire L; Chico, Martha E; Barreto, Mauricio L; Cooper, Philip J

    2010-01-01

    Background Asthma has emerged as an important public health problem of urban populations in Latin America. Epidemiological data suggest that a minority of asthma cases in Latin America may be associated with allergic sensitisation and that other mechanisms causing asthma have been overlooked. The aim of the present study was to investigate risk factors for atopic and non-atopic asthma in school-age children. Methods A cross-sectional study was conducted among 3960 children aged 6–16 years living in Afro-Ecuadorian rural communities in Esmeraldas province in Ecuador. Allergic diseases and risk factors were assessed by questionnaire and allergic sensitisation by allergen skin prick reactivity. Results A total of 390 (10.5%) children had wheeze within the previous 12 months, of whom 14.4% had at least one positive skin test. The population-attributable fraction for recent wheeze associated with atopy was 2.4%. Heavy Trichuris trichiura infections were strongly inversely associated with atopic wheeze. Non-atopic wheeze was positively associated with maternal allergic symptoms and sedentarism (watching television (>3 h/day)) but inversely associated with age and birth order. Conclusions The present study showed a predominance of non-atopic compared with atopic wheeze among schoolchildren living in a poor rural region of tropical Latin America. Distinct risk factors were associated with the two wheeze phenotypes and may indicate different causal mechanisms. Future preventive strategies in such populations may need to be targeted at the causes of non-atopic wheeze. PMID:20435862

  1. Human adenovirus type 8: the major agent of epidemic keratoconjunctivitis (EKC).

    Science.gov (United States)

    Adhikary, Arun Kumar; Banik, Urmila

    2014-12-01

    Human adenovirus type 8 (HAdV-8) is the most common causative agent of a highly contagious eye disease known as epidemic keratoconjunctivitis (EKC). HAdV-8 strains have been classified into genome types HAdV-8A to 8K and HAdV/D1 to D12 according to restriction endonuclease analysis. This review focuses on the significance of HAdV-8 as an agent of EKC. Molecular analysis of HAdV-8 genome types HAdV-53 and HAdV-54 was performed to reveal potential genetic variation in the hexon and fiber, which might affect the antigenicity and tropism of the virus, respectively. On the basis of the published data, three patterns of HAdV-8 genome type distribution were observed worldwide: (1) genome types restricted to a microenvironment, (2) genome types distributed within a country, and (3) globally dispersed genome types. Simplot and zPicture showed that the HAdV-8 genome types were nearly identical to each other. HAdV-54 is very close to the HAdV-8P, B and E genomes, except in the hexon. In a restriction map, HAdV-8P, B, and E share a very high percentage of restriction sites with each other. Hypervariable regions (HVRs) of the hexon were conserved and were 100% identical among the genome types. The fiber knob of HAdV-8P, A, E, J and HAdV-53 were 100% identical. In phylogeny, HVRs of the hexon and fiber knob of the HAdV-8 genome types segregated into monophyletic clusters. Neutralizing antibodies against one genome type will provide protection against other genome types, and the selection of future vaccine strains would be simple due to the stable HVRs. Molecular analysis of whole genomes, particularly of the capsid proteins of the remaining genome types, would be useful to substantiate our observations. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Therapeutic Effect of 0.1% Tacrolimus Eye Drops in the Tarsal Form of Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Wan, Qi; Tang, Jing; Han, Yu; Wang, Dan; Ye, Hongquan

    2017-08-12

    The purpose of this study was to evaluate the efficacy and safety of 0.1% tacrolimus eye drops in the tarsal form of vernal keratoconjunctivitis (VKC) and to survey the changes of dendritic cells at the palpebral conjunctiva in patients with VKC by in vivo confocal microscopy. A total of 17 patients (34 eyes) with the tarsal form of VKC were enrolled in this prospective, nonrandomized case series. They were treated with 0.1% tacrolimus eye drops twice daily after discontinuation of all other topical medications. Subjective ocular symptoms and objective ocular signs were scored on a 4-point scale by one ophthalmologist and the characteristics of the dendritic cells in each right eye at the palpebral conjunctiva were evaluated by in vivo confocal microscopy before treatment and at the 1st, 2th, 4th, and 8th weeks after treatment. After 1 week of treatment with 0.1% tacrolimus eye drops, the score for each symptom in all patients showed a significant (p < 0.001) improvement, and 13 patients (76%) experienced dramatic relief of symptoms. In addition, there was a significantly (p < 0.001) decreased clinical sign score (except for giant papillae) after 4 weeks, and a significant (p < 0.001) improvement in the score of giant papillae after 8 weeks of treatment. The characteristics of dendritic cells (including cell count, total area, average size, perimeter, and diameter) showed a significant (p < 0.05) decrease after 2 weeks of treatment. During the follow-up, no other topical medications were required and no significant changes in visual acuity were documented. No cataracts or elevation of intraocular pressures were detected. Only 5 patients (29%) had a tingling or burning sensation or discomfort. Tacrolimus 0.1% eye drops are an effective and safe treatment for the tarsal form of VKC, and can rapidly inhibit the activity of dendritic cells, improve symptoms, reduce papillary hyperplasia, and reverse damage at the palpebral conjunctiva. The side effects could affect the

  3. An essential role for dendritic cells in vernal keratoconjunctivitis: analysis by laser scanning confocal microscopy.

    Science.gov (United States)

    Liu, M; Gao, H; Wang, T; Wang, S; Li, S; Shi, W

    2014-03-01

    CD4+ T helper type 2 cells play a central role in the pathogenesis of vernal keratoconjunctivitis (VKC), and antigen-presenting cells are required for the cell activation. In this study, we aimed to survey the density, distribution, and morphology of dendritic cells (DCs) in patients with VKC by in vivo confocal microscopy. Thirty-five patients (mean, 12.4 ± 5.3 years) affected by VKC were included. All patients were treated with 0.1% fluorometholone eye drops and 0.5% cyclosporine A eye drops. The density and morphological and distributional characteristics of DCs in each right eye were evaluated by in vivo confocal microscopy before treatment and at 1, 3, and 6 months after treatment. Thirty-five age-matched normal subjects (mean, 16.5 ± 1.8 years) were studied as controls. There was significant difference in age between the VKC group and the control group (F = 18.17, P < 0.05). Compared with normal eyes, increased numbers of DCs were found in patients with VKC, with mean cell densities of 244.09 ± 59.76 cells/mm(2) at the bulbar conjunctiva, 574.53 ± 87.34 cells/mm(2) at the limbus, and 403.32 ± 106.59 cells/mm(2) at the peripheral cornea before treatment. These DCs exhibited a typical dendritic shape. At 3 months after treatment, the DC density at the conjunctiva decreased significantly (P < 0.05), approximating that in the controls. At 3 and 6 months, the DC densities at the limbus and peripheral cornea also decreased significantly (P < 0.05), but were still statistically higher than those in the controls. These DCs, with small dendritic processes or irregular shapes, were observed to gradually locate at the epithelial basal membrane and subbasal nerve plexus. In vivo confocal microscopy appears to be a valuable tool in evaluating the dynamic change of DCs at the conjunctiva and cornea. DCs play an essential role in VKC and therefore may constitute a target for therapeutic intervention for VKC. © 2013 John Wiley & Sons Ltd.

  4. Puntoplastia en el tratamiento de la queratoconjuntivitis seca Punctum surgery for the treatment of keratoconjunctivitis sicca

    Directory of Open Access Journals (Sweden)

    Nereyda G. Martínez Suárez

    2008-12-01

    autologous conjunctiva did not improve their condition. No patient got worse and complications did not occur. CONCLUSIONS: Quantitative and qualitative improvement was observed in 83,87 % of patients with 2nd degree keratoconjunctivitis sicca, who were performed punctum surgery with the punctual plug technique regardless of the used material.

  5. Iatrogenic keratoconjunctivitis sicca in a dog Ceratoconjuntivite seca iatrogênica em cão

    Directory of Open Access Journals (Sweden)

    Denise Eliza de Almeida

    2004-06-01

    Full Text Available Qualitative and quantitative abnormalities in primary components of the tear can alter the dynamics of the lacrimal film, compromising its function. Lipids, an aqueous fraction and mucoproteins constitute the lacrimal film. Keratoconjunctivitis sicca (KCS is a disease commonly diagnosed in dogs. It is characterized by the deficiency of the aqueous fraction in the lacrimal film that results in dryness, inflammation of the conjunctive and cornea with progressive corneal illness and reduction of vision and pain. Due to the significant contribution of the third eyelid lacrimal gland to the production of the aqueous fraction of the lacrimal film, the removal of this gland when prolapsed is an important cause of iatrogenic keratoconjuctivitis sicca. This paper describes a clinical case of iatrogenic keratoconjuctivitis sicca in a 10 month-old Boston Terrier which was caused by the removal of the third eyelid lacrimal gland due to its prolapse.Anormalidades quali-quantitativas em componentes primários da lágrima podem alterar a dinâmica do filme lacrimal, comprometendo sua função. O filme lacrimal é composto por lipídios, uma fração aquosa e por mucoproteínas. A ceratoconjuntivite seca (CCS é uma enfermidade freqüentemente diagnosticada em cães, caracterizada pela deficiência da fração aquosa do filme lacrimal, resultando em dessecação e inflamação da conjuntiva e córnea, dor, doença corneana progressiva e redução da visão. Devido à contribuição significativa da glândula da terceira pálpebra na produção da porção aquosa do filme lacrimal, a remoção desta glândula, quando prolapsada, constitui-se em importante causa de CCS iatrogênica. Este trabalho relata um caso clínico de ceratoconjuntivite seca iatrogênica, em um cão da raça Boston Terrier de 10 meses de idade, causada pela remoção cirúrgica da glândula lacrimal da terceira pálpebra, quando esta encontrava-se prolapsada.

  6. Characterization by phenotype of families with atopic dermatitis.

    Science.gov (United States)

    Bradley, M; Kockum, I; Söderhäll, C; Van Hage-Hamsten, M; Luthman, H; Nordenskjöld, M; Wahlgren, C F

    2000-01-01

    The aetiology of atopic dermatitis is unknown, but is probably multifactorial, with interactions between several genetic and environmental factors. Twin studies indicate a strong genetic factor, but the susceptibility genes are unknown. This paper, describing the phenotypes of family material, forms part of a large genetic study seeking to identify susceptibility genes for atopic dermatitis by linkage analysis. We selected families with at least 2 siblings affected with atopic dermatitis (1,097 affected siblings who together form 650 affected sib pairs and 49 affected half-sib pairs). We established a phenotype database of information about the affected siblings and their relatives, in total 5,830 individuals. All siblings were diagnosed with atopic dermatitis and participated in a standardized interview covering aspects of atopy and atopic dermatitis. Of the affected siblings, 72% suffered or had suffered from asthma and/or allergic rhinoconjunctivitis and 74% had raised total and/or allergen-specific IgE serum levels. Seventeen percent of the siblings had been hospitalized for atopic dermatitis. Sixty-nine percent had 1 or both parents with atopic dermatitis. Among siblings with 1 parent with atopic dermatitis, 37% had a father with atopic dermatitis and 63% had a mother with atopic dermatitis, indicating maternal preponderance. Analysis of the occurrence of atopic dermatitis in relation to the birth order in the sibship shows an increased risk of atopic dermatitis in persons born early in a sibship. Although the families were selected for genetic sib-pair linkage analysis, we believe that this material is representative of atopic dermatitis families managed at hospitals in Stockholm.

  7. 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

    OpenAIRE

    Abha Gahlot; Rupali Maheshgauri; Bhargav Kotadia; Kanisha Jethwa; Gira Raninga

    2016-01-01

    Introduction Vernal keratoconjunctivitis is a severe, typically seasonal recurrent ocular inflammatory disorder .Topical cyclosporine-A is inhibitory to many T-cell dependent inflammatory mechanisms which are likely to play role in treatment of vernal keratoconjunctivitis. Methodology The study was conducted on 100 patients of vernal keratoconjunctivits selected from Ophthalmology out patients Department of Dr. D.Y Patil Hospital, Pune. Patients were divided in two groups of 50 each...

  8. Diagnostic clinical features of atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Lata

    2001-01-01

    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.

  9. Nitrosative events in atopic asthma pathogenesis

    Directory of Open Access Journals (Sweden)

    Parilova O. O.

    2015-12-01

    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.

  10. Clinical and allergological analysis of ocular manifestations of sick building syndrome

    Directory of Open Access Journals (Sweden)

    Saeki Y

    2017-03-01

    Full Text Available Yusuke Saeki,1 Kazuaki Kadonosono,2 Eiichi Uchio1 1Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, 2Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan Purpose: The disease concept of sick building syndrome (SBS is still unclear. Ocular mucous membrane irritation is one of the major symptoms of SBS. However, the immunological aspects of the ocular complications of SBS are not yet clarified. The clinical and allergological aspects of SBS cases with ocular disorders with special reference to allergic conjunctival diseases (ACD were analyzed, especially with respect to local immunological features. Methods: Twelve cases of SBS with ocular findings and 49 cases of ACD (allergic conjunctivitis [AC], atopic keratoconjunctivitis [AKC], and vernal keratoconjunctivitis [VKC] for comparison were evaluated. The clinical findings in SBS and ACD were scored, and tear film breakup time (BUT was measured. Cytokine (interferon-γ [IFN-γ], interleukin [IL]-2, IL-4, IL-5, IL-6, IL-8, and IL-13 concentrations in tears were analyzed by cytometric bead arrays. Eosinophil count in peripheral blood, total IgE in serum, and multiple allergen simultaneous test (MAST for antigen-specific IgE were also measured. Results: In SBS, conjunctival lesions were observed in all cases, and corneal abnormalities were found in two-thirds of the cases. Limbal lesions were observed in 2 pediatric cases. Mean serum total IgE level in SBS was significantly higher than that in AC; however, it was significantly lower than that in AKC and VKC. Eosinophil count in peripheral blood and number of positive allergens in MAST were significantly lower in SBS than in AKC and VKC. Significant elevation of tear IL-4 was observed in SBS and ACD. However, in contrast to ACD, elevation of other cytokines in tears was not observed in SBS. Mean tear BUT in SBS was in the normal range. Conclusion: From these results, SBS is thought to be

  11. Treating pediatric atopic dermatitis: current perspectives

    OpenAIRE

    Dimitriades VR; Wisner E

    2015-01-01

    Victoria R Dimitriades, Elizabeth Wisner Division of Allergy/Immunology, Department of Pediatrics, Louisiana State University Health Sciences Center, Children's Hospital of New Orleans, New Orleans, LA, USAAbstract: Atopic dermatitis (AD) is a chronic, inflammatory skin condition which affects millions of people worldwide. It is most commonly seen in children but may also progress into adulthood. Management of this complex disease requires a multi-pronged approach which can address th...

  12. Non-pharmacologic therapies for atopic dermatitis.

    Science.gov (United States)

    Lio, Peter A

    2013-10-01

    Atopic dermatitis (AD) continues to present significant therapeutic challenges, especially in severe cases. Navigating the line between risk and benefit can be difficult for more powerful medications such as immunosuppressants, but non-pharmacologic treatments are often overlooked and underutilized. Creative application of these more physical therapies can serve to minimize the pharmacologic treatments and their side effects, and possibly even create synergy between modalities, to maximize benefit to the patient.

  13. First observation of the decay $\\bar{B}$$0\\atop{s}$ → D$±\\atop{s}$ K and measurement of the relative branching fraction B($\\bar{B}$$0\\atop{s}$→ D$±\\atop{s}$ K)/B($\\bar{B}$$0\\atop{s}$→ D$+\\atop{s}$ π-).

    Energy Technology Data Exchange (ETDEWEB)

    Muelmenstaedt, Johannes [Univ. of California, Berkeley, CA (United States)

    2007-01-01

    We present the first observation of the decay $\\bar{B}$$0\\atop{s}$→ D$±\\atop{s}$ K∓ and measure the relative branching fraction of $\\bar{B}$$0\\atop{s}$ → D$±\\atop{s}$ K∓ to $\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ π-. The measurement of the relative branching fraction is performed by applying a fit in invariant mass and specific ionization to 1.2 fb-1 of Ds(φπ)X data collected with the CDF II detector in pp collisions at √ s = 1.96 TeV at the Fermilab Tevatron collider. We measure B $\\bar{B}$$0\\atop{s}$ → D$±\\atop{s}$ K∓ /B $\\bar{B}$$0\\atop{s}$ → D$+\\atop{s}$ π- = 0.107±0.019(stat)±0.008(sys). The statistical significance of the $\\bar{B}$$0\\atop{s}$ → D$±\\atop{s}$ K signal is 7.9σ. To cross-check our analysis method, we also measure B $\\bar{B0}$→ D+K- /B $\\bar{B0}$ → D+π- and B $\\bar{B0}$ → D+*K- /B $\\bar{B0}$ → D*+π- and verify that our results are in agreement with the world average.

  14. AAPE proliposomes for topical atopic dermatitis treatment.

    Science.gov (United States)

    Jahn, Alexander; Song, Chung Kil; Balakrishnan, Prabagar; Hong, Soon-Sun; Lee, Ju-Hee; Chung, Suk-Jae; Kim, Dae-Duk

    2014-01-01

    Anti-inflammatory effect of advanced adipose stem cell derived protein extract (AAPE) could be improved by minimising protein degradation. To develop a proliposomal formulation of AAPE for the treatment of topical atopic dermatitis. Proliposomal powder was manufactured by evaporating a solution of soy phosphatidyl choline, AAPE and Poloxamer 407 in ethanol under vacuum on sorbitol powder. Characterisation of proliposomes (zeta potential, diameter, stability and flowability) as well as in vivo efficacy in a dermatitis mouse model was investigated. Reconstitution of the proliposomal powder formed liposomes of 589 ± 3.6 nm diameter with zeta potential of -51.33 ± 0.36 mV. Protein stability was maintained up to 90 days at 25 °C as proliposomes. In vivo studies on atopic dermatitis mouse model showed a significant reduction in IgE levels after topical AAPE proliposome treatment. AAPE proliposomes maintained protein stability and showed promising results for atopic dermatitis treatment.

  15. Atopic diseases in twins born after assisted reproduction

    DEFF Research Database (Denmark)

    Jäderberg, Ida; Thomsen, Simon F; Kyvik, Kirsten Ohm

    2012-01-01

    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...

  16. New and emerging trends in the treatment of atopic dermatitis.

    Science.gov (United States)

    Gelbard, Christina M; Hebert, Adelaide A

    2008-02-02

    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.

  17. THE APPLICATION OF ENTEROSORBENTS TO TREAT ATOPIC DERMATITIS AMONG CHILDREN

    Directory of Open Access Journals (Sweden)

    P.L. Shcherbakov

    2007-01-01

    Full Text Available The article is dedicated to the study of the peculiarities of atopic dermatitis run from the viewpoint of allergistcimmunologist and gastroenterologist. The authors give an analysis of the reasons for atopic dermatitis development conditioned by the food allergy and define the place and meaning of the digestive apparatus function within the mechanisms of the disease development. The authors dwell in detail on the state of the intestinal tract mucosa and peculiarities of its lesion during atopic dermatitis. They give the schemes of the combined treatment for atopic dermatitis aimed at recovery of the affected small bowel mucosa and recovery of its protective properties with the help of cytomucoprotective adsorbing agents. They also present the findings of their own clinical experience of treatment of children, suffering from atopic dermatitis and having various lesions of the digestive apparatus.Key words: atopic dermatitis, children, food allergy, cytomucoprotection, adsorbing agents, dioctahedral smectite.

  18. ROLE OF PSYCHO-EMOTIONAL DISTRESSES IN CHILD ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    O.A. Sidorenko

    2008-01-01

    Full Text Available This article studies the relation between vegetative and psycho emotional distresses in cases of child atopic dermatitis. The authors applied instrumental research methods to estimate the condition of vegetative nervous system (cardiointer valography together with anamnestic analysis and clinical psychopathological methods. Authors established the methods of correcting diagnosed distresses. Using psycho corrective therapy significantly increases the efficiency of complex treatment of atopic child dermatitis.Key words: atopic dermatitis, psycho emotional disorders, treatment, children.

  19. Treatment of patients with keratoconjunctivitis sicca with Optive™: results of a multicenter, open-label observational study in Germany

    Directory of Open Access Journals (Sweden)

    Thomas Kaercher

    2008-11-01

    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

  20. Respiratory comorbidity in South African children with atopic dermatitis

    National Research Council Canada - National Science Library

    C L Gray; M E Levin; G du Toit

    2017-01-01

    Background. Atopic dermatitis (AD) is an early and important step in the propagation of the allergic march, enhancing food and respiratory allergies via epicutaneous sensitisation to allergens. Objectives...

  1. [Atopic dermatitis: a modern view of pediatricians and pediatric allergologist].

    Science.gov (United States)

    Okhotnikova, O M

    2011-01-01

    The article presents the views of pediatric allergologist on the problem of atopic dermatitis/ atopic eczema in children. Atopic dermatitis (AD) is considered from a modern viewpoint of allergic 'march', which is characteristic (typical) for children with atopy. These data indicate to systemic nature of atopic 'march', the first step of which is atopic eczema. Further evolution of atopic dermatitis leads to a transformation of it in other atopic diseases--allergic rhinitis and bronchial asthma; this fact indicates that immunopathological disorders are united in these diseases and it conditions the possibility of prevention. It has taken into consideration the systemic nature of atopic diseases, combined therapy is great important and has to include not only basic local therapy, in particular topical corticosteroids (mometasone furoate--Elokom) during the exacerbation, and the systematic elimination of trigger factors, diet, the removal of the digestive system dysfunctions and the imbalance of vitamins. A long-time systemic basic therapy by H1-antihistamines of second generation, such as desloratadine (Aerius) takes a special place in the treatment of atopic dermatitis.

  2. Histamine H1 and H4 receptor expression on the ocular surface of patients with chronic allergic conjunctival diseases.

    Science.gov (United States)

    Inada, Noriko; Shoji, Jun; Shiraki, Yukiko; Aso, Hiroshi; Yamagami, Satoru

    2017-10-01

    This study investigated the histamine H1 and H4 receptors mRNA (H1R and H4R, respectively) expression on the ocular surface of patients with chronic forms of allergic conjunctival diseases to determine whether they can serve as biomarkers for allergic inflammation in the conjunctiva. We examined 19 patients with vernal or atopic keratoconjunctivitis (AKC/VKC group) and 15 healthy volunteers (control group). The AKC/VKC group was divided into active and stable stage subgroups. Specimens were obtained from the upper tarsal conjunctiva of each participant using a modified impression cytology method. H1R, H4R, and eotaxin-1, -2, and -3 mRNA (eotaxin-1, eotaxin-2, eotaxin-3, respectively) expression was determined by real-time RT-PCR. Immunohistochemical analysis for eosinophil cationic protein (ECP), eosinophil major basic protein (MBP), eotaxin-2, and histamine H4 receptor (H4R) were performed using conjunctival smears. The number of H4R-positive patients was higher in the active than the stable stage subgroup and control group, whereas no difference was observed for H1R. H1R levels were higher in the active than in the stable stage subgroup, while those of H4R were higher in the active stage subgroup than in the control group. H1R and H4R levels were correlated with eotaxin-2 level. In immunohistochemical analysis, H4R revealed their expression on eosinophils in conjunctival smears of patients with AKC/VKC. H4R is useful as biomarkers of allergic inflammation on ocular surfaces. Most notably, H4R expressed on eosinophils is useful as a biomarker of eosinophilic inflammation of the ocular surface. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  3. Observation of B$0\\atop{s}$ → Ψ(2S)Φ and Measurement of Branching Ratio of B(B$0\\atop{s}$ → Ψ(2S)Φ)/B(B$0\\atop{s}$ → J/ΨΦ)

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Daejung [Kyungpook National Univ., Daegu (Korea, Republic of)

    2006-01-01

    We report the first observation of B$0\\atop{s}$ → Ψ(2S)Φ decay in p$\\bar{p}$ collisions at √s = 1.96 TeV using 360 pb-1 of data collected by the CDF II detector at the Fermilab Tevatron. We present the first measurement of the relative branching fraction B$0\\atop{s}$ → Ψ(2S)Φ / B(B$0\\atop{s}$ → J/ΨΦ) = 0.52±0.13 (stat.)±0.04(syst.)±0.06(BR) using the Ψ(2S) → μ+μ- decay mode.

  4. HSP: bystander antigen in atopic diseases?

    Directory of Open Access Journals (Sweden)

    Joost A Aalberse

    2012-05-01

    Full Text Available Over the last years insight in the complex interactions between innate and adaptive immunity in the regulation of an inflammatory response has increased enormously. This has revived the interest in stress proteins; proteins that are expressed during cell stress. As these proteins can attract and trigger an immunological response they can act as important mediators in this interaction. In this respect, of special interest are proteins that may act as modulators of both innate and adaptive immunity. Heat shock proteins (HSPs are stress proteins that have these, and more, characteristics. More than two decades of studies on HSPs has revealed that they are part of intrinsic, natural mechanisms that steer inflammation. This has provoked comprehensive explorations of the role of HSPs in various human inflammatory diseases.Most studies have focused on classical autoimmune diseases. This has led to the development of clinical studies with HSPs that have shown promise in Phase II/III clinical trials. Remarkably, only very little is yet known of the role of HSPs in atopic diseases. In allergic disease a number of studies have investigated the possibility that allergen-specific regulatory T cell (Treg function is defective in individuals with allergic diseases. This raises the question whether methods can be identified to improve the Treg repertoire. Studies from other inflammatory diseases have suggested HSPs may have such a beneficial effect on the T cell repertoire. Based on the immune mechanisms of atopic diseases, in this review we will argue that, as in other human inflammatory conditions, understanding immunity to HSPs is likely also relevant for atopic diseases. Specifically, we will discuss why certain HSPs such as HSP60 connect the immune response to environmental antigens with regulation of the inflammatory response.Thus they provide a molecular link that may eventually even help to better understand the immune pathological basis of the hygiene

  5. Atopic Dermatitis: Racial and Ethnic Differences.

    Science.gov (United States)

    Mei-Yen Yong, Adeline; Tay, Yong-Kwang

    2017-07-01

    Atopic dermatitis (AD) is a common, chronic inflammatory skin condition affecting up to 20% of children and 3% of adults worldwide. There is wide variation in the prevalence of AD among different countries. Although the frequency of AD is increasing in developing countries, it seems to have stabilized in developed countries, affecting approximately 1 in 5 schoolchildren. Adult-onset AD is not uncommon and is significantly higher, affecting between 11% and 13% of adults in some countries, for example, Singapore, Malaysia, and Sweden. AD is thus associated with significant health care economic burden in all age groups. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. ROLE OF ENVIRONMENTAL ALLERGENS ON ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    M. Wardhana

    2014-01-01

    Full Text Available Background: Atopic dermatitis (AD is a chronic eczematous skin disease that develops in a patient with atopic diathesis, which is characterized by an increased liability to produce IgE antibodies for allergens mostly derived from environmental or inhalant allergens and food allergens. They are produced by cell-mediated allergic contact reactions, and recently contact sensitivity to various environmental allergens has been demonstrated in patients with AD. Atopic patients are recognized by their ability to produce large amounts of specific IgE antibodies to common substances as environmental allergens, i.e. house dust mites, grass pollens, animal danders, molds, food, etc. These antibodies can be detected by skin prick test. The aim of this study was to identify the sensitization against environmental or inhalants allergens through skin prick tests in the patients with atopic dermatitis. Material and Methods: This is a retrospective, descriptive study. We revised all medical records of patients with AD since January 2002 to December 2004 in the Out Patients Unit of Sanglah General Hospital, Bali-Indonesia. The variables studied were: gender, age, work related, diagnosis associates to AD, and prick test of environmental allergens. Results: In 3 years periods we had revised 46 of patients with AD that was done skin prick tests. The median age was 38 years (range 29-54 years, 34/46 (73.9 % of these were male and 12 (26.1 % female. Twenty nine patients presented pure AD, and 17 patients had AD with asthma and allergic rhinitis. Only 16 (34.7% of patients had no history of allergic disease. Thirsty six of 46 (78.20% of all tested AD patients had a positive skin prick tests against inhalant (aeroallergens 16 patients and food allergens 21 patients. Sixteen patients with positive of skin test include; dust mite in 12 patients, animal dander in 10 patients, grass pollen in 9 patients and cockroach in 6 patients. Conclusion: We concluded that

  7. A comparison between criteria for diagnosing atopic eczema in infants

    DEFF Research Database (Denmark)

    Jøhnke, H; Vach, W; Norberg, L A

    2005-01-01

    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 dis...

  8. Investigations on the immunopathogenesis of atopic dermatitis in cats

    NARCIS (Netherlands)

    Roosje, Pieternella Janna

    2002-01-01

    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

  9. Atopic diseases by filaggrin mutations and birth year

    DEFF Research Database (Denmark)

    Thyssen, J P; Linneberg, A; Johansen, J D

    2012-01-01

    The prevalence of atopic disorders has increased in recent years. The pathogenesis is complex with genetic and environmental risk factors. Filaggrin loss-of-function mutations are common and associated with atopic disorders. We investigated whether the prevalence of filaggrin mutations increased ...... in different birth cohorts in adults from the general population in Denmark....

  10. Clinical Profile Of Atopic Dermatitis In Benin City, Nigeria | Onunu ...

    African Journals Online (AJOL)

    Conclusion: The clinical characteristics of atopic dermatitis in our study population were similar to the pattern in other parts of the world. There is need for increased awareness of its importance as a cause of morbidity especially in children. Keywords: Atopic dermatitis, Clinical profile,Nigeria. Nigerian Journal of Clinical ...

  11. Feasibility of actigraphy wristband monitoring of atopic dermatitis in children.

    Science.gov (United States)

    Gustafson, C J; O'Neill, J; Hix, E; McLaren, D T; Buxton, O M; Feldman, S R

    2014-11-01

    Actigraphy monitors are used to monitor sleep and scratching. Previous studies have implemented these monitors to evaluate behavior in adult patients with atopic dermatitis. However, such monitoring devices have been implemented in a paucity of studies involving pediatric patients with atopic dermatitis. The purpose of this study was to assess the feasibility of actigraphy monitoring in children with mild-to-severe atopic dermatitis. A total of six pediatric subjects were recruited. The severity of atopic dermatitis at the wrist area was assessed prior to placement of the wristband monitor. After wearing the wristbands for 7 days, subjects returned to clinic to undergo reassessment of the wrist area to determine if atopic dermatitis was exacerbated by the wrist-worn device. Data on sleep quality and how often patients wore the wristband monitors were also collected. No subjective data from the subjects or parents/caregivers were collected on tolerability of the monitors. None of the subjects exhibited exacerbation of atopic dermatitis at the wrist area after wearing the actigraphy monitors for 7 days. No adverse events were reported. Pediatric patients with atopic dermatitis exhibited less total sleep time compared with children evaluated in previous actigraphy studies. Actigraphy wristband monitoring can be used to continuously assess disease severity in children with atopic dermatitis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Classification of atopic hand eczema and the filaggrin mutations

    DEFF Research Database (Denmark)

    G. Carson, Charlotte; Jørkov, Anne Lerbæk; Bisgaard, Hans

    2008-01-01

    Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis. Mo...

  13. Atopic Dermatitis and Comorbidities: Added Value of Comprehensive Dermatoepidemiology.

    Science.gov (United States)

    Nijsten, Tamar

    2017-05-01

    Atopic dermatitis is common and in its severe form is devastating. This chronic inflammatory dermatosis is part of the atopic syndrome, which includes asthma, food allergies, and hay fever and is known to be associated with mental health disorders. In line with psoriasis, several recent observational studies using national survey and linkage data have suggested a link between atopic dermatitis and cardiovascular disease. The atopic dermatitis field can benefit from the past experiences in psoriasis research and should not follow the same path, but, rather, aim for a more comprehensive approach from the beginning. A recent German consortium studying links between atopic dermatitis and cardiovascular disease first screened a large claims database, followed by analyses of more deeply phenotyped (birth) cohorts with longitudinal data. In addition, genetic and metabolic analyses assessing the predisposition of patients with atopic dermatitis for cardiovascular disease were performed. Overall, the association between atopic dermatitis and cardiovascular disease was at most modest, but in more refined cohorts the cardiovascular risk profile and genetic architecture was comparable. A more integrated approach could create clarity about the clinical relevance of cardiovascular disease in individuals with atopic dermatitis sooner, avoid speculation that affects patient care, and save scientific resources. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Nickel allergy and relationship with Staphylococcus aureus in atopic dermatitis.

    Science.gov (United States)

    Bogdali, Anna M; Anna, Bogdali M; Grazyna, Antoszczyk; Wojciech, Dyga; Aleksander, Obtulowicz; Anna, Bialecka; Andrzej, Kasprowicz; Zofia, Magnowska; Krystyna, Obtulowicz

    2016-01-01

    The increase of nickel air pollution is supposed to frequent side effects of nickel action related to virulence potential of Staphylococcus aureus in patients with nickel allergy in atopic dermatitis. The goal was to investigate the relationship between nickel allergy and infection by S. aureus in atopic dermatitis. Nickel allergy was confirmed in atopic patients and excluded in healthy volunteers using patch testing. Infection by S. aureus was tested in atopic patients and healthy volunteers by use of API Staph system. The specific IgE for staphylococcal enterotoxin A and B were measured. Secretion of IFN-g, IL-2, IL-13 by PBMC under nickel sulfate and the enterotoxins A and B stimulations were studied with ELISpot. We found the increased number of infections by S. aureus in atopic patients with nickel allergy in comparison to atopic patients and healthy volunteers without nickel allergy. The elevated secretion of IL-2 under nickel sulfate stimulation in vitro was exclusively found in atopic patients with nickel allergy infected by S. aureus. Our data suggest that nickel allergy and infection by S. aureus are linked in atopic dermatitis. Copyright © 2015 Elsevier GmbH. All rights reserved.

  15. The course of life of patients with childhood atopic dermatitis

    NARCIS (Netherlands)

    Elian, E.; Brenninkmeijer, A.; Legierse, C.M.; Sillevis Smitt, J.H.; Last, B.F.; Grootenhuis, M.A.; Bos, J.D.

    2009-01-01

    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

  16. The Course of Life of Patients with Childhood Atopic Dermatitis

    NARCIS (Netherlands)

    Brenninkmeijer, Elian E. A.; Legierse, Catharina M.; Sillevis Smitt, J. Henk; Last, Bob F.; Grootenhuis, Martha A.; Bos, Jan D.

    2009-01-01

    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

  17. Clinical Profile Of Atopic Dermatitis In Benin City, Nigeria | Onunu ...

    African Journals Online (AJOL)

    Objective: To study the clinical presentation and management problems of atopic dermatitis in Benin City, Nigeria. Design: A 15-year retrospective study from May 1985 to April 2000. Setting: Dermatology clinics of the University of Benin Teaching Hospital, Benin City, Nigeria. Subjects: All new cases of atopic dermatitis ...

  18. Atopic dermatitis: tacrolimus vs. topical corticosteroid use | Langa ...

    African Journals Online (AJOL)

    Atopic dermatitis (AD), the dermatological manifestation of the atopic diathesis, has a variety of clinical presentations. It is a chronic and relapsing inflammatory disorder, requiring a multifaceted treatment approach. Topical corticosteroids are the backbone of therapy. However, concerns over adverse drug reactions ...

  19. Prevalence of atopic diseases in Nigerian children with vernal ...

    African Journals Online (AJOL)

    Specifically inquired about were asthma, eczema, allergic rhinitis or hay fever, allergic skin rash e.g. scabies, reaction to drugs and others. The children were also examined to confirm or detect the presence of these atopic diseases. The overall prevalence of atopic conditions was 19.8% amongst cases of VKC.

  20. Endotoxin exposure and atopic sensitization in adult pig farmers

    NARCIS (Netherlands)

    Portengen, L.; Preller, L.; Tielen, M.; Doekes, G.; Heederik, D.

    2005-01-01

    Background: Recent studies have reported a low prevalence of atopic sensitization and respiratory allergy in children growing up on farms. Objectives: We sought to evaluate the dose-response relationship between endotoxin and atopic sensitization in adult farmers and to assess the effect on

  1. Prevalence of immunoglobulin E for fungi in atopic children

    NARCIS (Netherlands)

    Nolles, G; Hoekstra, MO; Schouten, JP; Gerritsen, J; Kauffman, HE

    2001-01-01

    Background The prevalence of sensitization to fungi in young atopic patients in relation to age and clinical importance is largely unknown. Objective The aim of this study was to investigate the prevalence of sensitization to different fungi in atopic children in relation to age and other

  2. Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes

    DEFF Research Database (Denmark)

    Heede, Nina G.; Thuesen, Betina H.; Thyssen, Jacob P.

    2017-01-01

    Background: Atopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences....... Objective: To investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations. Method: Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed...... in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1...

  3. Contact sensitivity in patients with recalcitrant atopic dermatitis.

    Science.gov (United States)

    Tamagawa-Mineoka, Risa; Masuda, Koji; Ueda, Sachiko; Nakamura, Naomi; Hotta, Eri; Hattori, Junko; Minamiyama, Rina; Yamazaki, Akiko; Katoh, Norito

    2015-07-01

    Patients with atopic dermatitis are usually responsive to conventional treatment such as topical steroids; however, they are sometimes refractory to the treatment. The influence of contact sensitivities on the course of patients with recalcitrant atopic dermatitis is not known. The aim of this study was to investigate whether contact sensitivities affect the course of patients with recalcitrant atopic dermatitis. We evaluated 45 patients with atopic dermatitis who had failed conventional therapy. Patch testing was performed with the Japanese standard series, metal series and/or suspected items. A total of 15 patients had a positive patch test reaction to at least one allergen. The most common allergens were nickel, topical drugs and rubber accelerators. Avoidance of products or food containing allergic substances greatly or partially improved skin symptoms in nine patients. These results suggest that contact allergens and metals may be critical factors causing eczematous lesions in patients with recalcitrant atopic dermatitis. © 2015 Japanese Dermatological Association.

  4. Therapeutic benefits of enhancing permeability barrier for atopic eczema

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    George Man

    2015-06-01

    Full Text Available The regulatory role of epidermal permeability barrier function in cutaneous inflammation has been well appreciated. While barrier disruption induces cutaneous inflammation, improvement of permeability barrier function alleviates inflammation. Studies have demonstrated that improvement of epidermal permeability barrier function not only prevents the development of atopic eczema, but also delays the relapse of these diseases. Moreover, enhancing the epidermal permeability barrier also alleviates atopic eczema. Furthermore, co-applications of barrier enhancing products with glucocorticoids can increase the therapeutic efficacy and reduce the adverse effects of glucocorticoids in the treatment of atopic eczema. Therefore, utilization of permeability barrier enhancing products alone or in combination with glucocorticoids could be a valuable approach in the treatment of atopic eczema. In this review, we discuss the benefits of improving the epidermal permeability barrier in the management of atopic eczema.

  5. Atopic dermatitis: global epidemiology and risk factors.

    Science.gov (United States)

    Nutten, Sophie

    2015-01-01

    Atopic dermatitis (AD) is a chronic inflammatory skin disease posing a significant burden on health-care resources and patients' quality of life. It is a complex disease with a wide spectrum of clinical presentations and combinations of symptoms. AD affects up to 20% of children and up to 3% of adults; recent data show that its prevalence is still increasing, especially in low-income countries. First manifestations of AD usually appear early in life and often precede other allergic diseases such as asthma or allergic rhinitis. Individuals affected by AD usually have genetically determined risk factors affecting the skin barrier function or the immune system. However, genetic mutations alone might not be enough to cause clinical manifestations of AD, and it is merely the interaction of a dysfunctional epidermal barrier in genetically predisposed individuals with harmful effects of environmental agents which leads to the development of the disease. AD has been described as an allergic skin disease, but today, the contribution of allergic reactions to the initiation of AD is challenged, and it is proposed that allergy is rather a consequence of AD in subjects with a concomitant underlying atopic constitution. Treatment at best achieves symptom control rather than cure; there is thus a strong need to identify alternatives for disease prevention. © 2015 S. Karger AG, Basel.

  6. Treating pediatric atopic dermatitis: current perspectives

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    Dimitriades VR

    2015-06-01

    Full Text Available Victoria R Dimitriades, Elizabeth Wisner Division of Allergy/Immunology, Department of Pediatrics, Louisiana State University Health Sciences Center, Children's Hospital of New Orleans, New Orleans, LA, USAAbstract: Atopic dermatitis (AD is a chronic, inflammatory skin condition which affects millions of people worldwide. It is most commonly seen in children but may also progress into adulthood. Management of this complex disease requires a multi-pronged approach which can address the myriad of issues which underscore its development. Avoidance of triggering factors is imperative in establishing consistent control of skin irritation while daily moisturization can be very effective in skin barrier repair and maintenance. Judicious use of anti-inflammatory medications has been shown to make a significant impact on both treatment as well as prevention of disease. Unfortunately, pruritus, a key feature of AD, has proven much harder to control. Finally, awareness of the risks of colonization and infection in patients with AD should be incorporated into their surveillance and management plans. While our understanding has progressed greatly regarding this disease, further research is still needed regarding future directions for both treatment and prevention. Keywords: atopic dermatitis, eczema, treatment, corticosteroids, antipruritic

  7. Systemic therapy of childhood atopic dermatitis.

    Science.gov (United States)

    Slater, Nathaniel A; Morrell, Dean S

    2015-01-01

    Atopic dermatitis (AD) is a common childhood inflammatory disease that, in a small percentage of cases, can become severe enough to require potent systemic treatment. Many trials have been conducted with systemic agents for the treatment of severe pediatric AD; we review the evidence here. Although corticosteroids are widely used in practice, they are not generally recommended as a systemic treatment option for AD in children. Most patients experience a relatively rapid and robust response to cyclosporine. Treating children with cyclosporine long term is troubling; however, azathioprine, mycophenolate mofetil, and methotrexate are all reasonable alternatives for maintenance therapy in recalcitrant cases. Several additional options are available for the most refractory cases, including interferon-γ, intravenous immunoglobulin, and various biologics. Phototherapy is another modality that can be effective in treating severe AD. Ultimately the choice of agent is individualized. Systemic therapy options are associated with potentially severe adverse effects and require careful monitoring. Nonsystemic approaches toward prevention of flares and long-term control of atopic dermatitis in pediatric patients should be continued in conjunction with systemic therapy. In the future, more targeted systemic treatments hold the potential for effective control of disease with fewer side effects than broadly immunosuppressive agents. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Topical steroid addiction in atopic dermatitis

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    Fukaya M

    2014-10-01

    Full Text Available Mototsugu Fukaya,1 Kenji Sato,2 Mitsuko Sato,3 Hajime Kimata,4 Shigeki Fujisawa,5 Haruhiko Dozono,6 Jun Yoshizawa,7 Satoko Minaguchi8 1Tsurumai Kouen Clinic, Nagoya, 2Department of Dermatology, Hannan Chuo Hospital, Osaka, 3Sato Pediatric Clinic, Osaka, 4Kimata Hajime Clinic, Osaka, 5Fujisawa Dermatology Clinic, Tokyo, 6Dozono Medical House, Kagoshima, 7Yoshizawa Dermatology Clinic, Yokohama, 8Department of Dermatology, Kounosu Kyousei Hospital, Saitama, Japan Abstract: The American Academy of Dermatology published a new guideline regarding topical therapy in atopic dermatitis in May 2014. Although topical steroid addiction or red burning skin syndrome had been mentioned as possible side effects of topical steroids in a 2006 review article in the Journal of the American Academy of Dermatology, no statement was made regarding this illness in the new guidelines. This suggests that there are still controversies regarding this illness. Here, we describe the clinical features of topical steroid addiction or red burning skin syndrome, based on the treatment of many cases of the illness. Because there have been few articles in the medical literature regarding this illness, the description in this article will be of some benefit to better understand the illness and to spur discussion regarding topical steroid addiction or red burning skin syndrome. Keywords: topical steroid addiction, atopic dermatitis, red burning skin syndrome, rebound, corticosteroid, eczema

  9. Topical tacrolimus as treatment of atopic dermatitis

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    Masutaka Furue

    2009-11-01

    Full Text Available Masutaka Furue, Satoshi TakeuchiDepartment of Dermatology, Faculty of Medical Sciences, Kyushu University, Fukuoka, JapanAbstract: Atopic dermatitis (AD is a common, chronic, relapsing, severely pruritic, eczematous skin disease. The mainstays of treatment for AD are topical tacrolimus and topical steroids. Tacrolimus, a calcineurin inhibitor, not only complements existing treatment options but also overcomes some of the drawbacks of topical steroid therapy when given topically and thus meets the long-term needs of patients in preventing disease progression. Topical tacrolimus has been widely recognized in terms of its short- and long-term efficacies and safety, and it is also accepted as a first-line treatment for inflammation in AD. The recent proactive use of topical tacrolimus may emphasize a long-term benefit of this calcineurin inhibitor for AD treatment. To reduce possible long-term adverse effects, it is important to monitor its topical doses in daily clinics.Keywords: atopic dermatitis, topical tacrolimus, topical steroids, dose, proactive use, adverse effects

  10. Atopic predisposition in cholinergic urticaria patients and its implications.

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    Altrichter, S; Koch, K; Church, M K; Maurer, M

    2016-12-01

    Cholinergic urticaria (CholU) is a frequent chronic urticaria disorder with itchy weal and flare-type skin reactions in response to physical exercise or passive warming. A higher frequency of atopy among CholU patients has been reported, but the significance of this observation is unclear. To assess the prevalence and relevance of atopy in CholU patients. Thirty CholU patients were assessed for atopic skin diathesis (atopic predisposition) by use of the Erlangen Atopy Score and divided into atopic and non-atopic predisposed CholU individuals. Both groups were assessed for disease severity (CholUSI) and activity (CholUAS7), quality of life impairment [Dermatology Life Quality Index (DLQI) and CU-Q2 OL], seasonal exacerbation, total and specific serum IgE and comorbidities. CholU patients were found to exhibit high rates of atopic predisposition (57%), with higher prevalence and scores in female than in male patients. High Erlangen Atopy Scores were linked to high CholU severity, activity and impact on QoL. Atopic predisposed CholU patients show different seasonal exacerbation patterns, IgE specificity and comorbidity profiles as compared to non-atopic CholU patients. Atopic predisposition and cholinergic urticaria appear to be linked more closely than previously thought, which suggests shared pathogenetic mechanisms. Atopic patients with cholinergic urticaria have more severe disease and poorer quality of life than those who do not. Thus, all cholinergic urticaria patients should be assessed for atopic predisposition. © 2016 European Academy of Dermatology and Venereology.

  11. The association of the 'additional height index' with atopic diseases, non-atopic asthma, ischaemic heart disease and mortality

    DEFF Research Database (Denmark)

    Fenger, R V; Vidal, C; Gonzalez-Quintela, A

    2014-01-01

    . CONCLUSIONS: Individuals with childhood conditions that led them to attain tallness higher than expected from their parents' height may be at lower risk of non-atopic asthma/wheeze and IHD/IHD mortality but possibly at higher risk of atopic conditions. The measure of tallness below or above the expected...

  12. Atopic diseases in twins born after assisted reproduction.

    Science.gov (United States)

    Jäderberg, Ida; Thomsen, Simon F; Kyvik, Kirsten O; Skytthe, Axel; Backer, Vibeke

    2012-03-01

    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 = 0.773 respectively) compared with children born after spontaneous conception. Assisted reproduction did not modify the heritability of atopic diseases. This study does not support an association between assisted reproduction and development of atopic diseases. This result must be confirmed in subsequent studies, preferably of singleton populations. © 2011 Blackwell Publishing Ltd.

  13. New and emerging trends in the treatment of atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Christina M Gelbard

    2009-01-01

    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

  14. Homeopathy in paediatric atopic diseases: long-term results in children with atopic dermatitis.

    Science.gov (United States)

    Rossi, Elio; Bartoli, Paola; Bianchi, Alba; Da Frè, Monica

    2012-01-01

    To study the socio-demographic features, the prescribed remedies and the outcome of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy), and the long-term outcome of children suffering from atopic dermatitis (AD) after an approximate 8-year period (range 5-10 years). Our data derive from an observational longitudinal study carried out on 213 children (38.6%) with atopic diseases out of 551 children consecutively examined from September 1998 to December 2008. We used the Glasgow Homeopathic Hospital Outcome Score to evaluate the results that were classified on the basis of a Likert scale. Eighty-three (39%) children were affected by asthma, 51 (24%) by allergic rhinoconjunctivitis, 76 (36%) by AD and 3 (1%) by food intolerance. Follow-up patients were 104 (48.8%), and 65 (62.5%) of them reported a major improvement or resolution. The parents of paediatric patients suffering from AD, who had started homeopathic treatment at children (mean age 12.9) were examined; 28/40 (70%) had a complete disappearance of AD, 12/40 children (30.0%) were still affected by AD; 8/40 (20%) had asthma and 8/40 patients had, or developed, allergic rhinitis. These preliminary results seem to confirm a positive therapeutic effect of homeopathy in atopic children. Furthermore, according to the data from the literature paediatric patients treated with homeopathy seem to show a reduced tendency to maintain AD and develop asthma (and allergic rhinitis) in adult age. Copyright © 2011 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  15. The natural history of atopic dermatitis and its association with Atopic March.

    Science.gov (United States)

    Somanunt, Sinjira; Chinratanapisit, Sasawan; Pacharn, Punchama; Visitsunthorn, Nualanong; Jirapongsananuruk, Orathai

    2017-09-01

    Atopic dermatitis (AD) is the first manifestation of Atopic March. The natural history of AD and predictive factors for Atopic March have not been widely studied in Asia. To study the natural history and associated factors of disease remission and risk of respiratory allergy in Thai children with AD. Medical records of AD patients attending Allergy clinic at Siriraj hospital from 2004-2014 were reviewed. Patients were further followed-up to obtain current symptoms and treatment. One hundred and two AD patients (60.8% female) were followed for 10.2±4.7 years. The median age at diagnosis was 1.5 (0.1-12.0) years. The most common allergen sensitization was Dermatophagoides pteronyssinus and Dermatophagoides farinae. Forty-four percent of patients had complete remission at the median age of 6.3 (2.0-15.0) years. Forty-seven percent of early AD patients (onset children had complete remission at school age with a better prognosis in early AD. At preschool age, two-thirds and one-third developed AR and asthma, respectively. Early AD and food allergy were risk factors of early asthma.

  16. Atopic dermatitis: new evidence on the role of allergic inflammation.

    Science.gov (United States)

    Heratizadeh, Annice

    2016-10-01

    Atopic dermatitis is a chronic relapsing inflammatory skin disease. In the presence of a complex genetic background, there is increasing evidence for the role of specific allergenic trigger factors in perpetuating skin inflammation in sensitized atopic dermatitis patients. In this review, clinical and in-vitro data so far published on allergen-induced adaptive immune responses in atopic dermatitis are summarized. Emerging new data have been published particularly on adaptive immune responses to inhalant allergens in atopic dermatitis. In a randomized controlled study, the induction of a flare-up by grass pollen exposure in sensitized atopic dermatitis patients could be demonstrated for the first time. T cells directed to the two major allergens of house dust mite have been characterized to display a Th2, and moreover, a Th17 and Th2/Th17 phenotype in sensitized atopic dermatitis patients. With regard to microbial antigens, T cell-mediated immune responses directed to proteins of the species themselves can be observed - as has been published for Staphylococcus aureus and Malassezia spp. Beyond this, specific T-cell activation to cross-reacting human proteins might further trigger the disease in distinct patients. The role of 'autoallergic' phenomena in atopic dermatitis, because of human antigens without known cross-reactivity to environmental allergens, is currently under investigation as well. Recent findings on immunological and clinical characteristics of adaptive immune responses to allergens in atopic dermatitis, but also on the identification of new, potentially relevant allergen sources might contribute to the development of effective treatment strategies 'customized' for allergic inflammation in atopic dermatitis in future.

  17. Breastfeeding and maternal diet in atopic dermatitis.

    Science.gov (United States)

    Lien, Tina Y; Goldman, Ran D

    2011-12-01

    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? The American Academy of Pediatrics suggests that lactating mothers with infants at high risk of developing AD should avoid peanuts and tree nuts, and should consider eliminating eggs, cow's milk, and fish from their diets. The World Health Organization also recommends breastfeeding infants up to 2 years of age. Studies have shown that breastfeeding can have a protective effect for AD in children; however, other studies have found insignificant or reversal effects. More research in this area is required.

  18. Genetic and epigenetic studies of atopic dermatitis.

    Science.gov (United States)

    Bin, Lianghua; Leung, Donald Y M

    2016-01-01

    Atopic dermatitis (AD) is a chronic inflammatory disease caused by the complex interaction of genetic, immune and environmental factors. There have many recent discoveries involving the genetic and epigenetic studies of AD. A retrospective PubMed search was carried out from June 2009 to June 2016 using the terms "atopic dermatitis", "association", "eczema", "gene", "polymorphism", "mutation", "variant", "genome wide association study", "microarray" "gene profiling", "RNA sequencing", "epigenetics" and "microRNA". A total of 132 publications in English were identified. To elucidate the genetic factors for AD pathogenesis, candidate gene association studies, genome-wide association studies (GWAS) and transcriptomic profiling assays have been performed in this period. Epigenetic mechanisms for AD development, including genomic DNA modification and microRNA posttranscriptional regulation, have been explored. To date, candidate gene association studies indicate that filaggrin (FLG) null gene mutations are the most significant known risk factor for AD, and genes in the type 2 T helper lymphocyte (Th2) signaling pathways are the second replicated genetic risk factor for AD. GWAS studies identified 34 risk loci for AD, these loci also suggest that genes in immune responses and epidermal skin barrier functions are associated with AD. Additionally, gene profiling assays demonstrated AD is associated with decreased gene expression of epidermal differentiation complex genes and elevated Th2 and Th17 genes. Hypomethylation of TSLP and FCER1G in AD were reported; and miR-155, which target the immune suppressor CTLA-4, was found to be significantly over-expressed in infiltrating T cells in AD skin lesions. The results suggest that two major biologic pathways are responsible for AD etiology: skin epithelial function and innate/adaptive immune responses. The dysfunctional epidermal barrier and immune responses reciprocally affect each other, and thereby drive development of AD.

  19. RESULTS OF APPLYING POLYVITAMIN COMPLEX FOR CHILDREN WITH ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    N.A. Ivanova

    2007-01-01

    Full Text Available The article presents findings of applying vitamin-and-mineral complex (VMC for children frequently suffering from diseases and children with atopic dermatitis. It shows that usage of VMC within a complex therapy promotes regression of subnormal vitamin provision symptoms, as well as symptoms of the core disease. This happens against heightened vitamin content in child's organism — which was proven with the test of A and E vitamins content in blood. The research has demonstrated a quite good tolerance of VMC by children suffering from atopic dermatitis.Key words: children frequently suffering from diseases, atopic dermatitis, vitamins, treatment.

  20. The association between atopic dermatitis and hand eczema

    DEFF Research Database (Denmark)

    Ruff, S M D; Engebretsen, K A; Zachariae, C

    2018-01-01

    Atopic dermatitis (AD) and hand eczema (HE) are common chronic and relapsing inflammatory skin conditions that often co-occur. While several studies have addressed their relationship, the exact association estimate is unknown. We systematically reviewed published literature on the association...... between AD and HE in PubMed, Embase, and Web of Science using the following search terms; (atopic dermatitis OR atopic eczema) AND (hand dermatitis OR hand eczema). Meta-analyses were then performed to examine the association between AD and the point-, one-year- and lifetime prevalence of HE, respectively...

  1. Review of Critical Issues in the Pathogenesis of Atopic Dermatitis.

    Science.gov (United States)

    Irvine, Alan D; Eichenfield, Lawrence F; Friedlander, Sheila F; Simpson, Eric L

    2016-06-01

    About a decade age, loss-of-function mutations in the filaggrin molecule were first implicated in the pathogenesis of ichthyosis vulgaris and, subsequently, of atopic dermatitis and other atopic diseases. Since then, intensive study of the role of filaggrin null mutations have led to other milestones in understanding the pathologic pathways in these diseases, including the initiation, maintenance, and promotion of the disease processes. The result has been new and emerging clinical and pharmacologic strategies for early identification of and intervention in atopic diseases. Semin Cutan Med Surg 35(supp5):S89-S91. 2016 published by Frontline Medical Communications.

  2. Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis in 25 Cavalier King Charles spaniel dogs. Part I: clinical signs, histopathology, and inheritance.

    Science.gov (United States)

    Hartley, Claudia; Donaldson, David; Smith, Ken C; Henley, William; Lewis, Tom W; Blott, Sarah; Mellersh, Cathryn; Barnett, Keith C

    2012-09-01

    The clinical presentation and progression (over 9 months to 13 years) of congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) in the Cavalier King Charles spaniel dog are described for six new cases and six previously described cases. Cases presented with a congenitally abnormal (rough/curly) coat and signs of KCS from eyelid opening. Persistent scale along the dorsal spine and flanks with a harsh frizzy and alopecic coat was evident in the first few months of life. Ventral abdominal skin was hyperpigmented and hyperkeratinized in adulthood. Footpads were hyperkeratinized from young adulthood with nail growth abnormalities and intermittent sloughing. Long-term follow-up of cases (13/25) is described. Immunomodulatory/lacrimostimulant treatment had no statistically significant effect on Schirmer tear test results, although subjectively, this treatment reduced progression of the keratitis. Histopathological analysis of samples (skin/footpads/lacrimal glands/salivary glands) for three new cases was consistent with an ichthyosiform dermatosis, with no pathology of the salivary or lacrimal glands identified histologically. Pedigree analysis suggests the syndrome is inherited by an autosomal recessive mode. © 2011 American College of Veterinary Ophthalmologists.

  3. Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis in Cavalier King Charles spaniel dogs. Part II: candidate gene study.

    Science.gov (United States)

    Hartley, Claudia; Barnett, Keith C; Pettitt, Louise; Forman, Oliver P; Blott, Sarah; Mellersh, Cathryn S

    2012-09-01

    To identify causative mutation(s) for congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) in Cavalier King Charles spaniel (CKCS) dogs using a candidate gene approach. DNA samples from 21 cases/parents were collected. Canine candidate genes (CCGs) for similar inherited human diseases were chosen. Twenty-eight candidate genes were identified by searching the Pubmed OMIM database (http://www.ncbi.nlm.nih.gov/omim). Canine orthologues of human candidate genes were identified using the Ensembl orthologue prediction facility (http://www.ensembl.org/index.html). Two microsatellites flanking each candidate gene were selected, and primers to amplify each microsatellite were designed using the Whitehead Institute primer design website (http://frodo.wi.mit.edu/primer3/). The microsatellites associated with all 28 CCGs were genotyped on a panel of 21 DNA samples from CKCS dogs (13 affected and eight carriers). Genotyping data was analyzed to identify markers homozygous in affected dogs and heterozygous in carriers (homozygosity mapping). None of the microsatellites associated with 25 of the CCGs displayed an association with CKCSID in the 21 DNA samples tested. Three CCGs associated microsatellites were monomorphic across all samples tested. Twenty-five CCGs were excluded as cause of CKCSID. Three CCGs could not be excluded from involvement in the inheritance of CKCSID. © 2012 American College of Veterinary Ophthalmologists.

  4. Sex Hormones in Allergic Conjunctivitis: Altered Levels of Circulating Androgens and Estrogens in Children and Adolescents with Vernal Keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Marta Sacchetti

    2015-01-01

    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.

  5. 'Pink eye' or 'zere oogjes' or keratoconjunctivitis infectiosa ovis (KIO). Clinical efficacy of a number of antimicrobial therapies.

    Science.gov (United States)

    König, C D

    1983-07-01

    In a comparative study the clinical efficacy of five different treatments of keratoconjunctivitis infectiosa ovis (KIO) were tested, namely an intramuscular injection of chloramphenicol base (dosage 15 mg/kg), spiramycin base (Suanovil dosages 10 to 25 mg/kg), oxytetracycline (Engemycine Forte, Terramycin LA, dosages respectively 5 and 10 mg/kg), tiamulin (Dynamutulin, dosage 10 mg/kg) and subcutaneous injection of procaine penicillin G, benzathine penicillin G. and dihydrostreptomycin in the lower eyelid. It appeared from these field trials that spiramycin base, oxytetracycline and tiamulin had a clearly positive effect on the clinical course of 'pink eye', although with tiamulin there was only a temporary effect (high percentage of relapses). In view of the field data the following dosage schemes are, for the time being, advised: spiramycin base (Suanovil), and oxytetracycline (formulation with a good biological availability) both 20 to 30 mg/kg and, if necessary, to be repeated on days 5 and 10 after the first intramuscular injection. The dosage scheme advised for tiamulin is 20-30 mg/kg to be repeated on day 3 and if necessary on days 6 and 9 after the intramuscular injection. In mild cases it is sufficient to rub the eyes with for example oxytetracycline eye-ointment, a few times a day.

  6. Treatment of patients with keratoconjunctivitis sicca with Optive: results of a multicenter, open-label observational study in Germany.

    Science.gov (United States)

    Kaercher, Thomas; Buchholz, Patricia; Kimmich, Friedemann

    2009-01-01

    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). 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). 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. Optive was well tolerated and improved the symptoms of dry eye after 2 to 4 weeks.

  7. Treatment of patients with keratoconjunctivitis sicca with Optive™: results of a multicenter, open-label observational study in Germany

    Science.gov (United States)

    Kaercher, Thomas; Buchholz, Patricia; Kimmich, Friedemann

    2009-01-01

    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 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. PMID:19668542

  8. Sequential Keraring implantation and corneal cross-linking for the treatment of keratoconus in children with vernal keratoconjunctivitis.

    Science.gov (United States)

    Abozaid, Mortada A

    2017-01-01

    The purpose of this study was to assess the safety and efficacy of femtosecond laser-assisted Keraring implantation followed by transepithelial accelerated corneal collagen cross-linking (CXL) for the treatment of keratoconus in children with vernal keratoconjunctivitis (VKC). This is a prospective interventional non-comparative case series. Eighteen eyes of 11 children with keratoconus and VKC were included in this study. All the cases were treated with femtosecond laser-assisted Keraring implantation followed after 2 weeks by transepithelial accelerated CXL, and the patients were followed up for 1 year. The preoperative mean uncorrected visual acuity (UCVA) was 1.01±0.2 (logMAR), whereas the postoperative mean UCVA was 0.6±0.2. The preoperative mean best-corrected visual acuity (BCVA) was 0.6±0.1, whereas the postoperative mean BCVA was 0.40±0.2. The preoperative average keratometry was 50.3±2.7 D, whereas the postoperative average keratometry was 45.8±3.1 D. The results of this study suggest that femtosecond laser-assisted Keraring implantation followed by CXL is safe and effective in the management of keratoconus in children with VKC. However, studies with a longer follow-up period are needed.

  9. Clinical study of conjunctival papilla grinding technique in the treatment of severe vernal keratoconjunctivitis with huge conjunctival nipple

    Directory of Open Access Journals (Sweden)

    Bing-Bing Chen

    2013-11-01

    Full Text Available AIM: To observe and assess the efficacy and safety of conjunctival papilla grinding technique in the treatment of severe vernal keratoconjunctivitis(VKCwith giant conjunctival papilla. METHODS: The prospective and controlled study was performed in 17 patients(24 eyeswith VKC. Eight patients(12 eyeswith giant conjunctival papillae were treated with grinding technique and 9 patients(12 eyeswere performed with conjunctival papillectomy, respectively. A comparison was made on the changes of symptoms including itching, tearing, light sensitivity and grittiness and physical signs of conjunctival papilla and the corneal epithelium before and after surgery.RESULTS:The symptoms and signs in the first week, the second week and the forth week after the operation were obviously improved in the two groups, and differences in these aspects before and after surgery were of statistical significance(P0.01. However, by grading of the signs of huge conjunctival nipple in the first week, the second week and the forth week after the operation, and conditions of repair of corneal damage in the second postoperative week, the result showed that efficacy of the grinding group was better than that of the surgical removal group(PCONCLUSION:Conjunctival nipples grinding operation can make the rough conjunctival wound flat quickly, relieve symptoms, and promote the repair of keratoconjunctival epithelium. And it is an effective, safe, and simple method to treat the severe VKC with huge conjunctival nipples.

  10. Comparison of efficacy and safety of topical Ketotifen (Zaditen with Cromolyn sodium in the treatment of Vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    MR Shoja

    2005-03-01

    Full Text Available Background: This study compared the efficacy of Ketotifen fumarate .025% (Zaditen with Cromolyn sodium 4% (Opticrom eye drops in prevention of itching, tearing, and redness in Vernal Keratoconjunctivitis (VKC. Methods: This double blind randomized single center clinical trial conducted between April and August 2004 in Yazd. One hundred eligible patients with clinical diagnosis of moderate VKC were randomly prescribed Zaditen (group A: n=50 and Cromolyn sodium (group B: n=50 eye drops for a 4 weeks period. Itching, lacrimation, redness, and photophobia were scored on a 4-points severity scale. Results: After 7 days of treatment, the response rates based on subjects assessment of global efficacy was significantly greater in Ketotifen group (61.5% than in Cromolyn group(53%.A clear response to treatment occurred in 94.4 of Zaditen and 81.2% of Sodium Cromoglycate treated patients. The investigator,s assessment of response rates also showed that Ketotifen was superior to Cromolyn sodium (P=0.001. Ketotifen produced a significantly better outcome than Cromolyn for relief of signs and symptoms of VKC (P<0.05. Ketotifen fumarate treatment significantly reduced the total signs and symptoms score for each patients, in compare with day 0. Conclusion: Ketotifen had a faster onset of action and provided better symptom relief than Cromolyn. The rapid onset of action and symptom control, make Zaditen a valuable treatment for VKC. Keywords : VKC , allergic conjuctivitis , zaditen

  11. Topical cyclosporine a 0.05% eyedrops in the treatment of vernal keratoconjunctivitis - randomized placebo-controlled trial.

    Science.gov (United States)

    Keklikci, Ugur; Dursun, Birgul; Cingu, Abdullah Kursat

    2014-01-01

    Vernal keratoconjunctivitis (VKC) is a chronic, bilateral inflammation of the conjunctiva that mostly affects children and young adult males. Management of VKC is primarily aimed at reducing symptoms and preventing serious vision threatening sequelae. To assess the efficacy of topical cyclosporine A (CsA) 0.05% on the signs and symtomps in the management of VKC. This is a placebo-controlled, randomized prospective study. Sixty-two patients with VKC were included in this study. Patients were randomly assigned (1 : 1) to treatment with topical 0.05% CsA eyedrops or a placebo (artificial tears) for a period of 4 weeks, 4 times daily. Ocular signs and symptoms were in all patients scored at entry and at the end of 4 weeks. When pre-treatment mean signs and symptoms scores were compared in both groups, there was no significant difference (p > 0.05). However, mean post-treatment scores as regards signs and symptoms were found to be lower in cyclosporine group than those in placebo group (p < 0.001). No side effects of the treatment with CsA 0.05% eyedrops were observed. It was found that topical CsA 0.05% eyedrops were safe and effective in the treatment of patients with VKC.

  12. The Study of Interleukin-17 Level in Vernal Keratoconjunctivitis Disease and its Relationship between Symptom and Sign Severity.

    Science.gov (United States)

    Validad, Mohammad Hosein; Khazaei, Hossein Ali; Pishjoo, Masoud; Safdari, Zohre

    2016-07-15

    Vernal keratoconjunctivitis (VKC) is a bilateral multi-factorial disease. The pathogenesis of this disease is not obviously determined, but the role of various inflammatory cytokines has been specified. This study has provided a comparison between the level of interleukin-17 (IL17) in the serum and tears of case and control groups, and also the relationship between the level of this interleukin with severity of signs and symptoms of the disease. This case-control study has been accomplished on 40 individuals (20 healthy people and 20 patients who suffer from VKC) in Al-Zahra Eye Center in 2014. The level of interleukin was isolated in an individual's tear by Schirmer strips; moreover, serum interleukin has been measured. The average of interleukin 17 in serum in the case group was 25.5±4.1 pg/dl and in the control group was 12.5±5.7 pg/dl. The average of interleukin 17 in the case group was 259.6±91.4 pg/dl in the tear and was 50.6±20.8 pg/dl for the control group; the signs and symptoms of the IL-17 disease were associated with the severity of Trantas dots. Interleukin-17 has a role in the pathogenesis of VKC and also has been proven in the former studies.

  13. Sex hormones in allergic conjunctivitis: altered levels of circulating androgens and estrogens in children and adolescents with vernal keratoconjunctivitis.

    Science.gov (United States)

    Sacchetti, Marta; Lambiase, Alessandro; Moretti, Costanzo; Mantelli, Flavio; Bonini, Stefano

    2015-01-01

    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. 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. 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). 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.

  14. Atualização no tratamento das ceratoconjuntivites cicatriciais Update of the treatment of cicatricial keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    José Alvaro Pereira Gomes

    2000-02-01

    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.

  15. Vernal Keratoconjunctivitis in School Children in Rwanda and Its Association with Socio-Economic Status: A Population-Based Survey

    Science.gov (United States)

    Smedt, Stefan De; Nkurikiye, John; Fonteyne, Yannick; Hogewoning, Arjan; Esbroeck, Marjan Van; Bacquer, Dirk De; Tuft, Stephen; Gilbert, Clare; Delanghe, Joris; Kestelyn, Philippe

    2011-01-01

    Vernal keratoconjunctivitis (VKC) is an allergic eye disease and an important cause of hospital referral among children in Africa and Asia. Hospital-based studies have suggested a role for parasites in its pathogenesis. To determine the prevalence and risk factors for VKC in Central Africa, we conducted a nested population-based case control study in Rwanda, involving randomly selected primary schools from different environments (rural/urban) and climate. A prevalence of VKC of 4.0% (95% confidence interval 3.3–4.7%) was found among 3,041 children studied (participation rate 94.7%). The intestinal parasitic burden was not related to VKC. Besides hot dry climate (odds ratio [OR] = 1.5, P = 0.05) and male gender (OR = 1.7, P = 0.005), multivariate analysis identified higher economic status as a risk for VKC (OR = 1.4, P = 0.005). The effect on VKC of higher economic status appears not to act through differences in parasitic intestinal load. PMID:21976577

  16. Therapeutic Effect of 0.03% Tacrolimus Ointment for Ocular Graft versus Host Disease and Vernal Keratoconjunctivitis

    Science.gov (United States)

    Ryu, Eun Hye; Kim, Joung Mok; Laddha, Pradnya M; Chung, Eui-Sang

    2012-01-01

    Purpose To determine whether topical tacrolimus might prove effective in the treatment of refractory anterior segment inflammatory diseases, and to evaluate its efficacy in eyes with ocular graft versus host disease (GVHD), and vernal keratoconjunctivitis (VKC). Methods Twenty-eight eyes of 14 patients with anterior segment inflammation refractory to steroid treatment were treated with 0.03% tacrolimus ointment at the Samsung Medical Center, Seoul, Korea from March 2008 through August 2009. Seven patients had ocular GVHD and seven had VKC. We evaluated the conjunctival and corneal inflammatory change at one, two, four, and eight weeks after treatment with a scoring system. Time to initial response of treatment and therapeutic effect between GVHD and VKC was also analyzed. After the eight-week treatment period, patients were divided into two groups (maintenance group and discontinuance group). Eight patients maintained the treatment for an additional four months, and six patients discontinued the treatments. Therapeutic effect was also compared between the groups at eight weeks and six months after treatment. Results The mean conjunctival and corneal inflammation score was reduced significantly at eight weeks after treatment (p 0.05). Six months after treatment, we noted no therapeutic differences between the maintenance group and discontinuance group (p > 0.05). Conclusions 0.03% tacrolimus ointment was safe and effective for use in anterior segment inflammatory disease refractory to steroid. PMID:22870021

  17. Efficacy of 1.25% and 1% topical cyclosporine in the treatment of severe vernal keratoconjunctivitis in childhood.

    Science.gov (United States)

    Spadavecchia, Laura; Fanelli, Pietro; Tesse, Riccardina; Brunetti, Luigia; Cardinale, Fabio; Bellizzi, Mario; Rizzo, Giovanna; Procoli, Ugo; Bellizzi, Gianfranco; Armenio, Lucio

    2006-11-01

    Cyclosporine eyedrops 2% have been used for treatment of corticosteroid-resistant vernal keratoconjunctivitis (VKC) cases. The purpose of our study was to verify the efficacy of 1.25% vs. 1% topical cyclosporine in improving severe form of VKC in childhood. Twenty children with severe VKC, were enrolled in a double-blind, placebo-controlled study and received cyclosporine 1.25% in one eye for 2 wk. Then an open trial was conducted during the next 3 months and 2 wk. Thirty-two more patients were recruited the next year into a new open trial and they received cyclosporine 1% for 4 months. Ocular subjective symptoms and objective signs were scored in all children at entry, 2 wk and 4 months. Skin prick tests and conjunctival scraping tests were also performed; serum immunological and biochemical markers were assessed. The mean score values for severity of subjective symptoms and objective signs were significantly decreased after 2 wk, and 4 months, compared with those at entry (p < 0.001), in both groups of children who received cyclosporine eyedrops 1.25% and 1%, respectively. Serum markers did not differ from the beginning to the end of treatment. Conjunctival eosinophils and cyclosporine serum levels were not detectable at the end of therapy, nor were endothelial corneal cells damaged. Our findings suggest that 1% cyclosporine concentration might be the minimal effective treatment regimen to control symptoms and local inflammation in severe forms of VKC.

  18. Clinical and Cytologic Evidence of Limbal Stem Cell Deficiency in Eyes With Long-Standing Vernal Keratoconjunctivitis.

    Science.gov (United States)

    Saboo, Ujwala S; Basu, Sayan; Tiwari, Shubha; Mohamed, Ashik; Vemuganti, Geeta K; Sangwan, Virender S

    2013-01-01

    We aimed to study the impression cytology (IC) of the ocular surface in eyes with vernal keratoconjunctivitis (VKC) and clinical evidence of limbal stem cell deficiency (LSCD). This is a prospective comparative study. This study included 78 eyes of 40 patients with VKC. Limbal stem cell deficiency was diagnosed clinically based on the presence of corneal findings such as dull irregular epithelial reflex, superficial neovascularization, conjunctivalization, and loss of limbal palisades of Vogt. The study group consisted of 28 eyes of 15 patients with clinically diagnosed LSCD and control group of 50 eyes of 25 patients without LSCD. Conjunctival and corneal IC was done in all eyes. Presence of goblet cells in the corneal samples on IC was considered confirmatory of LSCD. Compared with controls, patients with LSCD were older and had longer duration of disease. On IC, goblet cells were present on the cornea in 53.6% of eyes with clinically diagnosed LSCD and in none of the control eyes (P < 0.0001). Clinically diagnosed LSCD in study eyes correlated with cytologic findings of greater conjunctival squamous metaplasia, decreased conjunctival goblet cells, greater corneal cell metaplasia, and increased inflammation as compared with control eyes. Most of the eyes with VKC and clinical evidence of LSCD have cytologic evidence of LSCD with goblet cells on the cornea.

  19. ENTEROSORBENTS AS A PART OF COMPLEX THERAPY OF ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    A. A. Alexeeva

    2012-01-01

    Full Text Available Atopic dermatitis (AD is one of the most common allergic diseases in children which is assuming ever greater medical and social importance. Risk factors of AD include gastro-intestinal tract disturbances, especially intestinal dysbiosis, which is revealed in 89–94,1% of children with atopic dermatitis. Both correlation of the dysbiosis and AD manifestations severity and increase of underlying disease treatment efficacy as a result of target influence on intestinal microflora confirm that. For many decades guidelines of atopic dermatitis treatment in children along with elimination diet, antihistamine drugs and topic medicines include enterosorbents. The most effective drugs are those ones, consisting of prebiotics and sorbents. The wide experience of prebiotic drug with sorbent action (Lactofiltrum in complex therapy of atopic dermatitis in children is reviewed in this article.

  20. Adverse reactions to food additives in children with atopic symptoms

    DEFF Research Database (Denmark)

    Fuglsang, G.; Madsen, Charlotte Bernhard; Halken, S.

    1994-01-01

    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......, 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...... and 335 were subjected to open challenge. A total of 23 children developed positive reactions after the open challenge. Sixteen of these patients accepted the double-blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), coloring agents (atopic...

  1. Adverse reactions to food additives in children with atopic symptoms

    DEFF Research Database (Denmark)

    Fuglsang, G; Madsen, G; Halken, S

    1994-01-01

    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......, 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...... and 335 were subjected to open challenge. A total of 23 children developed positive reactions after the open challenge. Sixteen of these patients accepted the double-blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), coloring agents (atopic...

  2. Classification of atopic hand eczema and the filaggrin mutations

    DEFF Research Database (Denmark)

    Giwercman, C.; Lerbaek, A.; Bisgaard, H.

    2008-01-01

    mutations. We believe this will increase the possibility of subgrouping this otherwise heterogenic disease and thereby enable a better phenotype-genotype characterization of hand eczema. This could improve the preventive initiatives, secure better information of patients about the prognosis......Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis....... Moreover, one study point towards an association between the filaggrin null alleles and the subgroup of patients having both hand eczema and atopic dermatitis. For the remainder of hand eczema patients, still unknown genetic risk factors exist. We propose that in future, classification of atopic hand...

  3. Quality of Life of Parents of Children with Atopic Dermatitis

    National Research Council Canada - National Science Library

    Joanna Marciniak; Adam Reich; Jacek C. Szepietowski

    2017-01-01

    Atopic dermatitis (AD) is the most common chronic dermatitis in children. The influence of AD on quality of life of parents of children with AD was studied using the Family Dermatology Life Quality Index (FDLQI...

  4. [Skin and mucous membrane microbiocenosis during atopic dermatitis in children].

    Science.gov (United States)

    Repetskaia, M N; Maslov, Iu N; Shaĭdullina, E V; Burdina, O M

    2014-01-01

    Study the microbial landscape and determine the interaction between biocenoses of skin, oropharynx and intestine mucous membranes during atopic dermatitis in children. 60 children with atopic dermatitis were examined, bacteriologic study of skin, oropharynx, intestine was carried out. Significant changes were detected in both quantitative and qualitative composition of microbiocenosis of skin, oropharynx and intestine mucous membranes. Skin of patients is more frequently colonized by Staphylococcus aureus. Gram-positive bacteria dominated in oropharynx microflora. Comparative characteristics of microflora of skin and oropharynx mucous membrane revealed a direct of correlation. During microbiological study of intestine microflora, all the examined had microbial landscape disruptions of varying severity degree. Taking into consideration the direct correlation of microflora of skin and oropharynx mucous membrane during atopic dermatitis, seeding of oropharynx washes are recommended to be included into the examination complex of patients with subsequent correction of microbiocenosis. Examination of all the children with atopic dermatitis for the presence of intestine dysbiosis is advisable.

  5. Truth or fiction: risk factors for childhood atopic dermatitis.

    Science.gov (United States)

    Bergstrom, Kendra Gail

    2012-01-01

    Atopic dermatitis is increasing in prevalence throughout the developed world, in parallel with asthma and hay fever. The reasons for the increase remain unclear. As a practical question, it is valuable to understand which interventions might decrease risk for childhood atopic disease. Prospective studies among infants and children are challenging to design and to execute. Fortunately, several large studies from Europe and the United States are better characterizing whether behavioral interventions such as breastfeeding, delayed introduction of solid foods, hydrolyzed protein infant formulas, or pets in the home might be protective or impart increased risk of developing atopic dermatitis. As this body of literature grows, physicians will be able to recommend behavioral interventions that can prevent atopic dermatitis in individuals and ideally decrease prevalence over the population.

  6. Apgar score is related to development of atopic dermatitis

    DEFF Research Database (Denmark)

    Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff

    2013-01-01

    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...

  7. Incidence of allergy and atopic disorders and hygiene hypothesis.

    Czech Academy of Sciences Publication Activity Database

    Bencko, V.; Šíma, Petr

    2017-01-01

    Roč. 2, 6 March (2017), č. článku 1244. ISSN 2474-1663 Institutional support: RVO:61388971 Keywords : allergy disorders * atopic disorders * hygiene hypothesis Subject RIV: EE - Microbiology, Virology

  8. Soy allergy in patients suffering from atopic dermatitis.

    Science.gov (United States)

    Jarmila, Celakovská; Květuše, Ettlerová; Karel, Ettler; Jaroslava, Vaněčková; Josef, Bukač

    2013-07-01

    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. 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. 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. 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.

  9. Soy Allergy in patients suffering from atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Celakovská Jarmila

    2013-01-01

    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.

  10. Sesame seed sensitization in a group of atopic Egyptian children ...

    African Journals Online (AJOL)

    sensitization in Egypt. Objective: In this pilot study, we thought to estimate the frequency of sesame seed sensitization in a group of atopic Egyptian infants and children. Methods: We consecutively enrolled 90 patients with physician diagnosed ...

  11. Small intestinal permeability to sugars in patients with atopic eczema.

    Science.gov (United States)

    Ukabam, S O; Mann, R J; Cooper, B T

    1984-06-01

    Absorption of lactulose and mannitol was measured in eleven patients with atopic eczema and lactulose/mannitol excretion ratios were calculated. Mean lactulose absorption was increased in the patients with exzema and their excretion ratios were higher than those of controls. There was no correlation between either eczema extent or severity and the excretion ratio. We conclude that small intestinal passive permeability is increased in some patients with atopic eczema.

  12. Innovative technologies of teaching self-government atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Utz S.R.

    2016-09-01

    Full Text Available The new understanding of the disease requires the development of modern methods in the management strategy of atopic dermatitis. Individual approach to educate patients with use of modern gadgets in addition to the standard methods of treatment is a relatively new concept in dermatology. Educational programs for atopic dermatitis have a positive impact on the severity of dermatoses, as well as on psychological status.

  13. Parents' reported preference scores for childhood atopic dermatitis disease states

    Directory of Open Access Journals (Sweden)

    Walter Emmanuel B

    2004-10-01

    Full Text Available Abstract Background We sought to elicit preference weights from parents for health states corresponding to children with various levels of severity of atopic dermatitis. We also evaluated the hypothesis that parents with children who had been diagnosed with atopic dermatitis would assign different preferences to the health state scenarios compared with parents who did not have a child with atopic dermatitis. Methods Subjects were parents of children aged 3 months to 18 years. The sample was derived from the General Panel, Mommies Sub-Panel, and Chronic Illness Sub-Panel of Harris Interactive. Participants rated health scenarios for atopic dermatitis, asthma, and eyeglasses on a visual analog scale, imagining a child was experiencing the described state. Results A total of 3539 parents completed the survey. Twenty-nine percent had a child with a history of atopic dermatitis. Mean preference scores for atopic dermatitis were as follows: mild, 91 (95% confidence interval [CI], 90.7 to 91.5; mild/moderate, 84 (95%CI, 83.5 to 84.4; moderate, 73 (95%CI, 72.5 to 73.6; moderate/severe, 61 (95%CI, 60.6 to 61.8; severe, 49 (95% CI, 48.7 to 50.1; asthma, 58 (95%CI, 57.4 to 58.8; and eyeglasses, 87(95%CI, 86.3 to 87.4. Conclusions Parents perceive that atopic dermatitis has a negative effect on quality of life that increases with disease severity. Estimates of parents' preferences can provide physicians with insight into the value that parents place on their children's treatment and can be used to evaluate new medical therapies for atopic dermatitis.

  14. Atopic Dermatitis and Type 1 Diabetes Mellitus in Iranian Children

    OpenAIRE

    Ali R.  Tehrani; Zahra Rahnama; Elham Ahmadi

    2009-01-01

    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 pe...

  15. Linear growth in prepubertal children with atopic dermatitis

    OpenAIRE

    Patel, L.; Clayton, P; Addison,G.; Price, D.; David, T

    1998-01-01

    OBJECTIVE—To define the evolution of prepubertal growth in atopic dermatitis and the factors influencing that growth pattern.
METHODS—Height and height velocity over two years, weight, triceps and subscapular skin fold thickness, and bone age were assessed in 80 prepubertal patients with atopic dermatitis and a control group of 71 healthy prepubertal school children.
RESULTS—Height standard deviation scores (SDS) and height velocity SDS did not differ between patients ...

  16. Soy Allergy in Patients Suffering from Atopic Dermatitis

    OpenAIRE

    Celakovská Jarmila; Ettlerová Kvetuše; Ettler Karel; Vanecková Jaroslava; Bukac Josef

    2013-01-01

    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...

  17. Moisturizing effects of topical nicotinamide on atopic dry skin.

    Science.gov (United States)

    Soma, Yoshinao; Kashima, Masato; Imaizumi, Akiko; Takahama, Hideto; Kawakami, Tamihiro; Mizoguchi, Masako

    2005-03-01

    Certain moisturizers can improve skin barrier function in atopic dermatitis. The effect of topical nicotinamide on atopic dry skin is unknown. We examined the effect of topical nicotinamide on atopic dry skin and compared the results with the effect of white petrolatum in a left-right comparison study. Twenty-eight patients with atopic dermatitis, with symmetrical lesions of dry skin on both forearms, were enrolled, and were instructed to apply nicotinamide cream containing 2% nicotinamide on the left forearm and white petrolatum on the right forearm, twice daily over a 4- or 8-week treatment period. Transepidermal water loss and stratum corneum hydration were measured by instrumental devices. The amount of the stratum corneum exfoliated by tape stripping (desquamation index) was determined by an image analyzer. Nicotinamide significantly decreased transepidermal water loss, but white petrolatum did not show any significant effect. Both nicotinamide and white petrolatum increased stratum corneum hydration, but nicotinamide was significantly more effective than white petrolatum. The desquamation index was positively correlated with stratum corneum hydration at baseline and gradually increased in the nicotinamide group, but not in the white petrolatum group. Nicotinamide cream is a more effective moisturizer than white petrolatum on atopic dry skin, and may be used as a treatment adjunct in atopic dermatitis.

  18. SPECIAL CHARACTERISTICS OF TREATMENT OF SEVERE ATOPIC DERMATITIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    D. Sh. Macharadze

    2013-01-01

    Full Text Available The article analyzes modern data on risk factors of severe course of atopic dermatitis in children: the role of alimentary and inhalant allergens, cutaneous infections, allergic reactions to drugs used in the treatment of disease. The most important questions of differential diagnosis of atopic dermatitis in children and the distinctive features of the illness, which may be mistaken for atopic dermatitis (primary immunodeficiencies, keratosis pilaris, psoriasis, enteropatic acrodermatitis; cutaneous bacterial and fungal infections, and drug-induced contact dermatitis to topical creams and ointments are discussed. Treatment of atopic dermatitis is based on modern approaches and includes recommendations on the use of emolents, anti-inflammatory drugs (topical glucocorticoids and calcineurin inhibitors. The article provides indications and contraindications to the administration of anti-inflammatory drugs. Special recommendations for use of cleansers and emolents at all degrees of severity of atopic dermatitis, which helps reduce the risk of side effects of topical corticosteroids, complications such as cutaneous infections and helps to maintain remission of disease are given. The importance of training programs patients is emphasized. Compliance of patients and/or their parents contributes to the achievement of the desired effect of the treatment of atopic dermatitis, which will improve the patients’ quality of life.

  19. Quality of life in children and teenagers with atopic dermatitis.

    Science.gov (United States)

    Amaral, Cláudia Soïdo Falcão do; March, Maria de Fátima Bazhuni Pombo; Sant'Anna, Clemax Couto

    2012-01-01

    Atopic Dermatitis is a disease which has increased during the past years despite our improved understanding of it. To assess the impact of Atopic Dermatitis in the quality of life of children and teenagers and their family. A descriptive cross-sectional method with prospective data collection of 50 children and teenagers diagnosed with Atopic Dermatitis ranging in age from 5-16 years. Fifty parents and/or guardians answered the quality of life questionnaires The Children's Dermatology Life Quality Index and Family Dermatitis Impact Questionnaire. The socio-demographic and clinical variables were evaluated by a clinical record chart designed specifically for the research and socioeconomic standardized questionnaire by the Brazilian Association of Research Enterprises, which evaluates assets acquired and the educational level of the head of the household. Thirty-five out of the 50 patients were female (70%), and 28 (56%) of them were from social class C. The Questionnaire Children's Dermatology Life Quality Index showed that 19 (38%) patients ranged from 7 to 12 points (moderate impact of atopic dermatitis) and 17 patients (34%) ranged from 13 to 30 points (high impact of atopic dermatitis). The Family Dermatitis Impact Questionnaire revealed that 15 (30%) families had scores between 7 and 12 points and 22 families (44%) scored between 13 and 30 points. The results show that there is a very high impact on the QoL for atopic dermatitis patients and their families. This makes us suggest the importance of including the quality of life study in clinical evaluations.

  20. A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group

    NARCIS (Netherlands)

    Ruzicka, T.; Bieber, T.; Schöpf, E.; Rubins, A.; Dobozy, A.; Bos, J. D.; Jablonska, S.; Ahmed, I.; Thestrup-Pedersen, K.; Daniel, F.; Finzi, A.; Reitamo, S.

    1997-01-01

    Tacrolimus (FK 506) is an effective immunosuppressant drug for the prevention of rejection after organ transplantation, and preliminary studies suggest that topical application of tacrolimus is effective in the treatment of atopic dermatitis. We conducted a randomized, doubleblind, multicenter study

  1. Atopic march in pediatrics: genotype-associated mechanisms Part 1. Genotype-associated mechanisms of the atopic march in children

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    V.O. Dytiatkovsky

    2017-05-01

    Full Text Available The review deals with the data of studies over last 10 years of populations of different countries on association of atopic diseases being the components of the atopic march in children (atopic eczema, allergic rhinitis, allergic rhinoconjunctivitis, bronchial asthma with pathologic mutations of genes (single nucleotid polymorphisms — SNP, which encode the molecules participating in allergic inflammation in the skin and mucosa. PubMed had been used as the search tool. There is a review of studies provided on investigated SNPs — filaggrin, receptors, toll-like receptors; the article describes a perspective bronchial asthma inflammation cascade — interleukin-1 receptor-like-1 and interleukin-33. There has been proposed conducting the studies of SNP on Ukrainian pediatric population for working out the personalized genotype-associated approach for diagnosing and management of atopic diseases in Ukrainian children population.

  2. Children with Dry Skin and Atopic Predisposition: Outcome Measurement with Validated Scores for Atopic Dermatitis.

    Science.gov (United States)

    Sawatzky, Sabine; Schario, Marianne; Stroux, Andrea; Lünnemann, Lena; Zuberbier, Torsten; Blume-Peytavi, Ulrike; Garcia Bartels, Natalie

    2016-01-01

    Dry skin is a common skin condition in childhood. Few studies exist investigating the influence of daily skin care on dry skin in infants at risk of developing atopic dermatitis (AD). We aimed to assess the effect of skin care on dry skin in this special cohort using validated scores for AD and analysis of skin microtopography. 43 children were randomized to group 1 (G1) and group 2 (G2) and 22 infants to group 3 (G3). During 16 weeks, G1 and G3 applied daily a plant-based emollient and G2 a petrolatum-based emollient. The core outcome was assessed by Severity Scoring of Atopic Dermatitis (SCORAD) and Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD). The influence on the parents' life was evaluated by a questionnaire and microtopography by Visioscan® VC 98. The SCORAD index declined significantly until week (W) 16 in all groups (p ≤ 0.041). The sleeplessness score analyzed by PO-SCORAD was highly reduced after W12 in G1 and after W16 in G2 (p ≤ 0.030). The influence on the parents' anxiety was reduced in G3 at W12 and W16 (p = 0.016). The Visioscan parameter scaliness strongly diminished at W4 (p ≤ 0.049) and W16 (p ≤ 0.013) in all groups. This trial demonstrates improved skin conditions and sleep following daily emollient application in infants and children having dry skin and being at risk of AD. Especially parents of infants showed a reduced fear that their children might develop AD. Further studies are required to investigate the preventive effect of daily emollient therapy in this special cohort evaluating the outcome measures used in this trial. © 2016 S. Karger AG, Basel.

  3. Intestinal permeability in patients with atopic eczema.

    Science.gov (United States)

    Bjarnason, I; Goolamali, S K; Levi, A J; Peters, T J

    1985-03-01

    Intestinal permeability was investigated in adult patients with atopic eczema by in vivo and in vitro techniques. Patients with symptoms of 'immediate' food allergy were specifically excluded. A 51Cr-labelled ethylenediaminetetraacetate absorption test was carried out in eighteen patients. Their mean (+/- s.d.) 24-hour urine excretion following oral administration of the test substance (2.1 +/- 0.9%) did not differ significantly from that of thirty-four normal controls (1.9 +/- 0.5%). Small bowel permeability was estimated directly in jejunal mucosal samples in ten patients with three permeability probes of differing molecular weight. Mucosal permeability did not differ significantly from that of fifteen control patients for any of the test substances. Two patients had abnormal results by both tests and in one this was due to coeliac disease. These results suggest that altered intestinal permeability is not important in the pathogenesis of eczema. Patients demonstrating increased intestinal permeability should undergo jejunal biopsy to exclude significant small bowel disease.

  4. Allergic investigations in children with atopic eczema.

    Science.gov (United States)

    Siłakowska, Z; Rybak, B

    1995-01-01

    In the study the results of allergic investigations in 36 children with atopic eczema were demonstrated. Prick testing with 22 allergens made by Bencard and 5 natural allergens showed an allergic reaction in 28 children (77.8%). The positive reaction was noted more often in children with a generalized form of disease compared to a limited one (81.85 and 76.0% respectively). Allergy to inhalatory allergens was observed in 72.2%, to food allergens in 38.9% and to other allergens in 27.8% of patients. Among inhalatory allergens, sensitivity to domestic dust (55.6%), inhalatory allergens A1 and grass pollen (both 50.0%) and Dermatophagoides pt. (44.4%) were most common. Food allergens were represented by grain (16.7%), uncooked milk and chocolate (both 11.1%). The conducted investigations indicate, that uncooked or cooked milk and milk cream seem to be more accurate indicators of milk sensitivity than milk allergen by Bencard.

  5. Probiotics and Atopic Dermatitis: An Overview

    Directory of Open Access Journals (Sweden)

    Irfan A. Rather

    2016-04-01

    Full Text Available 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 prevention and treatment of AD remain elusive. However, evidence from different research groups show that probiotics could have positive effect on AD treatment, if any, that depend on multiple factors, such as specific probiotic strains, time of administration (onset time, duration of exposure, and dosage. However, till date we still lack strong evidence to advocate the use of probiotics in the treatment of AD, and questions remain to be answered considering its clinical use in future. Based on updated information, the processes that facilitate the development of AD and the topic of the administration of probiotics are addressed in this review.

  6. House dust mites in pediatric atopic dermatitis.

    Science.gov (United States)

    Adham, Tamer M; Tawfik, Safwat A; Abdo, Naglaa M

    2011-02-01

    To evaluate hypersensitivity to Dermatophagoides pteronyssinus (D. pteronyssinus) and D. farinae in pediatric patients with atopic dermatitis (AD), and to assess the therapeutic value of using acaricides with other environmental anti house dust mites (HDM) measures. Ninety-eight children with AD were chosen randomly from the Pediatric Allergy Clinic in Al-Noor Hospital, Khalifa branch, Abu Dhabi, United Arab Emirates during the period between January 2008 to January 2009 and were evaluated for severity and chronicity. They were subjected to skin prick test (SPT) including D. pteronyssinus and D. farinae antigens and were also assessed for the therapeutic value of acaricides and environmental anti HDM measures. We found that 74.5% of patients were sensitive to one or both strains of HDM. A highly significant association was found between the severity of the symptoms of AD and its persistence with hypersensitivity to HDM (p=0.001). Acaricides and environmental anti HDM measures can improve patients with mild AD. Hypersensitivity to HDM is an important factor for the more acute, more chronic, and more severe AD. Anti HDM measures including the use of acaricides can help control mild AD. We recommend SPT as a part of the work up of patients with AD. The HDM sensitive patients can benefit from anti HDM measures.

  7. Molecular Genetic of Atopic dermatitis: An Update

    Science.gov (United States)

    Al-Shobaili, Hani A.; Ahmed, Ahmed A.; Alnomair, Naief; Alobead, Zeiad Abdulaziz; Rasheed, Zafar

    2016-01-01

    Atopic dermatitis (AD) is a chronic multifactorial inflammatory skin disease. The pathogenesis of AD remains unclear, but the disease results from dysfunctions of skin barrier and immune response, where both genetic and environmental factors play a key role. Recent studies demonstrate the substantial evidences that show a strong genetic association with AD. As for example, AD patients have a positive family history and have a concordance rate in twins. Moreover, several candidate genes have now been suspected that play a central role in the genetic background of AD. In last decade advanced procedures similar to genome-wide association (GWA) and single nucleotide polymorphism (SNP) have been applied on different population and now it has been clarified that AD is significantly associated with genes of innate/adaptive immune systems, human leukocyte antigens (HLA), cytokines, chemokines, drug-metabolizing genes or various other genes. In this review, we will highlight the recent advancements in the molecular genetics of AD, especially on possible functional relevance of genetic variants discovered to date. PMID:27004062

  8. Immunoadsorption for treatment of severe atopic dermatitis.

    Science.gov (United States)

    Wegner, Joanna; Weinmann-Menke, Julia; von Stebut, Esther

    2017-11-01

    Atopic dermatitis (AD) is a common disease affecting up to 10-20% of the population with the largest disease burden in childhood. Treatment options include basic emollient treatment, topical as well as systemic immunosuppressants. The pathogenesis is complex and among various triggers, genetic predisposition and immunological alterations contribute to development of disease. Atopy is common in patients with AD and many patients have high levels of Immunoglobulin E (IgE), some of which recognizes exogenous or auto/self-allergens. Treatment options targeting IgE such as specific immunotherapy against e.g. house dust mites or using anti-IgE antibodies (omalizumab) showed variable results that were not convincing. We now review recent data on the application of unspecific and IgE-selective immunoadsorption (IA) in AD. All in all, 53 patients have been treated with non-specific pan Ig IA and 28 patients with IgE-selective IA. Side effects were rarely seen. The efficacy of IgE depletion was generally high (<∼80%) for each IA cycle, but transient and lasted only a few days/weeks. Of note, disease activity appeared to improve in almost all cases and lasted for several weeks. Although the evidence is still weak, these case studies suggest that IgE depletion in AD is effective and helped control the disease. The mechanism of action is not understood yet. Future controlled trials are needed to validate this observation. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Atopic dermatitis - risk factors and treatment].

    Science.gov (United States)

    Zaleska, Martyna; Trojacka, Ewelina; Savitskyi, Stepan; Terlikowska-Brzósko, Agnieszka; Galus, Ryszard

    2017-08-21

    Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by severe itching and eczematic skin lesions. In Poland from 1.5 to 2.5 million people suffer from AD. The pathophysiologic complexity and the wide spectrum of clinical phenotypes cause diagnostic and therapeutic problems and this is the basis for the division of the disease into subtypes. Heterogeneity of the disease is also confirmed in the study of the genotype of the disease. In relation with AZS more than 1000 loci in chromosomes were demonstrated. The roles of certain genes and the pathophysiology of lesions caused by their polymorphism were described. Wide spectrums of AD risk factors are: cigarette smoking, alcohol consumption during pregnancy, obesity and high and low birth weight. The quality of life in patients with AD is impaired, the disease disrupts family and professional relationships. Biological medical products are an example of an individual approach to the treatment of AD. It seems, individual approach to disease and treatment can be a successive solution to the problem.

  10. Atopic Dermatitis in Adults: A Diagnostic Challenge.

    Science.gov (United States)

    Silvestre Salvador, J F; Romero-Pérez, D; Encabo-Durán, B

    Atopic dermatitis (AD) has a prevalence of 1%-3% in adults. Adult-onset AD has only been defined recently, and lack of familiarity with this condition and confusion regarding the appropriate terminology persist. AD may first appear in childhood or de novo in adults and is characterized by pronounced clinical heterogeneity. The disease often deviates from the classic pattern of flexural dermatitis, and there are forms of presentation that are specific to adults, such as head-and-neck dermatitis, chronic eczema of the hands, multiple areas of lichenification, or prurigo lesions. Although diagnosis is clinical, adult-onset AD frequently does not fit the traditional diagnostic criteria for the disease, which were developed for children. Thus, AD is often a diagnosis of exclusion, especially in de novo cases. Additional diagnostic tests, such as the patch test, prick test, skin biopsy, or blood test, are usually necessary to rule out other diseases or other types of eczema appearing concomitantly with AD. This article presents an update of the different forms of clinical presentation for AD in adults along with a proposed diagnostic approach, as new treatments will appear in the near future and many patients will not be able to benefit from them unless they are properly diagnosed.

  11. ATOPIC DERMATITIS AS A CLINICAL CHALLENGE

    Directory of Open Access Journals (Sweden)

    Marija Davidovic

    2005-04-01

    Full Text Available Atopic dermatitis (AD is a chronic, inflammatory skin disease which is characterized by rash, pruritus and xerosis.The disease is most prevalent in infants and small children with about 70% of cases presenting before the age of 5.The prevalence of AD has increased two to three times during the past thirty years in industrially developed countries and, today, AD is considered to be a major public health concern.AD is a complex, multifactorial disease resulting from interactions between genetic and environmental factors. Although the pathogenesis of AD is not completely clear, it is known that T-helper cells play the central role in it. Its characteristic is predomination of Th2-type response to allergens instead of the Th1 response which is predominant in normal individuals.Disease runs a chronic course, with remissions and exacerbations, while clinical presentation varies among patients depending on age and disease severity.There is no cure for AD, and an adequate disease control generally involves a combination of preventive measures and an individualised therapeutic approach. The conventional management includes the use of emollients to maintain the proper skin hydratation. Topical corticosteroids are currently the mainstay of treatment to control disease flares. However the use of these agents is limited to intermittent and short-term treatment due to potentially adverse effects, such as skin atrophy. Tacrolimus and pimecrolimus are steroid-free topical immunomodulators, providing safe and effective treatment for moderate to severe AD.

  12. Autoimmune diseases in adults with atopic dermatitis.

    Science.gov (United States)

    Andersen, Yuki M F; Egeberg, Alexander; Gislason, Gunnar H; Skov, Lone; Thyssen, Jacob P

    2017-02-01

    An increased susceptibility to autoimmune disease has been shown in patients with atopic dermatitis (AD), but data remain scarce and inconsistent. We examined the co-occurrence of selected autoimmune diseases in adult patients with AD. Nationwide health registers were used. Adult patients with a hospital diagnosis of AD in Denmark between 1997 and 2012 were included as cases (n = 8112) and matched with controls (n = 40,560). The occurrence of autoimmune diseases was compared in the 2 groups. Logistic regression was used to estimate odds ratios. AD was significantly associated with 11 of 22 examined autoimmune diseases. In addition, AD was associated with having multiple autoimmune comorbidities. Patients with a history of smoking had a significantly higher occurrence of autoimmune comorbidities compared to nonsmokers. This study was limited to adult patients with AD. No information about AD severity or degree of tobacco consumption was available. Results from a hospital population of AD patients cannot be generalized to the general population. Our results suggest a susceptibility of autoimmune diseases in adult patients with AD, especially in smokers. While we cannot conclude on causality based on these data, an increased awareness of autoimmune comorbidities in patients with AD may be warranted. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Tacrolimus vs. cyclosporine eyedrops in severe cyclosporine-resistant vernal keratoconjunctivitis: A randomized, comparative, double-blind, crossover study.

    Science.gov (United States)

    Pucci, Neri; Caputo, Roberto; di Grande, Laura; de Libero, Cinzia; Mori, Francesca; Barni, Simona; di Simone, Lorena; Calvani, Annamaria; Rusconi, Franca; Novembre, Elio

    2015-05-01

    Vernal keratoconjunctivitis (VKC) is a chronic sight-threatening ocular disease. Topical cyclosporine A (Cyc) has been widely administered as a steroid-sparing drug, although in about 7-10% of cases, it has been ineffective. The purpose of this study was to evaluate the efficacy of 0.1% topical tacrolimus (Tcr) in patients with severe VKC who failed to respond to 1% Cyc eyedrops. Consecutive patients with severe, Cyc-resistant VKC were enrolled in a double-blind, comparative, crossover (DBCO) trial; all patients were treated with 1% Cyc in one eye and 0.1% Tcr in the other eye for 3 wk. After a washout period of 7 days, patients were instructed to cross over the medications for three additional weeks. Objective ocular score, subjective score, and quality-of-life questionnaires (QoLQ) were collected during the trial. Blood samples were drawn to assess several safety parameters. Thirty patients have been enrolled (mean age 9.05 ± 2.12 yr). In each of the two phases of the DBCO trial, a significant improvement in objective and subjective scores was observed in the eyes treated with 0.1% Tcr (p < 0.001). Likewise, the quality of life significantly improved despite only half the eyes being successfully treated. Serum creatinine and blood parameters were constantly within the normal range, and both blood Cyc and Tcr concentrations remained below the lowest detectable levels. Topical Tcr is very effective and safe in the short term for patients suffering from severe VKC resistant to topical Cyc. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Chaperone patterns in vernal keratoconjunctivitis are distinctive of cell and Hsp type and are modified by inflammatory stimuli.

    Science.gov (United States)

    Leonardi, A; Tarricone, E; Corrao, S; Alaibac, M; Corso, A J; Zavan, B; Venier, P; Conway de Macario, E; Macario, A J L; Di Stefano, A; Cappello, F; Brun, P

    2016-03-01

    Vernal keratoconjunctivitis (VKC) is a severe ocular allergy with pathogenic mechanism poorly understood and no efficacious treatment. The aims of the study were to determine quantities and distribution of Hsp chaperones in the conjunctiva of VKC patients and assess their levels in conjunctival epithelial and fibroblast cultures exposed to inflammatory stimuli. Hsp10, Hsp27, Hsp40, Hsp60, Hsp70, Hsp90, Hsp105, and Hsp110 were determined in conjunctiva biopsies from nine patients and nine healthy age-matched normal subjects, using immunomorphology and qPCR. Conjunctival epithelial cells and fibroblasts were cultured and stimulated with IL-1β, histamine, IL-4, TNF-α, or UV-B irradiation, and changes in Hsp levels were determined by Western blotting. Hsp27, Hsp40, Hsp70, and Hsp90 levels increased in the patients' conjunctiva, whereas Hsp10, Hsp60, Hsp100, and Hsp105 did not. Double immunofluorescence demonstrated colocalization of Hsp27, Hsp40, Hsp70, and Hsp90 with CD68 and tryptase. Testing of cultured conjunctival cells revealed an increase in the levels of Hsp27 in fibroblasts stimulated with IL-4; Hsp40 in epithelial cells stimulated with IL-4 and TNF-α and in fibroblasts stimulated with IL-4, TNF-α, and IL-1β; Hsp70 in epithelial cells stimulated with histamine and IL-4; and Hsp90 in fibroblasts stimulated with IL-1β, TNF-α, and IL-4. UV-B did not induce changes. VKC conjunctiva displays distinctive quantitative patterns of Hsps as compared with healthy controls. Cultured conjunctival cells respond to cytokines and inflammatory stimuli with changes in the Hsps quantitative patterns. The data suggest that interaction between the chaperoning and the immune systems drives disease progression. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Topical tacrolimus 0.03% as sole therapy in vernal keratoconjunctivitis: a randomized double-masked study.

    Science.gov (United States)

    Müller, Guilherme Gubert; José, Newton Kara; de Castro, Rosane Silvestre

    2014-03-01

    This study sought to evaluate the efficacy of the isolated use of tacrolimus compared with the combined use of tacrolimus and olopatadine for the treatment of severe vernal keratoconjunctivitis (VKC). Twenty-one patients with severe VKC were randomized into two groups: one treated with 0.03% tacrolimus ointment combined with 1% olopatadine ophthalmic solution and the other with 0.03% tacrolimus ointment combined with placebo eye drops. The clinical signs and symptoms were graded from 0 to 3, and the efficacy of treatment was determined by the difference between the score at the beginning of treatment and after 30 days. The clinical impression of improvement as perceived by the evaluator and the self-assessment provided by the patient were scored at day 30 of treatment and compared between the groups. The scores for symptoms decreased between the assessments in both groups (-1.7±3.9 in the experimental group; -0.6±1.6 in the control group), with no significant difference between groups (P=0.205). The scores for clinical signs decreased between the assessments in the experimental group (-1.1±2.7) and increased in the control group (0.3±0.9) but with no significant differences (P=0.205). There was no significant difference between the groups regarding the self-assessment (P=0.659) and the clinical impression of the evaluator (P=0.387). The isolated use of tacrolimus and the combined use of tacrolimus and olopatadine seems to have the same efficacy, although controlled studies with larger samples are required to confirm this hypothesis.

  16. Sequential Keraring implantation and corneal cross-linking for the treatment of keratoconus in children with vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Abozaid MA

    2017-10-01

    Full Text Available Mortada A Abozaid Ophthalmology Department, Faculty of Medicine, Sohag University, Sohag, Egypt Purpose: The purpose of this study was to assess the safety and efficacy of femtosecond laser-assisted Keraring implantation followed by transepithelial accelerated corneal collagen cross-linking (CXL for the treatment of keratoconus in children with vernal keratoconjunctivitis (VKC.Study design: This is a prospective interventional non-comparative case series.Patients and methods: Eighteen eyes of 11 children with keratoconus and VKC were included in this study. All the cases were treated with femtosecond laser-assisted Keraring implantation followed after 2 weeks by transepithelial accelerated CXL, and the patients were followed up for 1 year.Results: The preoperative mean uncorrected visual acuity (UCVA was 1.01±0.2 (logMAR, whereas the postoperative mean UCVA was 0.6±0.2. The preoperative mean best-corrected visual acuity (BCVA was 0.6±0.1, whereas the postoperative mean BCVA was 0.40±0.2. The preoperative average keratometry was 50.3±2.7 D, whereas the postoperative average keratometry was 45.8±3.1 D. Conclusion: The results of this study suggest that femtosecond laser-assisted Keraring implantation followed by CXL is safe and effective in the management of keratoconus in children with VKC. However, studies with a longer follow-up period are needed. Keywords: cross-linking plus, intrastromal corneal ring segments, pediatric keratoconus, spring catarrh

  17. Evaluation of retinal nerve fiber layer thickness in vernal keratoconjunctivitis patients under long-term topical corticosteroid therapy.

    Science.gov (United States)

    Cingu, Abdullah Kursat; Cinar, Yasin; Turkcu, Fatih Mehmet; Sahinoglu-Keskek, Nedime; Sahin, Alparslan; Sahin, Muhammed; Yuksel, Harun; Caca, Ihsan

    2014-09-01

    The aim of this study was to evaluate the retinal nerve fiber layer (RNFL) thickness in vernal keratoconjunctivitis (VKC) patients who were under long-term topical corticosteroid therapy. Thirty-six eyes of 36 VKC patients with clear cornea and normal videokeratography and 40 eyes of 40 age- and gender-matched normal children were included in the study. Clinical and demographic characteristics of the patients were noted and detailed ophthalmological examination was performed. Visual acuity (VA), spherical equivalent (SE), axial length (AL) and RNFL thickness measurements were compared between the groups. To correct ocular magnification effect on RNFL, we used Littmann's formula. All VKC patients had history of topical corticosteroid use and the mean duration of the topical corticosteroid use was 23.8 ± 9.09 months. There was no significant difference between the groups in terms of intraocular pressure (IOP). VKC group had significantly worse VA, greater SE and AL and thinner mean global, superior and inferior RNFL thickness. There were significant negative correlations between the duration of topical corticosteroid use and the mean global, superior and temporal RNFL thickness in VKC group. After correction of magnification effect, VKC group still had thinner mean global, superior and inferior RNFL thickness, and significant difference between the groups in inferior RNFL thickness did not disappear. Significant RNFL thickness difference between the groups suggests a possible effect of long-term corticosteroid use in VKC patients. Because visual field (VF) analysis in pediatric patients is difficult to perform and IOP may be illusive, RNFL thickness measurements in addition to routine examinations in VKC patients may help clinicians in their practice.

  18. Comparison between fish and linseed oils administered orally for the treatment of experimentally induced keratoconjunctivitis sicca in rabbits

    Directory of Open Access Journals (Sweden)

    Danielle Alves Silva

    2017-09-01

    Full Text Available The objective of this study was to compare the efficacy of two sources of omega 3 and 6, fish oil (FO and linseed oil (LO, orally administered, alone or in combination, for treating experimentally induced keratoconjunctivitis sicca (KCS in rabbits. Twenty-eight New Zealand rabbits were used in this study. Seven animals were allocated to the C group (negative control, and KCS was induced in 21 animals by topically applying 1% atropine sulfate drops for 7 days. Treatment with atropine was maintained throughout the study period (12 weeks. The rabbits were divided into 3 treatment groups containing 7 animals each: FO group, LO group and FLO group (FO and LO. The animals were evaluated using the Schirmer Tear Test I (STT I, Rose Bengal Test (RBT, fluorescein test (FT, tear film break-up time (TBUT, and conjunctival and histopathological analysis. There was a significant increase in STT I and TBUT values in treatment groups, but the increase occurred earlier in the FO group. The results of the RBT and FT were similar among treatment groups, except FT, in the FLO group, negative staining was only in 12 weeks. There was a significant decrease in the number of goblet cells in the FLO group compared with the other groups. The results demonstrated that orally administered of FO and LO improved the clinical signs of KCS. However, improvement occurred earlier in the FO group. Using oils in combination did not provide additional benefits. These results contribute to the future development of new oral formulations as adjuvant therapies for KCS.

  19. Corneal topographic response to intraocular pressure reduction in patients with vernal keratoconjunctivitis and steroid-induced glaucoma.

    Science.gov (United States)

    Dada, T; Konkal, V; Tandon, R; Singh, R; Sihota, R

    2007-02-01

    To study the corneal topographic response to IOP reduction in vernal keratoconjunctivitis (VKC) with steroid-induced glaucoma. A total of 42 eyes of 21 patients with VKC and steroid-induced glaucoma (Group I) and 66 eyes of 33 patients with VKC without glaucoma (Group II) underwent an evaluation by Orbscan topography. In eyes with glaucoma, the IOP was controlled medically and the corneal topography was repeated at 3 months to evaluate effect on corneal parameters. The mean baseline IOP was 36.40+/-13.08 mmHg in Group I, 14.67+/-4.62 mmHg in Group II (P<0.0001). The IOP after treatment at 3 months follow-up was 15.00+/-5.41 mmHg in Group I (P<0.0001). In Group I, the mean maximum Sim K decreased from 44.86+/-3.21 D to 43.87+/-2.62 D (P=0.031) and mean posterior corneal elevation decreased from 64.9+/-22.36 microm to 35.7+/-28.91 microm at 3 months after reduction of IOP (P=0.001). There was a significant positive correlation between the reduction in the IOP and the decrease in the posterior corneal elevation (r=0.664, P=0.001). Eyes with VKC with and without glaucoma have similar corneal topography. Increased IOP associated with steroid-induced glaucoma and VKC may contribute to an increase in the corneal curvature and posterior corneal elevation. These changes may be reversed by a reduction in the IOP with medical therapy.

  20. Nerve growth factor has a modulatory role on human primary fibroblast cultures derived from vernal keratoconjunctivitis-affected conjunctiva

    Science.gov (United States)

    Micera, Alessandra; Lambiase, Alessandro; Stampachiacchiere, Barbara; Sgrulletta, Roberto; Normando, Eduardo Maria; Bonini, Sergio

    2007-01-01

    Purpose To evaluate the role of nerve growth factor (NGF) in remodeling processes of vernal keratoconjunctivitis (VKC). VKC is a chronic inflammatory disorder of the conjunctiva and is characterized by marked tissue remodeling. NGF, a pleiotrophic factor with documented profibrogenic activities, is produced by inflammatory and structural cells populating the VKC conjunctiva and is increased in the serum and tears of VKC patients. Methods Primary cultures of VKC-derived fibroblasts (VKC-FBs) were exposed to increasing NGF concentrations (1-500 ng/ml) to evaluate and compare the expression of α-smooth muscle actin (αSMA, a defining myofibroblast marker), collagens (types I and IV), and metalloproteinases and tissue inhibitors (MMP9/TIMP1, MMP2/TIMP2) at the biochemical as well as molecular levels. Results Endogenous NGF was increased in the VKC-FB supernatant, as compared to healthy-FB supernatant. VKC-FBs expressed αSMA and increased types I and IV collagens. VKC-FBs, and in particular all αSMA positive cells, expressed both trkANGFR and p75NTR, while healthy-FBs only expressed trkANGFR. Exogenous NGF did not change αSMA expression, while αSMA expression was enhanced by specific neutralization of p75NTR. NGF (10 ng/ml) exposure significantly decreased type I collagen expression, without affecting type IV collagen, and increased MMP9mRNA and protein. Conclusions The autocrine modulation of differentiation and response of VKC-FBs to NGF exposure with downregulation of type I collagen and upregulation of MMP9 expression supports a relevant role for NGF in tissue remodeling of VKC. PMID:17653039

  1. [Assessment of nutritional status in children with atopic dermatitis].

    Science.gov (United States)

    López-Campos, Xiomara; Castro-Almarales, Raúl Lázaro; Massip Nicot, Juliette

    2011-01-01

    There has been described some exacerbating factors for atopic dermatitis, including foods. Several investigations have reported controversial results about the influence of foods on atopic dermatitis. But there is scarce information about the nutritional status of patients with atopic dermatitis. To characterize the nutritional condition in a sample of children with atopic dermatitis in Old Havana, Cuba. In this descriptive study, were included 60 children, aged between 2 and 14 years, with the diagnosis of atopic dermatitis from the Allergy Department in the municipality Havana, from January to April of 2008. For every patient we evaluated anthropometrics, biochemical and immunologic measurements, as well the frequency of meals ingestion and the types of foods. We found that 83.3% of the patients were younger than 6 years, with a slight prevalence of females (53.3%). Ninety-seven percent of the children had a normal height for its age and 48.3% had a normal weight for their height, and 20% of the patients had malnutrition. It was detected mild and moderate anemia in 63.3%. The daily frequency of taking breakfast was carried out in 55%, the lunch in 100% and dinner in 95%. The products of regular consumption are carbohydrates, candies nd sodas in 76.6%. Fish and shellfish are consumed only for 16% of the patients. In the studied sample of children with atopic dermatitis we found a high prevalence of malnutrition associated with poor dietary habits. Breast milk feeding was related to a less malnutrition percentage in children with atopic dermatitis.

  2. Allergic march in children: Atopic dermatitis in Japanese children with bronchial asthma

    OpenAIRE

    Mitsufumi Mayumi; Yusei Ohshima; Kenji Katamura; Setsuko Ito; Takao Hirao; Hiroshi Akutagawa; Naomi Kondo; Akihiro Morikawa

    1996-01-01

    Atopic diseases in children often develop in series and atopic dermatitis usually occurs first. To clarify the serial development of atopic dermatitis and bronchial asthma in atopic children in Japan, the present and/or past history of atopic dermatitis in patients with bronchial asthma was examined. Patients (n=280) with bronchial asthma in five prefectures in Japan were examined at a mean (± SD) age of 8.2 (±4.5) years and asked about prior and/or concurrent atopic dermatitis. The mean (± S...

  3. Current evidence of epidermal barrier dysfunction and thymic stromal lymphopoietin in the atopic march

    Directory of Open Access Journals (Sweden)

    Mei Li

    2014-09-01

    Full Text Available It has long been observed that the development of asthma, allergic rhinitis and food allergy are frequently preceded by atopic dermatitis, a phenomenon known as the “atopic march”. Clinical, genetic and experimental studies have supported the fact that atopic dermatitis could be the initial step of the atopic march, leading to the subsequent development of other atopic diseases. This brief review will focus on the current evidence showing that epidermal barrier dysfunction and the keratinocyte-derived cytokine thymic stromal lymphopoietin play critical roles in the onset of the atopic march.

  4. Eczema, Atopic Dermatitis, or Atopic Eczema: Analysis of Global Search Engine Trends.

    Science.gov (United States)

    Xu, Shuai; Thyssen, Jacob P; Paller, Amy S; Silverberg, Jonathan I

    The lack of standardized nomenclature for atopic dermatitis (AD) creates challenges for scientific communication, patient education, and advocacy. We sought to determine the relative popularity of the terms eczema, AD, and atopic eczema (AE) using global search engine volumes. A retrospective analysis of average monthly search volumes from 2014 to 2016 of Google, Bing/Yahoo, and Baidu was performed for eczema, AD, and AE in English and 37 other languages. Google Trends was used to determine the relative search popularity of each term from 2006 to 2016 in English and the top foreign languages, German, Turkish, Russian, and Japanese. Overall, eczema accounted for 1.5 million monthly searches (84%) compared with 247 000 searches for AD (14%) and 44 000 searches for AE (2%). For English language, eczema accounted for 93% of searches compared with 6% for AD and 1% for AE. Search popularity for eczema increased from 2006 to 2016 but remained stable for AD and AE. Given the ambiguity of the term eczema, we recommend the universal use of the next most popular term, AD.

  5. Intracellular IL-4, IL-5, and IFN-γ as the main characteristic of CD4+CD30+ T cells after allergen stimulation in patients with vernal keratoconjunctivitis.

    Science.gov (United States)

    Magaña, Diana; Aguilar, Gustavo; Linares, Marisela; Ayala-Balboa, Julio; Santacruz, Concepción; Chávez, Raúl; Estrada-Parra, Sergio; Garfias, Yonathan; Lascurain, Ricardo; Jiménez-Martínez, Maria C

    2015-01-01

    Vernal keratoconjunctivitis (VKC) is a severe form of allergic conjunctivitis, in which inflammatory infiltrates of the conjunctiva are characterized by CD3+ and CD30+ cells. Until today, the functional involvement of CD30+ T cells in VKC was unclear. Our aim was to evaluate the functional characteristics of CD30+ T cells after allergen stimulation in peripheral blood mononuclear cells obtained from patients with VKC. Seventeen consecutive patients at the Institute of Ophthalmology with active forms of VKC were included. After allergen stimulation, we observed the frequency of CD30+ T cells increased compared with non-stimulated cells (pkeratoconjunctivitis, compared with healthy controls (p=0.03). Blockage with IL-4 significantly diminished CD30 frequency in the allergen-stimulated cells. Our results suggest that after allergenic stimulation, CD4+CD30+ cells are the most important source of IL-4, IL-5, and IFN-γ. IL-4 acts as an activation loop that increases CD30 expression on T cells after specific stimulation. These findings suggest that CD4+CD30+ T cells are effector cells and play a significant role in the immune pathogenic response in patients with vernal keratoconjunctivitis.

  6. Leptin and Atopic Dermatitis in Korean Elementary School Children.

    Science.gov (United States)

    Seo, SungChul; Yoon, Won Suck; Cho, Yunjung; Park, Sang Hee; Choung, Ji Tae; Yoo, Young

    2016-04-01

    The prevalence of atopic dermatitis (AD) and obesity have been increasing considerably in Korean school-children. AD is a chronic pruritic recurrent inflammatory skin disorder. Leptin is secreted by adipocytes which has been suggested to be immunologically active; however, their role in AD has not yet been well understood. A total of 227 subjects out of 2,109 elementary school children were defined as having AD based on the ISAAC questionnaire survey. Ninety subjects with AD, aged between 6 and 12 years, completed scoring of severity of AD (SCORAD), skin prick testing, blood tests for total IgE, eosinophil counts, eosinophil cationic protein (ECP) and lipid profiles. Serum leptin levels were also measured. A subject with atopic AD was defined as an AD patient showing at least 1 positive reaction to allergens in skin prick testing. There were no significant differences in age, body mass index, percentage of breast milk feeding, mode of delivery, prevalence of atopy, and lipid profiles between atopic AD and non-atopic AD subjects. The serum leptin levels (log mean±SD) were significantly higher in non-atopic AD group than in the atopic AD group (0.86±0.57 ng/mL vs 0.53±0.72 ng/mL, p=0.045). Subjects with mild-to-moderate AD showed significantly higher serum leptin levels than those with severe AD (0.77±0.67 ng/mL vs 0.33±0.69 ng/mL, p=0.028). There was a marginal inverse correlation between the SCORAD index and the serum leptin concentration in total AD subjects (r=-0.216, p=0.053). The serum leptin levels were significantly higher in non-atopic AD subjects or mild-to-moderate AD subjects. Leptin did not seem to be associated with IgE-mediated inflammation in AD. Obesity-associated high leptin differed between non-atopic AD and atopic AD subjects.

  7. On Verification of Atopic Phenotype of Bronchial Asthma in Children

    Directory of Open Access Journals (Sweden)

    O.V. Belashova

    2014-03-01

    Full Text Available In order to establish the diagnostic value of the metabolic activity of blood granulocytes (eosinophils, neutrophils in the verification of atopic phenotype of bronchial asthma (BA in children there are formed two clinical groups. The first (I, basic group formed 38 children with atopic BA (having a positive own and/or family allergic anamnesis history, II clinical group consisted of 26 patients with non-atopic BA. Groups were comparable by the main characteristics. As indicators of the functional state of neutrophil and eosinophil leukocytes, we determined their phagocytic activity (%, phagocytic number (c.u., the intracellular content of eosinophil and neutrophil cationic protein (c.u.. It is found that in the development of atopic phenotype of BA in childhood there is a tendency to decrease in intracellular content of major cytotoxic agents (eosinophil cationic protein, peroxidase in eosinophilic granulocytes of the blood. The decrease of phagocytic activity parameters (less than 60 % and phagocytic number (less than 2.0 c.u. of blood eosinophils is associated with a significantly higher risk of atopic bronchial asthma in children.

  8. Clinical profile of atopic dermatitis in Benin City, Nigeria.

    Science.gov (United States)

    Onunu, A N; Eze, E U; Kubeyinje, E P

    2007-12-01

    To study the clinical presentation and management problems of atopic dermatitis in Benin City, Nigeria. A 15-year retrospective study from May 1985 to April 2000. Dermatology clinics of the University of Benin Teaching Hospital, Benin City, Nigeria. All new cases of atopic dermatitis presenting to the clinic during the study period. 594 patients suffering from atopic dermatitis, representing 7.92% of new dermatological cases were seen during the study period. There was a slight male preponderance; the male to female ratio was 1.2: 1. Most patients were below 30 years of age with the peak incidence in the 0 9-year age group, with most presenting in the first six months of life. Forty-six percent of the patients had a positive family history of atopy, while 73% also had other atopic disorders. The clinical patterns seen were infantile, childhood and adult forms, which is in keeping with reports from other parts of the world. Precipitating factors were most often obscure; however, high temperatures and humidity were the most common aggravating factors. The important problems encountered were misuse of topical medications, oral antibiotics, anti-fungal drugs and a high follow-up default rate. The clinical characteristics of atopic dermatitis in our study population were similar to the pattern in other parts of the world. There is need for increased awareness of its importance as a cause of morbidity especially in children.

  9. Clinical implications of new mechanistic insights into atopic dermatitis.

    Science.gov (United States)

    Leung, Donald Y M

    2016-08-01

    The review will examine recent advances in our understanding of atopic dermatitis and how these mechanisms provide a framework for new approaches to the management of this common skin disease. The mechanisms by which epithelial skin barrier and immune responses contribute to the complex clinical phenotypes found in atopic dermatitis are being elucidated. Atopic dermatitis often precedes food allergy because reduced skin barrier function allows environmental food allergens to penetrate the skin leading to systemic allergen sensitization. There is increasing evidence that atopic dermatitis is a systemic disease. New treatments are focused on intervention in polarized immune responses leading to allergic diseases. This includes antagonism of IL-4 and IL-13 effects. Prevention strategies involve maintaining normal skin barrier function with emollients to prevent allergens and microbes from penetrating the skin. Recent work on the pathogenesis of atopic dermatitis has important implications for its clinical management, including the development of effective barrier creams and biologicals targeting specific polarized immune pathways resulting in skin inflammation.

  10. A Case of Atopic Myelitis with Cervical Cavernous Angioma

    Directory of Open Access Journals (Sweden)

    Miyuki Fukuda

    2017-01-01

    Full Text Available Atopic myelitis, a type of myelitis which appears in patients with elevated serum levels of immunoglobulin E (IgE, occurs more commonly in the cervical spinal cord, but this mechanism has not yet been elucidated. Herein, we experienced a case of atopic myelitis developed during the growth of cervical cavernous angioma caused by bleeding. A 37-year-old woman suffered from hand swelling caused by a house cat licking. At the same time when cavernous angioma had grown, she experienced a numbness in her four extremities, and multifocal peritumoral hyperintense spinal cord signals were seen. The diagnosis of atopic myelitis was made because we observed significantly elevated levels of specific IgE antibody to cat dander. Symptoms disappeared immediately after steroid pulse therapy. We subsequently resected a cavernous angioma, and eosinophil invasion was found inside it. This is the first case report of atopic myelitis which developed in association with spinal cord vascular lesions. A local blood-brain barrier breakdown due to hemorrhagic lesions of the spinal cord may have contributed to the onset of atopic myelitis.

  11. A Case of Atopic Myelitis with Cervical Cavernous Angioma

    Science.gov (United States)

    Manabe, Hiroaki; Sasaki, Nobuhiro; Kuroda, Masayuki; Hoshimaru, Minoru

    2017-01-01

    Atopic myelitis, a type of myelitis which appears in patients with elevated serum levels of immunoglobulin E (IgE), occurs more commonly in the cervical spinal cord, but this mechanism has not yet been elucidated. Herein, we experienced a case of atopic myelitis developed during the growth of cervical cavernous angioma caused by bleeding. A 37-year-old woman suffered from hand swelling caused by a house cat licking. At the same time when cavernous angioma had grown, she experienced a numbness in her four extremities, and multifocal peritumoral hyperintense spinal cord signals were seen. The diagnosis of atopic myelitis was made because we observed significantly elevated levels of specific IgE antibody to cat dander. Symptoms disappeared immediately after steroid pulse therapy. We subsequently resected a cavernous angioma, and eosinophil invasion was found inside it. This is the first case report of atopic myelitis which developed in association with spinal cord vascular lesions. A local blood-brain barrier breakdown due to hemorrhagic lesions of the spinal cord may have contributed to the onset of atopic myelitis. PMID:28757876

  12. Emerging therapies for atopic dermatitis: The prostaglandin/leukotriene pathway.

    Science.gov (United States)

    Yanes, Daniel A; Mosser-Goldfarb, Joy L

    2018-03-01

    The role of leukotrienes and prostaglandins in development of atopy has been prototypically established in studies of asthma pathogenesis. Likewise, both in vitro and in vivo studies of atopic dermatitis have demonstrated that these molecules maintain important pathophysiologic roles. Thus, it follows that targeted therapies against these molecules may be promising in management of atopic dermatitis. Montelukast has had questionable efficacy in patients with atopic dermatitis, whereas small pilots using zileuton did have some clinically significant improvement. There are several agents in development that target leukotrienes and/or prostaglandins as well, including OC000459, Q301, and ZPL-521. In atopic dermatitis, OC000459 did not demonstrate efficacy in clinical trials, and the efficacy of the other 2 agents remains to be seen. Should these medications prove promising, these topical agents may play a future role in chronic maintenance therapy and flare prophylaxis in atopic dermatitis, as antileukotriene therapy does in asthma. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Exacerbating factors of itch in atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Hiroyuki Murota

    2017-01-01

    Full Text Available Atopic dermatitis (AD displays different clinical symptoms, progress, and response to treatment during early infancy and after childhood. After the childhood period, itch appears first, followed by formation of well-circumscribed plaque or polymorphous dermatoses at the same site. When accompanied with dermatitis and dry skin, treatment of skin lesions should be prioritized. When itch appears first, disease history, such as causes and time of appearance of itch should be obtained by history taking. In many cases, itch increases in the evening when the sympathetic nerve activity decreased. Treatment is provided considering that hypersensitivity to various external stimulations can cause itch. Heat and sweating are thought to especially exacerbate itch. Factors causing itch, such as cytokines and chemical messengers, also induce itch mainly by stimulating the nerve. Scratching further aggravates dermatitis. Skin hypersensibility, where other non-itch senses, such as pain and heat, are felt as itch, sometimes occurs in AD. Abnormal elongation of the sensory nerve into the epidermis, as well as sensitizing of the peripheral/central nerve, are possible causes of hypersensitivity, leading to itch. To control itch induced by environmental factors such as heat, treatment for dermatitis is given priority. In the background of itch exacerbated by sweating, attention should be given to the negative impact of sweat on skin homeostasis due to 1 leaving excess sweat on the skin, and 2 heat retention due to insufficient sweating. Excess sweat on the skin should be properly wiped off, and dermatitis should be controlled so that appropriate amount of sweat can be produced. Not only stimulation from the skin surface, but also visual and auditory stimulation can induce new itch. This “contagious itch” can be notably observed in patients with AD. This article reviews and introduces causes of aggravation of itch and information regarding how to cope with such

  14. Histamine and antihistamines in atopic dermatitis.

    Science.gov (United States)

    Buddenkotte, Jörg; Maurer, Marcus; Steinhoff, Martin

    2010-01-01

    Itching (pruritus) is perhaps the most common symptom associated with inflammatory skin diseases and can be a lead symptom ofextracutaneous disease (e.g., malignancy, infection, metabolic disorders). In atopic dermatitis itching sensations constitute one of the most prominent and distressing features. The most characteristic response to itching is the scratch reflex: a more or less voluntary, often sub-conscious motor activity, to counteract the itch by slightly painful stimuli. The benefit of a short-termed relieve from itching through this scratch reflex though is counteracted by a simultaneous damage of the epidermal layer of the skin which leads to increased transepidermal water loss and drying, which in turn results in a cycle of more itching and more scratching. A wide range of peripheral itch-inducing stimuli generated within or administered to the skin are able to trigger pruritus, one of them being histamine. Based on early experiments, histamine has been suggested to may play a key role in the pathogenesis ofAD. This is reflected by a history for antihistamines in the therapeutic medication of AD patients. Antihistamines are believed to share a common antipruritic effect and therefore are prescribed to the vast majority of AD patient suffering from itch to act alleviating. The level of evidence in support of the benefits of antihistamine treatment, however, is low. To assess the benefit of antihistamines in the treatment of AD in a better way, their mechanisms and specific effects need to be understood more precisely. In particular their precise indication is crucial for successful use. This book chapter will therefore summarize and assess the role of histamine in AD and the efficacy of antihistamines in its treatment based on results of basic research and clinical studies.

  15. Exacerbating factors of itch in atopic dermatitis.

    Science.gov (United States)

    Murota, Hiroyuki; Katayama, Ichiro

    2017-01-01

    Atopic dermatitis (AD) displays different clinical symptoms, progress, and response to treatment during early infancy and after childhood. After the childhood period, itch appears first, followed by formation of well-circumscribed plaque or polymorphous dermatoses at the same site. When accompanied with dermatitis and dry skin, treatment of skin lesions should be prioritized. When itch appears first, disease history, such as causes and time of appearance of itch should be obtained by history taking. In many cases, itch increases in the evening when the sympathetic nerve activity decreased. Treatment is provided considering that hypersensitivity to various external stimulations can cause itch. Heat and sweating are thought to especially exacerbate itch. Factors causing itch, such as cytokines and chemical messengers, also induce itch mainly by stimulating the nerve. Scratching further aggravates dermatitis. Skin hypersensibility, where other non-itch senses, such as pain and heat, are felt as itch, sometimes occurs in AD. Abnormal elongation of the sensory nerve into the epidermis, as well as sensitizing of the peripheral/central nerve, are possible causes of hypersensitivity, leading to itch. To control itch induced by environmental factors such as heat, treatment for dermatitis is given priority. In the background of itch exacerbated by sweating, attention should be given to the negative impact of sweat on skin homeostasis due to 1) leaving excess sweat on the skin, and 2) heat retention due to insufficient sweating. Excess sweat on the skin should be properly wiped off, and dermatitis should be controlled so that appropriate amount of sweat can be produced. Not only stimulation from the skin surface, but also visual and auditory stimulation can induce new itch. This "contagious itch" can be notably observed in patients with AD. This article reviews and introduces causes of aggravation of itch and information regarding how to cope with such causes. Copyright

  16. Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study

    NARCIS (Netherlands)

    Penders, John; Thijs, Carel; van den Brandt, Piet A.; Kummeling, Ischa; Snijders, Bianca; Stelma, Foekje; Adams, Hanne; van Ree, Ronald; Stobberingh, Ellen E.

    2007-01-01

    BACKGROUND AND AIMS: Perturbations in intestinal microbiota composition due to lifestyle changes may be involved in the development of atopic diseases. We examined gut microbiota composition in early infancy and the subsequent development of atopic manifestations and sensitisation. METHODS: The

  17. Specific IgE to Common Food Allergens in Children with Atopic Dermatitis

    National Research Council Canada - National Science Library

    Mozhgan Moghtaderi; Shirin Farjadian; Sara Kashef; Soheila Alyasin; Maryam Afrasiabi; Marzieh Orooj

    2012-01-01

    .... Although hypersensitivity to foods is assumed to play an essential role in the development of atopic dermatitis in some patients, little is known about common food allergens in Iranian children with atopic dermatitis. Objectives...

  18. Atopic dermatitis is associated with a fivefold increased risk of polysensitisation in children

    NARCIS (Netherlands)

    Broeks, Suzanne; Brand, Paulus

    Aim: It has been hypothesised that in atopic dermatitis, the dysfunctional skin barrier facilitates the transcutaneous presentation of allergens to the immune system. This study examined whether atopic dermatitis increased the likelihood of polysensitisation, namely sensitisation to five or more

  19. Atopic dermatitis: Burden of illness, quality of life, and associated complications.

    Science.gov (United States)

    Drucker, Aaron M

    2017-01-01

    Atopic dermatitis is a chronically relapsing inflammatory skin condition that is burdensome for individuals with the disease, their families, and for society as a whole. The purpose of this review was to provide a broad overview of the burden of atopic dermatitis, including quality of life and its associated complications. This article was divided into four main sections: (1) atopic dermatitis prevalence, persistence, and population-level burden; (2) burden of atopic dermatitis for individuals and their families; (3) medical complications and comorbidities of atopic dermatitis; and (4) assessment of the burden of atopic dermatitis in clinical practice. Having an understanding of the burden of atopic dermatitis is important for clinicians as they assess and manage atopic dermatitis in the clinical setting.

  20. The Skin Microbiome in Atopic Dermatitis and Its Relationship to Emollients.

    Science.gov (United States)

    Lynde, Charles W; Andriessen, Anneke; Bertucci, Vince; McCuaig, Catherine; Skotnicki, Sandy; Weinstein, Miriam; Wiseman, Marni; Zip, Catherine

    2016-01-01

    Human-associated bacterial communities on the skin, skin microbiome, likely play a central role in development of immunity and protection from pathogens. In atopic patients, the skin bacterial diversity is smaller than in healthy subjects. To review treatment strategies for atopic dermatitis in Canada, taking the skin microbiome concept into account. An expert panel of 8 Canadian dermatologists explored the role of skin microbiome in clinical dermatology, specifically looking at atopic dermatitis. The panel reached consensus on the following: (1) In atopic patients, the skin microbiome of lesional atopic skin is different from nonlesional skin in adjacent areas. (2) Worsening atopic dermatitis and smaller bacterial diversity are strongly associated. (3) Application of emollients containing antioxidant and antibacterial components may increase microbiome diversity in atopic skin. The skin microbiome may be the next frontier in preventive health and may impact the approach to atopic dermatitis treatment. © The Author(s) 2015.

  1. Increasing Comorbidities Suggest that Atopic Dermatitis Is a Systemic Disorder

    NARCIS (Netherlands)

    Brunner, Patrick M.; Silverberg, Jonathan I.; Guttman-Yassky, Emma; Paller, Amy S.; Kabashima, Kenji; Amagai, Masayuki; Luger, Thomas A.; Deleuran, Mette; Werfel, Thomas; Eyerich, Kilian; Stingl, Georg; Bagot, Martine; Hijnen, Dirk Jan|info:eu-repo/dai/nl/304815519; Ardern-Jones, Michael; Reynolds, Nick; Spuls, Phyllis; Taieb, Alain

    Atopic dermatitis comorbidities extend well beyond the march to allergic conditions (food allergy, asthma, allergic rhinitis, allergic conjunctivitis, and eosinophilic esophagitis), suggesting both cutaneous and systemic immune activation. In reviewing atopic dermatitis comorbidities, Councilors of

  2. Surfactant protein D in atopic dermatitis and psoriasis

    DEFF Research Database (Denmark)

    Hohwy, Thomas; Otkjaer, Kristian; Madsen, Jens

    2006-01-01

    was examined using immunohistochemistry on skin biopsies from patients with the two major dermatologic diseases, psoriasis and atopic dermatitis. SP-D was located in the stratum basale of all biopsies with similar intense staining in both diseased and normal skin. Differences were detected in stratum spinosum......, no substantial up-regulation of SP-D mRNA was detected in lesional psoriatic skin, and a comparison of serum levels of SP-D between patients with atopic dermatitis or psoriasis and a group of age matched healthy controls did not show significant differences. In conclusion SP-D was significantly more abundant...... where involved psoriatic skin showed intense staining through the entire region significantly different from uninvolved and normal skin. Lesional atopic skin showed moderate staining extending through the basal three-fourths of stratum spinosum. Using real time polymerase chain reaction analysis...

  3. The association of the 'additional height index' with atopic diseases, non-atopic asthma, ischaemic heart disease and mortality: a population-based study.

    Science.gov (United States)

    Fenger, R V; Vidal, C; Gonzalez-Quintela, A; Husemoen, L L N; Skaaby, T; Aadahl, M; Linneberg, A

    2014-02-28

    Intrauterine growth has been associated with atopic conditions. Growth and adult height have been associated with cardiovascular disease, cancers and mortality but are highly genetic traits. The objectives of the study were as follows: first, to define a height measure indicating an individual's height below or above that which could be expected based on parental height (genetic inheritance) and growth charts. It was named 'the additional height index' (AHI), defined as (attained-expected) height; second, to investigate possible associations of AHI with atopic versus non-atopic health outcomes and with ischaemic heart disease (IHD) and IHD mortality. General population-based study. Research centre. A random sample of 2656 men and women living in greater Copenhagen took part in the MONICA10 study (the Danish monitoring trends and determinants of cardiovascular disease). In total, 1900 participants with information of parental height were selected. Atopic sensitisation (serum IgE), questionnaire information of atopic dermatitis, rhinoconjunctivitis, asthma or wheezing, and registry-based diagnoses of IHD/IHD mortality from National Registries. Increasing levels of AHI were inversely associated with non-atopic asthma, non-atopic wheezing, IHD and IHD mortality (IHD-all). For one SD increase of AHI, the OR or HR with CI in adjusted analyses was non-atopic asthma OR=0.52 (0.36 to 0.74), non-atopic wheezing OR=0.67 (0.51 to 0.89), and IHD-all HR=0.89 (0.78 to 1.01). The level of AHI was higher among individuals with atopic dermatitis, allergic rhinoconjunctivitis and atopic sensitisation (all p values height may be at lower risk of non-atopic asthma/wheeze and IHD/IHD mortality but possibly at higher risk of atopic conditions. The measure of tallness below or above the expected height could be a sensitive alternative to normal height in epidemiological analyses.

  4. Some aspects of hadron-hadron collisions in high energy interactions (B$0\\atop{s}$ mixing oscillations in semileptonic decay at D0 experiment)

    Energy Technology Data Exchange (ETDEWEB)

    Naimuddin, Md [Univ. of Delhi, New Delhi (India)

    2006-01-01

    In this thesis, we report the study on one such particle called the B$0\\atop{s}$ meson made up of a bottom and a strange quark. B$0\\atop{s}$ mesons are currently produced in a great numbers only at the Tevatron and we report a study done to measure the mixing parameter Δms between the B$0\\atop{s}$ meson and its anti-particle $\\bar{B}$$0\\atop{s}$. Mixing is the ability of a very few neutral mesons to change from their particle to their antiparticle and vice versa. Until recently there existed only a lower limit on this measurement, here we report an upper bound and a most probable value for the mixing parameter. In the following chapter, we discuss the theoretical motivation behind this study. The measurement technique and the different factors that effect the measurement are also given. In Chapter 3, we provide an overview of the experimental setup needed to perform the study. In Chapter 4, we present a new initial state flavor tagging algorithm using electrons and measurement of the B$0\\atop{d}$ mixing parameter Δmd with the new technique. Details of the combined initial state tagging used in the B$0\\atop{s}$ mixing study are also given. A detailed description of the B$0\\atop{s}$ mixing analysis and the results are covered in Chapter 5. And finally the results from all the three channels and a bound on the mixing parameter are presented in Chapter 6.

  5. Atopic and Nonatopic Asthma in Children: two Different Diseases?

    Directory of Open Access Journals (Sweden)

    Michael J. Lentze, PhD²

    2012-09-01

    Full Text Available The majority of the studies in the field of childhood asthma lie within the scope of allergy/atopic asthma; however, airway hyperresponsiveness is considered a marker of asthma, independent of the atopic status and should be regarded as a parallel pathological process that can lead to subsequent symptoms and clinical evidence of asthma in children, without the evidence of atopy. The aim of this study is to estimate the possible differences in clinical and lung functions, and the immunological status of children with atopic and nonatopic asthma phenotypes. In a prospective study design, 54 children (age 3-18 years in Germany were monitored via active surveillance, by twice-a-week phone calls. All the children were divided into two groups, based on their atopic status, clinical date and lung function tests. The first 27 patients had atopic asthma (AA, whereas the second set of 27 patients had nonatopic asthma (NA. All patients underwent IgE and RAST tests for the most common inhalant allergens, and a quantitative measurement of Eosinophil Cationic Protein (ECP by CAP-radioallergosorbent test-fluorescence enzyme immunoassay (UniCAP, Pharmacia Diagnostics, Germany. Further, the IgA, IgM, IgG subclasses, IL-6 and CRP levels in the serum were tested. The resultant data showed significant differences in the prevailing IgE level 317.5±58 g/l in AA versus 83±21 in NA. However, there was no significant distinction either in the ECP serum level in children with atopic and nonatopic asthma or in the IL-6 serum level. An unexpected result was the significant drop in the level of serum CRP in group NA – 0.68±0.37 g/l; while in group AA this result was 1.5±0.38 g/l. No significant differences were noted between the mean values of the IgM and IgG levels in patients of all groups; however, the IgG levels increased only in the children with nonatopic asthma. Our study did not reveal any type of immunoglobulin deficiency. The IgA level was relatively

  6. Development of atopic dermatitis in the DARC birth cohort

    DEFF Research Database (Denmark)

    Eller, Esben; Kjaer, Henrik Fomsgaard; Høst, Arne

    2009-01-01

    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 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...

  7. USAGE OF DIOCTAHEDRAL SMECTITE IN CHILDREN WITH ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    A.S. Botkina

    2008-01-01

    Full Text Available The results of enter sorbent — dioctahedral Smectite (Neosmektin — usage as part of complex therapy of children with atopic dermatitis (ATD. It is shown that the administration of Smectite favored better efficacy of baseline treatment of ATD, more express and quick regression of skin manifestations of the disease, decrease in number of children with eosinophilia. High efficacy of ATD treatment with Smectite indicates the pathogenetic justification of efferent therapy of the disease. Observation results witness the good tolerability of Smectite: side effects related to the treatment were only observed in 14 percent of children.Key words: children, atopic dermatits, smectite, treatment.

  8. Impact of adult atopic dermatitis on topical drug penetration

    DEFF Research Database (Denmark)

    Garcia Ortiz, Patricia; Hansen, Steen H; Shah, Vinod P

    2009-01-01

    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...... in the atopic dermatitis compared with uninvolved skin (p... 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...

  9. Effect of probiotic Lactobacillus strains in children with atopic dermatitis

    DEFF Research Database (Denmark)

    Rosenfeldt, Vibeke; Benfeldt, Eva; Nielsen, Susanne Dam

    2003-01-01

    BACKGROUND: Recent studies suggest that oral bacteriotherapy with probiotics might be useful in the management of atopic dermatitis (AD). OBJECTIVE: The purpose of this investigation was to evaluate the clinical and anti-inflammatory effect of probiotic supplementation in children with AD. METHODS...... intervention (ie, better, unchanged, or worse). The clinical severity of the eczema was evaluated by using the scoring atopic dermatitis (SCORAD) score. As inflammatory markers, eosinophil cationic protein in serum and cytokine production by PBMCs were measured. RESULTS: After active treatment, 56...

  10. Atopic dermatitis-like pre-Sézary syndrome

    DEFF Research Database (Denmark)

    Sokolowska-Wojdylo, Malgorzata; Baranska-Rybak, Wioletta; Cegielska, Agnieszka

    2011-01-01

    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...... histology without presence of atypical cells). In our patients, overt Sézary syndrome developed after immunosuppressive treatment (including cyclosporine). These cases support the validity of the concept of pre-Sézary syndrome, which is a long-lasting, pre-malignant condition, and which may develop to true...

  11. Clinical evaluation of a nutraceutical diet as an adjuvant to pharmacological treatment in dogs affected by Keratoconjunctivitis sicca.

    Science.gov (United States)

    Destefanis, Simona; Giretto, Daniela; Muscolo, Maria Cristina; Di Cerbo, Alessandro; Guidetti, Gianandrea; Canello, Sergio; Giovazzino, Angela; Centenaro, Sara; Terrazzano, Giuseppe

    2016-09-22

    Canine keratoconjunctivitis sicca (cKCS) is an inflammatory eye condition related to a deficiency in the tear aqueous fraction. Etiopathogenesis of such disease is substantially multifactorial, combining the individual genetic background with environmental factors that contribute to the process of immunological tolerance disruption and, as a consequence, to the emergence of autoimmunity disease. In this occurrence, it is of relevance the role of the physiological immune-dysregulation that results in immune-mediated processes at the basis of cKCS. Current therapies for this ocular disease rely on immunosuppressive treatments. Clinical response to treatment frequently varies from poor to good, depending on the clinical-pathological status of eyes at diagnosis and on individual response to therapy. In the light of the variability of clinical response to therapies, we evaluated the use of an anti-inflammatory/antioxidant nutraceutical diet with potential immune-modulating activity as a therapeutical adjuvant in cKCS pharmacological treatment. Such combination was administered to a cohort of dogs affected by cKCS in which the only immunosuppressive treatment resulted poorly responsive or ineffective in controlling the ocular symptoms. Fifty dogs of different breeds affected by immune-mediated cKCS were equally distributed and randomly assigned to receive either a standard diet (control, n = 25) or the nutraceutical diet (treatment group, n = 25) both combined with standard immunosuppressive therapy over a 60 days period. An overall significant improvement of all clinical parameters (tear production, conjunctival inflammation, corneal keratinization, corneal pigment density and mucus discharge) and the lack of food-related adverse reactions were observed in the treatment group (p < 0.0001). Our results showed that the association of traditional immune-suppressive therapy with the antioxidant/anti-inflammatory properties of the nutraceutical diet resulted in

  12. Genetic parameters of infectious bovine keratoconjunctivitis and its relationship with weight and parasite infestations in Australian tropical Bos taurus cattle.

    Science.gov (United States)

    Ali, Abdirahman A; O'Neill, Christopher J; Thomson, Peter C; Kadarmideen, Haja N

    2012-07-27

    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. 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. 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. 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 and tick and helminth egg counts were moderate and opposite between pre

  13. Genetic parameters of infectious bovine keratoconjunctivitis and its relationship with weight and parasite infestations in Australian tropical Bos taurus cattle

    Directory of Open Access Journals (Sweden)

    Ali Abdirahman A

    2012-07-01

    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

  14. Nickel allergy and relationship with Staphylococcus aureus in atopic dermatitis

    DEFF Research Database (Denmark)

    Anna, Bogdali M.; Grazyna, Antoszczyk; Wojciech, Dyga

    2016-01-01

    . aureus in atopic dermatitis. Methods: Nickel allergy was confirmed in atopic patients and excluded in healthy volunteers using patch testing. Infection by S. aureus was tested in atopic patients and healthy volunteers by use of API Staph system. The specific IgE for staphylococcal enterotoxin A and B...

  15. A study of atopic diseases in Basrah | Alsaimary | African Journal of ...

    African Journals Online (AJOL)

    A study of atopic diseases; allergic rhinitis, bronchial asthma and atopic dermatitis were carried out in this investigation. From 174 patients, 39.08% has atopic dermatitis, while 33.90 and 27.01% have bronchial asthma and allergic rhinitis, respectively. Males has a greater percentage of bronchial asthma than females ...

  16. Reduced occurrence of early atopic dermatitis because of immunoactive prebiotics among low-atopy-risk infants

    NARCIS (Netherlands)

    Grueber, Christoph; van Stuijvenberg, Margriet; Mosca, Fabio; Moro, Guido; Chirico, Gaetano; Braegger, Christian P.; Riedler, Josef; Boehm, Guenther; Wahn, Ulrich

    2010-01-01

    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

  17. Rozdíly v charakteristice účastníků cyklistických akcí ve Slovinsku v letech 2005 a 2006 Differences in characteristics of cycling event participants in Slovenia in years 2005 and 2006

    Directory of Open Access Journals (Sweden)

    Tina Šetina

    2009-03-01

    Full Text Available Hlavním cílem této studie je nalézt určité charakteristiky náhodně vybraných účastníků cyklistických akcí v letech 2005 a 2006. Dvoudenní rekreační akce na podporu aktivního životního stylu poskytovala možnost cyklistického vyžití pro osoby obou pohlaví, různého věku a různých psychických a fyzických schopností. Náhodně vybraní rekreační cyklisté (261 byli požádáni, aby vyplnili anonymní dotazník. Výsledky ukazují malou, avšak statisticky významnou negativní korelaci (r = –0,268, p < 0,01 mezi frekvencí zapojení do pohybových/sportovních aktivit a věkem. Téměř 50 % účastníků v roce 2005 bylo aktivních 4–6 krát týdně a v následujícím roce to bylo 39 % soutěžících. Je zde také statisticky významný pozitivní vztah mezi frekvencí zapojení do pohybových/sportovních aktivit a subjektivním hodnocením zdravotního stavu v roce 2005 (r = 0,319, p < 0,01 a 2006 (r = 0,311, p < 0,01. Účastníci hodnotili svůj zdravotní stav jako dobrý či velmi dobrý v 83 % (v roce 2005 a v 77 % (v roce 2006. Koeficient také vyjadřuje malou, avšak statisticky významnou negativní korelaci (r = –0,219, p < 0,01 mezi důležitostí pohybových/sportovních aktivit a věkem. Znalost některých charakteristik rekreačních cyklistů může přispět ke zlepšení masových cyklistických (i jiných akcí a zároveň také k vývoji cykloturistiky ve Slovinsku, které má pro tyto aktivity skvělé přírodní podmínky. The main aim of this study is to find out some characteristics of randomly selected cycling event participants in the years 2005 and 2006. A two day recreation and active lifestyle promoting event provided a cycling offer that corresponded to both sexes and people of different ages and psychophysical abilities. Randomly selected recreational cyclists (261 were asked to complete the anonymous questionnaire. The results show a small but statistically significant

  18. EFFICIENT INTRODUCTION OF COMPLEMENTARY FOODS FOR CHILDREN WITH ATOPIC DERMATITIS AND PREDISPOSITION TO ALLERGIC REACTIONS FOR PREVENTION OF ATOPIC MARCH

    Directory of Open Access Journals (Sweden)

    A.V. Kamaev

    2011-01-01

    Full Text Available Prevalence of allergic diseases grows constantly. Realization of genetic defects to the disease depends of impact of environment and contacts with different allergens. Prophylactic dietary avoidance is important to prevent debut of the atopic dermatitis and secondary exacerbations of the disease. Terms and preferable sequence of complementary food introduction are discussed for breast-fed and formula-fed infants; advantages of ready-made industrial products of infant meals are proved. The gradual outreach of infant’s taste spectrum and increasing step by step of load on infant’s intestine can become serious hedge for the atopic march and important measure of prevention of allergic rhinitis and asthma.Key words: atopic march, dietetics, complementary foods, prevention of allergies, children.

  19. Significance of dietotherapy on the clinical course of atopic dermatitis.

    Science.gov (United States)

    Rokaite, Rūta; Labanauskas, Liutauras; Balciūnaite, Sigita; Vaideliene, Laimute

    2009-01-01

    The aim of this study was to determine the efficiency of individual balanced replacement diet in treatment of children with atopic dermatitis, to compare the course of atopic dermatitis and gastrointestinal disorders, as well as the data of skin patch test after a one-year period of dietary treatment. The study group included 154 children (their age varied from 6 months to 18 years) with atopic dermatitis, for whom food allergens were determined by allergic skin tests (skin prick and patch). These children were recommended an individual balanced replacement diet, where possible food allergens were replaced by other products that do not cause allergic reactions. After a one-year dietary treatment, 109 (70.8%) children (such number came for the second study) were tested repeatedly. The following aspects were evaluated for all these children: clinical course of atopic dermatitis (children's mothers provided answers about exacerbation of allergic rash during the last 12 months, gastrointestinal disorders, and used medicines), severity of the progress of atopic dermatitis (SCORAD index). Besides, skin patch test with 25 food allergens was carried out. Children who followed dietary recommendations were younger than children who failed to follow dietary recommendations because of a variety of reasons (P=0.01). Even 49 (62.8%) patients who followed dietary recommendations have shown the following results during the second test: allergic rash disappeared and they did not have to take medicines against allergy anymore. Patients who followed their individual dietary recommendations more rarely suffered from severe allergic rash problems during a 12-month period (P=0.01) and they had to take fewer medicines against allergy, compared to children who did not follow their dietary recommendations (P=0.001). Clinical course of atopic dermatitis in children who followed individual dietary recommendations was easier compared to children who did not follow such recommendations (P=0

  20. Essential fatty acids in breast milk of atopic mothers: comparison with non-atopic mothers, and effect of borage oil supplementation.

    Science.gov (United States)

    Thijs, C; Houwelingen, A; Poorterman, I; Mordant, A; van den Brandt, P

    2000-03-01

    To evaluate whether levels of n-6 long chain polyunsaturated fatty acids (LCPs) in human breast milk are related to the mother's atopic constitution, and whether a decreased level can be restored by gamma-linolenic acid supplementation. Cross-sectional study and dietary supplementation trial. 20 atopic mothers and 20 non-atopic mothers (controls), all lactating. General population. The atopic mothers were randomly assigned to low (n=10) or high (n=10) dosage oral supplementation with oral borage oil for one week (230 or 460 mg gamma-linolenic acid (18:3n-6) per day). Essential fatty acid composition of the breast milk total fat fraction, determined by gas liquid chromatography. Arachidonic acid (20:4n-6) was lower in breast milk of atopic mothers compared with non-atopic mothers (0.39 wt% vs 0.46 wt%, difference -0.07% wt% (95% confidence limits -0.13, -0.01 wt%; PLeeuwarden, The Netherlands).

  1. Type 1 diabetes mellitus and atopic diseases in children.

    African Journals Online (AJOL)

    Ehab

    Type 1 diabetes mellitus and atopic diseases in children. Nancy S. Elbarbary. Assistant Professor of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Background. Diabetes mellitus type 1 (T1DM) is a complex disease resulting from the interplay of genetic, epigenetic, and environmental factors.1 ...

  2. Relationship between breast milk feeding and atopic dermatitis in children.

    Science.gov (United States)

    Nakamura, Y; Oki, I; Tanihara, S; Ojima, T; Ito, Y; Yamazaki, O; Iwama, M; Tabata, Y; Katsuyama, K; Sasai, Y; Nakagawa, M; Matsushita, A; Hossaka, K; Sato, J; Hidaka, Y; Uda, H; Nakamata, K; Yanagawa, H; Hosaka, K

    2000-03-01

    To determine whether or not the breast milk feeding has a role in the prevalence of atopic dermatitis among children. The target population of the study was all children participating in health check-up program for 3-year-old children in 60 municipalities locating 10 selected prefectures during designated 2 months between October and December 1997. Using a questionnaire, information on nutrition in infants (breast milk only, bottled milk only, or mixed), parity, mothers' age at birth, and a history of atopic dermatitis was obtained. Besides, data on potential confounding factors were obtained. Questionnaires from 3856 children (81.6% of those who were to participate in the programs, and 96.4% of children who participated them) were analyzed. After the adjustment for all potential confounding factors using unconditional logistic models, the risk of atopic dermatitis was slightly higher among children with breast milk (odds ratio [OR] = 1.16 with 95% confidence interval [CI] 0.96-1.40). Mothers' age at birth (OR for those who were more than 30 years or older in comparison with those who were younger than 30 years = 1.15; 95% CI, 0.96-1.37) and those with second or later parity orders (OR = 1.14, 95% CI; 0.95-1.35) showed odds ratios that were higher than unity without statistical significance. Breast milk elevates the risk of atopic dermatitis slightly without statistical significance; the risk may be, however, higher in children in second or later parity orders.

  3. clinical profile of atopic dermatitis in benin city, nigeria.

    African Journals Online (AJOL)

    encountered were misuse 'of topical medications, oral antibiotics, anti-fungal drugs and a high follow-up default rate. Conclusion: The clinical characteristics of atopic dermatitis in our study population were similar to the pattern in other parts of the world. There is need for increased awareness of its importance as a cause of ...

  4. Inpatient Financial Burden of Atopic Dermatitis in the United States

    DEFF Research Database (Denmark)

    Narla, Shanthi; Hsu, Derek Y; Thyssen, Jacob P

    2017-01-01

    Little is known about the inpatient burden of atopic dermatitis (AD). We sought to determine the risk factors and financial burden of hospitalizations for AD in the United States. Data were analyzed from the 2002-2012 National Inpatient Sample, including a 20% representative sample of all...

  5. Alcohol during pregnacu and atopic dermatitis in the offspring

    DEFF Research Database (Denmark)

    Linneberg, a; Petersen, Janne; Grønbæk, M

    2005-01-01

    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...

  6. Alcohol during pregnancy and atopic dermatitis in the offspring

    DEFF Research Database (Denmark)

    Linneberg, A; Petersen, Janne; Grønbaek, M

    2004-01-01

    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...

  7. Distinct molecular signatures of mild extrinsic and intrinsic atopic dermatitis

    DEFF Research Database (Denmark)

    Martel, Britta Cathrina; Litman, Thomas; Hald, Andreas

    2016-01-01

    Atopic dermatitis (AD) is a common inflammatory skin disease with underlying defects in epidermal function and immune responses. In this study, we used microarray analysis to investigate differences in gene expression in lesional skin from patients with mild extrinsic or intrinsic AD compared...

  8. Epidemiology of atopic dermatitis | Todd | South African Medical ...

    African Journals Online (AJOL)

    Epidemiological studies on atopic dermatitis, primarily performed in children, have shown that the one-year prevalence rate of symptoms is population and area dependent. The few studies that have been done in South Africa among children of different age groups showed one-year prevalence rates of 1 - 13.3%. In adults ...

  9. Nonhistaminergic and mechanical itch sensitization in atopic dermatitis

    DEFF Research Database (Denmark)

    Andersen, H. H.; Elberling, J.; Sølvsten, H.

    2017-01-01

    Chronic or episodic severe itch is recurrent in atopic dermatitis (AD). Nonhistaminergic itch pathways are suggested to dominate in AD itch, contributing to an "itch-scratch-itch cycle" that prolongs and worsens itch, pain, and skin lesions. We hypothesized that nonhistaminergic neuronal...

  10. Non-pharmacological treatment modalities for atopic dermatitis ...

    African Journals Online (AJOL)

    Non-pharmacological measures to improve the management of atopic dermatitis (AD) are as important as pharmacotherapy for true healing of the skin. Skin dryness (which contributes to inflammation, loss of suppleness (leading to fissuring), impaired barrier function, and increased adherence of Staphylococcus aureus ...

  11. Atopic dermatitis of the face, scalp, and neck

    DEFF Research Database (Denmark)

    Jensen-Jarolim, E; Poulsen, L K; With, H

    1992-01-01

    We have previously reported that a lipophilic yeast, Pityrosporum ovale (P. ovale) produced a high frequency of positive skin prick tests and in vitro histamine-release (HR) tests in patients suffering from atopic dermatitis (AD) of the face, scalp, and neck. In the present study, our aim...

  12. Gallstone risk in adult patients with atopic dermatitis and psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Andersen, Yuki M.F.; Gislason, Gunnar H.

    2017-01-01

    Adult atopic dermatitis (AD) is associated with overweight, obesity and cardiovascular diseases (CVD) in Americans, similarly to psoriasis, but no increased risk of CVD has been shown in European patients with AD. This study investigated the prevalence and risk of gallstones in adults with AD...

  13. Neonatal risk factors of atopic dermatitis in Denmark

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Andersen, Yuki M F; Gislason, Gunnar

    2016-01-01

    BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin condition with a multifactorial etiopathogenesis. Studies have suggested that several perinatal factors may influence the risk of AD in early childhood. We investigated possible neonatal risk factors such as jaundice, blue light...

  14. Induction of atopic dermatitis by inhalation of house dust mite

    NARCIS (Netherlands)

    Tupker, RA; DeMonchy, JGR; Coenraads, PJ; vanderMeer, JB

    Background: The pathogenetic role of house dust mite in atopic dermatitis remains controversial. Recent studies have shown that intensive epicutaneous contact of house dust mite allergen with premanipulated skin may induce dematitis. It is, however, uncertain whether such conditions are met during

  15. Editorial update on emerging treatments of atopic dermatitis.

    Science.gov (United States)

    Ong, Peck Y

    2012-06-01

    Various new agents are in the research pipeline for atopic dermatitis. These include IL-4 receptor antagonist, cis-urocanic acid, κ-opiod receptor agonist, neurokinin receptor antagonist and antimicrobial peptide. The current review updates the status of these clinical trials and provides insight into other potential molecular targets including IL-22 and TLR-2.

  16. Lactose malabsorption in young Lithuanian children with atopic dermatitis.

    Science.gov (United States)

    Rudzeviciene, O; Narkeviciute, I; Eidukevicius, R

    2004-04-01

    To determine the prevalence of lactose malabsorption in young Lithuanian atopic dermatitis children; to evaluate the relationship between lactose malabsorption and the duration of exclusive breastfeeding, and the relationship between lactose malabsorption and cow's milk intolerance in parents and grandparents. 144 children with atopic dermatitis aged 1.5-24 mo (study group) and 32 children without symptoms of allergic diseases aged 1.5-23 mo (control group) were investigated. Lactose and glucose-galactose absorption tests based on serial blood glucose determination, culture of stool, latex agglutination test for rotavirus and microscopic examination of stool for parasites were performed. Lactose malabsorption was determined in 59 (40.9%) and glucose-galactose malabsorption in 17 (11.8%) children with atopic dermatitis. The risk of developing lactose malabsorption was higher in children fed exclusively on breast milk up to 1 mo of age than in children fed exclusively on breast milk for 4 to 6 mo (OR: 2.62; 95% CI: 1.02-6.75). Lactose malabsorption was significantly more frequent in patients whose mothers did not tolerate cow's milk (20/30; 66.7%) than in patients whose mothers were tolerant to it (39/95; 41.1%) (p = 0.02). Lactose malabsorption was determined in 40.9% of Lithuanian atopic dermatitis children aged under 2 y. Lactose malabsorption appeared to be associated with the duration of exclusive breastfeeding up to only 1 mo and mothers' milk intolerance.

  17. Colloidal oatmeal formulations as adjunct treatments in atopic dermatitis.

    Science.gov (United States)

    Fowler, Joseph F; Nebus, Judith; Wallo, Warren; Eichenfield, Lawrence F

    2012-07-01

    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.

  18. An overview of topical treatment for atopic eczema | Motswaledi ...

    African Journals Online (AJOL)

    Atopic eczema is a chronic, relapsing inflammatory disease of the skin. It is characterised by dry, itchy skin and a typical distribution on the elbows and knees in younger children, and the cubital and popliteal fossae in older children and adults. Treatment modalities include emollients, topical corticosteroids, calcineurin ...

  19. Allergic characteristics of urban schoolchildren with atopic eczema in Ghana

    NARCIS (Netherlands)

    Hogewoning, A. A.; Larbi, I. A.; Addo, H. A.; Amoah, A. S.; Boakye, D.; Hartgers, F.; Yazdanbakhsh, M.; van Ree, R.; Bouwes Bavinck, J. N.; Lavrijsen, A. P. M.

    2010-01-01

    Background Atopic eczema is an increasing clinical problem in Africa. Objective To determine allergic characteristics and to identify possible risk factors for eczema among schoolchildren in an urbanized area in Ghana. Patients and methods Schoolchildren aged 3-16 years with eczema were recruited.

  20. An approach to mild to moderate atopic eczema | Motswaledi | South ...

    African Journals Online (AJOL)

    Atopic eczema is a chronic, relapsing inflammatory disease of the skin characterised by dryness and itching, with typical distribution on the elbows and knees in younger children and on the cubital and popliteal fossae in older children and adults. It can be classified as mild, moderate or severe. S Afr Fam Pract 2012 ...

  1. Preventive and curative effects of probiotics in atopic patients.

    NARCIS (Netherlands)

    Bongaerts, G.P.A.; Severijnen, R.S.V.M.

    2005-01-01

    Normally, the transport of allergens through the intestinal epithelia to the blood is limited. It is hypothesised that if these compounds arrive in the blood circulation, they must percolate through the epithelial cell layer. Thus, food allergy (and thus atopic eczema) implies an increased

  2. Atopic eczema in school children | Melaku | Ethiopian Journal of ...

    African Journals Online (AJOL)

    Information on Atopic eczema is sparse in Ethiopia. This survey was conducted to determine the prevalence of eczema among school children in Addis Ababa, Ethiopia, in 1995. A standardized self-administered questionnaire developed by the International Study of Asthma and Allergies in Children (ISAAC) was used.

  3. Regulatory natural killer cell expression in atopic childhood asthma ...

    African Journals Online (AJOL)

    Introduction: Different subsets of natural killer (NK) cells were found to play a role in pathogenesis of allergy. We sought to investigate the expression of regulatory NK cells (CD56+CD16+CD158+) in atopic children with bronchial asthma in order to outline the value of these cells as biomarkers of disease severity and/or ...

  4. Cause specific mortality in adults with atopic dermatitis

    DEFF Research Database (Denmark)

    Thyssen, Jacob P; Skov, Lone; Egeberg, Alexander

    2018-01-01

    BACKGROUND: Adult atopic dermatitis (AD) has been associated with several co-morbidities, but cause-specific mortality risk is unknown. OBJECTIVES: To examine cause-specific death rates and risk in adults with AD. METHODS: We performed cross-linkage of nationwide health care and cause of death re...

  5. Respiratory comorbidity in South African children with atopic dermatitis

    African Journals Online (AJOL)

    Background. Atopic dermatitis (AD) is an early and important step in the propagation of the allergic march, enhancing food and respiratory allergies via epicutaneous sensitisation to allergens. Objectives. To determine the prevalence and patterns of aeroallergen sensitisation, asthma and allergic rhinitis in South African ...

  6. Relation between obesity, lipid profile, leptin and atopic disorders in ...

    African Journals Online (AJOL)

    EL-HAKIM

    inhibiting food intake and stimulating energy expenditure7. This study aimed to detect the relation between obesity and allergic disorders, relation of birth weight and breast feeding to obesity and allergic disorders, the role of leptin in obesity related atopic disorders, to plan for prevention and early detection of atopy in ...

  7. Treating atopic dermatitis: safety, efficacy, and patient acceptability of a ceramide hyaluronic acid emollient foam

    Directory of Open Access Journals (Sweden)

    Pacha O

    2012-05-01

    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

  8. The association of intrafamilial violence against children with symptoms of atopic and non-atopic asthma: A cross-sectional study in Salvador, Brazil.

    Science.gov (United States)

    Bonfim, Camila Barreto; dos Santos, Darci Neves; Barreto, Maurício Lima

    2015-12-01

    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. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Ceratoconjuntivite cicatricial bilateral associada a líquen plano: relato de caso Lichen planus leading to bilateral cicatrizing keratoconjunctivitis: case report

    Directory of Open Access Journals (Sweden)

    Camila Melo Gadelha Pereira Diniz

    2008-12-01

    Full Text Available Descrevemos um caso de ceratoconjuntivite cicatricial bilateral em uma paciente portadora de líquen plano e apresentamos revisão da literatura mundial sobre esse assunto. Cicatrização conjuntival, com formação de simbléfaro, olho seco, infiltração corneana, neovascularização e afinamento foram os sinais observados. Diagnóstico foi baseado nos achados clínicos e biópsia, após exclusão das causas típicas de ceratoconjuntivite cicatricial.To describe a case of bilateral cicatrizing keratoconjunctivitis in a patient with lichen planus and review the literature. Conjunctiva cicatrization with symblepharon formation, dry eye, corneal infiltration and neovascularization and thinning were the most observed prominent signs. Diagnosis was based on clinical findings and biopsy, after exclusion of typical causes of cicatricial keratoconjuntivitis.

  10. Uso da medicação homeopática no tratamento da ceratoconjuntivite primaveril: resultados iniciais Treatment of vernal keratoconjunctivitis with homeopathic medicine: a preliminary report

    Directory of Open Access Journals (Sweden)

    Cláudio Maciel de Sena

    2003-01-01

    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

  11. Phototherapy in atopic dermatitis: a systematic review of the literature.

    Science.gov (United States)

    Pérez-Ferriols, A; Aranegui, B; Pujol-Montcusí, J A; Martín-Gorgojo, A; Campos-Domínguez, M; Feltes, R A; Gilaberte, Y; Echeverría-García, B; Alvarez-Pérez, A; García-Doval, I

    2015-06-01

    Phototherapy is a treatment option for atopic dermatitis recommended by several guidelines. To perform a systematic review of the efficacy of different modalities of phototherapy and photochemotherapy in moderate to severe atopic dermatitis. We considered all randomized clinical trials (RCTs) performed in patients with atopic dermatitis, and accepted all outcome measures. Articles were identified via an online search of the MEDLINE (via Ovid) and Embase databases and the Cochrane Central Register of Controlled Trials. We also searched for clinical trials registered in Current Controlled Trials and in the World Health Organization's International Clinical Trials Registry Platform. Twenty-one RCTs (961 patients) were included in the qualitative analysis. Two of the trials included children and adolescents (32 patients). The efficacy of narrow-band UV-B and UV-A1 phototherapy was similar for the different outcome measures contemplated. Two RCTs assessed the efficacy of psoralen plus UV-A therapy (PUVA). No serious adverse events were described. In general, the publications reviewed were characterized by a high risk of bias and poor reporting of methodology and results. There is evidence for the use of narrow-band UV-B and UV-A1 phototherapy in moderate to severe atopic dermatitis. Evidence supporting the use of PUVA in atopic dermatitis is scarce and there is little information on the use of phototherapy in childhood. For the purpose of future studies, it would be advisable to use comparable criteria and scales for the evaluation of disease severity and patients, to standardize radiation methods, and to establish a minimum follow-up time. Copyright © 2014 Elsevier España, S.L.U. y AEDV. All rights reserved.

  12. Atopic dermatitis from adolescence to adulthood in the TOACS cohort: prevalence, persistence and comorbidities.

    Science.gov (United States)

    Mortz, C G; Andersen, K E; Dellgren, C; Barington, T; Bindslev-Jensen, C

    2015-07-01

    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. 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. 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 onset, childhood allergic rhinitis and hand eczema. A close association was also found with allergic contact dermatitis and increased specific IgE to Malassezia furfur, but not with filaggrin gene defect. Persistence of atopic dermatitis in adulthood is common and affects quality of life. Persistent atopic dermatitis is particularly prevalent in those with early onset, allergic rhinitis and hand eczema in childhood. It is important to recognizing atopic dermatitis as a common and disabling disease not only in children but also in adults. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Serum prolactin levels in atopic dermatitis and the relationship with disease severity.

    Science.gov (United States)

    Tugrul Ayanoğlu, Burcu; Muştu Koryürek, Özgül; Yıldırm Başkara, Songül

    2017-10-01

    Prolactin performs as a neuroendocrine modulator of skin epithelial cell proliferation and the skin immune system. The aim was to assess the serum prolactin levels in patients with atopic dermatitis and the relationship with disease severity. The study was performed on 46 patients with atopic dermatitis and 100 healthy controls aged between 0.5 years and 19.5 years. The diagnosis of atopic dermatitis was based on clinical findings and the severity of the disease was documented. Venous blood sampling was performed in order to measure prolactin levels. Prolactin levels in atopic dermatitis were not different from controls and there was no relationship between the severity of atopic dermatitis and serum prolactin levels. Prolactin may not have a role in the pathogenesis of atopic dermatitis. Further studies with larger sample sizes and measurement of prolactin levels in the skin may help to understand the role of prolactin in the pathogenesis of atopic dermatitis.

  14. Ex vivo induction of cytokines by mould components in whole blood of atopic and non-atopic volunteers

    DEFF Research Database (Denmark)

    Krüger, Tanja; Sigsgaard, Torben; Bonefeld-Jørgensen, Eva C

    2004-01-01

    We investigated the time-course release of IL-1beta and IL-8 protein as well as the steady state mRNA level of their genes in human whole blood after stimulation with LPS, beta-1,3-D-glucan and mould extracts. We compared the response of 10 non-atopic and 10 atopic individuals. In parallel......, cytokine protein release and the corresponding steady state mRNA level was determined by the standard ELISA and real-time on-line RT-PCR methods, respectively. Glucan induced the highest level of IL-1beta mRNA and protein release after 3 h. IL-8 was induced at 3 h after glucan, but not after LPS, induction......RNA steady state to lower levels in the atopics compared to the non-atopics. In contrast, no differences were found between the two groups in their capacity to induce cytokine protein release. These findings persisted after correction for the percentage of mononuclear cells. The data supported our hypothesis...

  15. Comparison of psoriasis and atopic dermatitis guidelines-an argument for aggressive atopic dermatitis management.

    Science.gov (United States)

    Lohman, Mary E; Lio, Peter A

    2017-11-01

    The development of effective systemic treatments has revolutionized the treatment of inflammatory skin diseases. The availability of safe new treatments and the understanding of psoriasis as a systemic disease with comorbidities and effects on quality of life have driven the current aggressive treatment paradigm of psoriasis. Historically the morbidity of atopic dermatitis (AD) has been dismissed, given the perception of AD as "just" a rash. Differences in the guidelines for psoriasis and AD management may suggest variations in the current conceptualization of disease severity and effects on quality of life. Published guidelines from the American Academy of Dermatology for the management of psoriasis and AD were reviewed. We recorded the similarities and differences in disease assessment and therapy. The threshold to use biologic agents for moderate to severe psoriasis highlights the aggressive nature of modern psoriasis treatment. AD guidelines include an assessment of quality of life but do not designate a disease severity threshold for systemic treatment. AD and psoriasis have a tremendous effect on quality of life. The AD guidelines have a less aggressive approach to disease management than the psoriasis guidelines. We should think critically about rapid advancement to systemic agents in AD management, especially now that more and better agents are being developed. © 2017 Wiley Periodicals, Inc.

  16. Spontaneous atopic dermatitis is mediated by innate immunity, with the secondary lung inflammation of the atopic march requiring adaptive immunity.

    Science.gov (United States)

    Saunders, Sean P; Moran, Tara; Floudas, Achilleas; Wurlod, Felicity; Kaszlikowska, Agnieszka; Salimi, Maryam; Quinn, Emma M; Oliphant, Christopher J; Núñez, Gabriel; McManus, Ross; Hams, Emily; Irvine, Alan D; McKenzie, Andrew N J; Ogg, Graham S; Fallon, Padraic G

    2016-02-01

    Atopic dermatitis (AD) is an inflammatory skin condition that can occur in early life, predisposing to asthma development in a phenomenon known as the atopic march. Although genetic and environmental factors are known to contribute to AD and asthma, the mechanisms underlying the atopic march remain poorly understood. Filaggrin loss-of-function mutations are a major genetic predisposer for the development of AD and progression to AD-associated asthma. We sought to experimentally address whether filaggrin mutations in mice lead to the development of spontaneous eczematous inflammation and address the aberrant immunologic milieu arising in a mouse model of filaggrin deficiency. Filaggrin mutant mice were generated on the proallergic BALB/c background, creating a novel model for the assessment of spontaneous AD-like inflammation. Independently recruited AD case collections were analyzed to define associations between filaggrin mutations and immunologic phenotypes. Filaggrin-deficient mice on a BALB/c background had profound spontaneous AD-like inflammation with progression to compromised pulmonary function with age, reflecting the atopic march in patients with AD. Strikingly, skin inflammation occurs independently of adaptive immunity and is associated with cutaneous expansion of IL-5-producing type 2 innate lymphoid cells. Furthermore, subjects with filaggrin mutations have an increased frequency of type 2 innate lymphoid cells in the skin in comparison with control subjects. This study provides new insights into our understanding of the atopic march, with innate immunity initiating dermatitis and the adaptive immunity required for subsequent development of compromised lung function. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Allergy and the eye

    Science.gov (United States)

    Leonardi, A; Motterle, L; Bortolotti, M

    2008-01-01

    The eye represents an ideal and frequent site for the allergic reactions. The term ‘allergic conjunctivitis’ refers to a collection of disorders that affect the lid, conjunctiva and/or cornea. Even though the diagnosis is essentially clinical, local tests such as cytology, conjunctival provocation and tear mediator analysis can be performed. The immunoglobulin E (IgE)-mediated mechanism does not explain completely the severity and the clinical course of chronic allergic ocular diseases such as vernal (VKC) and atopic keratoconjunctivitis (AKC), which are probably also related to T cell-mediated responses, massive eosinophil attraction and activation and non-specific hypersensitivity. An altered balance between T helper type 1 (Th1) and Th2 cells and between Th1- and Th2-types of cytokines is thought to be responsible of the development of ocular allergic disorders. New findings suggest that a wide range of cytokines, chemokines, proteases and growth factors are involved by complex interwoven interactions rather than distinct and parallel pathways. In addition, several non-specific enzymatic systems may be activated during acute and chronic allergic inflammation, thus contributing to the complex pathogenesis of the disease. Current drug treatment for ocular allergy targets the key mechanisms involved in the development of clinical disease: mast cells with mast cell stabilizers, histamine with histamine receptor antagonists and inflammation with corticosteroids, severe inflammation with immunomodulators. None of these agents lacks side effects and none abolishes signs and symptoms completely. New therapeutic strategies are still needed to respond to the complex pathogenesis of severe forms of ocular allergy such as VKC and AKC. PMID:18721324

  18. IMMUNOLOGICAL MARKERS OF UNCONTROLLED ATOPIC BRONCHIAL ASTHMA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    M. V. Smolnikova

    2017-01-01

    Full Text Available Bronchial asthma is a prevalent chronic allergic disease of lungs at early ages. A priority  task in allergology  is to search  biological  markers  related  to uncontrolled atopic  bronchial asthma. Cytokines fulfill their distinct function in pathogenesis of atopic  bronchial asthma, participating at the initiation, development and persistence of allergic inflammation in airways, causing different  variations of clinical course of the disease (with  respect  to its acuteness, severity, frequency of exacerbations. The  present  work has studied  indices  of cellular  and  humoral links of immunity, as well as levels of some  pro and  anti-inflammatory cytokines in peripheral blood serum (IL-4, IL-10, IL-2 and TNFα, aiming to determine potential markers of uncontrolled atopic bronchial asthma in children. A group of Caucasian (European children was involved into the research: Cohort 1, moderate atopic  bronchial asthma with controlled course during the last 3 months (n = 59; Cohort 2, severe/moderate-severe atopic bronchial asthma with uncontrolled course of the disease within last 3 months (n = 51,  Cohort 3 – control, practically healthy  children without signs of atopy  (n = 33. All the  children included in the group with atopic  bronchial asthma underwent regular mono/combined basic therapy  at high/ intermediate therapeutic doses.  We performed a comparative analysis  of cell  population indices  reflecting certain cellular  immunity links,  and  determined significantly  lower  levels of CD3+   lymphocytes, as well as decrease in relative  and  absolute  contents of CD4+  and  CD8+  cells in the  cohort with  uncontrolled course of atopic  bronchial asthma, as compared with controlled-course cohort. When  evaluating concentrations  of cytokines in peripheral blood serum of the patients with controlled and uncontrolled atopic  bronchial asthma, we revealed  significantly  higher

  19. B Flavor Tagging Calibration and Search for B$0\\atop{s}$ Oscillations in Semileptonic Decays with the CDF Detector at Fermilab

    Energy Technology Data Exchange (ETDEWEB)

    Giurgiu, Gavril A. [Carnegie Mellon Univ., Pittsburgh, PA (United States)

    2005-09-01

    In this thesis we present a search for oscillations of B$0\\atop{s}$ mesons using semileptonic B$0\\atop{s}$ → D$-\\atop{s}$ℓ+v decays. Data were collected with the upgraded Collider Detector at Fermilab (CDFII) from events produced in collisions of 980 GeV protons and antiprotons accelerated in the Tevatron ring. The total proton-antiproton center-of-mass energy is 1.96 TeV. The Tevatron is the unique source in the world for B$0\\atop{s}$ mesons, to be joined by the Large Hadron Collider at CERN after 2007. We establish a lower limit on the B$0\\atop{s}$ oscillation frequency Δms > 7.7 ps-1 at 95% Confidence Level. We also present a multivariate tagging algorithm that identifies semileptonic B → μX decays of the other B mesons in the event. Using this muon tagging algorithm as well as opposite side electron and jet charge tagging algorithms, we infer the B$0\\atop{s}$ flavor at production. The tagging algorithms are calibrated using high statistics samples of B0 and B+ semileptonic B0/+ → Dℓv decays. The oscillation frequency Δmd in semileptonic B0 → Dℓv decays is measured to be Δmd = (0.501 ± 0.029(stat.) ± 0.017(syst.)) ps-1.

  20. Satisfaction with treatment of atopic dermatitis in children

    Directory of Open Access Journals (Sweden)

    Małgorzata Maciejewska-Franczak

    2016-05-01

    Full Text Available Introduction . Atopic dermatitis is a frequent chronic skin disease in children. The major clinical manifestations include itching and dryness of the skin. The pathomechanism of skin changes results from an interaction of genetic and environmental factors as well as impairments of skin barrier function and immune response. Despite chronic treatment the disease is characterized by exacerbation and remission periods and lowers the quality of life of patients and their families. Objective. To evaluate treatment satisfaction in children with atopic dermatitis, identify components of medical care which contribute to treatment satisfaction, and evaluate the relationship between satisfaction and adherence to a doctor’s recommendations. Material and methods. One hundred and nineteen children (6 months to 12 years old, mean age 4.9 years with atopic dermatitis were enrolled in the study. The doctor performed physical examinations and history taking and filled in questionnaires evaluating the course and exacerbation of the disease, the type of administered therapy and diagnostics. The patients’ parents completed two questionnaires: a questionnaire assessing satisfaction with the therapy (the type of recommended therapy, adherence to recommendations, contact with the doctor, obtained information, degree of psychological support, role of parents in taking decisions regarding the therapy and a quality of life questionnaire. Results. The authors observed that 56% of parents were dissatisfied with the administered treatment, and 40% failed to adhere to at least one therapeutic recommendation. Parents of children with mild atopic dermatitis significantly more often stop using emollients. It was also observed that lack of treatment satisfaction in children with severe atopic dermatitis whose parents are insufficiently educated contributes to decreased adherence. The authors identified independent factors of lack of treatment satisfaction: failure to obtain

  1. Measurement of the ratio of branching fractions β(B$0\\atop{s}$ → D$-\\atop{s}$ D$+\\atop{s}$) /b (B0 → D- D$+\\atop{s}$) with the CDF detector

    Energy Technology Data Exchange (ETDEWEB)

    Iyutin, Boris [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

    2007-03-01

    In this thesis they report the measurement of ratios of branching fractions: β(B$0\\atop{s}$ → D$-\\atop{s}$ π+π+π-)/β(B0 → D-π+π+π-), and β(B0 → D-D$+\\atop{s}$)/β(B0 → D-π+π+π-), using 355 pb-1 of data collected by CDF detector at the Tevatron p$\\bar{p}$ collider at √s = 1.96 TeV.

  2. European birth cohort studies on asthma and atopic diseases I

    DEFF Research Database (Denmark)

    Keil, T; Kulig, M; Simpson, A

    2006-01-01

    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...

  3. Recent advances in epidemiology and prevention of atopic eczema.

    Science.gov (United States)

    Cipriani, Francesca; Dondi, Arianna; Ricci, Giampaolo

    2014-11-01

    Atopic dermatitis (AD), named also atopic eczema, is a chronic relapsing inflammatory skin disease with a considerable social and economic burden. The primum movens of AD is in most cases a genetic and/or immune-supported defect of the skin barrier, facilitating penetration and sensitization to food or airborne allergens, as well as infections by Staphylococcus aureus, herpes simplex virus, or other microbes. New pathogenetic concepts have generated new approaches to prevention and therapy of AD. In particular, the daily use of emollients in newborns at high risk of AD has shown interesting results, with a reduction in the cumulative incidence of AD ranging from 32% to 50% of the treated infants. On the other hand, the AD preventive efficacy of food and/or inhalant allergen avoidance has been questioned, and supplementation strategies (vitamin D, probiotics, or other compounds) need to be further investigated. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Consensus Conference on Clinical Management of pediatric Atopic Dermatitis.

    Science.gov (United States)

    Galli, Elena; Neri, Iria; Ricci, Giampaolo; Baldo, Ermanno; Barone, Maurizio; Belloni Fortina, Anna; Bernardini, Roberto; Berti, Irene; Caffarelli, Carlo; Calamelli, Elisabetta; Capra, Lucetta; Carello, Rossella; Cipriani, Francesca; Comberiati, Pasquale; Diociaiuti, Andrea; El Hachem, Maya; Fontana, Elena; Gruber, Michaela; Haddock, Ellen; Maiello, Nunzia; Meglio, Paolo; Patrizi, Annalisa; Peroni, Diego; Scarponi, Dorella; Wielander, Ingrid; Eichenfield, Lawrence F

    2016-03-02

    The Italian Consensus Conference on clinical management of atopic dermatitis in children reflects the best and most recent scientific evidence, with the aim to provide specialists with a useful tool for managing this common, but complex clinical condition. Thanks to the contribution of experts in the field and members of the Italian Society of Pediatric Allergology and Immunology (SIAIP) and the Italian Society of Pediatric Dermatology (SIDerP), this Consensus statement integrates the basic principles of the most recent guidelines for the management of atopic dermatitis to facilitate a practical approach to the disease. The therapeutical approach should be adapted to the clinical severity and requires a tailored strategy to ensure good compliance by children and their parents. In this Consensus, levels and models of intervention are also enriched by the Italian experience to facilitate a practical approach to the disease.

  5. The role of vitamin D in atopic dermatitis.

    Science.gov (United States)

    Dębińska, Anna; Sikorska-Szaflik, Hanna; Urbanik, Magdalena; Boznański, Andrzej

    2015-01-01

    Vitamin D has been suggested to have an important impact on a much wider aspects on human health than calcium homeostasis and mineral metabolism, specifically in the field of human immunology. It has been reported that vitamin D influences the regulation of both innate and adaptive immune systems, which makes the association between vitamin D and allergic diseases a field of interest. Although many studies have sought to determine whether vitamin D has an influence on progression of allergic disease, the impact of vitamin D on atopic dermatitis development and severity remains unclear. In this review, we summarize recent studies relating vitamin D to atopic dermatitis and discuss its possible role in the pathogenesis of allergic skin diseases, emphasizing the need for well-designed, prospective trials on vitamin D supplementation in the context of prevention and treatment for allergic conditions.

  6. [Hypnotherapy of atopic dermatitis in an adult. Case report].

    Science.gov (United States)

    Perczel, Kristóf; Gál, János

    2016-01-17

    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.

  7. Emerging therapies for atopic dermatitis: TRPV1 antagonists.

    Science.gov (United States)

    Bonchak, Jonathan G; Swerlick, Robert A

    2018-03-01

    Transient receptor potential (TRP) ion channels are important mediators of somatosensory signaling throughout the body. Our understanding of the contribution of TRPs to a multitude of cutaneous physiologic processes has grown substantially in the past decade. TRP cation channel subfamily V member 1 (TRPV1), one of the better-understood members of this large family of ion channels, affects multiple pathways involved in pruritus. Further, TRPV1 appears to play a role in maintaining skin barrier function. Together, these properties make TRPV1 a ripe target for new therapies in atopic dermatitis. Neurokinin antagonists may affect similar pathways and have been studied to this effect. Early trials data suggest that these therapies are safe, but assessment of their efficacy in atopic dermatitis is pending as we await publication of phase II and III clinical trials data. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  8. The role of melatonin in autoimmune and atopic diseases

    Directory of Open Access Journals (Sweden)

    J.R. Calvo

    2016-04-01

    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.

  9. [Relationship between breast milk and atopic dermatitis in children].

    Science.gov (United States)

    Nakamura, Y; Oki, I; Tanihara, S; Ojima, T; Kuwano, T; Tsukada, M; Momose, M; Kobayashi, M; Yanagawa, H

    1999-04-01

    To determine whether or not dioxins and furans in breast milk have a role in the prevalence of atopic dermatitis among children. The target population of the study was all children participating in health check-up program for 3-year-old children in Tochigi Prefecture in September and October 1997. Using a questionnaire, information on nutrition in infants (breast milk only, bottled milk only, or mixed), parity, mothers' age at birth, and a history of atopic dermatitis was obtained. Besides, data on potential confounding factors were obtained. Questionnaires from 2,968 children (85.3% of those who were to participate in the programs, and 90.2% of children who participated them) were analyzed. The risk of atopic dermatitis was higher among children with breast milk (odds ratio [OR] = 1.37 with 95% confidence interval [CI] 1.02-1.83) and those with mixed nutrition (OR = 1.21, 95% CI: 0.94-1.57) in comparison with children with only bottled milk. Mothers' age at birth (OR for those who were more than 30 years or older in comparison with those who were younger than 30 years = 1.27; 95% CI, 1.01-1.62) and those with second or later parity orders (OR = 1.32, 95% CI; 1.04-1.67) were also risk factors of the dermatitis after the adjustment for some potential confounding factors. Breast milk elevates the risk of atopic dermatitis slightly; the risk is, however, higher in children in second or later parity orders. If the PCDDs and PCDFs in breast milk cause the dermatitis, this would contradict the assumed metabolism of these chemicals in human bodies.

  10. Epidemiology of Asthma in 94 Children with Atopic Dermatitis

    OpenAIRE

    Arnaldo Cantani

    2015-01-01

    In this paper we present 94 children affected with Atopic Dermatitis (AD), aggravated by respiratory allergy, asthma and/ or Allergic Rhinitis (AR). AD is a common disorder, frequently complicated by asthma-like symptoms, we debate either disorder and concluded that both AR and asthma can afflict most babies with AD, especially when both parents smoke. We confirm our previous statistics, according to which little children not fed breast milk may react to smallest doses of allergens.

  11. The prevalence of atopic dermatitis history in asthmatic children

    OpenAIRE

    Rifda Suryati; Arwin AP Akib; I Boediman; Abdul Latief

    2016-01-01

    Background Atopic dermatitis (AD) is a risk factor of asthma. There is still limited information about its prevalence and characteristics in asthmatic children. Objective To find out the prevalence of AD history in asthmatic children. Methods This was a cross-sectional study conducted at the De- partment of Child Health, Cipto Mangunkusumo Hospital, Jakarta, from July until December 2004. Patients with asthma who were at or less than 5 years of age were included in the...

  12. Serum Interleukin-5 Changes in Partly Controlled Atopic Asthmatic Children

    OpenAIRE

    Yamamah, Gamal A; Abdel Meguid, Iman E; Fatouh, Amany A; Shaaban, Hala H; Nagwa A Kantoush; Shereen F Beharrey

    2014-01-01

    BACKGROUND: Cytokines including Interleukin-5 play a key role in orchestrating the chronic inflammation of asthma. We aimed to determine the level of serum IL-5 in partly controlled atopic asthma in children and to assess the effect of different therapies on their levels. METHODS: The study included 40 children aged 6-12 years with partly controlled asthma. Cases were randomly divided into two groups; group ‘A’ receiving Leukotriene modifiers and group ‘B’ receiving inhaled corticosteroid...

  13. Advanced Transport Operating System (ATOPS) utility library software description

    Science.gov (United States)

    Clinedinst, Winston C.; Slominski, Christopher J.; Dickson, Richard W.; Wolverton, David A.

    1993-01-01

    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.

  14. Selected aspects of quality of life in atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Joanna Kasznia-Kocot

    2014-06-01

    Full Text Available Introduction. Atopic dermatitis (AD is a chronic dermatological disease of multifactorial pathogenesis with persistent pruritus and extreme skin dryness including typical skin changes caused by many interactions between genetic and environmental factors. The study aims to evaluate the selected aspects of quality of life in AD. Material and methods. To what extent does the disease affect the daily practice of the patient and their family, what are their expenditures in connection with the treatment, and also how they perceive themselves and emotional, sexual, social behavior. 71 adult subjects 48(68% women and 23 (32% men were selected from the allergology clinics in the region of Silesia for this questionnaire based study. Results. Pruritus was felt by everyone, skin pain by 69%, and skin burning by 86%. The great majority of subjects had some constrains in doing housework due to skin complaints. The disease also affected professional work and school achievements. Almost everyone agreed that money spent on medication purchase and skin care agents impacted on financial resources. Atopic dermatitis affected 75% in social functioning, leisure time, sports practicing. The disease affected self-esteem level and confidence. Half of the examined subjects experienced bad feelings in contact with a partner, or felt stigmatized by negative reactions of the environment because of the skin appearance. Often atopic dermatitis caused problems with sound sleep (65% various emotional disorders and also disorders in the sexual sphere (32%. Every fourth subject felt depressed and every seventh thought of suicide. Conclusions. Atopic dermatitis is a disease which adversely influences many aspects of life and undoubtedly impairs the quality of life in a serious and distressing way. Therefore its treatment should be supported by psychotherapy.

  15. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Hansen, Peter R; Gislason, Gunnar H

    2017-01-01

    , socioeconomic status, health care consumption, smoking, alcohol abuse, diabetes, and cholesterol-lowering drug use. MAIN OUTCOME MEASURES: The outcome was initiation of pharmacotherapy used for treatment of ED. RESULTS: The sample consisted of 1,756,679 Danish men (age range = 30-100 years), of which 2...... population for men with AD. Egeberg A, Hansen PR, Gislason GH, et al. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis. J Sex Med 2017;XX:X-XX....

  16. Pro-inflammatory interleukins in middle ear effusions from atopic and non-atopic children with chronic otitis media with effusion.

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda

    2016-06-01

    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.

  17. Preventive and curative effects of probiotics in atopic patients.

    Science.gov (United States)

    Bongaerts, G P A; Severijnen, R S V M

    2005-01-01

    Normally, the transport of allergens through the intestinal epithelia to the blood is limited. It is hypothesised that if these compounds arrive in the blood circulation, they must percolate through the epithelial cell layer. Thus, food allergy (and thus atopic eczema) implies an increased intercellular leakage of the gut wall. Such increased intercellular leakage is thought to be caused by a slightly changed cellular morphology due to a slight cytopathologic effect because of both a limited decay of the cytoskeleton and a slightly reduced turgor. These events may be due to a reduced production of intracellular metabolic energy in the epithelial cells due to an increased concentration of familiar, frequently occurring, potentially toxic bacterial metabolites, i.e., d-lactic acid and/or ethanol. In this hypothesis we suggest that adequate probiotics can (i) prevent the increased characteristic intestinal permeability of children with atopic eczema and food allergy, (ii) can thus prevent the uptake of allergens, and (iii) finally can prevent the expression of the atopic constitution. The use of adequate probiotic lactobacilli, i.e., homolactic and/or facultatively heterolactic l-lactic acid-producing lactobacilli, reduces the intestinal amounts of the bacterial, toxic metabolites, d-lactic acid and ethanol by fermentative production of merely the non-toxic l-lactic acid from glucose. Thus, it is thought that beneficial probiotic micro-organisms promote gut barrier function and both undo and prevent unfavourable intestinal micro-ecological alterations in allergic individuals.

  18. Intestinal permeability, atopic eczema and oral disodium cromoglycate.

    Science.gov (United States)

    Ventura, A; Rinaldi, S; Florean, P; Agosti, E

    1991-01-01

    A dual sugar (lactulose-mannitol) absorption test was performed in 19 patients with atopic eczema before and after a 21 day elimination-diet. Moreover L/M test was carried out in 20 controls. The mean value of lactulose-mannitol urinary ratio (L/M) was 0.015 (+/- 0.018 SD) in the group of patients and 0.012 (+/- 0.011 SD) in the control group (p = 0.49). The mean clinical score improved significantly after elimination diet (41,6 +/- 12.9 SD before the diet, 21.7 +/- 10.4 SD after the diet, p less than 0.001) but no significant modification of intestinal permeability was recorded (L/M = 0.015 +/- 0.018 SD before the diet and 0.21 +/- 0.022 SD after the diet, p = 0.38). Using a double blind approach we were not able to demonstrate any significant effect of disodium cromoglycate on the clinical score and intestinal permeability. The connections between food allergy, intestinal permeability and atopic dermatitis have not been understood, but disodium cromoglycate doesn't seem to play a significant role in the treatment of atopic dermatitis nor in the modification of intestinal permeability.

  19. Atopic eczema in children: another harmful sequel of divorce.

    Science.gov (United States)

    Bockelbrink, A; Heinrich, J; Schäfer, I; Zutavern, A; Borte, M; Herbarth, O; Schaaf, B; von Berg, A; Schäfer, T

    2006-12-01

    Different lifestyle factors seem to be associated with the risk for atopic diseases and some studies suggest that stress increases the risk of allergic sensitization, asthma and atopic eczema. Only few studies have investigated the association of early stressful life events and atopic eczema (AE) in children. Parents of participants of the ongoing LISA birth cohort study were asked to give information on life events, such as severe disease or death of a family member, unemployment, or divorce of the parents. Lifetime prevalence of AE and incidence after the assessment period for life events were compared. Prevalence of AE until the age of 4 years was 21.4%. Reported life events within the first 2 years were: severe disease (17.5%) or death (8.4%) of a family member, divorce/separation (3.4%), and unemployment (2.7%). Divorce/separation was associated with a significantly [odds ratio (OR) 3.59, 95% confidence interval (CI) 1.69-7.66] increased and disease with a significantly (OR 0.29, 95% CI 0.13-0.68) decreased incidence of AE for the subsequent 2 years of life. No effect was seen for unemployment. Divorce/separation of the parents and severe disease of a family member influence the risk of developing AE.

  20. Systemic Agents for Severe Atopic Dermatitis in Children.

    Science.gov (United States)

    Notaro, Eliza R; Sidbury, Robert

    2015-12-01

    Atopic dermatitis (AD), or eczema, is a chronic inflammatory skin condition characterized by relapsing pruritic, scaly, erythematous papules and plaques frequently associated with superinfection. The lifelong prevalence of AD is over 20 % in affluent countries. When a child with severe AD is not responding to optimized topical therapy including phototherapy, and relevant triggers cannot be identified or avoided, systemic therapy should be considered. If studies show early aggressive intervention can prevent one from advancing along the atopic march, and relevant triggers such as food allergies cannot be either identified or avoided, systemic therapy may also play a prophylactic role. Though the majority of evidence exists in adult populations, four systemic non-specific immunosuppressive or immunomodulatory drugs have demonstrated efficacy in AD and are used in most patients requiring this level of intervention regardless of age: cyclosporine, mycophenolate mofetil, methotrexate, and azathioprine. This article reviews the use of these medications as well as several promising targeted therapies currently in development including dupilumab and apremilast. We briefly cover several other systemic interventions that have been studied in children with atopic dermatitis.