Mental Health Comorbidity in Atopic Dermatitis

PubMed Central

Yaghmaie, Pouya; Koudelka, Caroline W.; Simpson, Eric L.

2013-01-01

Background Recent data, primarily from Europe, suggest children with atopic dermatitis may be at increased risk of developing mental health disorders. Objective We aimed to quantify the mental health burden associated with pediatric atopic dermatitis in the United States. Methods A cross-sectional study design was used analyzing data from the 2007 National Survey of Children's Health – a survey reporting on the health status of 92,642 non-institutionalized children ages 0-17. The lifetime prevalence of various provider-diagnosed mental health conditions was calculated for those with and without a history of atopic dermatitis. Results The odds of having attention-deficit/hyperactivity disorder was significantly increased in children with atopic dermatitis compared to non-atopic dermatitis controls, OR 1.87 (95% CI 1.54, 2.27) even after controlling for known confounders. The adjusted odds ratios for depression, anxiety, conduct disorder, and autism were 1.81 (95% CI 1.33,2.46) , 1.77 (95% CI 1.36, 2.29), 1.87 (1.46, 2.39), and 3.04 (95% CI 2.13, 4.34), respectively, and these estimates were all statistically significant. A clear dose-dependent relationship was observed between the prevalence of a mental health disorder and the reported severity of the skin disease. Conclusions Our data reveal a striking association between mental health disorders and atopic dermatitis in the U.S. pediatric population. The severity of the skin disease alters the strength of the association. Prospective cohort studies are needed to verify these associations and to explore underlying mechanisms. Strategies to prevent atopic dermatitis or to aggressively treat early skin inflammation may modify the risk of developing mental health disorders in at-risk children. PMID:23245818

Efficacy and Safety of Dupilumab in Patients ≥12 to <18 Years of Age, With Moderate-to-Severe Atopic Dermatitis

ClinicalTrials.gov

2017-12-18

Moderate-to-Severe Atopic Dermatitis; Dermatitis, Dermatitis Atopic; Eczema, Skin Diseases, Skin; Diseases Genetic, Genetic; Diseases Inborn, Skin; Disease, Eczematous Skin; Hypersensitivity, Immediate; Hypersensitivity, Immune System Diseases; Dermatitis, Atopic

Risk assessment of bronchial asthma development in children with atopic dermatitis

NASA Astrophysics Data System (ADS)

Vуsotska, Olena V.; Klymenko, Viktoriia A.; Trubitcin, Alexei A.; Pecherska, Anna I.; Savchuk, Tamara O.; Kolimoldayev, Maksat; Wójcik, Waldemar; Szatkowska, Małgorzata; Burlibay, Aron

2017-08-01

This article offers a risk assessment of bronchial asthma development in children with atopic dermatitis by applying fuzzy-set theory to accumulated statistical data. It is shown that with a view to executing the said task one should exercise a complex approach involving factors such as "IgE level", "existence of obstructions" and "burdened bronchial asthma heredity of immediate relatives". The obtained results will assist in making adequate and well-informed medical decisions as well as facilitate the decrease of the risk of developing bronchial asthma in children with atopic dermatitis.

Child behaviour problems and childhood illness: development of the Eczema Behaviour Checklist.

PubMed

Mitchell, A E; Morawska, A; Fraser, J A; Sillar, K

2017-01-01

Children with atopic dermatitis are at increased risk of both general behaviour problems, and those specific to the condition and its treatment. This can hamper the ability of parents to carry out treatment and manage the condition effectively. To date, there is no published instrument available to assess child behaviour difficulties in the context of atopic dermatitis management. Our aim was to develop a reliable and valid instrument to assess atopic dermatitis-specific child behaviour problems, and parents' self-efficacy (confidence) for managing these behaviours. The Eczema Behaviour Checklist (EBC) was developed as a 25-item questionnaire to measure (i) extent of behaviour problems (EBC Extent scale), and (ii) parents' self-efficacy for managing behaviour problems (EBC Confidence scale), in the context of child atopic dermatitis management. A community-based sample of 292 parents completed the EBC, measures of general behaviour difficulties, self-efficacy with atopic dermatitis management and use of dysfunctional parenting strategies. There was satisfactory internal consistency and construct validity for EBC Extent and Confidence scales. There was a negative correlation between atopic dermatitis-specific behaviour problems and parents' self-efficacy for dealing with behaviours (r = -.53, p < .001). Factor analyses revealed a three-factor structure for both scales: (i) treatment-related behaviours; (ii) symptom-related behaviours; and (iii) behaviours related to impact of the illness. Variation in parents' self-efficacy for managing their child's atopic dermatitis was explained by intensity of illness-specific child behaviour problems and parents' self-efficacy for dealing with the behaviours. The new measure of atopic dermatitis-specific child behaviour problems was a stronger predictor of parents' self-efficacy for managing their child's condition than was the measure of general child behaviour difficulties. Results provide preliminary evidence of reliability and validity of the EBC, which has potential for use in clinical and research settings, and warrant further psychometric evaluation. © 2016 John Wiley & Sons Ltd.

Atopic dermatitis in the domestic dog.

PubMed

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.

[Peripheral blood cells luminol-dependent chemiluminescence at the different stages of atopic dermatitis].

PubMed

Elistratova, I V; Morozov, S G; Zakharova, I A; Tarasova, M V

2015-01-01

Aim of this work was to record the luminol-dependent spontaneous and induced chemiluminescence at the different stages of atopic dermatitis. Peripheral blood cells were obtained from adult patient with atopic dermatitis followed by the registration of luminol-dependent chemiluminescence on luminograph. Opsonized zymosan as well as yeasts Candida tropicalis have been used to induce the chemiluminescence. Spontaneous and induced chemiluminescence were slightly elevated at the mild atopic dermatitis but were decreased at the severe stage of disease. Statistically significant difference has been found between group with mild and severe atopic dermatitis, Skin contamination by yeasts Candida tropicalis causes the increased level of blood cells chemiluminescence at the first week of atopic relapse when the disease was mild. Severe stage of atopic dermatitis was coupled with statistically significant inhibition of both, spontaneous and induced chemiluminescence. Luminol-dependent chemiluminescence of peripheral blood cells from adult atopic dermatitis patients may be stimulated at the mild stage and suppressed at severe stage of atopic dermatitis.

Children with atopic dermatitis in Daejeon, Korea: individualized nutrition intervention for disease severity and nutritional status.

PubMed

Kim, Seong Hee; Lee, Jae Ho; Ly, Sun Yung

2016-12-01

Atopic dermatitis is one of the most common pediatric chronic inflammatory skin diseases, and certain food allergens and nutrients are closely related to the development and severity of atopic dermatitis. While avoidance of the causative foods is considered the mainstay of treatment, unverified excessive restriction might induce unnecessary limitations in the food intake, consequently leading to nutritional deficiencies and poor growth. This study aimed to identify the characteristics and nutrient intake status in children with atopic dermatitis and to investigate the effects of individualized nutrition intervention. We retrospectively reviewed electronic medical records of 77 pediatric patients with atopic dermatitis who received 4 months of individualized nutrition intervention combined with an elimination diet. The patient characteristics, nutrient intake status, and clinical status were examined before and after the intervention. Before the intervention, 5 children had a weight for height z-score below -2.0, and 48.1% had experienced food restriction; these children showed a significantly higher SCORing of Atopic Dermatitis index than those without experiences, with the number of restricted foods before the intervention positively correlating with the disease severity. The intakes of n-6 and n-3 fatty acids, calcium, folate, and vitamin D were lower than the recommended nutrient intakes for Koreans. After the intervention, the weight for height z-score of 35 children was significantly increased and their SCORing of Atopic Dermatitis index was significantly reduced (p<0.05). Individualized nutrition intervention appears useful for alleviating the severity of atopic dermatitis and improving the growth status by improving the nutrient intake.

Cost of illness of atopic dermatitis in children: a societal perspective.

PubMed

Kemp, Andrew S

2003-01-01

Childhood atopic dermatitis is a disorder with considerable social and financial costs. Consideration of these costs is increasingly important in view of the growing prevalence of atopic dermatitis, particularly in developed countries over recent decades. The family stress related to the care of children with moderate or severe atopic dermatitis is significantly greater than that of the care of children with type 1 diabetes mellitus. The factors contributing to family stress include sleep deprivation, loss of employment, time taken for care of atopic dermatitis and financial costs. The financial costs for the family and community include medical and hospital direct costs of treatments and indirect costs from loss of employment. There are many interventions utilised in the treatment of childhood atopic dermatitis which involve not only medical practitioners but nurses, pharmacists, dieticians, psychologists and purveyors of so-called alternative therapies such as naturopathy, aromatherapy and bioresonance, all of which contribute to the financial burdens on the parents and the community. It is possible that appropriate interventions directed to reducing trigger factors might produce worthwhile savings, although the cost benefit of these measures has not been demonstrated. In conclusion, atopic dermatitis should not be regarded as a minor skin disorder but as a condition which has the potential to be a major handicap with considerable personal, social and financial consequences both to the family and the community.

Differential Effects of Peptidoglycan Recognition Proteins on Experimental Atopic and Contact Dermatitis Mediated by Treg and Th17 Cells

PubMed Central

Park, Shin Yong; Gupta, Dipika; Kim, Chang H.; Dziarski, Roman

2011-01-01

Skin protects the body from the environment and is an important component of the innate and adaptive immune systems. Atopic dermatitis and contact dermatitis are among the most frequent inflammatory skin diseases and are both determined by multigenic predisposition, environmental factors, and aberrant immune response. Peptidoglycan Recognition Proteins (Pglyrps) are expressed in the skin and we report here that they modulate sensitivity to experimentally-induced atopic dermatitis and contact dermatitis. Pglyrp3 −/− and Pglyrp4 −/− mice (but not Pglyrp2 −/− mice) develop more severe oxazolone-induced atopic dermatitis than wild type (WT) mice. The common mechanism underlying this increased sensitivity of Pglyrp3 −/− and Pglyrp4 −/− mice to atopic dermatitis is reduced recruitment of Treg cells to the skin and enhanced production and activation Th17 cells in Pglyrp3 −/− and Pglyrp4 −/− mice, which results in more severe inflammation and keratinocyte proliferation. This mechanism is supported by decreased inflammation in Pglyrp3 −/− mice following in vivo induction of Treg cells by vitamin D or after neutralization of IL-17. By contrast, Pglyrp1 −/− mice develop less severe oxazolone-induced atopic dermatitis and also oxazolone-induced contact dermatitis than WT mice. Thus, Pglyrp3 and Pglyrp4 limit over-activation of Th17 cells by promoting accumulation of Treg cells at the site of chronic inflammation, which protects the skin from exaggerated inflammatory response to cell activators and allergens, whereas Pglyrp1 has an opposite pro-inflammatory effect in the skin. PMID:21949809

The association between phthalate exposure and atopic dermatitis with a discussion of phthalate induced secretion of interleukin-1β and thymic stromal lymphopoietin.

PubMed

Overgaard, Line E K; Bonefeld, Charlotte M; Frederiksen, Hanne; Main, Katharina M; Thyssen, Jacob P

2016-06-01

Phthalate diesters are widely used as emollients in plastic and cosmetics as well as in food packaging and perfumes, potentially leading to prolonged and repeated dermal, oral and airborne exposure. We here review published articles that have evaluated the putative role of phthalate diesters in the pathogenesis of atopic dermatitis and discuss possible pathogenic pathways. A literature search resulted in 563 articles in Embase and 263 articles in Pubmed. After identification of relevant articles based on screening of titles, abstracts and reference lists, a total of 39 articles were selected and included. While no clear association has been shown between systemic phthalate levels and atopic dermatitis in human studies, animal data suggests that phthalates may worsen dermatitis and in vitro data suggests that interleukin-4 could be upregulated. Moreover, both loss-of-function mutations in the filaggrin gene and atopic dermatitis have been associated with elevated systemic phthalate levels. There is a need for prospective studies to clarify the possible pathogenic role of phthalate diesters in atopic dermatitis and the associated health risk, especially with the general trend towards barrier restoration with emollients in infants at risk of developing atopic dermatitis. In summary, we conclude that the results from published studies are controversial and inconclusive.

Children with atopic dermatitis may have unacknowledged contact allergies contributing to their skin symptoms.

PubMed

Simonsen, A B; Johansen, J D; Deleuran, M; Mortz, C G; Skov, L; Sommerlund, M

2018-03-01

Whether children with atopic dermatitis have an altered risk of contact allergy than children without atopic dermatitis is frequently debated and studies have been conflicting. Theoretically, the impaired skin barrier in atopic dermatitis (AD) facilitates the penetration of potential allergens and several authors have highlighted the risk of underestimating and overlooking contact allergy in children with atopic dermatitis. To determine the prevalence of contact allergy in Danish children with atopic dermatitis and explore the problem of unacknowledged allergies maintaining or aggravating the skin symptoms. In a cross-sectional study, 100 children and adolescents aged 5-17 years with a diagnosis of atopic dermatitis were patch tested with a paediatric series of 31 allergens. Thirty per cent of the children had at least one positive patch test reaction, and 17% had at least one contact allergy that was relevant to the current skin symptoms. The risk of contact allergy was significantly correlated to the severity of atopic dermatitis. Metals and components of topical skincare products were the most frequent sensitizers. Patch testing is relevant as a screening tool in the management of children with atopic dermatitis as they may have unacknowledged contact allergies contributing to or maintaining their skin symptoms. Children with atopic dermatitis seem to be at greater risk of sensitization to certain allergens including metals and components of skincare products. © 2017 European Academy of Dermatology and Venereology.

Economic Impact of Atopic Dermatitis in Korean Patients

PubMed Central

Kim, Chulmin; Park, Kui Young; Ahn, Seohee; Kim, Dong Ha; Li, Kapsok; Kim, Do Won; Kim, Moon-Beom; Jo, Sun-Jin; Yim, Hyeon Woo

2015-01-01

Background Atopic dermatitis is a global public health concern owing to its increasing prevalence and socioeconomic burden. However, few studies have assessed the economic impact of atopic dermatitis in Korea. Objective We conducted a cost analysis of atopic dermatitis and evaluated its economic impacts on individual annual disease burden, quality of life, and changes in medical expenses with respect to changes in health related-quality of life. Methods The cost analysis of atopic dermatitis was performed by reviewing the home accounting records of 32 patients. The economic impact of the disease was evaluated by analyzing questionnaires. To handle uncertainties, we compared the results with the data released by the Health Insurance Review & Assessment Board on medical costs claimed by healthcare facilities. Results The direct cost of atopic dermatitis per patient during the 3-month study period was 541,280 Korean won (KRW), and expenditures on other atopic dermatitis-related products were 120,313 KRW. The extrapolated annual direct cost (including expenditures on other atopic dermatitis-related products) per patient was 2,646,372 KRW. The estimated annual indirect cost was 1,507,068 KRW. Thus, the annual cost of illness of atopic dermatitis (i.e., direct+indirect costs) was estimated to be 4,153,440 KRW. Conclusion The annual total social cost of atopic dermatitis on a national level is estimated to be 5.8 trillion KRW. PMID:26082587

Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy

PubMed Central

Catherine Mack Correa, M.; Nebus, Judith

2012-01-01

Atopic dermatitis is a common inflammatory skin disorder that afflicts a growing number of young children. Genetic, immune, and environmental factors interact in a complex fashion to contribute to disease expression. The compromised stratum corneum found in atopic dermatitis leads to skin barrier dysfunction, which results in aggravation of symptoms by aeroallergens, microbes, and other insults. Infants—whose immune system and epidermal barrier are still developing—display a higher frequency of atopic dermatitis. Management of patients with atopic dermatitis includes maintaining optimal skin care, avoiding allergic triggers, and routinely using emollients to maintain a hydrated stratum corneum and to improve barrier function. Flares of atopic dermatitis are often managed with courses of topical corticosteroids or calcineurin inhibitors. This paper discusses the role of emollients in the management of atopic dermatitis, with particular emphasis on infants and young children. PMID:23008699

[Atopic dermatitis and domestic animals].

PubMed

Song, M

2000-09-01

Several arguments are raised attributing to aeroallergens an important role in atopic dermatitis. The aeroallergens that penetrate the epidermis could be fixed by IgE on the Langerhans cells and then induce a cellular mediator reaction comparable to that of allergic contact eczema. Patch tests have been developed to evaluate the role of aeroallergens (dust mites, animal dander, etc.). Preventive anti-dust mites measures in the home of atopic patients are recommended. Eviction of domestic animals (cat, dog, etc.) or avoidance measures for animal dander in the home can produce improvement in atopic dermatitis. Oral specific immunotherapy is being validated as a treatment for this disease.

[Symptoms of anxiety and depression in atopic eczema/dermatitis syndrome].

PubMed

Brzoza, Zenon; Badura-Brzoza, Karina; Nowakowski, Marek; Matysiakiewicz, Jerzy; Rogala, Barbara; Hese, Robert T

2005-01-01

The presence of chronic disease is a risk factor for the development of mood disturbances and panic disorders. They can influence the course of disease and effectiveness of therapy. Depression may be the cause of making light doctor's advice. Anxious patients often aggravate symptoms of the disease. To study symptoms of anxiety and depression in patients suffering from atopic eczema/dermatitis syndrome (ZAZS). Material. We studied 38 patients suffering from adequately controlled moderate ZAZS and 62 volunteers in the control group. Mental status of subjects was assessed by means of State and Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) questionnaires. ZAZS patients demonstrated higher intensity of anxiety (as a trait and as a state) than healthy subjects. Intensity and prevalence of depression in the atopic eczema/ dermatitis syndrome group was higher than in the control group. Patients suffering from atopic/eczema dermatitis syndrome are pre-disposed to anxiety and depression manifestation. Even adequately controlled symptoms of atopic/eczema dermatitis syndrome may be the cause of those disturbances' occurrence.

Saussurea lappa alleviates inflammatory chemokine production in HaCaT cells and house dust mite-induced atopic-like dermatitis in Nc/Nga mice.

PubMed

Lim, Hye-Sun; Ha, Hyekyung; Lee, Mee-Young; Jin, Seong-Eun; Jeong, Soo-Jin; Jeon, Woo-Young; Shin, Na-Ra; Sok, Dai-Eun; Shin, Hyeun-Kyoo

2014-01-01

Saussurea lappa is a traditional herbal medicine used for to treat various inflammatory diseases. In this study, we investigated the protective effects of S. lappa against atopic dermatitis using human keratinocyte HaCaT cells, murine mast cell line MC/9 cells, and a house dust mite-induced atopic dermatitis model of Nc/Nga mice. Treatment with the S. lappa caused a significant reduction in the mRNA levels and production of inflammatory chemokines and cytokine, including thymus- and activation-regulated chemokine (TARC), macrophage-derived chemokine (MDC), regulated on activation, normal T-cell expressed and secreted (RANTES), and interleukin-8 (IL-8) in tumor necrosis factor-α/interferone-γ-stimulated HaCaT cells. S. lappa exhibited the significant reduction in histamine production in MC/9 cells. In the atopic dermatitis model, S. lappa significantly reduced the dermatitis score and serum IgE and TARC levels. In addition, the back skin and ears of S. lappa-treated Nc/Nga mice exhibited reduced histological manifestations of atopic skin lesions such as erosion, hyperplasia of the epidermis and dermis, and inflammatory cell infiltration. In conclusion, an extract of S. lappa effectively suppressed the development of atopic dermatitis, which was closely related to the reduction of chemokines and cytokine. Our study suggests that S. lappa may be a potential treatment for atopic dermatitis. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

London-born black Caribbean children are at increased risk of atopic dermatitis.

PubMed

Williams, H C; Pembroke, A C; Forsdyke, H; Boodoo, G; Hay, R J; Burney, P G

1995-02-01

Previous reports suggest that atopic dermatitis is more common in black Caribbean children born in the United Kingdom than in white children. It is unclear whether these differences are caused by selection bias or variations in the use of the word "eczema" in the groups studied. Our objective was to explore ethnic group differences in the prevalence of atopic dermatitis in London schoolchildren. A cross-sectional prevalence survey of 693 junior school children in three schools was performed. Atopic dermatitis was defined in three ways: (1) by a dermatologist, (2) by visible flexural dermatitis as recorded by an independent observer, and (3) by a history of flexural dermatitis according to the child's parents. The prevalence of atopic dermatitis according to examination by a dermatologist was 16.3% in black Caribbean children and 8.7% in white children. This increased risk was present for different methods of defining of a atopic dermatitis and persisted after adjustment for potential confounders. London-born black Caribbean children appear to be at an increased risk of having atopic dermatitis.

Lack of Association Between Toll-like Receptor 2 Polymorphisms (R753Q and A-16934T) and Atopic Dermatitis in Children from Thrace Region of Turkey

PubMed Central

Can, Ceren; Yazıcıoğlu, Mehtap; Gürkan, Hakan; Tozkır, Hilmi; Görgülü, Adnan; Süt, Necdet Hilmi

2017-01-01

Background: Atopic dermatitis is the most common chronic inflammatory skin disease. A complex interaction of both genetic and environmental factors is thought to contribute to the disease. Aims: To evaluate whether single nucleotide polymorphisms in the TLR2 gene c.2258C>T (R753Q) (rs5743708) and TLR2 c.-148+1614T>A (A-16934T) (rs4696480) (NM_0032643) are associated with atopic dermatitis in Turkish children. Study Design: Case-control study. Methods: The study was conducted on 70 Turkish children with atopic dermatitis aged 0.5-18 years. The clinical severity of atopic dermatitis was evaluated by the severity scoring of atopic dermatitis index. Serum total IgE levels, specific IgE antibodies to inhalant and food allergens were measured in both atopic dermatitis patients and controls, skin prick tests were done on 70 children with atopic dermatitis. Genotyping for TLR2 (R753Q and A-16934T) single nucleotide polymorphisms was performed in both atopic dermatitis patients and controls. Results: Cytosine-cytosine and cytosin-thymine genotype frequencies of the TLR2 R753Q single nucleotide polymorphism in the atopic dermatitis group were determined as being 98.6% and 1.4%, cytosine allele frequency for TLR2 R753Q single nucleotide polymorphism was determined as 99.29% and the thymine allele frequency was 0.71%, thymine-thymine, thymine-adenine, and adenine-adenine genotype frequencies of the TLR2 A-16934T single nucleotide polymorphism were 24.3%, 44.3%, and 31.4%. The thymine allele frequency for the TLR2 A-16934T single nucleotide polymorphism in the atopic dermatitis group was 46.43%, and the adenine allele frequency was 53.57%, respectively. There was not statistically significant difference between the groups for all investigated polymorphisms (p>0.05). For all single nucleotide polymorphisms studied, allelic distribution was analogous among atopic dermatitis patients and controls, and no significant statistical difference was observed. No homozygous carriers of the TLR2 R753Q single nucleotide polymorphism were found in the atopic dermatitis and control groups. Conclusion: The TLR2 (R753Q and A-16934T) single nucleotide polymorphisms are not associated with atopic dermatitis in a group of Turkish patients. PMID:28443596

Lack of Association Between Toll-like Receptor 2 Polymorphisms (R753Q and A-16934T) and Atopic Dermatitis in Children from Thrace Region of Turkey.

PubMed

Can, Ceren; Yazıcıoğlu, Mehtap; Gürkan, Hakan; Tozkır, Hilmi; Görgülü, Adnan; Süt, Necdet Hilmi

2017-05-05

Atopic dermatitis is the most common chronic inflammatory skin disease. A complex interaction of both genetic and environmental factors is thought to contribute to the disease. To evaluate whether single nucleotide polymorphisms in the TLR2 gene c.2258C>T (R753Q) (rs5743708) and TLR2 c.-148+1614T>A (A-16934T) (rs4696480) (NM_0032643) are associated with atopic dermatitis in Turkish children. Case-control study. The study was conducted on 70 Turkish children with atopic dermatitis aged 0.5-18 years. The clinical severity of atopic dermatitis was evaluated by the severity scoring of atopic dermatitis index. Serum total IgE levels, specific IgE antibodies to inhalant and food allergens were measured in both atopic dermatitis patients and controls, skin prick tests were done on 70 children with atopic dermatitis. Genotyping for TLR2 (R753Q and A-16934T) single nucleotide polymorphisms was performed in both atopic dermatitis patients and controls. Cytosine-cytosine and cytosin-thymine genotype frequencies of the TLR2 R753Q single nucleotide polymorphism in the atopic dermatitis group were determined as being 98.6% and 1.4%, cytosine allele frequency for TLR2 R753Q single nucleotide polymorphism was determined as 99.29% and the thymine allele frequency was 0.71%, thymine-thymine, thymine-adenine, and adenine-adenine genotype frequencies of the TLR2 A-16934T single nucleotide polymorphism were 24.3%, 44.3%, and 31.4%. The thymine allele frequency for the TLR2 A-16934T single nucleotide polymorphism in the atopic dermatitis group was 46.43%, and the adenine allele frequency was 53.57%, respectively. There was not statistically significant difference between the groups for all investigated polymorphisms (p>0.05). For all single nucleotide polymorphisms studied, allelic distribution was analogous among atopic dermatitis patients and controls, and no significant statistical difference was observed. No homozygous carriers of the TLR2 R753Q single nucleotide polymorphism were found in the atopic dermatitis and control groups. The TLR2 (R753Q and A-16934T) single nucleotide polymorphisms are not associated with atopic dermatitis in a group of Turkish patients.

Effects of dog ownership and genotype on immune development and atopy in infancy.

PubMed

Gern, James E; Reardon, Claudia L; Hoffjan, Sabine; Nicolae, Dan; Li, Zhanhai; Roberg, Kathy A; Neaville, William A; Carlson-Dakes, Kirstin; Adler, Kiva; Hamilton, Rebekah; Anderson, Elizabeth; Gilbertson-White, Stephanie; Tisler, Christopher; Dasilva, Douglas; Anklam, Kelly; Mikus, Lance D; Rosenthal, Louis A; Ober, Carole; Gangnon, Ronald; Lemanske, Robert F

2004-02-01

Exposure to furred pets might confer protection against the development of allergic sensitization through a mechanism that is incompletely understood. The objective of this study was to determine the effects of pet exposure and genotype on immunologic development and the incidence of atopic markers and diseases in the first year of life. Pet exposure in the home was compared with cytokine secretion patterns (mitogen-stimulated mononuclear cells at birth and age 1 year) and indicators of atopy (allergen-specific and total IgE, eosinophilia, food allergy, atopic dermatitis) in 285 infants. Interactions with genotype at the CD14 locus were also evaluated in the data analyses. Exposure to dogs was associated with reduced allergen sensitization (19% vs 33%, P =.020) and atopic dermatitis (30% vs 51%, P <.001). The risk for atopic dermatitis was further influenced by genotype at the CD14 locus (P =.006), even after adjusting for exposure to dogs (P =.003). Furthermore, infants with the genotype -159TT were less likely to develop atopic dermatitis if they were exposed to a dog (5% vs 43%, P =.04). Last, dog exposure was associated with increased IL-10 (117 vs 79 pg/mL, P =.002) and IL-13 (280 vs 226 pg/mL, P =.013) responses at age 1 year. Having a dog in infancy is associated with higher IL-10 and IL-13 cytokine secretion profiles and reduced allergic sensitization and atopic dermatitis. These findings suggest that postnatal exposure to dogs can influence immune development in a genotype-specific fashion and thereby attenuate the development of atopy in at-risk children.

Cesarean section delivery and development of food allergy and atopic dermatitis in early childhood.

PubMed

Papathoma, Evangelia; Triga, Maria; Fouzas, Sotirios; Dimitriou, Gabriel

2016-06-01

Delivery by Cesarean section (CS) may predispose to allergic disorders, presumably due to alterations in the establishment of normal gut microbiota in early infancy. In this study, we sought to investigate the association between CS and physician-diagnosed food allergy and atopic dermatitis during the first 3 years of life, using data from a homogeneous, population-based, birth cohort. A total of 459 children born and cared for in the same tertiary maternity unit were examined at birth and followed up at 1, 6, 12, 18, 24, 30 and 36 months of age. Participants with symptoms suggestive of food allergy or atopic dermatitis were evaluated by a pediatric allergy specialist to confirm the diagnosis based on well-defined criteria. The rate of CS was 50.8% (n = 233). Food allergy was diagnosed in 24 participants (5.2%) while atopic dermatitis was diagnosed in 62 children (13.5%). Cesarean section (OR 3.15; 95% CI 1.14-8.70), atopic dermatitis of the child (OR 3.01; 95% CI 1.18-7.80), parental atopy (OR 4.33; 95% CI 1.73-12.1), and gestational age (OR 1.57; 95% CI 1.07-2.37) were significant and independent predictors of food allergy. Children with at least one allergic parent delivered by CS had higher probability of developing food allergy compared with vaginally delivered children of non-allergic parents (OR 10.0; 95% CI 3.06-32.7). Conversely, the effect of CS on atopic dermatitis was not significant (OR 1.35; 95% CI 0.74-2.47). Delivery by CS predisposes to the development of food allergy but not atopic dermatitis in early childhood. Cesarean section delivery seems to upregulate the immune response to food allergens, especially in children with allergic predisposition. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Identifying patients likely to have atopic dermatitis: development of a pilot algorithm.

PubMed

Farage, Miranda A; Bowtell, Philip; Katsarou, Alexandra

2010-01-01

A quick method to distinguish people who are predisposed to skin complaints would be useful in a variety of fields. Certain subgroups, such as people with atopic dermatitis, might be more susceptible to skin irritation than the typical consumer and may be more likely to report product-related complaints. To develop a rapid, questionnaire-based algorithm to predict whether or not individuals who report skin complaints have atopic dermatitis. A 9-item questionnaire on self-perceived skin sensitivity and product categories reportedly associated with skin reactions was administered to two groups of patients from a dermatology clinic: one with clinically diagnosed, active atopic dermatitis (n = 25) and a control group of patients with dermatologic complaints unrelated to atopic dermatitis (n = 25). Questionnaire responses were correlated with the patients' clinical diagnoses in order to derive the minimum number of questions needed to best predict the patients' original diagnoses. We demonstrated that responses to a sequence of three targeted questions related to self-perceived skin sensitivity, preference for hypoallergenic products, and reactions to or avoidance of alpha-hydroxy acids were highly predictive of atopic dermatitis among a population of dermatology clinic patients. The predictive algorithm concept may be useful in postmarketing surveillance programs to rapidly assess the possible status of consumers who report frequent or persistent product-related complaints. Further refinement and validation of this concept is planned with samples drawn from the general population and from consumers who report skin complaints associated with personal products.

Parenting and childhood atopic dermatitis: A cross-sectional study of relationships between parenting behaviour, skin care management, and disease severity in young children.

PubMed

Mitchell, Amy E; Fraser, Jennifer A; Morawska, Alina; Ramsbotham, Joanne; Yates, Patsy

2016-12-01

The development of child behaviour and parenting difficulties is understood to undermine treatment outcomes for children with atopic dermatitis. Past research has reported on correlates of child behaviour difficulties. However, few research studies have sought to examine parenting confidence and practices in this clinical group. To examine relationships between child, parent, and family variables, parent-reported and directly-observed child and parent behaviour, parents' self-efficacy with managing difficult child behaviour, self-reported parenting strategies, and disease severity. Cross-sectional study design. Parent-child dyads (N=64) were recruited from the dermatology clinic of a paediatric tertiary referral hospital in Brisbane, Australia. Children had a diagnosis of atopic dermatitis of ≥3months and no other chronic health conditions except asthma, allergic rhinitis, or allergy. Parents completed self-report measures assessing child behaviour; parent depression, anxiety, and stress; parenting conflict and relationship satisfaction; self-efficacy with managing difficult child behaviour, and use of ineffective parenting strategies; and self-efficacy for managing atopic dermatitis, and performance of atopic dermatitis management tasks. The Scoring Atopic Dermatitis index was used to assess disease severity. Routine at-home treatment sessions were coded for parent and child behaviour. Pearson's and Spearman's correlations identified relationships (p<0.05) between self-efficacy with managing difficult child behaviour and child behaviour problems, parent depression and stress, parenting conflict and relationship satisfaction, and household income. There were also relationships between each of these variables and use of ineffective parenting strategies. Greater use of ineffective parenting strategies was associated with more severe atopic dermatitis. Using multiple linear regressions, child behaviour and household income explained unique variance in self-efficacy for managing difficult child behaviour; household income alone explained unique variance in use of ineffective parenting strategies. Self-efficacy for managing difficult child behaviour and self-efficacy for managing atopic dermatitis were positively correlated (rho=0.48, p<0.001), and more successful self-reported performance of atopic dermatitis management tasks correlated with less permissive (r=0.35, p=0.005) and less authoritarian (r=0.41, p=0.001) parenting. Directly observed aversive child behaviour was associated with more severe atopic dermatitis, parent stress, and parent-reported child behaviour problems. This study revealed relationships between parents' self-efficacy and parenting practices across the domains of child behaviour management and atopic dermatitis management. Parents of children with more severe atopic dermatitis may have difficulty responding to child behaviour difficulties appropriately, potentially impacting on illness management. Incorporating parent and parenting support within treatment plans may improve not only child and family wellbeing, but also treatment outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Morus alba L. suppresses the development of atopic dermatitis induced by the house dust mite in NC/Nga mice

PubMed Central

2014-01-01

Background Morus alba, a medicinal plant in Asia, has been used traditionally to treat diabetes mellitus and hypoglycemia. However, the effects of M. alba extract (MAE) on atopic dermatitis have not been verified scientifically. We investigated the effects of MAE on atopic dermatitis through in vitro and in vivo experiments. Methods We evaluated the effects of MAE on the production of nitric oxide (NO) and prostaglandin E2 (PGE2) in RAW 264.7, as well as thymus and activation-regulated chemokine (TARC/CCL17) in HaCaT cells. In an in vivo experiment, atopic dermatitis was induced by topical application of house dust mites for four weeks, and the protective effects of MAE were investigated by measuring the severity of the skin reaction on the back and ears, the plasma levels of immunoglobulin E (IgE) and histamine, and histopathological changes in the skin on the back and ears. Results MAE suppressed the production of NO and PGE2 in RAW 264.7 cells, as well as TARC in HaCaT cells, in a dose-dependent manner. MAE treatment of NC/Nga mice reduced the severity of dermatitis and the plasma levels of IgE and histamine. MAE also reduced the histological manifestations of atopic dermatitis-like skin lesions such as erosion, hyperplasia of the epidermis and dermis, and inflammatory cell infiltration in the skin on the back and ears. Conclusion Our results suggest that MAE has potent inhibitory effects on atopic dermatitis-like lesion and may be a beneficial natural resource for the treatment of atopic dermatitis. PMID:24755250

Determinants of total and specific IgE in infants with atopic dermatitis. ETAC Study Group. Early Treatment of the Atopic Child.

PubMed

1997-11-01

ETAC (Early Treatment of the Atopic Child), a multi-centre predominantly European study to investigate the potential for cetirizine to prevent the development of asthma in infants with atopic dermatitis has completed enrollment: 817 children have been randomised to 18 months' treatment with either active or placebo and a subsequent 18 months of post-treatment follow-up. Results of the therapeutic effects will not be available for some time, but the study has provided an opportunity to investigate influences on sensitization to allergens in a large cohort of 1-2 years olds with already established atopic dermatitis, resident in different countries and in different environments. The study shows that in infants with atopic dermatitis, raised serum total IgE has significantly different determinants from that a specific allergen sensitization. In infancy, increased total IgE is more affected by factors increasing risk of intercurrent infection and non-specific airway inflammation, such as environmental tobacco smoke exposure (p < 0.001) and the use of gas cookers (p = 0.02). Specific allergen sensitization as represented by detectable IgE antibodies is influenced primarily by allergen exposure. In Sweden, low level exposure to allergens is associated with reduced specific allergen sensitization rates even though the infants already have atopic dermatitis.

Atopic Dermatitis and Comorbidities: Added Value of Comprehensive Dermatoepidemiology.

PubMed

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.

Stressors in Atopic Dermatitis.

PubMed

Barilla, Steven; Felix, Kayla; Jorizzo, Joseph L

2017-01-01

As with other inflammatory skin disorders, atopic dermatitis has a tendency to cause stress and also be exacerbated by it. Patients with atopic dermatitis have several disease-associated stressors, some of which include physical discomfort due to itching and altered appearance due to flare-ups. These stressors have been shown to effect patients psychosocially by altering sleep patterns, decreasing self-esteem and interfering with interpersonal relationships. In combination with its direct effect on patients, atopic dermatitis also causes stress for parents and caregivers. Studies suggest that atopic dermatitis is strongly correlated with co-sleeping habits, which can negatively impact the health and mood of parents or caregivers. It has also been reported to interfere with the formation of a strong mother-child relationship. In order to optimize treatment for patients with atopic dermatitis, it is important to note the impact that it has on quality of life. By implementing patient counseling, sleep-targeted therapies, and the use of quality of life (QoL) indices, atopic dermatitis patients and caregivers have the potential to experience greater satisfaction with treatment.

The Association Between Bathing Habits and Severity of Atopic Dermatitis in Children.

PubMed

Koutroulis, Ioannis; Pyle, Tia; Kopylov, David; Little, Anthony; Gaughan, John; Kratimenos, Panagiotis

2016-02-01

Atopic dermatitis is an inflammatory skin disease that frequently affects children. The current recommendations on management using lifestyle modification are highly variable, leading to confusion and uncertainty among patients. To determine current bathing behaviors and the subsequent impact on disease severity. This was an observational cross-sectional study conducted at an urban pediatric emergency department. Parents were asked to fill out a questionnaire concerning the patient's bathing habits. The results were correlated with the atopic dermatitis severity determined by the SCORAD (SCORing Atopic Dermatitis) tool. No difference between variables was found to be significant for bathing frequency, time spent bathing, or use of moisturizers. Multivariate analysis showed that atopic dermatitis severity increased with age greater than 2 years (P = .0004) and with greater bathing duration (P = .001). Atopic dermatitis severity may be associated with a longer duration of bathing. The frequency of bathing does not appear to affect atopic dermatitis severity. © The Author(s) 2015.

The Development of a Practical and Reliable Assessment Measure for Atopic Dermatitis (ADAM).

ERIC Educational Resources Information Center

Charman, Denise; Varigos, George; Horne, David J. de L.; Oberklaid, Frank

1999-01-01

A study was conducted in Australia to develop a reliable, valid, and practical measure of atopic dermatitis. The test development process and validity evaluation with two doctors and 51 patients are discussed. Results suggest that operational definitions of the scales need to be defined more clearly. The measure satisfies assumptions for a partial…

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

PubMed

Böhme, Maria; Lannerö, Eva; Wickman, Magnus; Nordvall, S Lennart; Wahlgren, Carl-Fredrik

2002-01-01

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

Developing drugs for treatment of atopic dermatitis in children (≥3 months to <18 years of age): Draft guidance for industry.

PubMed

Siegfried, Elaine C; Jaworski, Jennifer C; Eichenfield, Lawrence F; Paller, Amy; Hebert, Adelaide A; Simpson, Eric L; Altman, Emily; Arena, Charles; Blauvelt, Andrew; Block, Julie; Boguniewicz, Mark; Chen, Suephy; Cordoro, Kelly; Hanna, Diane; Horii, Kimberly; Hultsch, Thomas; Lee, James; Leung, Donald Y; Lio, Peter; Milner, Joshua; Omachi, Theodore; Schneider, Christine; Schneider, Lynda; Sidbury, Robert; Smith, Timothy; Sugarman, Jeffrey; Taha, Sharif; Tofte, Susan; Tollefson, Megha; Tom, Wynnis L; West, Dennis P; Whitney, Lucinda; Zane, Lee

2018-05-01

Atopic dermatitis is the most common chronic skin disease, and it primarily affects children. Although atopic dermatitis (AD) has the highest effect on burden of skin disease, no high-level studies have defined optimal therapy for severe disease. Corticosteroids have been used to treat AD since the 1950s and remain the only systemic medication with Food and Drug Administration approval for this indication in children, despite published guidelines of care that recommend against this option. Several clinical trials with level 1 evidence have supported the use of topical treatments for mild to moderate atopic dermatitis in adults and children, but these trials have had little consistency in protocol design. Consensus recommendations will help standardize clinical development and trial design for children. The Food and Drug Administration issues guidance documents for industry as a source for "the Agency's current thinking on a particular subject." Although they are nonbinding, industry considers these documents to be the standard for clinical development and trial design. Our consensus group is the first to specifically address clinical trial design in this population. We developed a draft guidance document for industry, Developing Drugs for Treatment of Atopic Dermatitis in Children (≥3 months to <18 years of age). This draft guidance has been submitted to the Food and Drug Administration based on a provision in the Federal Register (Good Guidance Practices). © 2018 Wiley Periodicals, Inc.

Developing the Second Generation of Improvised Explosive Device Detector Dog

DTIC Science & Technology

2013-04-15

improvement, we obtained a consult from Dr. Thierry Olivry, a veterinary dermatologist, who recommended further treatment for bacterial dermatitis ...cefovecin (Convenia) long-acting injectable, 8 mg/kg for two doses, plus medicated baths) but also suggested possibility of atopic dermatitis . After...presumptive diagnosis of atopic dermatitis , we started a novel protein diet trial in April (Iams kangaroo/potato), and most clinical signs were resolved

Food Allergy and Atopic Dermatitis: Fellow Travelers or Triggers?

PubMed

Tom, Wynnis L

2016-03-01

Many children with atopic dermatitis also have an allergy to one or more foods, but the presence of these two conditions in an individual does not necessarily indicate a causal link between them. Testing and interpretation, sometimes with specialist consultation, may be required to discern whether food allergy is present in a child with atopic dermatitis and-if it is present-whether the food is triggering or exacerbating signs and symptoms of atopic dermatitis. Recent milestone trials have demonstrated that early introduction of peanuts can reduce the development of peanut allergy in at-risk children. Parents may benefit from education about current revised guidelines that now recommend offering peanut-containing foods to most children at the time he or she is ready for solid food. Semin Cutan Med Surg 36(supp4):S95-S97. 2017 published by Frontline Medical Communications.

Longitudinal Evaluation of the Skin Microbiome and Association with Microenvironment and Treatment in Canine Atopic Dermatitis.

PubMed

Bradley, Charles W; Morris, Daniel O; Rankin, Shelley C; Cain, Christine L; Misic, Ana M; Houser, Timothy; Mauldin, Elizabeth A; Grice, Elizabeth A

2016-06-01

Host-microbe interactions may play a fundamental role in the pathogenesis of atopic dermatitis, a chronic relapsing inflammatory skin disorder characterized by universal colonization with Staphylococcus species. To examine the relationship between epidermal barrier function and the cutaneous microbiota in atopic dermatitis, this study used a spontaneous model of canine atopic dermatitis. In a cohort of 14 dogs with canine atopic dermatitis, the skin microbiota were longitudinally evaluated with parallel assessment of skin barrier function at disease flare, during antimicrobial therapy, and post-therapy. Sequencing of the bacterial 16S ribosomal RNA gene showed decreased bacterial diversity and increased proportions of Staphylococcus (S. pseudintermedius in particular) and Corynebacterium species compared with a cohort of healthy control dogs (n = 16). Treatment restored bacterial diversity with decreased proportions of Staphylococcus species, concurrent with decreased canine atopic dermatitis severity. Skin barrier function, as measured by corneometry, pH, and transepidermal water loss also normalized with treatment. Bacterial diversity correlated with transepidermal water loss and pH level but not with corneometry results. These findings provide insights into the relationship between the cutaneous microbiome and skin barrier function in atopic dermatitis, show the impact of antimicrobial therapy on the skin microbiome, and highlight the utility of canine atopic dermatitis as a spontaneous nonrodent model of atopic dermatitis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Analysis of Food Allergy in Atopic Dermatitis Patients – Association with Concomitant Allergic Diseases

PubMed Central

Čelakovská, Jarmila; Bukač, Josef

2014-01-01

Background: A few reports demonstrate the comorbidity of food allergy and allergic march in adult patients. Aims and Objectives: To evaluate, if there is some relation in atopic dermatitis patients at the age 14 years and older who suffer from food allergy to common food allergens to other allergic diseases and parameters as bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. Materials and Methods: Complete dermatological and allergological examination was performed; these parameters were examined: food allergy (to wheat flour, cow milk, egg, peanuts and soy), the occurrence of bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. The statistical evaluation of the relations among individual parameters monitored was performed. Results: Food allergy was altogether confirmed in 65 patients (29%) and these patients suffer significantly more often from bronchial asthma and allergic rhinitis. Persistent atopic dermatitis lesions and positive data in family history about atopy are recorded significantly more often in patients with confirmed food allergy to examined foods as well. On the other hand, the onset of atopic dermatitis under 5 year of age is not recorded significantly more often in patients suffering from allergy to examined foods. Conclusion: Atopic dermatitis patients suffering from food allergy suffer significantly more often from allergic rhinitis, bronchial asthma, persistent eczematous lesions and have positive data about atopy in their family history. PMID:25284847

[A guide for education programs in atopic dermatitis].

PubMed

Barbarot, S; Gagnayre, R; Bernier, C; Chavigny, J-M; Chiaverini, C; Lacour, J-P; Dupre-Goetghebeur, D; Misery, L; Piram, M; Cuny, J-F; Dega, H; Stalder, J-F

2007-02-01

Education about therapy applies to many chronic diseases. The aim is to improve patient management through the development of certain skills by patients themselves. Atopic dermatitis is an area amenable to the development of therapeutic education. The purpose of this study was to define the skills required for management of atopic dermatitis suitable for therapeutic education and to bring together these skills in a handbook suitable for use. Thirty caregivers were involved in the drafting of the handbook (dermatologists, a doctor specialising in therapeutic education, a psychologist and nurses), each of whom has experience of therapeutic education in atopic dermatitis. Four age groups were selected (under 5 years, 6 to 10 years, pre-teens/adults, parents of children aged under 5 years). For each age group, different levels of skill were identified for patients or parents of children and suitable learning methods were selected. Skills were classed according to 3 levels: (i) knowledge about the disease, treatments, triggering factors, (ii) knowledge about provision of care by patients or their parents, (iii) knowledge in terms of explaining the disease and treatment methods to family, and knowing who to contact and when. Finally, a 10-question evaluation guide was drawn up. In this paper we report the method of production and content of the handbook of skills for atopic dermatitis patients. The aim is not to impose all skills listed in this work on patients but rather to provide caregivers with a complete handbook covering therapeutic education. The book is intended for patients with moderate to severe forms of atopic dermatitis currently in therapeutic failure. It may be used by anyone treating such patients, whether doctors, nurses or psychologists, depending on the items chosen. It is intended for use as a support for the elaboration, diffusion and evaluation of a therapeutic education programme for atopic dermatitis.

Dysbiosis and Staphylococcus aureus colonization drives inflammation in atopic dermatitis

PubMed Central

Kobayashi, Tetsuro; Glatz, Martin; Horiuchi, Keisuke; Kawasaki, Hiroshi; Akiyama, Haruhiko; Kaplan, Daniel H.; Kong, Heidi H.; Amagai, Masayuki; Nagao, Keisuke

2015-01-01

Summary Staphylococcus aureus skin colonization is universal in atopic dermatitis and common in cancer patients treated with epidermal growth factor receptor inhibitors. However, the causal relationship of dysbiosis and eczema has yet to be clarified. Herein, we demonstrate that Adam17fl/flSox9-Cre mice, generated to model ADAM17-deficiency in human, developed eczematous dermatitis with naturally occurring dysbiosis, similar to that observed in atopic dermatitis. Corynebacterium mastitidis, S. aureus, and Corynebacterium bovis sequentially emerged during the onset of eczematous dermatitis, and antibiotic specific for these bacterial species almost completely reversed dysbiosis and eliminated skin inflammation. Whereas S. aureus prominently drove eczema formation, C. bovis induced robust T helper 2 cell responses. Langerhans cells were required for eliciting immune responses against S. aureus inoculation. These results characterize differential contributions of dysbiotic flora during eczema formation, and highlight the microbiota-host immunity axis as a possible target for future therapeutics in eczematous dermatitis. PMID:25902485

Allergic Skin Conditions

MedlinePlus

... most common types are atopic dermatitis (often called eczema) and contact dermatitis. Atopic Dermatitis (Eczema) Eczema is a chronic ... contact with your skin, they may cause a rash called contact dermatitis. There are two kinds of contact dermatitis: ...

Development of a pharmacokinetic/pharmacodynamic/disease progression model in NC/Nga mice for development of novel anti-atopic dermatitis drugs.

PubMed

Baek, In-Hwan; Lee, Byung-Yo; Chae, Jung-Woo; Song, Gyu Yong; Kang, Wonku; Kwon, Kwang-Il

2014-11-01

1. JHL45, a novel immune modulator against atopic dermatitis (AD), was synthesized from decursin isolated from Angelica gigas. The goal is to evaluate the lead compound using quantitative modeling approaches to novel anti-AD drug development. 2. We tested the anti-inflammatory effect of JHL45 by in vitro screening, characterized its in vitro pharmacokinetic (PK) properties. The dose-dependent efficacy of JHL45 was developed using a pharmacokinetics/pharmacodynamics/disease progression (PK/PD/DIS) model in NC/Nga mice. 3. JHL45 has drug-like properties and pharmacological effects when administered orally to treat atopic dermatitis. The developed PK/PD/DIS model described well the rapid metabolism of JHL45, double-peak phenomenon in the PK of decursinol and inhibition of IgE generation by compounds in NC/Nga mice. Also, a quantitative model was developed and used to elucidate the complex interactions between serum IgE concentration and atopic dermatitis symptoms. 4. Our findings indicate that JHL45 has good physicochemical properties and powerful pharmacological effects when administered orally for treatment of AD in rodents.

Diet and Dermatitis: Food Triggers

PubMed Central

Schlichte, Megan

2014-01-01

Given increasing awareness of the link between diet and health, many patients are concerned that dietary factors may trigger dermatitis. Research has found that dietary factors can indeed exacerbate atopic dermatitis or cause dermatitis due to systemic contact dermatitis. In atopic dermatitis, dietary factors are more likely to cause an exacerbation among infants or children with moderate-to-severe atopic dermatitis relative to other populations. Foods may trigger rapid, immunoglobulin E-mediated hypersensitivity reactions or may lead to late eczematous reactions. While immediate reactions occur within minutes to hours of food exposure, late eczematous reactions may occur anywhere from hours to two days later. Screening methods, such as food allergen-specific serum immunoglobulin E tests or skin prick tests, can identify sensitization to specific foods, but a diagnosis of food allergy requires specific signs and symptoms that occur reproducibly upon food exposure. Many patients who are sensitized will not develop clinical findings upon food exposure; therefore, these tests may result in false-positive tests for food allergy. This is why the gold standard for diagnosis remains the double-blind, placebo-controlled food challenge. In another condition, systemic contact dermatitis, ingestion of a specific food can actually cause dermatitis. Systemic contact dermatitis is a distinct T-cell mediated immunological reaction in which dietary exposure to specific allergens results in dermatitis. Balsam of Peru and nickel are well-known causes of systemic contact dermatitis, and reports have implicated multiple other allergens. This review seeks to increase awareness of important food allergens, elucidate their relationship with atopic dermatitis and systemic contact dermatitis, and review available diagnostic and treatment strategies. PMID:24688624

T-cell receptor excision circles (TREC) in CD4+ and CD8+ T-cell subpopulations in atopic dermatitis and psoriasis show major differences in the emission of recent thymic emigrants.

PubMed

Just, Helle L; Deleuran, Mette; Vestergaard, Christian; Deleuran, Bent; Thestrup-Pedersen, Kristian

2008-01-01

We used T-cell receptor excision circles (TREC) to evaluate thymic function in adult patients with atopic dermatitis and psoriasis. We observed that men, but not women, with atopic dermatitis had a significantly faster decline in TREC content with increasing age compared with healthy men. In contrast, both men and women with psoriasis had significantly reduced TREC levels, which were, on average, only 30% of that of healthy persons. In atopic dermatitis the levels of TREC declined with increasing levels of IgE, disease intensity and extent of eczema. Furthermore, patients with atopic dermatitis showed signs of altered thymus function, as they had a significantly greater variation in TREC content measured over time than healthy controls, especially within the CD8+ T-cell subpopulation. Because both atopic dermatitis and psoriasis patients have an increased number of T-cells, this indicates that atopic dermatitis patients can have compensatory emissions of thymic emigrants, whereas psoriatic patients do not, thus supporting different thymic function in these two diseases.

Eosinophil cationic protein in human milk is associated with development of cow's milk allergy and atopic eczema in breast-fed infants.

PubMed

Osterlund, Pamela; Smedberg, Tanja; Hakulinen, Arja; Heikkilä, Hannele; Järvinen, Kirsi-Marjut

2004-02-01

The precise role of leukocytes and mediators in human milk is still unresolved. Eosinophils are uncommonly detected in human milk and their presence has previously been associated with maternal atopy and development of cow's milk allergy (CMA) in the breast-fed infant. The purpose of this study was to examine the levels of eosinophil cationic protein (ECP) in human milk and to compare the levels with development of allergic diseases in breast-fed infants. Altogether 94 breast-feeding mothers (58 atopic, 36 nonatopic) with their babies were prospectively followed from birth for development of CMA or atopic dermatitis. Colostrum and mature milk samples (at 3 mo of lactation), together with mother's peripheral blood samples, were collected. Milk and blood leukocyte content was evaluated with a light microscope. ECP concentration in human milk was measured by commercial UniCAP method. By the end of a 2-y follow-up, 51 mothers had an infant with CMA, 24 had an infant with atopic dermatitis, and 19 had a healthy infant. ECP concentration in milk was under the detection limit (2 microg/L) in all the mothers with a healthy infant, whereas detectable levels were found in 27% of mothers with a CMA infant and in 42% of those with a baby with atopic dermatitis. Measurable ECP in milk was detected in 26% of the atopic and 25% of the nonatopic mothers. Presence of ECP in human milk is associated with development of CMA and atopic dermatitis in the breast-fed infant, but has no direct association with the maternal atopy.

Does Stress Increase the Risk of Atopic Dermatitis in Adolescents? Results of the Korea Youth Risk Behavior Web-Based Survey (KYRBWS-VI)

PubMed Central

Kwon, Jeoung A.; Park, Eun-Cheol; Lee, Minjee; Yoo, Ki-Bong; Park, Sohee

2013-01-01

This study investigated the relationship between level of stress in middle and high school students aged 12–18 and risk of atopic dermatitis. Data from the Sixth Korea Youth Risk Behavior Web-based Survey (KYRBWS-VI), a cross-sectional study among 74,980 students in 800 middle schools and high schools with a response rate of 97.7%, were analyzed. Ordinal logistic regression analyses were conducted to determine the relationship between stress and atopic dermatitis with severity. A total of 5,550 boys and 6,964 girls reported having been diagnosed with atopic dermatitis. Younger students were more likely to have atopic dermatitis. Interestingly, the educational level of parents was found to be associated with having atopic dermatitis and having more severe condition. In particular, girls with mothers with at least college education had a 41% higher risk of having atopic dermatitis and severe atopic condition (odds ratio (OR)) = 1.41, 95% CI, 1.22–1.63; P<0.0001) compared with those with mothers who had attended middle school at most. Similar trend was shown among both boys and girls for their father's education level. The stress level was found to be significantly associated with the risk of atopic dermatitis. Compared to boys with who reported “no stress”, boys with “very high” stress had 46% higher the risk of having more severe atopic dermatitis (OR = 1.46, 95% CI, 1.20–1.78; P<0.0001), 44% higher (OR = 1.44, 95% CI, 1.19–1.73; P<0.0001) with “high” stress, and 21% higher (OR = 1.21, 95% CI, 1.00–1.45; P = 0.05) with “moderate” stress. In contrast, we found no statistically significant relationship between stress and atopic dermatitis in girls. This study suggests that stress and parents' education level were associated with atopic dermatitis. Specifically, degree of stress is positively correlated with likelihood of being diagnosed with this condition and increasing the severity. PMID:23940513

Effect of environmental tobacco smoke on atopic dermatitis among children in Korea.

PubMed

Yi, Okhee; Kwon, Ho-Jang; Kim, Ho; Ha, Mina; Hong, Soo-Jong; Hong, Yun-Chul; Leem, Jong-Han; Sakong, Joon; Lee, Chul Gab; Kim, Su-Young; Kang, Dongmug

2012-02-01

The prevalence of atopic dermatitis is increasing in many countries. Several factors are known to be associated with childhood atopic dermatitis. Environmental tobacco smoke (ETS) is one of the most common indoor pollutants, and children are more vulnerable to ETS exposure than adults are. In this study, the possible association of ETS with atopic dermatitis was evaluated in 7030 individuals aged 6-13 years who participated in the Children's Health and Environment Research study. In addition, predictive factors, such as the allergic history of the parents, children's immunoglobulin E levels and children's history of rhinitis and its association with dermatitis, were assessed. After adjustment for possible confounding variables, atopic dermatitis was found to be highly correlated with ETS, especially among children whose mothers had smoked during pregnancy and/or in the first year after birth (OR=2.06, 95% CI: 1.01-4.22). In conclusion, our results show that childhood exposure to ETS is a major risk factor for atopic dermatitis. Copyright © 2012 Elsevier Inc. All rights reserved.

The Role of Malassezia spp. in Atopic Dermatitis

PubMed Central

Glatz, Martin; Bosshard, Philipp P.; Hoetzenecker, Wolfram; Schmid-Grendelmeier, Peter

2015-01-01

Malassezia spp. is a genus of lipophilic yeasts and comprises the most common fungi on healthy human skin. Despite its role as a commensal on healthy human skin, Malassezia spp. is attributed a pathogenic role in atopic dermatitis. The mechanisms by which Malassezia spp. may contribute to the pathogenesis of atopic dermatitis are not fully understood. Here, we review the latest findings on the pathogenetic role of Malassezia spp. in atopic dermatitis (AD). For example, Malassezia spp. produces a variety of immunogenic proteins that elicit the production of specific IgE antibodies and may induce the release of pro-inflammatory cytokines. In addition, Malassezia spp. induces auto-reactive T cells that cross-react between fungal proteins and their human counterparts. These mechanisms contribute to skin inflammation in atopic dermatitis and therefore influence the course of this disorder. Finally, we discuss the possible benefit of an anti-Malassezia spp. treatment in patients with atopic dermatitis. PMID:26239555

Treatment of Atopic Dermatitis From the Perspective of Traditional Persian Medicine

PubMed Central

Choopani, Rasool; Mehrbani, Mehrzad; Fekri, Alireza; Mehrabani, Mitra

2015-01-01

There is a strong current trend for using complementary and alternative medications to treat atopic dermatitis. Atopic dermatitis is a common, chronic, pruritic, and inflammatory skin disease. It can have a profound, negative effect on patients’ quality of life. Mild cases of atopic dermatitis can be controlled by the application of moisturizers and topical corticosteroids. However, in severe cases, application of immunosuppressive medication is unavoidable but it can have adverse effects. In traditional Persian medicine, diseases similar to resistant atopic dermatitis are treated with whey in combination with decoction of field dodder. Both whey and field dodder have anti-inflammatory properties. Consumption of whey can also aid skin repair, mitigate pruritus, and help combat the high level of stress experienced by patients. Therefore, it is hypothesized that consumption of traditional medicinal treatment of whey with decoction of field dodder can be applied as a complementary treatment for atopic dermatitis. PMID:26260045

Parents' reported preference scores for childhood atopic dermatitis disease states

PubMed Central

Friedman, Joëlle Y; Reed, Shelby D; Weinfurt, Kevin P; Kahler, Kristijan H; Walter, Emmanuel B; Schulman, Kevin A

2004-01-01

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. PMID:15491500

Increasing Comorbidities Suggest that Atopic Dermatitis Is a Systemic Disorder.

PubMed

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

2017-01-01

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 the International Eczema Council found a strong pattern of immune activation in peripheral blood and the propensity to both skin and systemic infections. Associations with cardiovascular, neuropsychiatric, and malignant diseases were increasingly reported, but confirmation of their link with atopic dermatitis requires longitudinal studies. Given the possibility of atopic dermatitis-related systemic immune activation, future investigations of new interventions should concurrently examine the impact on these comorbidities. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Atopic Dermatitis According to GARP: New Mechanistic Insights in Disease Pathogenesis.

PubMed

Nousbeck, Janna; Irvine, Alan D

2016-12-01

In complex disease such as atopic dermatitis, the journey from identification of strong risk loci to profound functional and mechanistic insights can take several years. Here, Manz et al. have elegantly deciphered the mechanistic pathways in the well-established 11q13.5 atopic dermatitis risk locus. Their genetic and functional insights emphasize a role for T regulatory cells in atopic dermatitis pathogenesis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

High circulating folate and vitamin B-12 concentrations in women during pregnancy are associated with increased prevalence of atopic dermatitis in their offspring.

PubMed

Kiefte-de Jong, Jessica C; Timmermans, Sarah; Jaddoe, Vincent W V; Hofman, Albert; Tiemeier, Henning; Steegers, Eric A; de Jongste, Johan C; Moll, Henriette A

2012-04-01

Recent studies suggest that in utero exposure of methyl donors influences programming of the fetal immune system in favor of development of allergic disease. The aim of this study was to assess whether the MTHFR C677T polymorphism, folic acid supplementation, and circulating folate and vitamin B-12 concentrations during pregnancy were associated with wheezing, shortness of breath, and atopic dermatitis in offspring. The study was a population-based birth cohort from fetal life until 48 mo (n = 8742). The use of folic acid supplementation during pregnancy was assessed by questionnaire. Plasma folate and serum vitamin B-12 concentrations and the MTHFR C677T polymorphism were available from blood collected in early pregnancy. Atopic dermatitis, wheezing, and shortness of breath in the offspring were assessed by parental-derived questionnaires at 12, 24, 36, and 48 mo. Maternal folate >16.2 nmol/L and vitamin B-12 >178 pmol/L were positively associated with the development of atopic dermatitis [adjusted OR: 1.18 (95% CI: 1.05-1.33) and adjusted OR: 1.30 (95% CI: 1.06-1.60) for the highest quartiles of folate and vitamin B-12 concentrations, respectively] but not with wheezing and shortness of breath. Maternal MTHFR C677T polymorphism and folic acid supplementation were not associated with wheezing, shortness of breath, and atopic dermatitis. No interactions were found by age, family history of atopy, folic acid supplementation, MTHFR C677T polymorphism, or maternal smoking (P-interaction > 0.10). High folate and vitamin B-12 levels during pregnancy are associated with increased prevalence of atopic dermatitis in the offspring. Potential risks of high folate and vitamin B-12 concentrations on allergic outcomes should be evaluated when discussing mandatory fortification programs.

Effect of Benralizumab in Atopic Dermatitis

ClinicalTrials.gov

2018-06-22

Dermatitis, Atopic; Dermatitis; Eczema; Skin Diseases; Skin Diseases, Genetic; Genetic Diseases, Inborn; Skin Diseases, Eczematous; Hypersensitivity; Hypersensitivity, Immediate; Immune System Diseases

Advances in understanding and managing atopic dermatitis

PubMed Central

Barton, Michael; Sidbury, Robert

2015-01-01

Atopic dermatitis is a chronic, pruritic skin disease characterized by an improperly functioning skin barrier and immune dysregulation. We review proposed atopic dermatitis pathomechanisms, emphasizing how these impact current perspectives on natural history, role of allergic sensitization, and future therapeutic targets. PMID:26918129

[Atopic dermatitis in children: general principles of management].

PubMed

Takeuchi, Yusuke Leo; Christen-Zaech, Stéphanie

2013-04-03

Atopic dermatitis is the most frequent dermatosis in childhood. Numerous studies underscored the central role of skin barrier alterations in the pathogenesis of the inflammatory skin lesions. The management of atopic dermatitis has to be multidimensional. It combines among others some daily local care and a sporadic topical anti-inflammatory treatment during the acute flare-ups. The objective of this article is to summarize, in light of the recent European guidelines, the general principles of management of atopic dermatitis, for the general practitioner.

A prospective study on canine atopic dermatitis and food-induced allergic dermatitis in Switzerland.

PubMed

Picco, F; Zini, E; Nett, C; Naegeli, C; Bigler, B; Rüfenacht, S; Roosje, P; Gutzwiller, M E Ricklin; Wilhelm, S; Pfister, J; Meng, E; Favrot, C

2008-06-01

Canine atopic dermatitis sensu stricto and food-induced allergic dermatitis are common canine skin conditions, which are often considered clinically undistinguishable. Several attempts have been made to describe populations of atopic dogs and determine breed predisposition but the results were often biased by the use of hospital populations as control group. The present study aims to describe a population of Swiss atopic and food-allergic dogs and to compare it with a data set representing more than 85% of all Swiss dogs. The study, which was carried out during 1 year in several practices and teaching hospital in Switzerland, describes a group of 259 allergic dogs, determines breed predisposition for atopic dermatitis and food-induced allergic dermatitis, compares the clinical signs and features of both conditions, and outlines the clinical picture of five frequently affected breeds.

Topical Therapy for Atopic Dermatitis: New and Investigational Agents.

PubMed

Stein Gold, Linda F; Eichenfield, Lawrence F

2016-03-01

Recently a new class of topical medications for mild to moderate atopic dermatitis has been introduced with US Food and Drug Administration (FDA) approval of the first new prescription medication for this condition in more than a decade. Crisaborole, the newly approved medication, has relieved pruritus in more than one-third of patients within as little as 48 hours. It also has demonstrated efficacy in patients with skin of color. Topical therapies representing other new approaches to atopic dermatitis, with novel mechanisms of action, have shown promise in clinical development. Semin Cutan Med Surg 36(supp4):S99-S102. 2017 published by Frontline Medical Communications.

Dysbiosis and Staphylococcus aureus Colonization Drives Inflammation in Atopic Dermatitis.

PubMed

Kobayashi, Tetsuro; Glatz, Martin; Horiuchi, Keisuke; Kawasaki, Hiroshi; Akiyama, Haruhiko; Kaplan, Daniel H; Kong, Heidi H; Amagai, Masayuki; Nagao, Keisuke

2015-04-21

Staphylococcus aureus skin colonization is universal in atopic dermatitis and common in cancer patients treated with epidermal growth factor receptor inhibitors. However, the causal relationship of dysbiosis and eczema has yet to be clarified. Herein, we demonstrate that Adam17(fl/fl)Sox9-(Cre) mice, generated to model ADAM17-deficiency in human, developed eczematous dermatitis with naturally occurring dysbiosis, similar to that observed in atopic dermatitis. Corynebacterium mastitidis, S. aureus, and Corynebacterium bovis sequentially emerged during the onset of eczematous dermatitis, and antibiotics specific for these bacterial species almost completely reversed dysbiosis and eliminated skin inflammation. Whereas S. aureus prominently drove eczema formation, C. bovis induced robust T helper 2 cell responses. Langerhans cells were required for eliciting immune responses against S. aureus inoculation. These results characterize differential contributions of dysbiotic flora during eczema formation, and highlight the microbiota-host immunity axis as a possible target for future therapeutics in eczematous dermatitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Health-related quality of life in adult dermatitis patients stratified by filaggrin genotype.

PubMed

Heede, Nina G; Thyssen, Jacob P; Thuesen, Betina H; Linneberg, Allan; Szecsi, Pal B; Stender, Steen; Johansen, Jeanne D

2017-03-01

Information concerning health-related quality of life (HRQoL) and comorbidities of adult dermatitis patients stratified by loss-of-function mutations in the filaggrin gene (FLG) is limited. To investigate HRQoL, skin symptoms and comorbidities in adult FLG mutation carriers. This cross-sectional study included patients diagnosed with atopic dermatitis and/or hand eczema (n = 520). Patients completed questionnaires about dermatitis, skin symptoms, HRQoL, and comorbidities, including actinic keratosis, and atopic and mental disorders. FLG mutations (R501X, 2282del4, and R2447X) were identified in 16.9% of patients, and were significantly associated not only with atopic dermatitis, but also independently with skin fissures on the fingers and heels, and self-reported actinic keratosis. Although FLG mutations were significantly associated with reduced HRQoL, as measured by use of the Dermatology Life Quality Index (DLQI), no association with self-reported anxiety or depression was identified. Notably, the highest median DLQI score, reflecting greater impairment, was reported by patients with both FLG mutations and atopic dermatitis. Overall, 19.7% of patients with both atopic dermatitis and FLG mutations reported a 'large or extremely large' impact on their lives; this represents twice the prevalence seen in patients with atopic dermatitis and wild-type FLG (9.6%). Patients with both atopic dermatitis and common FLG mutations are more frequently affected by reduced HRQoL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Altered cytokine production by dendritic cells from infants with atopic dermatitis.

PubMed

Yao, Weiguo; Chang, JiHoon; Sehra, Sarita; Travers, Jeffrey B; Chang, Cheong-Hee; Tepper, Robert S; Kaplan, Mark H

2010-12-01

Dendritic cells (DC) are potent initiators of immune responses, compared to other professional antigen-presenting cells, based on their ability to capture antigen, express high amounts of MHC and co-stimulatory molecules, and to secrete immunostimulatory cytokines. Altered functions of DC in atopic individuals have been observed, though it is not clear if this is a cause or a result of the development of allergic disease. In this report we demonstrate altered cytokine production by DC isolated from infants with atopic dermatitis but without a diagnosis of asthma, compared to infants with non-atopic dermatitis. Increased production of IL-6, IL-10 and IFNα from DC isolated from atopic infants is less apparent when DC from infants were examined 1 year later. An increase in the same cytokines was observed in neonatal mice that are genetically predisposed towards allergic inflammation. These results suggest that an atopic environment promotes altered cytokine production by DC from infants. Copyright © 2010 Elsevier Inc. All rights reserved.

Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention

PubMed Central

Simpson, Eric L.; Chalmers, Joanne R.; Hanifin, Jon M.; Thomas, Kim S.; Cork, Michael J.; McLean, W.H. Irwin; Brown, Sara J.; Chen, Zunqiu; Chen, Yiyi; Williams, Hywel C.

2014-01-01

Background Atopic dermatitis (atopic eczema) is a chronic inflammatory skin disease that has reached epidemic proportions in children worldwide and is increasing in prevalence. Because of the significant socioeconomic effect of atopic dermatitis and its effect on the quality of life of children and families, there have been decades of research focused on disease prevention, with limited success. Recent advances in cutaneous biology suggest skin barrier defects might be key initiators of atopic dermatitis and possibly allergic sensitization. Objective Our objective was to test whether skin barrier enhancement from birth represents a feasible strategy for reducing the incidence of atopic dermatitis in high-risk neonates. Methods We performed a randomized controlled trial in the United States and United Kingdom of 124 neonates at high risk for atopic dermatitis. Parents in the intervention arm were instructed to apply full-body emollient therapy at least once per day starting within 3 weeks of birth. Parents in the control arm were asked to use no emollients. The primary feasibility outcome was the percentage of families willing to be randomized. The primary clinical outcome was the cumulative incidence of atopic dermatitis at 6 months, as assessed by a trained investigator. Results Forty-two percent of eligible families agreed to be randomized into the trial. All participating families in the intervention arm found the intervention acceptable. A statistically significant protective effect was found with the use of daily emollient on the cumulative incidence of atopic dermatitis with a relative risk reduction of 50% (relative risk, 0.50; 95% CI, 0.28-0.9; P = .017). There were no emollient-related adverse events and no differences in adverse events between groups. Conclusion The results of this trial demonstrate that emollient therapy from birth represents a feasible, safe, and effective approach for atopic dermatitis prevention. If confirmed in larger trials, emollient therapy from birth would be a simple and low-cost intervention that could reduce the global burden of allergic diseases. PMID:25282563

Grades of Severity and the Validation of an Atopic Dermatitis Assessment Measure (ADAM).

ERIC Educational Resources Information Center

Charman, Denise P.; Varigos, George A.

1999-01-01

Studied the validity of the Atopic Dermatitis Assessment Measure (D. Charman and others, 1999) with 171 pediatric patients in Australia using partial credit analyses to produce clinically relevant "word pictures" of grades of severity for atopic dermatitis. Discusses implications for measurement in medicine. (SLD)

[Inpatient rehabilitation of chronic dermatoses illustrated by atopic dermatitis].

PubMed

Nürnberg, W

2005-07-01

Atopic dermatitis is defined as a chronically relapsing skin disease resulting from complex interactions between genetic and environmental factors. It usually occurs during early childhood and shows typical clinical manifestations, depending on the patient's age. In cases of chronic atopic dermatitis, negative effects on professional and social activities and participation have to be expected. To counteract or overcome these threatening impairments in the different facets of life, prescribing inpatient rehabilitative measures should be considered early. Dermatological rehabilitation according to guidelines guarantees an interdisciplinary and multimodal treatment of atopic dermatitis.

Case for diagnosis. Infective dermatitis associated with HTLV-1: differential diagnosis of atopic dermatitis.

PubMed

Oliveira, Lorena Maria Lima de; Souza, Marcos Vilela de; Guedes, Antonio Carlos Martins; Araújo, Marcelo Grossi

2017-01-01

Infective dermatitis associated with HTLV-1 (IDH) is the main cutaneous marker of HTLV-1 infection. This disease occurs primarily in children and should be differentiated from other eczemas, especially from atopic dermatitis. The largest series of IDH are from Jamaica and Brazil. There are an estimated 15 to 20 million infected people in the world, and Brazil is one of the endemic regions. Studies suggest that IDH in children may be a marker for the development of T-cell leukemia/lymphoma (ATL) or myelopathy associated with HTLV-1/tropical spastic paraparesis (HAM / TSP) in adulthood.

Classification and possible bacterial infection in outpatients with eczema and dermatitis in China

PubMed Central

Wang, Xin; Shi, Xiao-Dong; Li, Lin-Feng; Zhou, Ping; Shen, Yi-Wei

2017-01-01

Abstract Little is known about the classification and bacterial infection in outpatients with eczema and dermatitis in China. To investigate the prevalence of eczema and dermatitis in outpatients of dermatology clinics in China, examine classification and proportion of common types of dermatitis and the possible bacterial infection, and analyze the possible related factors. Outpatients with eczema or dermatitis from 39 tertiary hospitals of 15 provinces in mainland China from July 1 to September 30, 2014, were enrolled in this cross-sectional and multicenter study. Among 9393 enrolled outpatients, 636 patients (6.7%) were excluded because of incomplete information. The leading subtypes of dermatitis were unclassified eczema (35.5%), atopic dermatitis (13.4%), irritant dermatitis (9.2%), and widespread eczema (8.7%). Total bacterial infection rate was 52.3%, with widespread eczema, stasis dermatitis, and atopic dermatitis being the leading three (65.7%, 61.8%, and 61.4%, respectively). Clinically very likely bacterial infection has a significant positive correlation with disease duration, history of allergic disease, history of flexion dermatitis, and severe itching. Atopic dermatitis has become a common subtype of dermatitis in China. Secondary bacterial infection is common in all patients with dermatitis, and more attentions should be paid on this issue in other type of dermatitis apart from atopic dermatitis. PMID:28858126

Classification and possible bacterial infection in outpatients with eczema and dermatitis in China: A cross-sectional and multicenter study.

PubMed

Wang, Xin; Shi, Xiao-Dong; Li, Lin-Feng; Zhou, Ping; Shen, Yi-Wei

2017-09-01

Little is known about the classification and bacterial infection in outpatients with eczema and dermatitis in China.To investigate the prevalence of eczema and dermatitis in outpatients of dermatology clinics in China, examine classification and proportion of common types of dermatitis and the possible bacterial infection, and analyze the possible related factors.Outpatients with eczema or dermatitis from 39 tertiary hospitals of 15 provinces in mainland China from July 1 to September 30, 2014, were enrolled in this cross-sectional and multicenter study. Among 9393 enrolled outpatients, 636 patients (6.7%) were excluded because of incomplete information.The leading subtypes of dermatitis were unclassified eczema (35.5%), atopic dermatitis (13.4%), irritant dermatitis (9.2%), and widespread eczema (8.7%). Total bacterial infection rate was 52.3%, with widespread eczema, stasis dermatitis, and atopic dermatitis being the leading three (65.7%, 61.8%, and 61.4%, respectively). Clinically very likely bacterial infection has a significant positive correlation with disease duration, history of allergic disease, history of flexion dermatitis, and severe itching.Atopic dermatitis has become a common subtype of dermatitis in China. Secondary bacterial infection is common in all patients with dermatitis, and more attentions should be paid on this issue in other type of dermatitis apart from atopic dermatitis.

Prevalence and risk factors for atopic dermatitis: a cross-sectional study of 6,453 Korean preschool children.

PubMed

Choi, Won Jun; Ko, Joo Yeon; Kim, Jin Wou; Lee, Kwang Hoon; Park, Chun Wook; Kim, Kyu Han; Kim, Myeung Nam; Lee, Ai Young; Cho, Sang Hyun; Park, Young Lip; Choi, Jee Ho; Seo, Seong Jun; Lee, Yang Won; Roh, Joo Young; Park, Young Min; Kim, Dong Jae; Ro, Young Suck

2012-09-01

The aims of this study were to evaluate the prevalence, severity and risk factors for atopic dermatitis in Korean pre-school children as determined by dermatological examination vs questionnaire survey. A total of 6,453 pre-school children from 59 kindergartens and 14 day-care centres were evaluated. Parents responded to an International Study of Asthma and Allergies in Childhood (ISAAC)-based questionnaire containing questions concerning 23 risk factors, as well as the prevalence, and severity of atopic dermatitis. Fourteen dermatologists then examined the participants according to the Korean diagnostic criteria for atopic dermatitis, and the Eczema Area and Severity Index (EASI) score. Atopic dermatitis prevalence determined by dermatological examination was lower than the questionnaire-based prevalence (9.2% vs 19.1%). Most patients (96.2%) had mild atopic dermatitis according to the EASI score (mean ± SD 3.91 ± 4.73; median 1.5; range 0.2-38.0). However, 17.4% had sleep disturbance, and 56.7% had not obtained complete remission of their rash over the previous 12 months. Among the 12 risk factors, "changing the patient's house to a newly built house during the first year of life" had significant odds ratio. In conclusion, the prevalence of atopic dermatitis in Korea in the ISAAC-based survey conducted by paediatricians was similar to that in several European countries, and lower than the 2006 Korean figure (28.9%). In addition, the prevalence of atopic dermatitis was lower when assessed by dermatological examination than by questionnaire.

Synbiotics could not reduce the scoring of childhood atopic dermatitis (SCORAD): a randomized double blind placebo-controlled trial.

PubMed

Shafiei, Alireza; Moin, Mostafa; Pourpak, Zahra; Gharagozlou, Mohammad; Aghamohammadi, Asghar; Aghamohamadi, Asghar; Sajedi, Vahid; soheili, Habib; Sotoodeh, Soheila; Movahedi, Masoud

2011-03-01

Despite preliminary evidence, the role of probiotic and synbiotic in treatment of the atopic dermatitis has shown varying results. We aimed to evaluate whether synbiotic supplementation decrease severity of atopic dermatitis (AD) in childhood. In a randomized double blind-placebo controlled trial, we evaluated the synbiotic supplementation efficiency on the treatment of atopic dermatitis. Infants aged 1-36 months with moderate to severe atopic dermatitis were randomized (n=41) and received either synbiotic (probiotic plus prebiotic) (n=20) or placebo (n=21) daily as a powder for two months. Emollient (Eucerin) and topical corticosteroid (Hydrocortisone) were permitted. Children were scored for severity of atopic dermatitis (SCORAD). Also allergen Skin Prick Tests (SPT), IgE blood level and eosinophil count were measured at first visit. Patients' SCORAD were reevaluated at the end of intervention. We followed 36 out of 41 subjects for two months (drop out rate = 9%). In the whole group, the mean Total SCORAD (at base line 40.93) decreased by 56% (p=0.00). The mean Objective SCORAD (at base line 31.29) decreased by 53% (p=0.00). There was no significant difference in the mean decrease of total SCORAD between placebo (22.3) and synbiotic groups (24.2). There was also no difference between two intervention groups in the mean decrease of total SCORAD regarding to different demographic, clinical and para clinical subgroups. This study could not confirm synbiotic as an effective treatment for childhood atopic dermatitis and further studies are needed. These findings challenge the role of synbiotics in the treatment of childhood atopic dermatitis.

[Canine atopic dermatitis].

PubMed

Bensignor, Emmanuel

2010-10-01

Canine atopic dermatitis is an inflammatory skin disease characterized by typical clinical signs and affecting up to 10 % of dogs aged from 1 to 3 years. The diagnosis is mainly clinical and the treatment is complex. This canine form may offer a good model of human atopic dermatitis, as the two diseases show many pathogenetic, clinical and therapeutic similarities.

Protein Palmitoylation by ZDHHC13 Protects Skin against Microbial-Driven Dermatitis.

PubMed

Chen, Li-Ying; Yang-Yen, Hsin-Fang; Tsai, Chun-Chou; Thio, Christina Li-Ping; Chuang, Hsiao-Li; Yang, Liang-Tung; Shen, Li-Fen; Song, I-Wen; Liu, Kai-Ming; Huang, Yen-Te; Liu, Fu-Tong; Chang, Ya-Jen; Chen, Yuan-Tsong; Yen, Jeffrey J Y

2017-04-01

Atopic dermatitis is a complex chronic inflammatory skin disorder that results from intimate interactions among genetic predisposition, host environment, skin barrier defects, and immunological factors. However, a clear genetic roadmap leading to atopic dermatitis remains to be fully explored. From a genome-wide mutagenesis screen, deficiency of ZDHHC13, a palmitoylacyl transferase, has previously been associated with skin and multitissue inflammatory phenotypes. Here, we report that ZDHHC13 is required for skin barrier integrity and that deficiency of ZDHHC13 renders mice susceptible to environmental bacteria, resulting in persistent skin inflammation and an atopic dermatitis-like disease. This phenotype is ameliorated in a germ-free environment and is also attenuated by antibiotic treatment, but not by deletion of the Rag1 gene, suggesting that a microbial factor triggers inflammation rather than intrinsic adaptive immunity. Furthermore, skin from ZDHHC13-deficient mice has both elevated levels of IL-33 and type 2 innate lymphoid cells, reinforcing the role of innate immunity in the development of atopic dermatitis. In summary, our study suggests that loss of ZDHHC13 in skin impairs the integrity of multiple barrier functions and leads to a dermatitis lesion in response to microbial encounters. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

[The potential of the non-pharmacological methods for the rehabilitation and prophylaxis in the patients suffering from with atopic dermatitis].

PubMed

Kosheleva, I V; Bitkina, O A; Klivitskaya, N A; Shadyzheva, L I

This article was designed to discuss the therapeutic potential of various non-pharmacological and physiotherapeutic methods for the treatment and rehabilitation of the patients presenting with atopic dermatitis (AD) during the inter-recurrence period of the disease. The particular emphasis is placed on the physical agents most frequently used for the purpose with special reference to the combined therapy of atopic dermatitis in the adults and children and to their rehabilitation in the inter-exacerbation periods. In addition, the data on the prospects for the use of various medications intended for tissue- and organotherapy of the patients suffering from atopic dermatitis are presented. The main traditional approaches to the management of the patients with atopic dermatitis under conditions of the spa and health resort facilities are considered based on the original experience of the authors including the application of various modes of ozone therapy regarded as a physiotherapeutic procedure for the treatment of atopic dermatitis in the children and adult patients, their rehabilitation, and the prevention of exacerbations of the pathological process based on the external and/or systemic application of the ozone-oxygen gaseous mixture. The selected modalities of ozone therapy used to treat various clinical forms and stages of the atopic dermatitis differing in severity are described in detail. The data on the influence of ozone therapy on a variety of pathogenetic factors of atopic dermatitis are presented as obtained by the investigations into dynamics of the characteristics of immunity, microcirculation, and the levels of free radical metabolites. The results of the study give evidence of the high effectiveness of ozone therapy as a method of physiotherapeutic treatment both in the capacity of a component of combined therapy during the acute phase of atopic dermatitis and as the means of secondary (post-exposure) prophylaxis of the exacerbations and relapses of this condition based at the medical and preventive treatment facilities of various specialization.

Advances in pediatric asthma and atopic dermatitis.

PubMed

Foroughi, Shabnam; Thyagarajan, Ananth; Stone, Kelly D

2005-10-01

Allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, food allergy, and urticaria are common in general pediatric practice. This review highlights several significant advances in pediatric allergy over the past year, focusing on asthma and atopic dermatitis. With increasing options for the treatment of allergic diseases, much work is now focused on methods for individualizing treatments to a patient's phenotype and genotype. Progress over the past year includes the characterization of effects of regular albuterol use in patients with genetic variations in the beta-adrenergic receptor. Maintenance asthma regimens for children in the first years of life are also an ongoing focus. The relation between upper airway allergic inflammation and asthma has continued to accumulate support and now extends to the middle ear. Environmental influences on asthma and interventions have been described, including environmental controls for asthma and the role of air pollution on lung development in children. Finally, concerns have been raised regarding the use of topical immunomodulators in young children with atopic dermatitis. Progress continues in the care of children with atopic diseases. Attention to treatment with appropriate medications, patient-individualized environmental controls, and extensive education are the keys to successfully treating atopic children. This review highlights several recent advances but is not intended to be a comprehensive review.

Can atopic dermatitis be prevented?

PubMed

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.

Measurement of Health Care Quality in Atopic Dermatitis - Development and Application of a Set of Quality Indicators.

PubMed

Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M

2018-05-15

Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Prevalence of tinea pedis in psoriasis, compared to atopic dermatitis and normal controls--a prospective study.

PubMed

Leibovici, Vera; Ramot, Yuval; Siam, Rula; Siam, Ihab; Hadayer, Noa; Strauss-Liviatan, Nurith; Hochberg, Malka

2014-12-01

There are discrepancies in the literature regarding the prevalence of tinea pedis in psoriasis. The aim of this investigation was to conduct a cross-sectional study of the prevalence of tinea pedis in psoriasis compared to atopic dermatitis patients and normal controls. We enrolled 232 psoriatic patients, 190 atopic dermatitis patients and 202 normal controls, between the years 2010 and 2013. The prevalence of tinea pedis was 13.8% in psoriasis patients, not significantly different from that in atopic dermatitis patients 8.4% (P = 0.092)), but significantly higher than in normal controls 7.4% (P = 0.043). Both gender and age affected the prevalence of tinea pedis in psoriasis and normal controls, while only age affected the prevalence of tinea pedis in atopic dermatitis. Regarding gender, there was higher prevalence of tinea pedis in men: 19.1% (P = 0.019) in psoriasis and 12.1% (P = 0.013) in normal controls. Age affected the prevalence of tinea pedis in normal controls (P < 0.001), psoriasis patients (P = 0.001) and atopic dermatitis patients (P = 0.001), with higher prevalence with increasing age. Trichophyton rubrum was the most common species in psoriasis (71.9%), atopic dermatitis (75.0%) and normal controls (73.3%). Our study found a relatively high prevalence of tinea pedis among psoriasis patients. © 2014 Blackwell Verlag GmbH.

Cutaneous nocardiosis in two dogs receiving ciclosporin therapy for the management of canine atopic dermatitis.

PubMed

Siak, Meng K; Burrows, Amanda K

2013-08-01

Ciclosporin is a calcineurin inhibitor that is currently registered for the treatment of canine atopic dermatitis. The most common adverse effects include mild, transient gastrointestinal disturbances. Single case reports of opportunistic infections due to Nocardia spp., Neospora spp. and papillomaviruses have also been reported. Clinicians should be aware of the potential risk of systemic immunosuppression and subsequent infection with Nocardia spp. in dogs receiving ciclosporin. Cutaneous nocardiosis in two dogs receiving ciclosporin therapy for management of canine atopic dermatitis. Histopathology, PCR for Nocardia spp. and computed tomography. One dog developed disseminated nocardiosis due to Nocardia brasiliensis and a second dog developed localized cutaneous nocardiosis due to a novel Nocardia species subsequent to ciclosporin administration at the recommended dose rate for the management of canine atopic dermatitis. The second case was receiving a combination of ciclosporin and ketoconazole, and serum trough ciclosporin levels were elevated. Clinicians should be aware of the potential risk of systemic immunosuppression and subsequent infection with Nocardia spp. in dogs receiving ciclosporin. Measurement of serum ciclosporin levels may be useful in identifying those individuals which are at risk of opportunistic infections. © 2013 ESVD and ACVD.

Food compounds inhibit Staphylococcus aureus bacteria and the toxicity of Staphylococcus Enterotoxin A (SEA) associated with atopic dermatitis

USDA-ARS?s Scientific Manuscript database

Atopic dermatitis or eczema is characterized by skin rashes and itching is an inflammatory disease that affects 10-20% of children and 1-3% of adults. Staphylococcus aureus bacteria are present on the skin of nearly all patients with atopic dermatitis. Antibiotics that suppress colonization of S. au...

Texting atopic dermatitis patients to optimize learning and eczema area and severity index scores: A pilot randomized control trial.

PubMed

Singer, Hannah M; Levin, Laura E; Morel, Kimberly D; Garzon, Maria C; Stockwell, Melissa S; Lauren, Christine T

2018-05-02

Atopic dermatitis is a common, chronic, debilitating disease. Poor adherence to treatment is the most important preventable contributor to adverse outcomes. Thus, improving adherence can improve patient outcomes. Text message reminders with embedded condition-specific information have been shown to improve pediatric immunization adherence but have not been assessed in atopic dermatitis. The objective was to assess the effect of daily text messages on Eczema Area Severity Index scores and caregiver knowledge of atopic dermatitis. In this pilot randomized controlled trial, caregivers of children with atopic dermatitis enrolled during their initial appointment with a pediatric dermatologist and randomized 1:1 to standard care or daily text messages with patient education material and treatment reminders. Participants completed a multiple-choice atopic dermatitis knowledge quiz at initial and follow-up visits, and Eczema Area Severity Index scores were assessed. Forty-two patients enrolled, and 30 completed the study: 16 standard care group, 14 text message group. There was no significant difference in Eczema Area Severity Index score between the standard care and text message groups at follow-up, with mean decreases in Eczema Area Severity Index score of 53% and 58%, respectively. Mean score on follow-up atopic dermatitis knowledge quiz was significantly higher in the text message group (84% correct) than in the standard care group (75% correct) (P = .04). This pilot study did not demonstrate a difference in Eczema Area Severity Index scores with text message reminders. The significantly higher follow-up atopic dermatitis quiz score in the text message group indicates that participants read and retained information from text messages. Limitations include small sample size and short duration of follow-up. © 2018 Wiley Periodicals, Inc.

Evaluation of out-in skin transparency using a colorimeter and food dye in patients with atopic dermatitis.

PubMed

Mochizuki, H; Tadaki, H; Takami, S; Muramatsu, R; Hagiwara, S; Mizuno, T; Arakawa, H

2009-05-01

Atopic dermatitis is a disease of skin barrier dysfunction and outside stimuli can cross the skin barrier. To examine a new method for evaluating the outside to inside skin transparency with a colorimeter and yellow dyes. In study 1, a total of 28 volunteer subjects (24 normal and four with atopic dermatitis) participated. After provocation with yellow dye, the skin colour of all the subjects was measured using a colorimeter. The skin transparency index was calculated by the changes of the skin colour to yellow. Other variables of skin function, including transepidermal water loss (TEWL) and stratum corneum hydration, were also measured. In study 2, the skin transparency index was evaluated for a cohort of 38 patients with atopic dermatitis, 27 subjects with dry skin and 29 healthy controls. In study 1, the measurement of skin colour (b*) using tartrazine showed good results. There was a significant relationship between the skin transparency index with tartrazine and the atopic dermatitis score (P = 0.014). No other measurements of skin function, including the TEWL, were correlated. In study 2, the skin transparency index score obtained with tartrazine in the patients with atopic dermatitis was significantly higher than that of the controls and those with dry skin (P < 0.001 and P = 0.022, respectively). However, the TEWL in patients with atopic dermatitis was not significantly higher than that of patients with dry skin and the TEWL in subjects with dry skin was not higher than that of the controls. This method, which used a colorimeter and food dye, is noninvasive, safe and reliable for the evaluation of out-in skin transparency and can demonstrate the characteristic dysfunction in the skin barrier in patients with atopic dermatitis.

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

PubMed Central

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

2012-01-01

Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

Polysensitization and individual susceptibility to allergic contact dermatitis.

PubMed

Gosnell, Amy L; Schmotzer, Brian; Nedorost, Susan T

2015-01-01

Patients with allergic contact dermatitis to 1 antigen have been shown to be at increased risk of developing delayed type hypersensitivity reactions to additional antigens. Both environmental and genetic factors likely influence the risk of sensitization. The aim of this study was to determine whether polysensitization occurs at a higher frequency than would be expected based on chance and whether polysensitization occurs more often in subsets of patients with hand involvement and atopic dermatitis. From a database of patch test results from a single practitioner, the probability of having positive reactions to 3 or more unrelated allergens was calculated under the assumption that positive reactions are independent and compared with the observed proportion having positive reactions to 3 or more unrelated allergens. The analysis was repeated excluding patients with leg involvement as a proxy for venous insufficiency dermatitis. The proportion of patients from the polysensitized and nonpolysensitized cohorts with either hand involvement or a history of atopic dermatitis was also calculated. Polysensitization occurs more often than expected based on chance. Polysensitized patients were more likely to have hand dermatitis. Atopic dermatitis was not significantly associated with polysensitization in this analysis. Polysensitized individuals may represent a phenotype with increased genetic susceptibility to sensitization.

Effect of administrating polysaccharide from black currant (Ribes nigrum L.) on atopic dermatitis in NC/Nga mice.

PubMed

Ashigai, Hiroshi; Komano, Yuta; Wang, Guanying; Kawachi, Yasuji; Sunaga, Kazuko; Yamamoto, Reiko; Takata, Ryoji; Miyake, Mika; Yanai, Takaaki

2018-01-01

Atopic dermatitis (AD) is a chronic inflammatory skin disease that causes dry skin and functional disruption of the skin barrier. AD is often accompanied by allergic inflammation. AD patient suffer from heavy itching, and their quality of life is severely affected. Some pharmaceuticals for AD have some side effects such as skin atrophy. So it is necessary to develop mild solutions such as food ingredients without side effects. There are various causes of AD. It is especially induced by immunological imbalances such as IFN-γ reduction. IFN-γ has an important role in regulating IgE, which can cause an allergy reaction. NC/Nga mice develop AD and IgE hyperproduction. In a previous study, we revealed that administration of polysaccharide from black currant ( R. nigrum ) has an effect on immunomodulation. It induces IFN-γ production from myeloid dendritic cells. We named this polysaccharide cassis polysaccharide (CAPS). In this report, we studied the effect of administering CAPS on atopic dermatitis in NC/Nga mice. Thirty NC/Nga mice that developed symptoms of atopic dermatitis were used. We divided them into three groups (control, CAPS administration 12 mg/kg/day, CAPS administration 60 mg/kg/day). For 4 weeks, we evaluated clinical score, serum IgE levels, gene expression of spleen, and skin pathology. We revealed that CAPS administration improves atopic dermatitis symptoms. We also found that CAPS administration suppresses IgE hyperproduction and induces IFN-γ gene transcription in the spleen. Finally, we confirmed that CAPS administration suppresses mast cell migration to epidermal skin. These results indicated that CAPS has an effect on AD.

New and developing therapies for atopic dermatitis*

PubMed Central

Hajar, Tamar; Gontijo, João Renato Vianna; Hanifin, Jon M

2018-01-01

Atopic dermatitis is a common inflammatory skin disease. New understanding in disease pathogenesis has led to a considerable number of promising new drugs in development. New topical agents can be especially helpful for children, providing an alternative to the need for chronic topical corticosteroid use. While many patients with mild or moderate disease can be managed with topical treatments, there are unmet needs for recalcitrant and severe cases. New and developing therapies hold promise for real advances in management of this complex disease. PMID:29641707

Addressing the immunopathogenesis of atopic dermatitis: advances in topical and systemic treatment.

PubMed

Eichenfield, Lawrence F; Stein Gold, Linda F

2017-03-01

Several immunologic mediators-phosphodiesterase (PDE), interleukin (IL), small molecules, and Janus kinase-have been implicated in the pathogenesis of atopic dermatitis, and evidence has shown that blocking these mediators can help modify the disease process. Several new topical medications have been developed that target the enzyme PDE; crisaborole was recently approved by the US Food and Drug Administration (FDA) for the treatment of atopic dermatitis, and phase II studies have been completed on OPA-15406. The phase III clinical trial results of the systemic medication dupilumab, an inhibitor of the IL-4 receptor α subunit (which inhibits both IL-4 and IL-13 signaling), are currently being reviewed by the FDA. ©2017 Frontline Medical Communications.

The effect of a Web-based education programme (WBEP) on disease severity, quality of life and mothers' self-efficacy in children with atopic dermatitis.

PubMed

Son, Hae Kyoung; Lim, Jiyoung

2014-10-01

To develop and evaluate the effects of a web-based education programme in early childhood for children with atopic dermatitis. The prevalence rate of atopic dermatitis is highest in early childhood. A holistic approach is urgently needed for young children with respect to disease severity, quality of life and management, particularly parental knowledge about atopic dermatitis and adherence to treatment. A quasi-experimental study design was used. A total of 40 mother-child dyads participated in the study from 1 July-30 November 2011 in Korea. All children were under 3 years of age. The programme was based on the Network-Based Instructional System Design model, which consists of five phases: analysis, design, development, implementation and evaluation. The experimental group participated in the programme for 2 weeks. Participants took part in a learning session during the first week and then conducted the practice session at home during the second week. Participant knowledge and compliance were evaluated through online quizzes and self-checklists. Statistical analyses (chi-square test and t-test) were performed using the Statistical Analysis System, Version 9.13. There was a significant improvement in disease severity, quality of life and mothers' self-efficacy in the experimental group; thus, the web-based education programme was effective. The web-based education programme as an advanced intervention may be useful in providing basic data for future atopic dermatitis-related studies. Moreover, the programme may serve as a nursing educational intervention tool for clinical nursing practices. © 2014 John Wiley & Sons Ltd.

Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis.

PubMed

Song, Sanghwan; Lee, Kiyoung; Lee, Young-Mi; Lee, Jung-Hyun; Lee, Sang Il; Yu, Seung-Do; Paek, Domyung

2011-04-01

Although ambient particulate pollutants have been shown to exacerbate existing allergic symptoms of mucous membranes including rhinitis and asthma, the effects on skin such as atopic dermatitis in childhood deserve further study. We investigated the effects of urban particulate pollutants including ultrafine particles on atopic severity in children with atopic dermatitis. We included 41 schoolchildren, 8-12 years old, who had been diagnosed with atopic dermatitis. For 67 consecutive days, all of them measured their symptoms in a diary. To assess exposure, the daily ambient mass concentrations of particulate matter less than 10, 2.5 and 1 μm (PM(10), PM(2.5) and PM(1), respectively) and concentrations of submicron particles (0.01- 1 μm) were measured at a local school. The mean mass concentrations of PM(10), PM(2.5) and PM(1) were 74.0, 57.8 and 50.8 μg/m(3), respectively. The mean concentrations were 41,335/cm(3) ultrafine particles (UFPs) and 8577/cm(3) accumulation mode (0.1-1 μm) particles. Significant associations were found between the concentrations of ultrafine particles and the itchiness symptom in children with atopic dermatitis. An interquartile range (IQR) increase in previous day ultrafine particles concentration (IQR: 28-140/m(3)) was significantly associated with a 3.1% (95% confidence interval, 0.2-6.1) increase in the itch symptom score for children with atopic dermatitis. The results suggested that the concentration of ambient ultrafine particles may exacerbate skin symptoms in children with atopic dermatitis. Copyright © 2011. Published by Elsevier Inc.

Japanese Guideline for Atopic Dermatitis 2014.

PubMed

Katayama, Ichiro; Kohno, Yoichi; Akiyama, Kazuo; Aihara, Michiko; Kondo, Naomi; Saeki, Hidehisa; Shoji, Shunsuke; Yamada, Hidekazu; Nakamura, Koichiro

2014-09-01

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 a 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 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.

Patch-test reaction patterns in patients with a predisposition to atopic dermatitis.

PubMed

Brasch, Jochen; Schnuch, Axel; Uter, Wolfgang

2003-10-01

Patients with a predisposition to atopic dermatitis often need to be patch tested in order to detect possible contact sensitization. However, it is unknown whether immunologic or other peculiarities of atopic skin are related to altered patch-test reaction patterns. Our study was aimed at answering this question, because patch-test reaction patterns are of considerable practical importance in the reading and interpretation of patch tests. Therefore, we compared patterns of patch-test reactions in patients with a predisposition to atopic dermatitis and in control patients matched for sex, age, reason for testing and test centre. Patch-test results from 9 centres (2322 patients with a disposition to atopic dermatitis and 2126 matched controls) were evaluated retrospectively. All patients were tested with nickel sulfate, fragrance mix, potassium dichromate, lanolin alcohol, formaldehyde and mercury ammonium chloride. Patch tests applied for 1 day with readings on days 1, 2 and 3 were evaluated in order to cover the early phase of the reactions. Not unexpectedly, we found that, compared to the matched controls, patients with a predisposition to atopic dermatitis tended to have more doubtful and irritant reactions on day 1. As a new observation, it turned out that they had less reactions of crescendo pattern and more strong reactions on day 3. All these differences were slight/insignificant. A higher skin irritability in patients with a predisposition to atopic dermatitis is a likely explanation. In conclusion, standard methods for patch testing can be applied in patients with a predisposition to atopic dermatitis, but minor differences in reaction patterns should be considered.

Human Atopic Dermatitis Complicated by Eczema Herpeticum is Associated with Abnormalities in Gamma Interferon Response

PubMed Central

Leung, Donald YM; Gao, Pei-Song; Grigoryev, Dmitry N; Rafaels, Nicholas M; Streib, Joanne E; Howell, Michael D; Taylor, Patricia A; Boguniewicz, Mark; Canniff, Jennifer; Armstrong, Brian; Zaccaro, Daniel J; Schneider, Lynda C; Hata, Tissa R; Hanifin, Jon M; Beck, Lisa A; Weinberg, Adriana; Barnes, Kathleen C

2011-01-01

Background The basis for increased susceptibility of atopic dermatitis (AD) patients to develop disseminated viral skin infections such as eczema herpeticum (ADEH+) is poorly understood. Objective We sought to determine whether atopic dermatitis subjects prone to disseminated viral skin infections have defects in their interferon responses. Methods GeneChip profiling was used to identify differences in gene expression of peripheral blood mononuclear cells (PBMC) from patients with a history of ADEH+ as compared to ADEH− and non-atopic controls. Key differences in protein expression were verified by ELISPOT and/or ELISA. Clinical relevance was further demonstrated by a mouse model of disseminated viral skin infection and genetic association analysis for genetic variants in IFNG and IFNGR1 and ADEH among 435 cases and controls. Results We demonstrate by global gene expression analysis selective transcriptomic changes within the interferon (IFN) superfamily of PBMCs from ADEH+ subjects reflecting low IFNγ and IFNγ receptor gene expression. IFNγ protein production was also significantly lower in ADEH+ (N=24) compared to ADEH− (N=20) and non-atopic (NA; N=20) controls. IFNγ receptor knockout (KO) mice developed disseminated viral skin infection after epicutaneous challenge with vaccinia virus (VV). Genetic variants in IFNG and IFNGR1 SNPs were significantly associated with ADEH (112 cases, 166 controls) and IFNγ production: a 2-SNP (A–G) IFNGR1 haplotype (rs10457655 and rs7749390) showed the strongest association with a reduced risk of ADEH+ ((13.2% ADEH+ vs 25.5% ADEH−, P = 0.00057). Conclusions ADEH+ patients have reduced IFNγ production, and IFNG and IFNGR1 SNPs are significantly associated with ADEH+ and may contribute to an impaired immune response to herpes simplex virus (HSV). Clinical Implications Atopic dermatitis subjects prone to disseminated viral skin infections have defects in their interferon responses. Capsule summary Using genomic, immunologic and genetic approaches, these investigators demonstrated that atopic dermatitis subjects prone to disseminated viral skin infections have defects in their interferon responses. PMID:21458658

Prevalence of Suicidal Ideation in Patients with Atopic Dermatitis

ERIC Educational Resources Information Center

Kimata, Hajime

2006-01-01

The prevalence of suicidal ideation in patients with mild, moderate, and severe atopic dermatitis between the age of 15 to 49 years were 0.21%, 6%, and 19.6%, respectively. In addition, the prevalence of homicide-suicidal ideation in mothers or fathers of patients (aged 0-14 years) with mild, moderate, and severe atopic dermatitis were 0.11%,…

Atopic dermatitis: professional orientation.

PubMed

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.

A retrospective review of streptococcal infections in pediatric atopic dermatitis.

PubMed

Sugarman, Jeffrey L; Hersh, Adam L; Okamura, Tessie; Howard, Renee; Frieden, Ilona J

2011-01-01

In order to assess the clinical characteristics and impact of group A streptococcal infection in children with atopic dermatitis, a retrospective review was performed in children diagnosed with atopic dermatitis who had a skin culture. Culture results and clinical characteristics of those with group A streptococcus were compared with those with Staphlococcus aureus. Infection with group A streptococcus was present in 16%; infection with Staphlococcus aureus was present in 72%, and 14% had mixed cultures. Patients infected with group A streptococcus were more likely to be febrile, to have facial and periorbital involvement, and to be hospitalized compared with those infected with Staphlococcus aureus alone (p ≤ 0.01 for all comparisons). Bacteremia and cellulitis were significantly more common in those infected with group A streptococcus than in those infected with Staphlococcus aureus. Retrospective design and review of only those patients receiving bacterial cultures may select for greater severity than in the general atopic dermatitis population. Group A streptococcus appears to be a significant skin pathogen infecting children with atopic dermatitis. Children with atopic dermatitis and group A streptococcal infection are more likely to have invasive disease and complications than those infected with Staphlococcus aureus alone. © 2011 Wiley Periodicals, Inc.

Physical Activity, Sedentary Habits, Sleep, and Obesity are Associated with Asthma, Allergic Rhinitis, and Atopic Dermatitis in Korean Adolescents.

PubMed

Lim, Man Sup; Lee, Chang Hee; Sim, Songyong; Hong, Sung Kwang; Choi, Hyo Geun

2017-09-01

Since pathophysiologic evidence has been raised to suggest that obesity could facilitate an allergic reaction, obesity has been known as an independent risk factor for allergic disease such as asthma. However, the relationship between sedentary behavior and lifestyle which could lead to obesity, and those allergic diseases remains unclear. We analyzed the relations between physical activity, including sitting time for study, sitting time for leisure and sleep time, and obesity, asthma, allergic rhinitis, and atopic dermatitis using the Korea Youth Risk Behavior Web-based Survey, which was conducted in 2013. Total 53769 adolescent participants (12 through 18 years old) were analyzed using simple and multiple logistic regression analyses with complex sampling. Longer sitting time for study and short sitting time for leisure were associated with allergic rhinitis. High physical activity and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis. Underweight was negatively associated with atopic dermatitis, whereas overweight was positively correlated with allergic rhinitis and atopic dermatitis. High physical activity, and short sleep time were associated with asthma, allergic rhinitis, and atopic dermatitis. © Copyright: Yonsei University College of Medicine 2017

Childhood atopic dermatitis: a cross-sectional study of relationships between child and parent factors, atopic dermatitis management, and disease severity.

PubMed

Mitchell, Amy E; Fraser, Jennifer A; Ramsbotham, Joanne; Morawska, Alina; Yates, Patsy

2015-01-01

Successful management of atopic dermatitis poses a significant and ongoing challenge to parents of affected children. Despite frequent reports of child behaviour problems and parenting difficulties, there is a paucity of literature examining relationships between child behaviour and parents' confidence and competence with treatment. To examine relationships between child, parent, and family variables, parents' self-efficacy for managing atopic dermatitis, self-reported performance of management tasks, observed competence with providing treatment, and atopic dermatitis severity. Cross-sectional study design. Participants A sample of 64 parent-child dyads was recruited from the dermatology clinic of a paediatric tertiary referral hospital in Brisbane, Australia. Parents completed self-report questionnaires examining child behaviour, parents' adjustment, parenting conflict, parents' relationship satisfaction, and parents' self-efficacy and self-reported performance of key management tasks. Severity of atopic dermatitis was assessed using the Scoring Atopic Dermatitis index. A routine home treatment session was observed, and parents' competence in carrying out the child's treatment assessed. Pearson's and Spearman's correlations identified significant relationships (p<.05) between parents' self-efficacy and disease severity, child behaviour difficulties, parent depression and stress, parenting conflict, and relationship satisfaction. There were also significant relationships between each of these variables and parents' self-reported performance of management tasks. More profound child behaviour difficulties were associated with more severe atopic dermatitis and greater parent stress. Using multiple linear regressions, significant proportions of variation in parents' self-efficacy and self-reported task performance were explained by child behaviour difficulties and parents' formal education. Self-efficacy emerged as a likely mediator for relationships between both child behaviour and parents' education, and self-reported task performance. Direct observation of treatment sessions revealed strong relationships between parents' treatment competence and parents' self-efficacy, outcome expectations, and self-reported task performance. Less competent task performance was also associated with greater parent-reported child behaviour difficulties, parent depression and stress, parenting conflict, and relationship dissatisfaction. This study revealed the importance of child behaviour to parents' confidence and practices in the context of atopic dermatitis management. Children with more severe atopic dermatitis are at risk of presenting with challenging behaviour problems and their parents struggle to manage the condition successfully. Copyright © 2014 Elsevier Ltd. All rights reserved.

Canine and Human Atopic Dermatitis: Two Faces of the Same Host-Microbe Interaction.

PubMed

Santoro, Domenico; Rodrigues Hoffmann, Aline

2016-06-01

Host-microbe interaction has been suggested to play a critical role in the pathogenesis of atopic dermatitis. The dog has been shown to be the best model to study both pathogenesis and microbiome modifications in atopic dermatitis. Bradley et al. show a significant correlation between microbiome diversity, clinical signs, and skin barrier function in atopic dogs before, during, and after antimicrobial therapy. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Current management of atopic dermatitis and interruption of the atopic march.

PubMed

Boguniewicz, Mark; Eichenfield, Lawrence F; Hultsch, Thomas

2003-12-01

Treatment of atopic dermatitis requires a comprehensive approach that includes evaluation of potential triggers and education of the patient and family regarding proper avoidance measures. Hydration of the skin and maintenance of an intact skin barrier remain integral to proper management. Although topical corticosteroids have been a mainstay of anti-inflammatory therapy, the newer topical calcineurin inhibitors offer advantages for treatment of this chronic, relapsing disease. Studies aimed at defining optimal combination therapy and early intervention might change the treatment paradigm for atopic dermatitis.

Less common clinical manifestations of atopic dermatitis: prevalence by age.

PubMed

Julián-Gónzalez, Rolando Elias; Orozco-Covarrubias, Luz; Durán-McKinster, Carola; Palacios-Lopez, Carolina; Ruiz-Maldonado, Ramon; Sáez-de-Ocariz, Marimar

2012-01-01

The common manifestations of atopic dermatitis (AD) appear sequentially with involvement of the cheeks in infancy, flexural extremities in childhood, and hands in adulthood. Although less common clinical manifestations are well described, they have not been the subject of epidemiologic studies to describe their prevalence in specific age groups. This observational, cross-sectional, comparative study included 131 children younger than 18 of both sexes with AD who attended the clinics of the Dermatology Department of the National Institute of Pediatrics in Mexico City. Patients were examined to determine the presence of infrequent clinical manifestations of AD during infancy, preschool and school age, and adolescence and stratified according to sex, age, and number of clinical signs. A chi-square test was used to detect differences according to age and sex. Logistic regression analysis was also performed. The main findings according to age were genital dermatitis and papular-lichenoid dermatitis variant in infants; atopic feet, prurigo-like, nummular pattern, and erythroderma in preschool and school-aged children; and eyelid eczema and nipple dermatitis in adolescents. The risk of development of nipple dermatitis and eyelid eczema increased with age, and the development of genital dermatitis decreased with age. The knowledge of the prevalence of less common clinical manifestations of AD according to age in different populations might be helpful in diagnosing incipient cases of AD. © 2012 Wiley Periodicals, Inc.

[Quality of life in patients with atopic dermatitis: using the Japanese version of the SF-36 health status questionnaire].

PubMed

Fukuroku, Keiko; Nagano, Takuzou; Ogino, Satoshi

2002-12-01

Atopic dermatitis is a common skin disorder with an age onset mainly from infancy to adolescence. Patients with this disorder usually have a long history of repeated relief and relapse. The aim of the present studies is to quantify the relationship between the QOL score of patients and symptomatic characteristics (including severity measured by SF-36). From November 2000 to February 2001, the study recruited 281 patients with atopic dermatitis who had been treated at the Nagano dermatology and allergology clinic. The results of this study demonstrated that the symptoms severity and pruritus grade had strong influences on QOL score, and the location of pruritic lesion on the neck had the strongest influence on their self-perceived health status. The patients group with moderate atopic dermatitis who showed pruritus lesion in face, neck, and or knee, and female had consistently lower scores than male on all of the subscales. In conclusion, it is critically important to control of pruritus, and to develop an appropriate management.

The Atopic March: Progression from Atopic Dermatitis to Allergic Rhinitis and Asthma

PubMed Central

Bantz, Selene K.; Zhu, Zhou; Zheng, Tao

2014-01-01

The development of atopic dermatitis (AD) in infancy and subsequent allergic rhinitis and asthma in later childhood is known as the atopic march. This progressive atopy is dependent on various underlying factors such as the presence of filaggrin mutations as well as the time of onset and severity of AD. Clinical manifestations vary among individuals. Previously it was thought that atopic disorders may be unrelated with sequential development. Recent studies support the idea of a causal link between AD and later onset atopic disorders. These studies suggest that a dysfunctional skin barrier serves as a site for allergic sensitization to antigens and colonization of bacterial super antigens. This induces systemic Th2 immunity that predisposes patients to allergic nasal responses and promotes airway hyper reactivity. While AD often starts early in life and is a chronic condition, new research signifies that there may be an optimal window of time in which targeting the skin barrier with therapeutic interventions may prevent subsequent atopic disorders. In this review we highlight recent studies describing factors important in the development of atopic disorders and new insights in our understanding of the pathogenesis of the atopic march. PMID:25419479

Infantile eczema at one month of age is associated with cord blood eosinophilia and subsequent development of atopic dermatitis and wheezing illness until two years of age.

PubMed

Matsumoto, Kenji; Shimanouchi, Yasuhiro; Kawakubo, Keiichi; Oishi, Naobumi; Wakiguchi, Hiroshi; Futamura, Kyoko; Saito, Hirohisa

2005-01-01

Physiological and pathological skin eruptions are commonly encountered in neonates in our clinical practice. However, the types of skin eruptions that are associated with the subsequent development of atopic dermatitis and the mechanisms of these associations remain uncertain. A total of 105 newborn babies with normal delivery were enrolled in this prospective cohort study. The cord blood eosinophil count was measured and the neonates were examined at 1 month of age and followed until 8 years of age. At 1 month of age, infantile eczema, seborrheic dermatitis, intertrigo and diaper dermatitis were diagnosed in a total of 29, 7, 14 and 24 neonates, respectively. No association was found among the prevalences of these eruptions. Neonates with infantile eczema had a significantly higher number and ratio of eosinophils in the cord blood (eosinophil count: 670.8 +/- 67.8 vs. 349.0 +/- 30.3/microl, p < 0.0001; eosinophil ratio: 5.12 +/- 0.53 vs. 2.61 +/- 0.22%, p < 0.0001, for the presence and the absence of infantile eczema, respectively). In contrast, no such tendency was found for any other skin eruptions. In neonates with infantile eczema at 1 month of age, the diagnosis of atopic dermatitis had been made significantly earlier and the prevalence of wheezing illness was significantly higher than in those without infantile eczema until 2 years of age. Infantile eczema, but not other skin eruptions, precedes the development of atopic dermatitis and wheezing illness during early infancy, presumably because of the activation of eosinophils before birth. Copyright 2005 S. Karger AG, Basel.

Lumps, Bumps, and Things that Go Itch in Your Office!

ERIC Educational Resources Information Center

McLeod, Renee P.

2004-01-01

This article presents a short dermatological case presentation involving a 9-year-old black female student who suffered from a severe case of atopic dermatitis (AD). Health history, physical findings on the subject, and differential diagnosis, such as impetigo, atopic dermatitis, contact dermatitis, scabies, and seborrheic dermatitis, are given.…

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

PubMed

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.

The efficacy of cetirizine hydrochloride on the pruritus of cats with atopic dermatitis: a randomized, double-blind, placebo-controlled, crossover study.

PubMed

Wildermuth, Kerstin; Zabel, Sonja; Rosychuk, Rod A W

2013-12-01

Various antihistamines have been used in the management of feline atopic dermatitis, with variable reported benefit. To date, there have been no randomized, double-blind, placebo-controlled, crossover clinical trials on the use of this drug class in cats. To evaluate the clinical efficacy of cetirizine hydrochloride for the control of pruritus and dermatitis in cats diagnosed with atopic dermatitis. In this randomized, double-blind, placebo-controlled crossover clinical trial, 21 client-owned cats diagnosed with mild to moderate nonseasonal atopic dermatitis were randomly assigned to two groups. Cats in each group received either 1 mg/kg cetirizine hydrochloride or placebo once daily per os for 28 days followed by a 14 day wash-out period. Treatments were then crossed over, and cats received placebo or cetirizine hydrochloride for another 28 days. Owners marked a pruritus severity scale before inclusion in the study and weekly throughout the entire study period. Lesions were scored by the clinician using a Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 modified for the cat before enrolment and at day 28 of each treatment. Nineteen cats completed the study. There were no statistically significant differences between treatment with cetirizine hydrochloride and placebo for modified CADESI-03 or pruritus scores. This study suggests that cetirizine hydrochloride cannot be recommended for the management of feline atopic dermatitis. © 2013 ESVD and ACVD.

Reevaluation of the non-lesional dry skin in atopic dermatitis by acute barrier disruption: an abnormal permeability barrier homeostasis with defective processing to generate ceramide.

PubMed

Sugiura, Ayumi; Nomura, Tsuyoshi; Mizuno, Atsuko; Imokawa, Genji

2014-07-01

Atopic dermatitis is characterized by disruption of the cutaneous barrier due to reduced ceramide levels even in non-lesional dry skin. Following further acute barrier disruption by repeated tape strippings, we re-characterized the non-lesional dry skin of subjects with atopic dermatitis, which shows significantly reduced levels of barrier function and ceramide but not of beta-glucocerebrosidase activity. For the first time, we report an abnormal trans-epidermal water loss homeostasis in which delayed recovery kinetics of trans-epidermal water loss occurred on the first day during the 4 days after acute barrier disruption compared with healthy control skin. Interestingly, whereas the higher ceramide level in the stratum corneum of healthy control skin was further significantly up-regulated at 4 days post-tape stripping, the lower ceramide level in the stratum corneum of subjects with atopic dermatitis was not significantly changed. In a parallel study, whereas beta-glucocerebrosidase activity at 4 days post-tape stripping was significantly up-regulated in healthy control skin compared with before tape stripping, the level of that activity remained substantially unchanged in atopic dermatitis. These findings indicate that subjects with atopic dermatitis have a defect in sphingolipid-metabolic processing that generates ceramide in the interface between the stratum corneum and the epidermis. The results also support the notion that the continued disruption of barrier function in atopic dermatitis non-lesional skin is associated with the impaired homeostasis of a ceramide-generating process, which underscores an atopy-specific inflammation-triggered ceramide deficiency that is distinct from other types of dermatitis.

Patch test reactions to metal salts in patients with different types of dermatitis.

PubMed

Turčić, Petra; Marinović Kulišić, Sandra; Lipozenčić, Jasna

2013-01-01

Metal allergies can be a clinical problem, especially in atopic individuals. This study is unique and contributes with new knowledge in everyday life skin care of irritant and atopic dermatitis patients. The aim of the study was to determine the frequency of positive patch test reactions to metal contact allergens (potassium dichromate, cobalt chloride, nickel sulfate, white mercury precipitate) in patients diagnosed with allergic contact dermatitis, irritant contact dermatitis, and atopic dermatitis. Between 2007 and 2011, patch testing was performed in 2185 patients according to the International Contact Dermatitis Research Group technique. Study results showed statistically significant differences in patch test responses to 2 allergens, nickel sulfate (χ(2)=24.22; p<0.001) and cobalt chloride (χ(2)=22.72; p<0.001). Nickel sulfate was the most common allergen in allergic contact dermatitis and atopic dermatitis, while for irritant contact dermatitis the most common allergen was cobalt chloride. Among the 4 tested metal allergens, the most common and relevant was nickel sulfate (χ(2)=17.25; p<0.004), found in almost all study subjects. In conclusion, the increased awareness of allergens and their potential sources may help limit the use of these chemicals in consumer product manufacturing.

Japanese Guideline for Atopic Dermatitis 2014.

PubMed

Katayama, Ichiro; Kohno, Yoichi; Akiyama, Kazuo; Aihara, Michiko; Kondo, Naomi; Saeki, Hidehisa; Shoji, Shunsuke; Yamada, Hidekazu; Nakamura, Koichiro

2014-01-01

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 coun- termeasures 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 a 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 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. © 2014 Japanese Society of Allergology.

Japanese guidelines for atopic dermatitis 2017.

PubMed

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.

Early Relief of Pruritus in Atopic Dermatitis with Crisaborole Ointment, A Non-steroidal, Phosphodiesterase 4 Inhibitor.

PubMed

Yosipovitch, Gil; Gold, Linda F; Lebwohl, Mark G; Silverberg, Jonathan I; Tallman, Anna M; Zane, Lee T

2018-04-27

Pruritus occurs in all patients with atopic dermatitis and requires quick relief to reduce disease exacerbation and improve quality of life. Crisaborole ointment is a non-steroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis. This post hoc analysis explores crisaborole ointment for early relief of pruritus in patients with mild to moderate atopic dermatitis from 2 phase III studies. Patients received crisaborole or vehicle twice daily for 28 days. Pruritus was graded on a 4-point scale of none (0) to severe (3). Early improvement in pruritus required a score of none (0) or mild (1), with a ≥ 1-grade improvement from baseline on day 6. Significantly more patients experienced early improvement in pruritus with crisaborole than with vehicle (56.6% vs 39.5%; p< 0.001), including at earliest assessment (day 2, 34.3% vs 27.3%; p = 0.013). Crisaborole is a topical treatment option that can rapidly relieve atopic dermatitis-associated pruritus.

Management of Itch in Atopic Dermatitis

PubMed Central

Hong, Judith; Buddenkotte, Joerg; Berger, Timothy G.; Steinhoff, Martin

2013-01-01

Atopic dermatitis is a common, pruritic, inflammatory skin disorder. Chronic, localized, or even generalized pruritus is the diagnostic hallmark of atopic dermatitis, and its management remains a challenge for physicians. The threshold for itch and alloknesis is markedly reduced in these patients, and infections can promote exacerbation and thereby increase the itch. Modern management consists of anti-inflammatory, occasionally antiseptic, as well as antipruritic therapies to address the epidermal barrier as well as immunomodulation or infection. Mild forms of atopic dermatitis may be controlled with topical therapies, but moderate-to-severe forms often require a combination of systemic treatments consisting of antipruritic and immunosuppressive drugs, phototherapy, and topical compounds. In addition, patient education and a therapeutic regimen to help the patient cope with the itch and eczema are important adjuvant strategies for optimized long-term management. This review highlights various topical, systemic, and complementary and alternative therapies, as well as provide a therapeutic ladder for optimized long-term control of itch in atopic dermatitis. PMID:21767767

Nickel allergy and relationship with Staphylococcus aureus in atopic dermatitis.

PubMed

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.

Hydrogel-gauze dressing for moderate-to-severe atopic dermatitis: development and efficacy study on atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Ng, Shiow-Fern; Lew, Pit-Chin; Sin, Yong-Boey

2014-11-01

Topical emollients are known to provide symptomatic relief for atopic dermatitis. In hospitals, wet-wrap therapy has been shown to benefit children with moderate-to-severe atopic dermatitis (AD), but the application of wet-wraps is tedious and time-consuming. Topical emollients have low residence time and often dry out easily. The aim of this work was to develop a hydrogel-gauze dressing that is not only easy to apply but also rehydrates and traps moisture to provide longer relief for AD patients. In this study, a prototype hydrogel-gauze dressing was developed with varying ratios of sodium carboxymethylcellulose (NaCMC) and propylene glycol. The hydrogel-gauze dressings were assessed based on the moisture vapor transmission rate, moisture absorption, mechanical properties and storage stability over three months. Then, the efficacy of the hydrogel-gauze dressing was compared to topical emollients using transgenic NC/Nga mice with AD-like lesions. The NaCMC hydrogel-gauze dressings significantly lowered transepidermal water loss, and the animals displayed a faster recovery, which indicates that hydrogel-gauze dressings can trap moisture more effectively and accelerate AD healing. Hence, we propose that hydrogel-gauze dressings can potentially become an alternative to wet-wrap therapy due to the ease of application and the higher efficacy compared to topical products.

Cross allergic reactions in infants and toddlers with atopic dermatitis.

PubMed

Cudowska, B; Kaczmarski, M; Wasilewska, J

2013-01-01

Prevalence and clinical significance of cross sensitization in children up to 3 years old, diagnosed with atopic dermatitis. The retrospective study included 69 children up to 3 years old with atopic dermatitis. Allergological diagnostics was performed based on skin tests, determination of total IgE concentration and allergen-specific IgE. Cross sensitization was found in 26% of children. Other patients were qualified to the control group. The sensitization to trees pollen and fruits as well as grass pollen and vegetables were the most frequent types of cross allergy. The patient's family history was positive with regard to atopy in 72% of children from the study group vs. 31% of children from the control group. The statistically higher prevalence of allergic rhinitis and bronchial asthma as well as co-existence of sensitization to house dust mite and animal dander were revealed in the study group. The total concentration of IgE, eosinophilia and SCORAD values were statistically higher in the study group. Children with cross sensitization required systemic steroid therapy more frequently. In children up to 3 years with atopic dermatitis and sensitization to plant pollen, the role of a pollen-food allergy syndrome must be taken into account in the pathogenesis of the disease. In children with cross sensitization, the course of atopic dermatitis is more severe; the symptoms from the respiratory and digestive system co-exist. The positive family history is a factor, predisposing to the development of cross sensitization in infants and toddlers.

Fermented rice bran prevents atopic dermatitis in DNCB-treated NC/Nga mice

PubMed Central

Saba, Evelyn; Lee, Chun Hee; Jeong, Da Hye; Lee, Kija; Kim, Tae-Hwan; Roh, Seong-Soo; Kim, Seung-Hyung; Rhee, Man Hee

2016-01-01

Abstract The fermentation of natural plants has a favorable effect on the functional and biological activities of living systems. These include anti-oxidative, anti-inflammatory, and anti-platelet aggregation activities. This is attributed to the chemical conversion of the parent plants to functional constituents, which show more potent biological activity. In our study, rice bran along with oriental medicinal plants (Angelicae gigantis, Cnidium officinale, Artemisia princeps, and Camellia sinensis) was fermented by Lactobacillus rhamnosus and Pichia deserticola (FRBE). We evaluated the effects of oral administration of FRBE on atopic dermatitis in 1-chloro-2,4-dinitrobenzene (DNCB)-treated NC/Nga mice. FRBE significantly ameliorated the macroscopic and microscopic appearance of skin lesions in DNCB-induced atopic dermatitis and reduced levels of serum immunoglobulin E and the differential white blood cell count. In addition, it reduced skin thickness compared to that of atopic dermatitis-affected skin. FRBE treatment also reduced mast cell incorporation in skin lesions of atopic dermatitis. The total cell number in dorsal skin tissue and the axillary lymph node increased following DNCB application, and this was normalized by FRBE treatment. Moreover, it decreased the levels of CD8+ helper T cells and Gr-1+/CD11b+ B cells in peripheral blood mononuclear cells and skin lesions in DNCB-induced atopic dermatitis. Using real-time polymerase chain reaction analysis, we demonstrated that FRBE significantly inhibited mRNA expression of cytokines (e.g., interleukin-5 and interleukin-13) and cyclooxygenase-2 in AD skin lesions. These results suggest that FRBE could be a valuable herbal remedy for the treatment of atopic dermatitis. PMID:27323667

The efficacy of commercially available veterinary diets recommended for dogs with atopic dermatitis.

PubMed

Glos, Katharina; Linek, Monika; Loewenstein, Christine; Mayer, Ursula; Mueller, Ralf S

2008-10-01

The classical treatments for dogs with atopic dermatitis have traditionally been oral antipruritic drugs, allergen-specific immunotherapy and topical therapy. Fifty dogs with atopic dermatitis were included in this multicentred, double-blinded, randomized study to compare clinical response to an 8-week period of feeding one of three commercial veterinary foods marketed for dogs with atopic dermatitis (diets A-C) or a widely distributed supermarket food (diet D). Atopic dermatitis was diagnosed using Willemse's criteria and through the exclusion of differential diagnoses. Fourteen dogs were assigned to diet A and 12 dogs each to diet B, C or D. Flea and tick control using a monthly fipronil spot-on product was administered for a minimum of 4 weeks prior to inclusion in the study and during the study period. Evaluations were made monthly. These included lesion scores, using an established scoring system (canine atopic dermatitis extent and severity index, CADESI-03) and owner evaluation of pruritus level using a visual analogue scale. After 8 weeks on the new diets, there was a significant improvement in CADESI and pruritus scores with diet B (Wilcoxon test, P = 0.043 and paired t-test, P = 0.012, respectively), in pruritus scores with diet A (paired t-test, P = 0.019) and in CADESI scores with diet D (Wilcoxon test, P = 0.037). No significant changes were detected with diet C. Based on the results of this study, in addition to the conventional therapies, changing the diet of dogs with atopic dermatitis may be a useful adjunctive therapeutic measure.

Characteristics and prescription patterns of traditional Chinese medicine in atopic dermatitis patients: ten-year experiences at a medical center in Taiwan.

PubMed

Lin, Jing-Fan; Liu, Pi-Hua; Huang, Tzu-Ping; Lien, Angela Shin-Yu; Ou, Liang-Shiou; Yu, Chin-Hui; Yang, Shu-Ling; Chang, Hen-Hong; Yen, Hung-Rong

2014-02-01

Complementary and alternative therapies in treating atopic dermatitis are not uncommon. However, substantial evidence and consensus on treating atopic dermatitis is lacking. The aim of this study is to investigate the characteristics and utilization of traditional Chinese medicine in patients with atopic dermatitis. We retrospectively collected patients with atopic dermatitis at the Chang Gung Memorial Hospital in Taiwan between 2002 and 2011. Patients' demographic data, duration and frequency of treatment, serum total immunoglobulin E levels, and traditional Chinese medicine treatment principles and prescription were analyzed. There were 4145 patients (8.8%) received traditional Chinese medicine therapy between 2002 and 2011. Among them, 2841 (68.54%) chose TCM only and 1304 (31.46%) chose to combine TCM and WM therapies. Those who chose combination therapy were younger, and needed more times of visit and longer duration of treatment. The most frequent comorbid conditions accompany atopic dermatitis were allergic rhinitis (46.06%) and asthma (21.46%). Among the 87,573 prescriptions written for Chinese medicine, the most frequently prescribed herbal formula and single herb were Xiao-Feng-San (Eliminate Wind Powder) (16.98%) and Bai-Xian-Pi (Cortex Dictamni) (12.68%), respectively. The most commonly used therapeutic principles of herbal formulas and single herbs were releasing exterior (20.23%) and clearing heat (41.93%), respectively. Our hospital-based study characterized the utilization patterns of traditional Chinese medicine in atopic dermatitis patients. This information could be used as references for clinical application and provide valuable information for future clinical trials. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evolving Concepts in Atopic Dermatitis.

PubMed

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.

Atopic dermatitis: current treatment guidelines. Statement of the experts of the Dermatological Section, Polish Society of Allergology, and the Allergology Section, Polish Society of Dermatology.

PubMed

Nowicki, Roman; Trzeciak, Magdalena; Wilkowska, Aleksandra; Sokołowska-Wojdyło, Małgorzata; Ługowska-Umer, Hanna; Barańska-Rybak, Wioletta; Kaczmarski, Maciej; Kowalewski, Cezary; Kruszewski, Jerzy; Maj, Joanna; Silny, Wojciech; Śpiewak, Radosław; Petranyuk, Andriy

2015-08-01

Atopic dermatitis (AD) is a condition frequently encountered in medical practices across the country. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). Patients with AD have a unique predisposition to colonization or infection by Staphylococcus aureus. Treatments for AD need to rapidly control symptoms of the disease, improve quality of life and prevent exacerbations. Given the chronic and relapsing nature of the disease, therapies need to encourage good compliance and be well tolerated.

Investigation of the correlation of serum IL-31 with severity of dermatitis in an experimental model of canine atopic dermatitis using beagle dogs.

PubMed

Marsella, Rosanna; Ahrens, Kim; Sanford, Rachel

2018-02-01

IL-31 is a cytokine that is believed to play an important role in atopic dermatitis (AD). IL-31 levels positively correlate with disease severity in children with AD. Currently, there is no study that has investigated such a correlation in atopic dogs. The purpose of this study was to evaluate the correlation between IL-31 serum levels and severity of dermatitis. It was hypothesized that a positive correlation exists between severity of AD and circulating levels of IL-31. Sixteen atopic beagles experimentally sensitized to house dust mites. Atopic beagles were exposed to dust mites epicutaneously twice weekly for four weeks. Severity of dermatitis was scored by the Canine Atopic Dermatitis and Extent Severity Index, 3 rd iteration (CADESI-03) on days 0 and 28. Blood samples were taken on days 0 and 28 to measure serum IL-31 using a commercially available ELISA. Correlation between CADESI-03 scores and serum IL-31 levels was not detected on day 0 (Pearson, r = -0.2609, P = 0.3291). After flare-up of dermatitis was induced with allergen exposure, a significant positive correlation was detected between serum IL-31 and CADESI-03 on Day 28 (r = 0.6738, P = 0.004). Positive correlation was detected in active disease between severity of dermatitis and circulating levels of IL-31. Additional studies are needed to investigate this correlation in other breeds of dogs and to test whether circulating levels of IL-31 may predict clinical response to biological agents aimed at IL-31. © 2017 ESVD and ACVD.

[Food hypersensitivity dermatitis in the dog: diagnostic possibilities].

PubMed

Wilhelm, S; Favrot, C

2005-04-01

Dogs with food hypersensitivity usually develop chronic pruritic dermatoses virtually indistinguishable from atopic dermatitis. These reactions are often called food allergy but the pathogenesis is poorly characterized. Several studies have addressed the incidence of canine adverse reactions to food but the outcomes were conflicting. The gold standard for the diagnosis of such a condition is the restricted dietary trial and the subsequent provocation challenge. Some attempts have been made to develop serological tests but none of these tests accurately predicted canine food sensitivity. The aim of the present study was to determine the incidence of food hypersensitivity dermatitis and to evaluate a newly developed serological test for the diagnosis of food allergy in dogs. Only 9% of 55 dogs with dermatological signs compatible with food hypersensitivity or atopic dermatitis have been diagnosed as food hypersensitive dogs. The repeatability of the serological test has shown to be insufficient.

Lichen simplex chronicus

MedlinePlus

... lichen simplex chronicus; Atopic dermatitis - lichen simplex chronicus; Psoriasis - lichen simplex chronicus ... people who have: Skin allergies Eczema (atopic dermatitis) Psoriasis Nervousness, anxiety, depression, and other emotional problems The ...

Relevance of inhalant and food allergens to the etiology and management of patients with atopic dermatitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Platts-Mills, T.A.; Mitchell, E.B.; Rowntree, S.

Patients with atopic dermatitis have IgE antibodies to common environmental antigens, both foods and inhalants. Such antibodies are probably relevant and exposure to the corresponding antigens can give rise to eczema. Nevertheless, the mechanisms involved and the role of other etiologies, e.g. contact reactions, remain to be elucidated. Patients with atopic dermatitis should have comprehensive evaluations to determine the role of environmental antigens.

CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE ITCHING SEVERITY SCALE IN CHILDREN AND ADOLESCENTS WITH ATOPIC DERMATITIS.

PubMed

Bruscky, Dayanne Mota Veloso; Melo, Ana Caroline Cavalcanti Dela Bianca; Sarinho, Emanuel Sávio Cavalcanti

2017-01-01

To translate, adapt and validate the Itch Severity Scale to a Brazilian version (ISS-Ped) in order to measure the severity of pruritus in children and adolescents with atopic dermatitis. This is a methodological study of validation of an instrument following recommended protocols. The translated version was evaluated by a group of experts including one professional with experience in instrument validation, three English teachers, one linguistics teacher and seven allergists. After this, the scale was applied to 42 parents of children aged between 2 and 18 years old with atopic dermatitis, and 42 parents of children without pruritic diseases. Results were evaluated according to the severity of atopic dermatitis and disease control, and they were compared between groups with and without atopic dermatitis. More than 90% of the questions were clear to the parents. The ISS-Ped showed a strong positive correlation with the severity of atopic dermatitis (Pearson: 0.74; p<0.001) and a good correlation with the control of dermatitis (point-biserial correlation coefficient: 0.65; p<0.001). The scale showed excellent internal consistency (Cronbach's α: 0.96) and adequate test and retest agreement (95% confidence interval of intraclass correlation coefficient: 0.89-0.99; p<0.001). The ISS-Ped is a feasible, valid, reliable and satisfactorily equivalent. The translated scale was appropriate to assess the severity of itching in children and adolescents with eczema, allowing comparisons in the clinical practice and in the research setting.

Atopic dermatitis: emerging therapies.

PubMed

Simpson, Eric; Udkoff, Jeremy; Borok, Jenna; Tom, Wynnis; Beck, Lisa; Eichenfield, Lawrence F

2017-09-01

Crisaborole and dupilumab represent the first 2 Food and Drug Administration (FDA)-approved therapies for atopic dermatitis (AD) in more than 15 years, and there are many promising drugs currently in development. This new wave of therapeutics capitalizes on the large body of work clarifying the pathogenesis of AD over the last several decades. In particular, type 2 cytokine-driven inflammation and skin barrier dysfunction are key processes underlying AD pathogenesis. ©2017 Frontline Medical Communications.

Mast Cells Regulate Epidermal Barrier Function and the Development of Allergic Skin Inflammation.

PubMed

Sehra, Sarita; Serezani, Ana P M; Ocaña, Jesus A; Travers, Jeffrey B; Kaplan, Mark H

2016-07-01

Atopic dermatitis is a chronic inflammatory skin disease characterized by infiltration of eosinophils, T helper cells, and mast cells. The role of mast cells in atopic dermatitis is not completely understood. To define the effects of mast cells on skin biology, we observed that mast cells regulate the homeostatic expression of epidermal differentiation complex and other skin genes. Decreased epidermal differentiation complex gene expression in mice that genetically lack mast cells (Kit(W-sh/W-sh) mice) is associated with increased uptake of protein antigens painted on the skin by dendritic cells (DCs) compared with similarly treated wild-type mice, suggesting a protective role for mast cells in exposure to nominal environmental allergens. To test this further, we crossed Kit(W-sh/W-sh) mice with signal transducer and activator of transcription 6 (i.e., Stat6) VT transgenic mice that develop spontaneous atopic dermatitis-like disease that is dependent on T helper cell 2 cytokines and is associated with high serum concentrations of IgE. We observed that Stat6VT × Kit(W-sh/W-sh) mice developed more frequent and more severe allergic skin inflammation than Stat6VT transgenic mice that had mast cells. Together, these studies suggest that mast cells regulate epidermal barrier function and have a potential protective role in the development of atopic dermatitis-like disease. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Dendritic Core-Multishell Nanocarriers in Murine Models of Healthy and Atopic Skin.

PubMed

Radbruch, Moritz; Pischon, Hannah; Ostrowski, Anja; Volz, Pierre; Brodwolf, Robert; Neumann, Falko; Unbehauen, Michael; Kleuser, Burkhard; Haag, Rainer; Ma, Nan; Alexiev, Ulrike; Mundhenk, Lars; Gruber, Achim D

2017-12-01

Dendritic hPG-amid-C18-mPEG core-multishell nanocarriers (CMS) represent a novel class of unimolecular micelles that hold great potential as drug transporters, e.g., to facilitate topical therapy in skin diseases. Atopic dermatitis is among the most common inflammatory skin disorders with complex barrier alterations which may affect the efficacy of topical treatment.Here, we tested the penetration behavior and identified target structures of unloaded CMS after topical administration in healthy mice and in mice with oxazolone-induced atopic dermatitis. We further examined whole body distribution and possible systemic side effects after simulating high dosage dermal penetration by subcutaneous injection.Following topical administration, CMS accumulated in the stratum corneum without penetration into deeper viable epidermal layers. The same was observed in atopic dermatitis mice, indicating that barrier alterations in atopic dermatitis had no influence on the penetration of CMS. Following subcutaneous injection, CMS were deposited in the regional lymph nodes as well as in liver, spleen, lung, and kidney. However, in vitro toxicity tests, clinical data, and morphometry-assisted histopathological analyses yielded no evidence of any toxic or otherwise adverse local or systemic effects of CMS, nor did they affect the severity or course of atopic dermatitis.Taken together, CMS accumulate in the stratum corneum in both healthy and inflammatory skin and appear to be highly biocompatible in the mouse even under conditions of atopic dermatitis and thus could potentially serve to create a depot for anti-inflammatory drugs in the skin.

Lactoferricin/verbascoside topical emulsion: a possible alternative treatment for atopic dermatitis in dogs.

PubMed

Biasibetti, Elena; Bruni, Natascia; Bigliati, Mauro; Capucchio, Maria Teresa

2017-08-28

Atopic dermatitis affects 3-15% of the general dog population and it has been diagnosed by veterinarians up to 58% of dogs affected with skin disease. It is usually a life-long pathology which can be controlled, but it can be seldom cured. The present investigation describes a case study in which lactoferricin and verbascoside are part of a formulation to obtain a dermatological lotion for canine dermatitis treatment. The study was an open-label trial design of two-week treatment. Thirty-eight dogs (23 females and 15 males), with atopic dermatitis and secondary bacterial or yeast overgrowth have been included. During treatment period the total clinical score progressively decreased associated with an improvement in clinical signs. No adverse effects were reported in any of the treated dogs. The present research suggests that daily applications of tested emulsion are effective in reducing bacterial overgrowth and clinical signs in skin folds and atopic dermatitis.

Utility of Boron in Dermatology.

PubMed

Jackson, David G; Cardwell, Leah A; Oussedik, Elias; Feldman, Steven R

2017-08-09

Boron compounds are being investigated as therapies for dermatologic conditions. Several features of boron chemistry make this element an ideal component in dermatologic treatments. We review the published dermatologically-relevant clinical trials and case studies pertaining to boron compounds. PubMed was utilized to query terms boron, chemistry, drug, development, dermatology, atopic dermatitis, psoriasis, onychomycosis, tavaborole, AN 2690, crisaborole, and AN 2728. Clinical trials, case studies, animal studies and in vitro studies. pertaining to atopic dermatitis, psoriasis and onychomycosis were included. Crisaborole 2% topical solution reduced atopic dermatitis lesions by approximately 60% when compared to pre-treatment baseline. Crisaborole maintains its dose-dependent effect in treatment of psoriasis and significantly reduces psoriatic plaques when compared to controls. Adverse effects were mild, frequency of events varied between studies. Crisaborole was well tolerated when applied to sensitive skin. Topical tavaborole significantly reduced or eliminated onychomycosis with minimal side effects compared to placebo. Tavaborole was effective in treating recalcitrant onychomycosis. Boron-based compounds form stable interactions with enzyme targets and are safe medications for the treatment of atopic dermatitis, psoriasis, and onychomycosis. The mild and rare side effects of topical boron-based compounds may make them ideal treatments for individuals with sensitive skin and pediatric populations.

Atopic Dermatitis in Animals and People: An Update and Comparative Review

PubMed Central

Marsella, Rosanna; De Benedetto, Anna

2017-01-01

Atopic dermatitis is an extremely common, pruritic, and frustrating disease to treat in both people and animals. Atopic dermatitis is multifactorial and results from complex interactions between genetic and environmental factors. Much progress has been done in recent years in terms of understanding the complex pathogenesis of this clinical syndrome and the identification of new treatments. As we learn more about it, we appreciate the striking similarities that exist in the clinical manifestations of this disease across species. Both in animals and people, atopic disease is becoming increasingly common and important similarities exist in terms of immunologic aberrations and the propensity for allergic sensitization. The purpose of this review is to highlight the most recent views on atopic dermatitis in both domestic species and in people emphasizing the similarities and the differences. A comparative approach can be beneficial in understanding the natural course of this disease and the variable response to existing therapies. PMID:29056696

Atopic Dermatitis in Animals and People: An Update and Comparative Review.

PubMed

Marsella, Rosanna; De Benedetto, Anna

2017-07-26

Atopic dermatitis is an extremely common, pruritic, and frustrating disease to treat in both people and animals. Atopic dermatitis is multifactorial and results from complex interactions between genetic and environmental factors. Much progress has been done in recent years in terms of understanding the complex pathogenesis of this clinical syndrome and the identification of new treatments. As we learn more about it, we appreciate the striking similarities that exist in the clinical manifestations of this disease across species. Both in animals and people, atopic disease is becoming increasingly common and important similarities exist in terms of immunologic aberrations and the propensity for allergic sensitization. The purpose of this review is to highlight the most recent views on atopic dermatitis in both domestic species and in people emphasizing the similarities and the differences. A comparative approach can be beneficial in understanding the natural course of this disease and the variable response to existing therapies.

A pilot study of silver-loaded cellulose fabric with incorporated seaweed for the treatment of atopic dermatitis.

PubMed

Park, K Y; Jang, W S; Yang, G W; Rho, Y H; Kim, B J; Mun, S K; Kim, C W; Kim, M N

2012-07-01

Because clothing has the longest and most direct contact with human skin, it is important to carefully choose suitable fabrics for atopic patients who have disrupted skin. To evaluate the clinical effectiveness and biophysical properties of a newly developed silver-loaded cellulose fabric with incorporated seaweed, we enrolled 12 subjects with mild to moderate atopic dermatitis into a clinical control study. The subjects wore a two-piece garment (top and leggings), each piece of which was divided into two parts: one side was made of SkinDoctor(®) fabric, and the other of 100% cotton. Treatment efficacy was measured with the modified SCORing Atopic Dermatitis (mSCORAD) index, transepidermal water loss (TEWL) and the patients' subjective impressions. All three of these measures had significantly better scores on the side covered with SkinDoctor. These results suggest that SkinDoctor is a beneficial fabric that can improve the comfort of patients with AD. © The Author(s). CED © 2012 British Association of Dermatologists.

[Do breast-feeding and "diet" milks have any preventive or curative effect in the management of atopic dermatitis in children?].

PubMed

de Boissieu, D

2005-01-01

A) The preventive interest of infants' food in the onset of atopic dermatitis. Measures of prevention of atopic dermatitis concern predisposed children. Most studies agree on the protective effect of breast feeding for at least 3 to 4 months, compared with industrial milk products, on the onset of atopic dermatitis. Partial breast feeding is not protective. There is no preventive effect of breast feeding on the onset of atopic dermatitis in the absence of a family history of atopy. However, a few studies have raised the question of the aggravation of eczema during prolonged breast feeding. The "breast fed" group is probably not a homogenous group. Mothers' milk contains IgA, TGFb-type cytokines and long-chain polyinsaturated fatty acids that may play an important part in the acquisition of tolerance to food and the prevention of atopic dermatitis. The administration of a protein hydrolysate is preferable in terms of prevention of an allergy to a formula based on cow's milk, but does not provide any benefit compared with breast feeding. The preventive effect on atopic dermatitis of a casein hydrolysate is greater than that of a partial hydrolysate, which itself is greater than a formula based on cow's milk. In conclusion, the first preventive measure is breast feeding for 3 to 4 months, associated with intensive protein hydrolysate in the case of mixed feeding. In the absence of breast feeding, intensive hydrolysate is recommended in children at high risk. B) The curative interest of infants' food in the management of atopic dermatitis. The curative interest implies the responsibility of food in the triggering-off or maintenance of atopic dermatitis. This concerns non-diversified infants exhibiting severe or moderate eczema concomitant to digestive disorders. In such cases, the diagnosis of food allergy should be evoked. If the infant is fed on industrial milk, a test diet should be proposed with a hydrolysate or based on amino acids, followed by the re-introduction of the formula used previously. If the infant is exclusively breast fed, diagnosis of an allergy to one of the foodstuffs ingested by the mother should be searched for and treated. Early diagnosis of food allergy in infants, before diversification, is the optimal factor of prognosis.

Owner assessment of therapeutic interventions for canine atopic dermatitis: a long-term retrospective analysis.

PubMed

Dell, Darin L; Griffin, Craig E; Thompson, Lori A; Griffies, Joel D

2012-06-01

Canine atopic dermatitis is a frequent diagnosis in veterinary medicine; however, the long-term prognosis for canine atopic dermatitis has not been evaluated in a systematic fashion. To compare the relative efficacy of commonly used therapies for canine atopic dermatitis in two groups of dogs over 5 and 10 year time periods. Dogs were identified from the medical record database of a privately owned veterinary dermatology practice in the USA. Clients completed a four-part, 28-question, Internet-based survey. Surveys were included in the analysis if one entire section was completed. Each question was completed independently of the answers to other questions. Several respondents failed to complete all questions. Some respondents answered similar questions with contradictory answers. Each question was analysed individually. A total of 136 owner surveys were completed, 39 from the 10 year and 97 from the 5 year study dogs. Eighty-five of 135 respondents indicated that their pet was receiving some form of medical therapy for atopic dermatitis at the time of the survey. Thirty of 90 respondents (33.3%) indicated that their dog improved during a dietary trial. Five dogs met the study's definition for clinical cure. All five of these dogs had been treated with allergen-specific immunotherapy. This study revealed that clients believe antihistamines can be a useful part of multimodal therapy for canine atopic dermatitis. The results also demonstrated that a significant number of canines benefited from dietary modification. In addition, allergen-specific immunotherapy was the only treatment to induce true clinical remission of atopic dermatitis. © 2012 The Authors. Veterinary Dermatology. © 2012 ESVD and ACVD.

The link between serum vitamin D level, sensitization to food allergens, and the severity of atopic dermatitis in infancy.

PubMed

Baek, Ji Hyeon; Shin, Youn Ho; Chung, In Hyuk; Kim, Hae Jung; Yoo, Eun-Gyong; Yoon, Jung Won; Jee, Hye Mi; Chang, Young Eun; Han, Man Yong

2014-10-01

To investigate the association between serum vitamin D levels, sensitization to food allergens, and the severity of atopic dermatitis in infants. We investigated serum 25-hydroxyvitamin D (25[OH]D) and specific immunoglobulin E levels to common or suspected food allergens in 226 infants with atopic dermatitis or food allergy. The severity of atopic dermatitis by the Scoring Atopic Dermatitis index and amount of vitamin D intake was measured in subcohort children. Sensitization to food allergen was categorized by the number (non-, mono-, and poly-) of sensitized allergens and the degree (undetected-, low-, and high-level) of sensitization. Significant differences in 25(OH)D levels were found between groups on number (P = .006) and degree (P = .005) of food sensitization. The polysensitization group had significantly lower levels of 25(OH)D than the nonsensitization (P = .001) and monosensitization (P = .023) group. High-level sensitization group had significantly lower 25(OH)D levels compared with undetected (P = .005) and low-level (P = .009) sensitization group. Vitamin D deficiency increased the risk of sensitization to food allergens (OR 5.0; 95% CI 1.8-14.1), especially to milk (OR 10.4; 95% CI 3.3-32.7) and wheat (OR 4.2; 95% CI 1.1-15.8). In addition, the Scoring Atopic Dermatitis index was independently related to 25(OH)D levels after adjusting for the level of sensitization (adjusted R(2) = 0.112, P = .031). Our results suggest that vitamin D deficiency increases the risk of sensitization to food allergens and that atopic dermatitis may be more severe in infants with vitamin D deficiency. Copyright © 2014 Elsevier Inc. All rights reserved.

Fermented rice bran prevents atopic dermatitis in DNCB-treated NC/Nga mice.

PubMed

Saba, Evelyn; Lee, Chun Hee; Jeong, Da Hye; Lee, Kija; Kim, Tae-Hwan; Roh, Seong-Soo; Kim, Seung-Hyung; Rhee, Man Hee

2016-07-01

The fermentation of natural plants has a favorable effect on the functional and biological activities of living systems. These include anti-oxidative, anti-inflammatory, and anti-platelet aggregation activities. This is attributed to the chemical conversion of the parent plants to functional constituents, which show more potent biological activity. In our study, rice bran along with oriental medicinal plants (Angelicae gigantis, Cnidium officinale, Artemisia princeps, and Camellia sinensis) was fermented by Lactobacillus rhamnosus and Pichia deserticola (FRBE). We evaluated the effects of oral administration of FRBE on atopic dermatitis in 1-chloro-2,4-dinitrobenzene (DNCB)-treated NC/Nga mice. FRBE significantly ameliorated the macroscopic and microscopic appearance of skin lesions in DNCB-induced atopic dermatitis and reduced levels of serum immunoglobulin E and the differential white blood cell count. In addition, it reduced skin thickness compared to that of atopic dermatitis-affected skin. FRBE treatment also reduced mast cell incorporation in skin lesions of atopic dermatitis. The total cell number in dorsal skin tissue and the axillary lymph node increased following DNCB application, and this was normalized by FRBE treatment. Moreover, it decreased the levels of CD8(+) helper T cells and Gr-1(+)/CD11b(+) B cells in peripheral blood mononuclear cells and skin lesions in DNCB-induced atopic dermatitis. Using real-time polymerase chain reaction analysis, we demonstrated that FRBE significantly inhibited mRNA expression of cytokines (e.g., interleukin-5 and interleukin-13) and cyclooxygenase-2 in AD skin lesions. These results suggest that FRBE could be a valuable herbal remedy for the treatment of atopic dermatitis. © 2016 the Journal of Biomedical Research. All rights reserved.

Role of primary and secondary prevention in atopic dermatitis

PubMed Central

Michalak, Iwonna; Gutfreund, Katarzyna; Bienias, Wojciech; Matych, Marta; Szewczyk, Anna; Kaszuba, Andrzej

2015-01-01

Atopic dermatitis (AD) is a serious epidemiological problem in industrialized countries. The incidence of AD has increased considerably over the last 30 years. Atopic dermatitis is a chronic, recurrent, inflammatory skin disease accompanied by strong itching. It is characterized by typical features depending on age. The parents of children suffering from AD must be prepared to change their lifestyle. They should avoid factors which can promote skin lesions and apply appropriate, regular skin care. The article describes primary prevention of AD as well as prophylactic measures to avoid skin eczema. It presents the role of infections, vaccinations, breastfeeding and the influence of domestic animals, house renovation and moulds on development of AD. The article also describes the significance of the epidermal barrier, skin colonization by microbial agents, pruritus, stress, food and inhalant allergy among people who suffer from AD. PMID:26755903

The role of vitamin D in atopic dermatitis.

PubMed

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.

Feline atopic dermatitis. A model for Langerhans cell participation in disease pathogenesis.

PubMed

Roosje, P J; Whitaker-Menezes, D; Goldschmidt, M H; Moore, P F; Willemse, T; Murphy, G F

1997-10-01

Atopic dermatitis is a disorder characterized by cutaneous exanthemata as a consequence of exaggerated eczematous reactions to topical and systemic allergens. Langerhans cells, expressing CD1a and HLA-DR, and dermal dendritic cells, expressing HLA-DR, are known to be potent antigen-presenting cells and are thought to play an important role in the pathogenesis of atopic dermatitis. The immunophenotype of lesional skin in atopic dermatitis in humans involves increased numbers of CD1a+/MHC class II+ dendritic cells in addition to activated T cells, mast cells, and macrophages. To establish feline skin as a model for the study of human atopic dermatitis, and to elucidate the role of dendritic cells in feline atopic dermatitis, we investigated the presence of CD1a+ cells and MHC class II+ cells in the epidermis and dermis of lesional feline skin and in skin of healthy control animals. Immunohistochemistry revealed that MHC class II+ epidermal dendritic cells were CD1a+ in normal feline skin and significantly increased numbers of CD1a+ cells and MHC class II+ cells were present in the epidermis and dermis of lesional skin. These data provide the first correlative documentation of CD1a expression by feline dendritic cells containing Birbeck granules, and indicate the utility of feline skin in the study of human cutaneous atopy.

Obsessive Compulsive Symptoms and Quality of Life in mothers of Children With Atopic Dermatitis.

PubMed

Gunduz, S; Usak, E; Ozen, S; Gorpelioglu, C

2017-06-01

Atopic dermatitis is one of the most common skin disorders in children and it can negatively affect both children and their families. The purpose of this study was to investigate the effect of atopic dermatitis on quality of life related to maternal health and maternal obsessive compulsive symptoms. A cross-sectional study was conducted in the pediatric and dermatology polyclinics. The SCORAD index was used for determining the severity of disease, and the Maudsley Obsessive Compulsive Inventory (MOCI) and SF-36 form were applied to the participants' mothers. A total of 120 children and their mothers participated the study. Comparing the atopic dermatitis group and the healthy control group, no statistically significant differences were seen in terms of MOCI and SF-36 scores, except for the physical functioning subscore. The results showed that having a child with atopic dermatitis and the severity of the disease do not influence their mothers in terms of obsessive-compulsive symptoms and health-related quality of life, except for physical functioning scores. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Food hypersensitivity in patients over 14 years of age suffering from atopic dermatitis.

PubMed

Celakovská, Jarmila; Ettler, K; Ettlerová, K; Vaněčková, J

2014-05-01

Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity. A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5) years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%), no reactions were recorded in 32 patients (24%). Foods with the most often recorded reactions are: Nuts (in 35% of patients), tomatoes (in 20%), and kiwi (in 17, 5%), apples and spices (in 16%), tangerines and oranges (in 15%), capsicum (in 13%), fishes (in 12%), celery (in 9%), and chocolate (in 7%). Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen-associated foods play a role in the majority of patients suffering from atopic dermatitis.

Effect of breast-feeding on the development of atopic dermatitis during the first 3 years of life--results from the GINI-birth cohort study.

PubMed

Laubereau, Birgit; Brockow, Inken; Zirngibl, Angelika; Koletzko, Sibylle; Gruebl, Armin; von Berg, Andrea; Filipiak-Pittroff, Birgit; Berdel, Dietrich; Bauer, Carl Peter; Reinhardt, Dietrich; Heinrich, Joachim; Wichmann, H-Erich

2004-05-01

To investigate if exclusive breast-feeding for 4 months is associated with atopic dermatitis during the first 3 years of life. Data on 3903 children were taken from yearly parental-administered questionnaires from a birth cohort study in Germany (recruited 1995-1998) comprised of a noninterventional (NI) and an interventional (I) subgroup. Outcomes were physician-diagnosed atopic dermatitis (AD) and itchy rash. Multiple logistic regression was performed for the entire cohort and stratified by family history of allergy and by study group adjusting for a fixed set of risk factors for allergies. Exclusive breast-feeding (52 % of children) was not associated with higher risk for AD either in the entire cohort (OR(adj,) 0.95; 95% CI, 0.79-1.14) or if stratified by family history of AD. In the I subgroup, but not in the NI subgroup, exclusive breast-feeding showed a significant protective effect on AD if compared with conventional cow's milk formula (OR(adj), 0.64; 95% CI, 0.45-0.90). These findings do not support the hypothesis that exclusive breast-feeding is a risk factor for development of atopic dermatitis but is protective if compared with conventional cow's milk. Observational studies might not be able to effectively control for selection bias and reverse causation.

Ichthyosis vulgaris: the filaggrin mutation disease.

PubMed

Thyssen, J P; Godoy-Gijon, E; Elias, P M

2013-06-01

Ichthyosis vulgaris is caused by loss-of-function mutations in the filaggrin gene (FLG) and is characterized clinically by xerosis, scaling, keratosis pilaris, palmar and plantar hyperlinearity, and a strong association with atopic disorders. According to the published studies presented in this review article, FLG mutations are observed in approximately 7·7% of Europeans and 3·0% of Asians, but appear to be infrequent in darker-skinned populations. This clinical review article provides an overview of ichthyosis vulgaris epidemiology, related disorders and pathomechanisms. Not only does ichthyosis vulgaris possess a wide clinical spectrum, recent studies suggest that carriers of FLG mutations may have a generally altered risk of developing common diseases, even beyond atopic disorders. Mechanistic studies have shown increased penetration of allergens and chemicals in filaggrin-deficient skin, and epidemiological studies have found higher levels of hand eczema, irritant contact dermatitis, nickel sensitization and serum vitamin D levels. When relevant, individuals should be informed about an increased risk of developing dermatitis when repeatedly or continuously exposed to nickel or irritants. Moreover, with our current knowledge, individuals with ichthyosis vulgaris should be protected against neonatal exposure to cats to prevent atopic dermatitis and should abstain from smoking to prevent asthma. Finally, they should be advised against excessive exposure to factors that decrease skin barrier functions and increase the risk of atopic dermatitis. © 2013 The Authors. BJD © 2013 British Association of Dermatologists.

Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of ‘atopic dermatitis’

PubMed Central

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

2017-01-01

Background 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. 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. Conclusion 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. PMID:27392131

[Dry hands (irritative contact dermatitis) in housewives which is not alleviated on cessation of domestic work: clinical varieties].

PubMed

Grimalt, F; Romaguera, C; Vilaplana, J; Mascaro, J

1988-01-01

There are three types of hand dermatitis in housewives. The most usual are cured when housework is stopped. Another type is that of housewife contact dermatitis which appears on pre-existing endogenous lesions such as dyshidrosis or nummular eczema. The third form is housewife hand contact dermatitis which appears, or coexists with, localized endogenous lesions of the hands. The last two forms are not cured when housework is stopped. In some cases the three forms may coexist or appear one after another. It is not usual for a person suffering from typical flexural atopic dermatitis to present with one of the described three forms of hand dermatitis. Nevertheless, without having some relationship to atopic diathesis no woman could suffer from any of these three forms of dermatitis. In spite of the lack of analytical data, everyday clinical facts (one example being these different forms of housewife hand dermatitis) suggest the need to accept a subgroup of cutaneous atopic diathesis.

CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE ITCHING SEVERITY SCALE IN CHILDREN AND ADOLESCENTS WITH ATOPIC DERMATITIS

PubMed Central

Bruscky, Dayanne Mota Veloso; Melo, Ana Caroline Cavalcanti Dela Bianca; Sarinho, Emanuel Sávio Cavalcanti

2017-01-01

ABSTRACT Objective: To translate, adapt and validate the Itch Severity Scale to a Brazilian version (ISS-Ped) in order to measure the severity of pruritus in children and adolescents with atopic dermatitis. Methods: This is a methodological study of validation of an instrument following recommended protocols. The translated version was evaluated by a group of experts including one professional with experience in instrument validation, three English teachers, one linguistics teacher and seven allergists. After this, the scale was applied to 42 parents of children aged between 2 and 18 years old with atopic dermatitis, and 42 parents of children without pruritic diseases. Results were evaluated according to the severity of atopic dermatitis and disease control, and they were compared between groups with and without atopic dermatitis. Results: More than 90% of the questions were clear to the parents. The ISS-Ped showed a strong positive correlation with the severity of atopic dermatitis (Pearson: 0.74; p<0.001) and a good correlation with the control of dermatitis (point-biserial correlation coefficient: 0.65; p<0.001). The scale showed excellent internal consistency (Cronbach’s α: 0.96) and adequate test and retest agreement (95% confidence interval of intraclass correlation coefficient: 0.89-0.99; p<0.001). Conclusions: The ISS-Ped is a feasible, valid, reliable and satisfactorily equivalent. The translated scale was appropriate to assess the severity of itching in children and adolescents with eczema, allowing comparisons in the clinical practice and in the research setting. PMID:28977301

Harmful Effects of Synthetic Surface-Active Detergents against Atopic Dermatitis.

PubMed

Deguchi, Hajime; Aoyama, Riho; Takahashi, Hideaki; Isobe, Yoshinari; Tsutsumi, Yutaka

2015-01-01

We report herein two cases of intractable atopic dermatitis successfully treated by simply avoiding the contact with surface-active detergents in the daily life and living. The detergents were closely related to the exacerbation and remission of the disease. Steroid ointment was no longer used. We discuss that the removal of horny layer lipids by surface-active detergents accelerates the transepidermal water loss and disturbs the barrier function of the epidermis and thus is intimately involved in the pathogenesis of atopic dermatitis.

[Atopic dermatitis physiopathology].

PubMed

Waton, J

2017-12-01

Our understanding of the physiopathology of atopic dermatitis has much improved over the recent years. Epidermal barrier alterations are integrated into 2 theories called inside out and outside in. They are related to complex immune abnormalities. Understanding their mechanism makes it possible to foresee new therapeutics. Moreover, environmental biodiversity, the diversity of cutaneous microbiota and genetic predispositions in atopic dermatitis lead to a new, more comprehensive theory, « the biodiversity theory », integrating epigenetics. © 2017 Elsevier Masson SAS. Tous droits réservés.

Comorbidity in Atopic Dermatitis.

PubMed

Simpson, Eric L

2012-03-01

The negative impact of atopic dermatitis (AD) often extends beyond the skin. Children with AD experience increased rates of infectious, mental health, and allergic diseases compared to their non-atopic peers. The mechanisms underlying these associations remain elusive. New insights from genetic and epidermal research pinpoint the skin barrier as a primary initiator of AD. Epicutaneous sensitization represents an intriguing new model which links a disrupted skin barrier to the later development of IgE-mediated diseases in patients with AD. Recent epidemiological studies have identified new comorbidities linked to AD as well, including several mental health disorders and obesity. This manuscript reviews the recent literature regarding both classic and newly described AD comorbidities.

AN-2728, a PDE4 inhibitor for the potential topical treatment of psoriasis and atopic dermatitis.

PubMed

Nazarian, Rachel; Weinberg, Jeffrey M

2009-11-01

Cytokines are signaling molecules that are believed to be key factors in perpetuating the inflammatory process in psoriasis and atopic dermatitis. AN-2728, being developed by Anacor Pharmaceuticals Inc, is a topically administered, boron-containing, anti-inflammatory compound that inhibits PDE4 activity and thereby suppresses the release of TNFalpha, IL-12, IL-23 and other cytokines. At the time of publication, three phase Ib clinical trials, a IIa trial and a IIb trial of AN-2728 in patients with psoriasis had been completed; the compound was also undergoing phase II development for atopic dermatitis, but no data were available for this indication. AN-2728 was reported to be well tolerated and to demonstrate significant effects on markers of efficacy, with results that were comparable to positive controls. AN-2728 appears to have good therapeutic potential, although further and larger trials are required to assess the long-term safety and characterize the broad utility of this drug.

Exposure to pets and atopic dermatitis during the first two years of life. A cohort study.

PubMed

Zirngibl, Angelika; Franke, Kaethe; Gehring, Ulrike; von Berg, Andrea; Berdel, Dietrich; Bauer, Carl Peter; Reinhardt, Dietrich; Wichmann, H-Erich; Heinrich, Joachim

2002-12-01

The aim of this study was to assess the association between keeping pets in early childhood and the occurrence of atopic dermatitis in an ongoing birth cohort followed up to the age of 2 years. We analyzed data of 4578 children in the intervention and observation part of an ongoing cohort study. The children were recruited at birth in the two study regions Wesel and Munich between January 1996 and June 1998. Information on atopic diseases and pet ownership was obtained by questionnaire at the child's first and second birthday. The logistic regression model showed a negative association between 'keeping any pet' and in particular 'keeping dogs' in the 1st year of life and the development of atopic dermatitis in the 1st and the 2nd years of life. The protective effects remained statistically significant after adjusting for several possible confounding variables (1st year(any) pet OR 0.71, 95% CI [0.55;0.92], 1st year(dog) OR 0.62, 95% CI [0.39;0.98], 2nd year(any) pet OR 0.74, 95% CI [0.57;0.97], 2nd year(dog) OR 0.63, 95% CI [0.40;0.98]). Ownership of small furred pets (hamster, rabbit and guinea pig) also showed a borderline protective effect for the 1st year. We assume an association between keeping pets and undefined environmental factor(s) that contribute protectively to the development of atopic dermatitis in early life, presumably by effects on the maturation of the immune system.

HPV16-E7 Expression in skin induces TSLP secretion, type 2 ILC infiltration and atopic dermatitis-like lesions

PubMed Central

Bergot, Anne-Sophie; Monnet, Nastasia; Tran, Le Son; Mittal, Deepak; Al-Kouba, Jane; Steptoe, Raymond J.; Grimbaldeston, Michele A.; Frazer, Ian H.; Wells, James W.

2014-01-01

Atopic dermatitis is a common pruritic and inflammatory skin disorder with unknown etiology. Most commonly occurring during early childhood, atopic dermatitis is associated with eczematous lesions and lichenification, in which the epidermis becomes hypertrophied resulting in thickening of the skin. In this study, we report an atopic dermatitis-like pathophysiology results in a murine model following the expression of the high-risk Human Papillomavirus (HPV) 16 oncoprotein E7 in keratinocytes under the Keratin 14 promoter. We show that HPV 16 E7 expression in the skin is associated with skin thickening, acanthosis and light spongiosis. Locally, HPV 16 E7 expressing skin secreted high levels of TSLP and contained increased numbers of ILCs. High levels of circulating IgE were associated with increased susceptibility to skin allergy in a model of cutaneous challenge, and to airway bronchiolar inflammation, enhanced airway goblet cell metaplasia and mucus production in a model of atopic march. Surprisingly, skin pathology occurred independently of T-cells and mast cells. Thus, our findings suggest that the expression of a single HPV oncogene in the skin can drive the onset of atopic dermatitis-like pathology through the induction of TSLP and type 2 ILC infiltration. PMID:25601274

Erythrocyte and plasma fatty acid patterns in dogs with atopic dermatitis and healthy dogs in the same household

PubMed Central

Zimmermann, Annett; Gück, Thomas; Oechtering, Gerhard

2006-01-01

Abstract Recent studies have indicated that dogs with canine atopic dermatitis (CAD) may have a disorder of fatty acid metabolism: possibly low or absent activity of Δ6-desaturase or Δ5-desaturase, or both. To clarify this possibility, we examined the erythrocyte and plasma fatty acid patterns of 8 dogs with CAD and their 8 healthy housemates. Atopic dermatitis was diagnosed according to the criteria proposed by Willemse; other causes of dermatitis were excluded clinically and by appropriate tests. Erythrocyte ghosts were prepared from blood samples. Membrane lipids were extracted and separated by thin-layer chromatography. From plasma and lipid fractions, fatty acid content was determined by gas chromatography. In erythrocytes, but not in plasma, we observed significant differences in the fatty acid pattern that suggested a reduction in the n6 fatty acid products of the Δ6- and Δ5-desaturases in dogs with atopic dermatitis when compared with healthy housemates. PMID:16850941

Multi-ethnic genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis

PubMed Central

Waage, Johannes; Baurecht, Hansjörg; Hotze, Melanie; Strachan, David P; Curtin, John A; Bønnelykke, Klaus; Tian, Chao; Takahashi, Atsushi; Esparza-Gordillo, Jorge; Alves, Alexessander Couto; Thyssen, Jacob P; den Dekker, Herman T; Ferreira, Manuel A; Altmaier, Elisabeth; Sleiman, Patrick MA; Xiao, Feng Li; Gonzalez, Juan R; Marenholz, Ingo; Kalb, Birgit; Yanes, Maria Pino; Xu, Cheng-Jian; Carstensen, Lisbeth; Groen-Blokhuis, Maria M; Venturini, Cristina; Pennell, Craig E; Barton, Sheila J; Levin, Albert M; Curjuric, Ivan; Bustamante, Mariona; Kreiner-Møller, Eskil; Lockett, Gabrielle A; Bacelis, Jonas; Bunyavanich, Supinda; Myers, Rachel A; Matanovic, Anja; Kumar, Ashish; Tung, Joyce Y; Hirota, Tomomitsu; Kubo, Michiaki; McArdle, Wendy L; Henderson, A J; Kemp, John P; Zheng, Jie; Smith, George Davey; Rüschendorf, Franz; Bauerfeind, Anja; Lee-Kirsch, Min Ae; Arnold, Andreas; Homuth, Georg; Schmidt, Carsten O; Mangold, Elisabeth; Cichon, Sven; Keil, Thomas; Rodríguez, Elke; Peters, Annette; Franke, Andre; Lieb, Wolfgang; Novak, Natalija; Fölster-Holst, Regina; Horikoshi, Momoko; Pekkanen, Juha; Sebert, Sylvain; Husemoen, Lise L; Grarup, Niels; de Jongste, Johan C; Rivadeneira, Fernando; Hofman, Albert; Jaddoe, Vincent WV; Pasmans, Suzanne GMA; Elbert, Niels J; Uitterlinden, André G; Marks, Guy B; Thompson, Philip J; Matheson, Melanie C; Robertson, Colin F; Ried, Janina S; Li, Jin; Zuo, Xian Bo; Zheng, Xiao Dong; Yin, Xian Yong; Sun, Liang Dan; McAleer, Maeve A; O'Regan, Grainne M; Fahy, Caoimhe MR; Campbell, Linda E; Macek, Milan; Kurek, Michael; Hu, Donglei; Eng, Celeste; Postma, Dirkje S; Feenstra, Bjarke; Geller, Frank; Hottenga, Jouke Jan; Middeldorp, Christel M; Hysi, Pirro; Bataille, Veronique; Spector, Tim; Tiesler, Carla MT; Thiering, Elisabeth; Pahukasahasram, Badri; Yang, James J; Imboden, Medea; Huntsman, Scott; Vilor-Tejedor, Natàlia; Relton, Caroline L; Myhre, Ronny; Nystad, Wenche; Custovic, Adnan; Weiss, Scott T; Meyers, Deborah A; Söderhäll, Cilla; Melén, Erik; Ober, Carole; Raby, Benjamin A; Simpson, Angela; Jacobsson, Bo; Holloway, John W; Bisgaard, Hans; Sunyer, Jordi; Hensch, Nicole M Probst; Williams, L Keoki; Godfrey, Keith M; Wang, Carol A; Boomsma, Dorret I; Melbye, Mads; Koppelman, Gerard H; Jarvis, Deborah; McLean, WH Irwin; Irvine, Alan D; Zhang, Xue Jun; Hakonarson, Hakon; Gieger, Christian; Burchard, Esteban G; Martin, Nicholas G; Duijts, Liesbeth; Linneberg, Allan; Jarvelin, Marjo-Riitta; Noethen, Markus M; Lau, Susanne; Hübner, Norbert; Lee, Young-Ae; Tamari, Mayumi; Hinds, David A; Glass, Daniel; Brown, Sara J; Heinrich, Joachim; Evans, David M; Weidinger, Stephan

2015-01-01

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified 10 novel risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with novel secondary signals at 4 of these). Notably, the new loci include candidate genes with roles in regulation of innate host defenses and T-cell function, underscoring the important contribution of (auto-)immune mechanisms to atopic dermatitis pathogenesis. PMID:26482879

Multi-ancestry genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis.

PubMed

Paternoster, Lavinia; Standl, Marie; Waage, Johannes; Baurecht, Hansjörg; Hotze, Melanie; Strachan, David P; Curtin, John A; Bønnelykke, Klaus; Tian, Chao; Takahashi, Atsushi; Esparza-Gordillo, Jorge; Alves, Alexessander Couto; Thyssen, Jacob P; den Dekker, Herman T; Ferreira, Manuel A; Altmaier, Elisabeth; Sleiman, Patrick Ma; Xiao, Feng Li; Gonzalez, Juan R; Marenholz, Ingo; Kalb, Birgit; Yanes, Maria Pino; Xu, Cheng-Jian; Carstensen, Lisbeth; Groen-Blokhuis, Maria M; Venturini, Cristina; Pennell, Craig E; Barton, Sheila J; Levin, Albert M; Curjuric, Ivan; Bustamante, Mariona; Kreiner-Møller, Eskil; Lockett, Gabrielle A; Bacelis, Jonas; Bunyavanich, Supinda; Myers, Rachel A; Matanovic, Anja; Kumar, Ashish; Tung, Joyce Y; Hirota, Tomomitsu; Kubo, Michiaki; McArdle, Wendy L; Henderson, A J; Kemp, John P; Zheng, Jie; Smith, George Davey; Rüschendorf, Franz; Bauerfeind, Anja; Lee-Kirsch, Min Ae; Arnold, Andreas; Homuth, Georg; Schmidt, Carsten O; Mangold, Elisabeth; Cichon, Sven; Keil, Thomas; Rodríguez, Elke; Peters, Annette; Franke, Andre; Lieb, Wolfgang; Novak, Natalija; Fölster-Holst, Regina; Horikoshi, Momoko; Pekkanen, Juha; Sebert, Sylvain; Husemoen, Lise L; Grarup, Niels; de Jongste, Johan C; Rivadeneira, Fernando; Hofman, Albert; Jaddoe, Vincent Wv; Pasmans, Suzanne Gma; Elbert, Niels J; Uitterlinden, André G; Marks, Guy B; Thompson, Philip J; Matheson, Melanie C; Robertson, Colin F; Ried, Janina S; Li, Jin; Zuo, Xian Bo; Zheng, Xiao Dong; Yin, Xian Yong; Sun, Liang Dan; McAleer, Maeve A; O'Regan, Grainne M; Fahy, Caoimhe Mr; Campbell, Linda E; Macek, Milan; Kurek, Michael; Hu, Donglei; Eng, Celeste; Postma, Dirkje S; Feenstra, Bjarke; Geller, Frank; Hottenga, Jouke Jan; Middeldorp, Christel M; Hysi, Pirro; Bataille, Veronique; Spector, Tim; Tiesler, Carla Mt; Thiering, Elisabeth; Pahukasahasram, Badri; Yang, James J; Imboden, Medea; Huntsman, Scott; Vilor-Tejedor, Natàlia; Relton, Caroline L; Myhre, Ronny; Nystad, Wenche; Custovic, Adnan; Weiss, Scott T; Meyers, Deborah A; Söderhäll, Cilla; Melén, Erik; Ober, Carole; Raby, Benjamin A; Simpson, Angela; Jacobsson, Bo; Holloway, John W; Bisgaard, Hans; Sunyer, Jordi; Hensch, Nicole M Probst; Williams, L Keoki; Godfrey, Keith M; Wang, Carol A; Boomsma, Dorret I; Melbye, Mads; Koppelman, Gerard H; Jarvis, Deborah; McLean, Wh Irwin; Irvine, Alan D; Zhang, Xue Jun; Hakonarson, Hakon; Gieger, Christian; Burchard, Esteban G; Martin, Nicholas G; Duijts, Liesbeth; Linneberg, Allan; Jarvelin, Marjo-Riitta; Noethen, Markus M; Lau, Susanne; Hübner, Norbert; Lee, Young-Ae; Tamari, Mayumi; Hinds, David A; Glass, Daniel; Brown, Sara J; Heinrich, Joachim; Evans, David M; Weidinger, Stephan

2015-12-01

Genetic association studies have identified 21 loci associated with atopic dermatitis risk predominantly in populations of European ancestry. To identify further susceptibility loci for this common, complex skin disease, we performed a meta-analysis of >15 million genetic variants in 21,399 cases and 95,464 controls from populations of European, African, Japanese and Latino ancestry, followed by replication in 32,059 cases and 228,628 controls from 18 studies. We identified ten new risk loci, bringing the total number of known atopic dermatitis risk loci to 31 (with new secondary signals at four of these loci). Notably, the new loci include candidate genes with roles in the regulation of innate host defenses and T cell function, underscoring the important contribution of (auto)immune mechanisms to atopic dermatitis pathogenesis.

Instant noodles, processed food intake, and dietary pattern are associated with atopic dermatitis in an adult population (KNHANES 2009-2011).

PubMed

Park, Sunmin; Choi, Hyun-Seok; Bae, Ji-Hyun

2016-01-01

The incidence of atopic dermatitis (AD) is continuously increasing in industrialized countries, possibly due to dietary and lifestyle changes. However, the association between processed food intake and AD has not been studied in a large adult population. We investigated the association between dietary habits and AD in 17,497 adults in the 2009-2011 Korean National Health and Nutrition Examination Survey (KNHANES). We identified 4 dietary patterns using principal components analysis of a 63-item food frequency questionnaire: the "traditional dietary pattern", rich in rice and kimchi; the "processed food pattern", with more meat, instant noodles, soda, and processed foods; the "healthy dietary pattern", high in grains, vegetables, fruits, and seaweeds; and the "drinking dietary pattern", mainly drinking coffee and alcohol. Adjusted odds ratios (ORs) for AD were calculated according to dietary patterns after adjusting for potential confounders with incorporation of sample weights for the complex sample design. The "meat and processed food" pattern was associated with a significant 1.57 fold higher OR for atopic dermatitis than the low consumption group. Further analysis revealed that the increased atopic dermatitis was most closely associated with instant noodles. In contrast, the groups with high intake of rice and kimchi exhibited lower ORs, 0.38 and 0.43 folds, compared to the low intake group. Consuming instant noodles, meat and processed foods was associated with increased prevalence of atopic dermatitis, whereas consuming rice and kimchi, and coffee was associated with decreased prevalence of atopic dermatitis.

Targeted Resequencing and Functional Testing Identifies Low-Frequency Missense Variants in the Gene Encoding GARP as Significant Contributors to Atopic Dermatitis Risk.

PubMed

Manz, Judith; Rodríguez, Elke; ElSharawy, Abdou; Oesau, Eva-Maria; Petersen, Britt-Sabina; Baurecht, Hansjörg; Mayr, Gabriele; Weber, Susanne; Harder, Jürgen; Reischl, Eva; Schwarz, Agatha; Novak, Natalija; Franke, Andre; Weidinger, Stephan

2016-12-01

Gene-mapping studies have consistently identified a susceptibility locus for atopic dermatitis and other inflammatory diseases on chromosome band 11q13.5, with the strongest association observed for a common variant located in an intergenic region between the two annotated genes C11orf30 and LRRC32. Using a targeted resequencing approach we identified low-frequency and rare missense mutations within the LRRC32 gene encoding the protein GARP, a receptor on activated regulatory T cells that binds latent transforming growth factor-β. Subsequent association testing in more than 2,000 atopic dermatitis patients and 2,000 control subjects showed a significant excess of these LRRC32 variants in individuals with atopic dermatitis. Structural protein modeling and bioinformatic analysis predicted a disruption of protein transport upon these variants, and overexpression assays in CD4 + CD25 - T cells showed a significant reduction in surface expression of the mutated protein. Consistently, flow cytometric (FACS) analyses of different T-cell subtypes obtained from atopic dermatitis patients showed a significantly reduced surface expression of GARP and a reduced conversion of CD4 + CD25 - T cells into regulatory T cells, along with lower expression of latency-associated protein upon stimulation in carriers of the LRRC32 A407T variant. These results link inherited disturbances of transforming growth factor-β signaling with atopic dermatitis risk. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Randomized controlled trial using vitamins E and D supplementation in atopic dermatitis.

PubMed

Javanbakht, Mohammad Hassan; Keshavarz, Seyed Ali; Djalali, Mahmoud; Siassi, Fereydoun; Eshraghian, Mohammad Reza; Firooz, Alireza; Seirafi, Hassan; Ehsani, Amir Hooshang; Chamari, Maryam; Mirshafiey, Abbas

2011-06-01

Atopic dermatitis is a chronically relapsing, highly pruritic and inflammatory skin disease. This study was done to assess the effects of vitamins D and E supplementation on the clinical manifestation of atopic dermatitis. Forty-five atopic dermatitis patients were included in a randomized, double-blind, placebo-controlled trial. They were randomly divided into four groups and treated for 60 days: group P (n = 11), vitamins D and E placebos; group D (n = 12), 1600 IU vitamin D(3) plus vitamin E placebo; group E (n = 11), 600 IU synthetic all-rac-α-tocopherol plus vitamin D placebo; and group DE (n = 11), 1600 IU vitamin D(3) plus 600 IU synthetic all-rac-α-tocopherol. Serum 25(OH) vitamin D and plasma α-tocopherol were determined before and after the trial. The clinical improvement was evaluated with SCORing Atopic Dermatitis (SCORAD). Data were analyzed by analysis of variance (ANOVA) and Kruskal-Wallis tests. SCORAD was reduced after 60 days in groups D, E and DE by 34.8%, 35.7% and 64.3%, respectively (p = 0.004). Objective SCORAD also showed significant improvement. There was a positive correlation between SCORAD and intensity, objective, subjective and extent (p < 0.001). We found a significant negative association between plasma α-tocopherol and SCORAD, intensity, objective and extent (p = 0.02). This study supports the contributing and beneficial effects of vitamins D and E in the treatment of atopic dermatitis.

GUIDELINES OF CARE FOR THE MANAGEMENT OF ATOPIC DERMATITIS

PubMed Central

Eichenfield, Lawrence F.; Tom, Wynnis L.; Chamlin, Sarah L.; Feldman, Steven R.; Hanifin, Jon M.; Simpson, Eric L.; Berger, Timothy G.; Bergman, James N.; Cohen, David E.; Cooper, Kevin D.; Cordoro, Kelly M.; Davis, Dawn M.; Krol, Alfons; Margolis, David J.; Paller, Amy S.; Schwarzenberger, Kathryn; Silverman, Robert A.; Williams, Hywel C.; Elmets, Craig A.; Block, Julie; Harrod, Christopher G.; Begolka, Wendy Smith; Sidbury, Robert

2014-01-01

Atopic dermatitis (AD) is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2–3% of adults. This guideline addresses important clinical questions that arise in AD management and care, providing updated and expanded recommendations based on the available evidence. In this first of four sections, methods for diagnosis and monitoring of disease, outcomes measures for assessment and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed. PMID:24290431

Discovery and structure-activity study of a novel benzoxaborole anti-inflammatory agent (AN2728) for the potential topical treatment of psoriasis and atopic dermatitis.

PubMed

Akama, Tsutomu; Baker, Stephen J; Zhang, Yong-Kang; Hernandez, Vincent; Zhou, Huchen; Sanders, Virginia; Freund, Yvonne; Kimura, Richard; Maples, Kirk R; Plattner, Jacob J

2009-04-15

A series of phenoxy benzoxaboroles were synthesized and screened for their inhibitory activity against PDE4 and cytokine release. 5-(4-Cyanophenoxy)-2,3-dihydro-1-hydroxy-2,1-benzoxaborole (AN2728) showed potent activity both in vitro and in vivo. This compound is now in clinical development for the topical treatment of psoriasis and being pursued for the topical treatment of atopic dermatitis.

Tissue immunostaining for factor XIIIa in dermal dendrocytes of pityriasis alba skin lesions*

PubMed Central

Carneiro, Francisca Regina Oliveira; do Amaral, Gabriela Borborema; Mendes, Maiana Darwich; Quaresma, Juarez Antônio Simões

2014-01-01

BACKGROUND Pityriasis alba affects 1% of the world population and about 9.9% of the children in Brazil. However, its etiology remains uncertain. OBJECTIVE The objective of the present study was to evaluate the immunoexpression of factor XIIIa in dermal dendrocytes of skin lesions of pityriasis alba. METHOD Twenty patients with pityriasis alba and 20 patients with atopic dermatitis underwent biopsy. The dermal dendrocytes marked by factor XIIIa were counted by means of immunohistochemical analysis. RESULTS The mean amount of dermal dendrocytes found in the patients with pityriasis alba was 2, whereas in the patients with atopic dermatitis it was 4, with a statistically significant difference between them. A cutoff point of 3 cells/square inch was established to differentiate pityriasis alba from atopic dermatitis, with 80% sensibility and 90% specificity. CONCLUSION We believe that pityriasis alba and atopic dermatitis should be considered different clinical forms within the spectrum of atopic disease, in which sun radiation plays an important role by modulating the progression of the disease. PMID:24770500

Formaldehyde-Induced Aggravation of Pruritus and Dermatitis Is Associated with the Elevated Expression of Th1 Cytokines in a Rat Model of Atopic Dermatitis

PubMed Central

Back, Seung Keun; Lee, Hyunkyoung; Lee, JaeHee; Kim, Hye young; Kim, Hee Jin; Na, Heung Sik

2016-01-01

Atopic dermatitis is a complex disease of heterogeneous pathogenesis, in particular, genetic predisposition, environmental triggers, and their interactions. Indoor air pollution, increasing with urbanization, plays a role as environmental risk factor in the development of AD. However, we still lack a detailed picture of the role of air pollution in the development of the disease. Here, we examined the effect of formaldehyde (FA) exposure on the manifestation of atopic dermatitis and the underlying molecular mechanism in naive rats and in a rat model of atopic dermatitis (AD) produced by neonatal capsaicin treatment. The AD and naive rats were exposed to 0.8 ppm FA, 1.2 ppm FA, or fresh air (Air) for 6 weeks (2 hours/day and 5 days/week). So, six groups, namely the 1.2 FA-AD, 0.8 FA-AD, Air-AD, 1.2 FA-naive, 0.8 FA-naive and Air-naive groups, were established. Pruritus and dermatitis, two major symptoms of atopic dermatitis, were evaluated every week for 6 weeks. After that, samples of the blood, the skin and the thymus were collected from the 1.2 FA-AD, the Air-AD, the 1.2 FA-naive and the Air-naive groups. Serum IgE levels were quantified with ELISA, and mRNA expression levels of inflammatory cytokines from extracts of the skin and the thymus were calculated with qRT-PCR. The dermatitis and pruritus significantly worsened in 1.2 FA-AD group, but not in 0.8 FA-AD, compared to the Air-AD animals, whereas FA didn't induce any symptoms in naive rats. Consistently, the levels of serum IgE were significantly higher in 1.2 FA-AD than in air-AD, however, there was no significant difference following FA exposure in naive animals. In the skin, mRNA expression levels of Th1 cytokines such as TNF-α and IL-1β were significantly higher in the 1.2 FA-AD rats compared to the air-AD rats, whereas mRNA expression levels of Th2 cytokines (IL-4, IL-5, IL-13), IL-17A and TSLP were significantly higher in 1.2 FA-naive group than in the Air-naive group. These results suggested that 1.2 ppm of FA penetrated the injured skin barrier, and exacerbated Th1 responses and serum IgE level in the AD rats so that dermatitis and pruritus were aggravated, while the elevated expression of Th2 cytokines by 1.2 ppm of FA in naive rats was probably insufficient for clinical manifestation. In conclusion, in a rat model of atopic dermatitis, exposure to 1.2 ppm of FA aggravated pruritus and skin inflammation, which was associated with the elevated expression of Th1 cytokines. PMID:28005965

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: first results of ETAC. Early Treatment of the Atopic Child.

PubMed

1998-08-01

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (> or = 30 kU/l) or specific IgE (> or = 0.35 kUA/l) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.

Atopic dermatitis results in intrinsic barrier and immune abnormalities: Implications for contact dermatitis

PubMed Central

Gittler, Julia K.; Krueger, James G.; Guttman-Yassky, Emma

2014-01-01

Atopic dermatitis (AD), as well as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), are common skin diseases. These diseases are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Although AD, ICD, and ACD can be encountered in pure forms by allergists and dermatologists, patients with AD often present with increased frequency of ICD and ACD. Although a disturbed barrier alone could potentiate immune reactivity in patients with AD through increased antigen penetration, additional immune mechanisms might explain the increased susceptibility of atopic patients to ICD and ACD. This review discusses cellular pathways associated with increased skin inflammation in all 3 conditions and presents mechanisms that might contribute to the increased rate of ICD and ACD in patients with AD. PMID:22939651

Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology.

PubMed

Muraro, Antonella; Lemanske, Robert F; Hellings, Peter W; Akdis, Cezmi A; Bieber, Thomas; Casale, Thomas B; Jutel, Marek; Ong, Peck Y; Poulsen, Lars K; Schmid-Grendelmeier, Peter; Simon, Hans-Uwe; Seys, Sven F; Agache, Ioana

2016-05-01

In this consensus document we summarize the current knowledge on major asthma, rhinitis, and atopic dermatitis endotypes under the auspices of the PRACTALL collaboration platform. PRACTALL is an initiative of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology aiming to harmonize the European and American approaches to best allergy practice and science. Precision medicine is of broad relevance for the management of asthma, rhinitis, and atopic dermatitis in the context of a better selection of treatment responders, risk prediction, and design of disease-modifying strategies. Progress has been made in profiling the type 2 immune response-driven asthma. The endotype driven approach for non-type 2 immune response asthma, rhinitis, and atopic dermatitis is lagging behind. Validation and qualification of biomarkers are needed to facilitate their translation into pathway-specific diagnostic tests. Wide consensus between academia, governmental regulators, and industry for further development and application of precision medicine in management of allergic diseases is of utmost importance. Improved knowledge of disease pathogenesis together with defining validated and qualified biomarkers are key approaches to precision medicine. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Evidence-based treatment of atopic dermatitis with topical moisturizers.

PubMed

Micali, Giuseppe; Paternò, Valentina; Cannarella, Rossella; Dinotta, Franco; Lacarrubba, Francesco

2018-06-01

Skin barrier restoration represents the mainstay of the treatment of atopic dermatitis and the use of moisturizers is recommended by several international guidelines. The aim of the study was to investigate through an evidence-based medicine analysis the effectiveness and safety of different moisturizing products available for a non-pharmacological treatment of atopic dermatitis. A total of 92 randomized controlled trials (RCTs) have been identified and analyzed. The results confirm the presence of a reasonable number of studies highlighting moisturizers safety and effectiveness in the treatment of atopic dermatitis by improving disease severity, increasing the time of relapse and reducing the time of flares. Moisturizers containing urea, glycerin or glycyrrhetinic acid seem to show the greater evidence of efficacy being supported by more clinical trials. Among the existing moisturizers, those containing a single agent generally work although the heterogeneity of RCTs does not allow reaching more definitive conclusions. Moisturizers made of a mixture of substances seem to be more effective thanks to the presence of different active substances that may exert a synergistic effect. A meta-analysis of 4 RCTs confirms the efficacy of a medical device containing glycyrrhetinic acid, hyaluronic acid, shea butter, telmesteine, and vitis vinifera in the treatment of atopic dermatitis.

Clinical and Immunological Changes of Immunotherapy in Patients with Atopic Dermatitis: Randomized Controlled Trial

PubMed Central

Sánchez Caraballo, Jorge Mario; Cardona Villa, Ricardo

2012-01-01

Background. Immunotherapy has proven to be an useful tool in the management of allergic respiratory diseases; however, little has been studied in atopic dermatitis. Objective. To evaluate the clinical and immunological impact of immunotherapy with mites allergen extracts in atopic dermatitis. Methods. Patients with atopic dermatitis were assigned with computer-generated randomization to either of the following groups: (a) controls received only topical treatment with steroids and/or tacrolimus and (b) actively treated patients received topical treatment plus immunotherapy. Levels of serum total IgE, mites-specific IgE and IgG4 were assessed at study start and after one year of immunotherapy. Results. 31 patients in the active group and 29 in the control group completed the study. Symptoms and medication scores were significantly reduced in the active group after six months. Three patients in the control group showed new sensitizations to mites, while 3 patients in the active group showed neosensitization to shrimp with negative oral food challenge. We observed significant increase of mites-specific IgG4 levels in active group. Conclusion. Specific allergen immunotherapy induced a tolerogenic IgG4 response to mite allergens associated with favorable clinical effects in atopic dermatitis patients. PMID:23724240

Asthma and Atopic Dermatitis: A Review of Targeted Inhibition of Interleukin-4 and Interleukin-13 As Therapy for Atopic Disease.

PubMed

Buzney, Catherine D; Gottlieb, Alice B; Rosmarin, David

2016-02-01

Type 2 helper T cell (Th2)-mediated inflammation plays a critical role in the pathogenesis of allergic asthma and atopic dermatitis (AD). Recent research focusing on the suppression of the Th2 axis with targeted inhibitors in atopic disease is showing promising early results. In particular, the simultaneous blockage of interleukin (IL)-4 and IL-13 has successfully mitigated symptoms of allergic asthma and AD in preliminary clinical trials. Given the current therapeutic challenges of treating these chronic and severe diseases, this review brings to light new data demonstrating that agents targeting IL-4 and IL-13 are relatively safe and effective medications in blocking the inflammatory cascade responsible for allergic asthma and atopic dermatitis.

The inhibitory effect of naringenin on atopic dermatitis induced by DNFB in NC/Nga mice.

PubMed

Kim, Tae-Ho; Kim, Gun-Dong; Ahn, Hyun-Jong; Cho, Jeong-Je; Park, Yong Seek; Park, Cheung-Seog

2013-10-10

Atopic dermatitis (AD) is a chronic and relapsing inflammatory dermatitis characterized by pruritic and eczematous skin lesions. Here, we investigated the therapeutic effect of the fruit flavonoid naringenin on DNFB induced atopic dermatitis mice model. AD-like skin lesion was induced by repetitive skin contact with DNFB in NC/Nga mice and the effects of the fruit flavonoid naringenin were evaluated on the basis of histopathological findings of skin, ear swelling and cytokine production of CD4(+)T cells. Intraperitoneal injection of naringenin for one week after DNFB challenge significantly lowered ear swelling and improved back skin lesions. In addition, naringenin significantly suppressed production of interferon-gamma (IFN-γ) by activated CD4(+) T cells and serum IgE level. Furthermore, naringenin reduced DNFB-induced infiltration of eosinophils, mast cells, CD4(+) T cells, and CD8(+) T cells in skin lesions. Naringenin may suppress the development of AD-like skin lesions in DNFB-treated NC/Nga mice by reducing IFN-γ production of activated CD4(+) T cells, serum IgE levels and infiltration of immune cells to skin lesion. © 2013.

Systemic Agents for Severe Atopic Dermatitis in Children.

PubMed

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.

Therapeutic strategies for allergic diseases

NASA Astrophysics Data System (ADS)

Barnes, Peter J.

1999-11-01

Many drugs are now in development for the treatment of atopic diseases, including asthma, allergic rhinitis and atopic dermatitis. These treatments are based on improvements in existing therapies or on a better understanding of the cellular and molecular mechanisms involved in atopic diseases. Although most attention has been focused on asthma, treatments that inhibit the atopic disease process would have application to all atopic diseases, as they often coincide. Most of the many new therapies in development are aimed at inhibiting components of the allergic inflammatory response, but in the future there are real possibilities for the development of preventative and even curative treatments.

[Interpretation of laboratory tests for allergies in dogs].

PubMed

Roosje, P

2010-03-01

There is widespread use of serum allergy tests which are promoted for identifying the reaction against certain allergens in atopic dermatitis, sarcoptes infestation and also food hypersensitivity in dogs. Around 20 years ago the first in-vitro tests were developed to identify allergen-specific IgE in dogs with atopic dermatitis. Since then, technical developments have markedly improved the quality of antibodies as well as the methods. The limitation of serum tests lies in the interpretation of test results as well as the diseases they are used for. This overview discusses usefulness and limitations in different skin diseases.

Vitamin D in atopic dermatitis, asthma and allergic diseases.

PubMed

Searing, Daniel A; Leung, Donald Y M

2010-08-01

This review examines the scientific evidence behind the hypothesis that vitamin D plays a role in the pathogenesis of allergic diseases, along with a focus on emerging data regarding vitamin D and atopic dermatitis. Elucidated molecular interactions of vitamin D with components of the immune system and clinical data regarding vitamin D deficiency and atopic diseases are discussed. The rationale behind the sunshine hypothesis, laboratory evidence supporting links between vitamin D deficiency and allergic diseases, the clinical evidence for and against vitamin D playing a role in allergic diseases, and the emerging evidence regarding the potential use of vitamin D to augment the innate immune response in atopic dermatitis are reviewed. Copyright 2010 Elsevier Inc. All rights reserved.

Physicians' perceptions of an eczema action plan for atopic dermatitis.

PubMed

Ntuen, Edidiong; Taylor, Sarah L; Kinney, Megan; O'Neill, Jenna L; Krowchuk, Daniel P; Feldman, Steven R

2010-01-01

Poor adherence to topical medications in atopic dermatitis may lead to exposure to more costly and potentially toxic systemic agents. Written action plans (WAPs) improve adherence and treatment outcomes in asthma patients and may be useful for children with atopic dermatitis. To assess physicians' perceptions of a WAP for atopic dermatitis and their openness to using it. An Eczema Action Plan (EAP) was modeled from those used in pediatric asthma. A brief survey to assess the perceived practicality and usefulness of the EAP was sent to 48 pediatricians in our local area and to 17 pediatric dermatologists nationally. Survey items included layout, graphics, readability, accuracy, and utility. Qualitative analyses were performed due to small sample sizes. Seventeen pediatricians from five community practices and eight pediatric dermatologists responded (response rates of 35% and 41%, respectively). Layout was rated as excellent by 59% of pediatricians and 43% of pediatric dermatologists, the graphics were rated good (60% and 70%), the readability as good to excellent (100% and 86%), the accuracy as excellent or good (83% and 86%), and usefulness as good to excellent (100% of both groups). Most (71%) of the pediatric dermatologists reported already having their own patient education materials for atopic dermatitis, but none of the pediatricians did. All pediatricians and 60% of pediatric dermatologists reported they were likely to use the EAP in their clinical practices. Limitations included the sample size being small, but it still provided for qualitative assessment of generalists and sub-specialists. We did not assess how the EAP would be perceived by patients or their families. The practice settings of the community and academic physicians are not identical, which may make for weakened comparisons. Pediatricians are open to using an EAP for atopic dermatitis. If an EAP were effective at improving adherence and outcomes in atopic dermatitis, widespread implementation should be feasible.

Use of moisturizers in dermatologic disease: the role of healthcare providers in optimizing treatment outcomes.

PubMed

Nicol, Noreen Heer

2005-12-01

Although atopic dermatitis is a common cutaneous disorder, patients often are frustrated in their attempts to understand the disease and its treatment. Studies have shown that the patient-provider relationship is key to patient compliance with a skin care regimen and that most patients with atopic dermatitis are eager to be well informed. However, many patients fail to receive an adequate explanation of the causes of atopic dermatitis or to be taught how to apply topical treatments, even though instruction and practical demonstrations are associated with a dramatic improvement in the treatment outcome. Efforts to educate patients regarding the use of moisturizers are correlated with clinical improvement and a reduction in the use of topical medications such as corticosteroids and calcineurin inhibitors. In addition to topical moisturizers, medications, wet wraps, and hydration therapy has become a frequently used practice in the management of atopic dermatitis.

Atopic dermatitis: an overview.

PubMed

Berke, Rebecca; Singh, Arshdeep; Guralnick, Mark

2012-07-01

Atopic dermatitis, also known as atopic eczema, is a chronic pruritic skin condition affecting approximately 17.8 million persons in the United States. It can lead to significant morbidity. A simplified version of the U.K. Working Party's Diagnostic Criteria can help make the diagnosis. Asking about the presence and frequency of symptoms can allow physicians to grade the severity of the disease and response to treatment. Management consists of relieving symptoms and lengthening time between flare-ups. Regular, liberal use of emollients is recommended. The primary pharmacologic treatment is topical corticosteroids. Twice-daily or more frequent application has not been shown to be more effective than once-daily application. A maintenance regimen of topical corticosteroids may reduce relapse rates in patients who have recurrent moderate to severe atopic dermatitis. Pimecrolimus and tacrolimus are calcineurin inhibitors that are recommended as second-line treatment for persons with moderate to severe atopic dermatitis and who are at risk of atrophy from topical corticosteroids. Although the U.S. Food and Drug Administration has issued a boxed warning about a possible link between these medications and skin malignancies and lymphoma, studies have not demonstrated a clear link. Topical and oral antibiotics may be used to treat secondary bacterial infections, but are not effective in preventing atopic dermatitis flare-ups. The effectiveness of alternative therapies, such as Chinese herbal preparations, homeopathy, hypnotherapy/biofeedback, and massage therapy, has not been established.

Diaper area skin microflora of normal children and children with atopic dermatitis.

PubMed Central

Keswick, B H; Seymour, J L; Milligan, M C

1987-01-01

In vitro studies established that neither cloth nor disposable diapers demonstrably contributed to the growth of Escherichia coli, Proteus vulgaris, Staphylococcus aureus, or Candida albicans when urine was present as a growth medium. In a clinical study of 166 children, the microbial skin flora of children with atopic dermatitis was compared with the flora of children with normal skin to determine the influence of diaper type. No biologically significant differences were detected between groups wearing disposable or cloth diapers in terms of frequency of isolation or log mean recovery of selected skin flora. Repeated isolation of S. aureus correlated with atopic dermatitis. The log mean recovery of S. aureus was higher in the atopic groups. The effects of each diaper type on skin microflora were equivalent in the normal and atopic populations. PMID:3546360

[Observational study to evaluate the impact of an educational/informative intervention in the emotional status (anxiety) of patients with atopic dermatitis (CUIDA-DEL)].

PubMed

Guerra-Tapia, A; Lleonart, M; Balañá, M

2007-05-01

One of the first therapeutic measures in atopic dermatitis should be the educational and informative approach about prophylactic aspects and evolution of the disease. This type of proceedings has been shown to be beneficial for the anxious type of emotional status in patients with atopic dermatitis. We evaluated the impact of an educational/informative intervention in the emotional status (anxiety) of patients with atopic dermatitis in Spain. Investigators were randomized into two study groups: the control group (CG) that followed current clinical practice and the intervention group (IG) that handed patients, in each visit, a booklet of information about different prophylactic aspects and care of atopic dermatitis. The duration of the study was 6 months with quarterly visits. All included patients had a diagnosis of atopic dermatitis. Anxiety was evaluated with the STAI anxiety questionnaire and clinical data regarding dermatological aspects (IGA, pruritus scale, location of the lesions) were also recorded. A total of 1,247 patients were recruited thanks to the collaboration of 158 investigators. Patients were distributed as follows: 683 (54.7 %) in the CG and 564 (45.2 %) in the IG. Both group were homogeneous with respect to basal characteristics, and were constituted by 54 % of women with a mean age of 19 years. Eighty-six percent of atopic dermatitis lesions were preferentially located in extremities. Patients of both study groups showed improvement in their emotional status (trait and state anxiety) throughout the study with significant decreases in the STAI scores compared to basal ones. Regarding improvement in the questionnaire scores, no significant differences were observed between groups except in children aged 9 to 15 years, in the pediatric version of the STAI trait where the percentage of score decrease at 6 months adjusted to the basal score was 5.5 (19.0) for the CG and 10.6 (18.9) for the IG, (p < 0.05). A higher percentage of patients finished the study in the IG compared to the CG (83.1 % vs. 76.1 % p < 0.005). Although patients in the IG showed greater compliance with the follow-up of the study, the informative intervention about prophylactic aspects of atopic dermatitis designed in this study does not appear to have had an impact in improving the emotional status of adult patients.

Topical application of rapamycin ointment ameliorates Dermatophagoides farina body extract-induced atopic dermatitis in NC/Nga mice.

PubMed

Yang, Fei; Tanaka, Mari; Wataya-Kaneda, Mari; Yang, Lingli; Nakamura, Ayumi; Matsumoto, Shoji; Attia, Mostafa; Murota, Hiroyuki; Katayama, Ichiro

2014-08-01

Atopic dermatitis (AD), a chronic inflammatory skin disease characterized by relapsing eczema and intense prurigo, requires effective and safe pharmacological therapy. Recently, rapamycin, an mTOR (mammalian target of rapamycin) inhibitor, has been reported to play a critical role in immune responses and has emerged as an effective immunosuppressive drug. In this study, we assessed whether inhibition of mTOR signalling could suppress dermatitis in mice. Rapamycin was topically applied to inflamed skin in a murine AD model that was developed by repeated topical application of Dermatophagoides farina body (Dfb) extract antigen twice weekly for 7 weeks in NC/Nga mice. The efficacy of topical rapamycin treatment was evaluated immunologically and serologically. Topical application of rapamycin reduced inflammatory cell infiltration in the dermis, alleviated the increase of serum IgE levels and resulted in a significant reduction in clinical skin condition score and marked improvement of histological findings. In addition, increased mTOR phosphorylation in the lesional skin was observed in our murine AD model. Topical application of rapamycin ointment inhibited Dfb antigen-induced dermatitis in NC/Nga mice, promising a new therapy for atopic dermatitis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Dermal fibroblasts from acute inflamed atopic dermatitis lesions display increased eotaxin/CCL11 responsiveness to interleukin-4 stimulation.

PubMed

Gahr, N; Fölster-Holst, R; Weichenthal, M; Christophers, E; Schröder, J-M; Bartels, J

2011-03-01

The presence of eosinophils and/or eosinophil-derived products in the dermis is characteristic for involved skin of patients with atopic dermatitis and contributes to the observed tissue injury. CCL11 is a potent chemoattractant and activator of human eosinophils and interleukin (IL)-4 is a potent inducer of CCL11 expression in dermal fibroblasts. As increased fibroblast CCL11 expression may explain eosinophilic infiltration of involved skin areas in atopic dermatitis, we asked whether dermal fibroblasts from atopic patients differ from fibroblasts of healthy individuals in their ability to express CCL11. We compared IL-4-induced CCL11 mRNA expression using reverse transcription-polymerase chain reaction from cultured dermal fibroblasts derived from biopsies of chronic lesional and acute lesional atopic skin as well as from skin biopsies derived from normal skin of healthy donors. Considerable variability in IL-4-induced relative CCL11 mRNA expression was detected in fibroblasts derived from biopsies of different individuals. The lowest median IL-4 concentration inducing half maximal CCL11 mRNA expression (EC(50)) was found in fibroblasts derived from acute inflamed atopic lesions. Inducibility of CCL11 in dermal fibroblasts upon stimulation with Th2 cytokines explains the tissue eosinophilia observed in the presence of Th2 cytokines and the localization of eosinophils to the dermis. Decreased EC(50) values of IL-4-induced CCL11 expression in fibroblasts from acute inflamed atopic skin lesions indicates increased IL-4 responsiveness in these lesions and further substantiates the special role for IL-4-induced dermal fibroblast CCL11 expression in acute lesions. Variable CCL11 expression in fibroblasts from different patients with atopic dermatitis indicates heterogeneity of factors determining atopic phenotype in atopic dermatitis. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

Occupational dermatitis in hairdressers - influence of individual and environmental factors.

PubMed

Carøe, Tanja K; Ebbehøj, Niels E; Agner, Tove

2017-03-01

Hairdressers are at risk of developing occupational contact dermatitis because of their intense contact with wet work in combination with chemicals. To perform an analysis of a cohort study of hairdressers with occupational contact dermatitis recognized in the period 2006-2011, focusing on individual and environmental factors associated with the disease. The study was a descriptive, register-based survey including all hairdressers with recognized occupational contact dermatitis in Denmark in the period January 2006 to September 2011. Data were obtained from the Danish National Board of Industrial Injuries. The study comprised 381 patients (373 women and 8 men). The median age was 25 years, 64.8% were apprentices, and 35.2% were fully trained hairdressers. The prevalence of atopic dermatitis was 36.0%, and was significantly higher among apprentices than among fully trained hairdressers (44.9% and 19.4%, respectively) (p < 0.001). Of the patients, 48.3% had their dermatitis recognized as occupational irritant contact dermatitis, 46.7% had their dermatitis recognized as as occupational allergic contact dermatitis or combined allergic and irritant contact dermatitis, and 5.0% were recognized as having occupational contact urticaria. The low median age, the high percentages of atopic dermatitis in apprentices and the fact that more apprentices than fully trained hairdressers had recognized occupational contact dermatitis underlines the importance of early prevention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Phosphodiesterase 4 Inhibitor Therapies for Atopic Dermatitis: Progress and Outlook.

PubMed

Ahluwalia, Jusleen; Udkoff, Jeremy; Waldman, Andrea; Borok, Jenna; Eichenfield, Lawrence F

2017-09-01

Phosphodiesterase 4 (PDE4) is a cyclic AMP degrading enzyme in leukocytes. Several decades ago, increased PDE activity was demonstrated in patients with atopic dermatitis (AD). Currently, several PDE4 inhibitors in both topical and oral formulation have been developed to target the inflammatory cascade of AD. This review shows the pathogenic rationale behind these inhibitors, and discusses multiple PDE4 inhibitors that are under evaluation or in the market. PDE4 inhibitors may be considered as favorable agents in the repertoire of current interventions for AD.

Vitamin D in Atopic Dermatitis, Asthma and Allergic Diseases

PubMed Central

Searing, Daniel A; Leung, Donald YM

2010-01-01

Synopsis This review examines the scientific evidence behind the hypothesis that vitamin D plays a role in the pathogenesis of allergic diseases, with a particular focus on emerging data regarding vitamin D and atopic dermatitis. Both elucidated molecular interactions of vitamin D with components of the immune system, as well as clinical data regarding vitamin D deficiency and atopic diseases are discussed. The rationale behind the “sunshine hypothesis,” laboratory evidence supporting links between vitamin D deficiency and allergic diseases, the clinical evidence for/and against vitamin D playing a role in allergic diseases, and the emerging evidence regarding the potential use of vitamin D in augmentation of the innate immune response in atopic dermatitis are reviewed. PMID:20670821

[Inpatient rehabilitation of adults with atopic dermatitis].

PubMed

Breuer, K; Kapp, A

2006-07-01

Atopic dermatitis is a chronic inflammatory skin disease which often persists until adulthood. In severe cases, eczematous lesions and pruritus are resistant to therapy and result in depression, impairment of professional activities and social withdrawal. The goal of inpatient rehabilitation measures is to keep the patient involved and active in professional and social activities. Rehabilitative measures include diagnostics and medical therapy according to current guidelines, instruction in basic medical information, psychological intervention (relaxation techniques, improvement of self-confidence), dietetic measures, exercise, and social advice. Patients with atopic dermatitis often have work-related problems which should be identified as early as possible during rehabilitation.

Use of a silklike bedding fabric in patients with atopic dermatitis.

PubMed

Kurtz, Eleanor J; Yelverton, Christopher B; Camacho, Fabian T; Fleischer, Alan B

2008-01-01

Symptoms of atopic dermatitis are often affected by environmental irritants. Modulation of potential irritants may benefit such symptoms. The purpose of this study was to evaluate the impact of a novel silklike bedding fabric for persons with mild to moderate atopic dermatitis. Participants with mild to moderate atopic dermatitis were provided a bedsheet set. Eczema Area and Severity Index and Investigator Global Assessment were the primary outcome measures. Visual Analog Scale for itch and a quality of life were also evaluated. The Wilcoxon signed rank test indicated a significant decrease in severity, with the Investigator Global Assessment score decreasing from 2.05 to 1.74 at week 8 (p = 0.03), the Eczema Area and Severity Index decreasing from 2.63 at baseline to 2.19 (p = 0.014), and the itching score decreasing from 3.97 to 3.00 (p = 0.010). An increase in the study-specific quality of life index was also observed, changing from -0.08 (no change in quality of life) to 1.23 (some improvement) (p < 0.0001). Atopic dermatitis is commonly recalcitrant to therapy and synthetic silklike bed linens may have value as another option for the treatment of this disease. This pilot study demonstrated promising results that warrant confirmation in controlled clinical studies.

Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis.

PubMed

Chiang, Charles; Eichenfield, Lawrence F

2009-01-01

Standard recommendations for skin care for patients with atopic dermatitis stress the importance of skin hydration and the application of moisturizers. However, objective data to guide recommendations regarding the optimal practice methods of bathing and emollient application are scarce. This study quantified cutaneous hydration status after various combination bathing and moisturizing regimens. Four bathing/moisturizer regimens were evaluated in 10 subjects, five pediatric subjects with atopic dermatitis and five subjects with healthy skin. The regimens consisted of bathing alone without emollient application, bathing and immediate emollient application, bathing and delayed application, and emollient application alone. Each regimen was evaluated in all subjects, utilizing a crossover design. Skin hydration was assessed with standard capacitance measurements. In atopic dermatitis subjects, emollient alone yielded a significantly (p < 0.05) greater mean hydration over 90 minutes (206.2% baseline hydration) than bathing with immediate emollient (141.6%), bathing and delayed emollient (141%), and bathing alone (91.4%). The combination bathing and emollient application regimens demonstrated hydration values at 90 minutes not significantly greater than baseline. Atopic dermatitis subjects had a decreased mean hydration benefit compared with normal skin subjects. Bathing without moisturizer may compromise skin hydration. Bathing followed by moisturizer application provides modest hydration benefits, though less than that of simply applying moisturizer alone.

Enhancement of allergic skin wheal responses in patients with atopic eczema/dermatitis syndrome by playing video games or by a frequently ringing mobile phone.

PubMed

Kimata, H

2003-06-01

Playing video games causes physical and psychological stress, including increased heart rate and blood pressure and aggression-related feelings. Use of mobile phones is very popular in Japan, and frequent ringing is a common and intrusive part of Japanese life. Atopic eczema/dermatitis syndrome is often exacerbated by stress. Stress increases serum IgE levels, skews cytokine pattern towards Th2 type, enhances allergen-induced skin wheal responses, and triggers mast cell degranulation via substance P, vasoactive intestinal peptide and nerve growth factor. (1). In the video game study, normal subjects (n = 25), patients with allergic rhinitis (n = 25) or atopic eczema/dermatitis syndrome (n = 25) played a video game (STREET FIGHTER II) for 2 h. Before and after the study, allergen-induced wheal responses, plasma levels of substance P, vasoactive intestinal peptide and nerve growth factor, and in vitro production of total IgE, antihouse dust mite IgE and cytokines were measured. (2). In the mobile phone study, normal subjects (n = 27), patients with allergic rhinitis (n = 27) or atopic eczema/dermatitis syndrome (n = 27) were exposed to 30 incidences of ringing mobile phones during 30 min. Before and after the study, allergen-induced wheal responses, plasma levels of substance P, vasoactive intestinal peptide and nerve growth factor were measured. Playing video games had no effect on the normal subjects or the patients with allergic rhinitis. In contrast, playing video games significantly enhanced allergen-induced skin wheal responses and increased plasma levels of substance P, vasoactive intestinal peptide and nerve growth factors in the patients with atopic eczema/dermatitis syndrome. Moreover, playing video games enhanced in vitro production of total IgE and anti-house dust mite IgE with concomitant increased production of IL-4, IL-10 and IL-13 and decreased production of IFN-gamma and IL-12 in the patients with atopic eczema/dermatitis syndrome. However, exposure to frequently ringing mobile phones significantly enhanced allergen-induced skin wheal responses, plasma levels of substance P, vasoactive intestinal peptide and nerve growth factors in the patients with atopic eczema/dermatitis syndrome, but not in the normal subjects or the patients with allergic rhinitis. Playing video games enhanced allergic responses with a concomitant increased release of substance P, vasoactive intestinal peptide and nerve growth factor, and skewing of the cytokine pattern toward Th2 type in the patients with atopic eczema/dermatitis syndrome. In addition, exposure to frequently ringing mobile phones also enhanced allergic responses with a concomitant increased release of substance P, vasoactive intestinal peptide and nerve growth factor Collectively, high technology causes stress, which in turn may aggravate symptoms of atopic eczema/dermatitis syndrome.

Oral administration of Lactococcus chungangensis inhibits 2,4-dinitrochlorobenzene-induced atopic-like dermatitis in NC/Nga mice.

PubMed

Choi, Woo Jin; Konkit, Maytiya; Kim, Yena; Kim, Mi-Kyung; Kim, Wonyong

2016-09-01

Interest is increasing in the potentially beneficial role of probiotics in the prevention and treatment of atopic diseases. In this study, we investigated the protective effects of Lactococcus chungangensis CAU 28(T) against atopic dermatitis using murine macrophage RAW 264.7 cells, human keratinocyte HaCaT cells, human mast cell line HMC-1 cells, and a 2,4-dinitrochlorobenzene-induced atopic dermatitis model (NC/Nga mice). The results showed that L. chungangensis CAU 28(T) exhibited potent antiinflammatory activity by inhibiting the production of the proinflammatory mediators nitric oxide and prostaglandin E2 in lipopolysaccharide-stimulated RAW 264.7 cells. Treatment with L. chungangensis CAU 28(T) reduced the release of β-hexosaminidase and histamine in HMC-1 cells stimulated with mast cell activator compound 48/80. In addition, the back skin and ears of NC/Nga mice exhibited reduced histological manifestations of atopic skin lesions such as erosion, hyperplasia of the epidermis and dermis, and inflammatory cell infiltration. Oral administration of L. chungangensis CAU 28(T) suppressed the production of IL-4, IL-5, IL-12, IFN-γ, tumor necrosis factor-α, and thymus- and activation-regulated chemokine (TARC) in skin lesions, indicating that it strongly drives the local immune system with efficacy comparable to that of tacrolimus, a topical immunomodulatory drug used for the treatment of atopic dermatitis. The findings indicate that L. chungangensis CAU 28(T) could be a novel probiotic candidate for controlling the symptoms of atopic dermatitis. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Assessment of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Atopic Dermatitis Patients

PubMed Central

Jiang, Ying; Ma, Wencong

2017-01-01

Background To develop new strategies for identifying atopic dermatitis patients, a better understanding of the signs for chronic inflammatory status is needed. This study was designed to investigate whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are related to the severity of atopic dermatitis (AD) assessed by the Scoring Atopic Dermatitis (SCORAD) index. Material/Methods A retrospective study involving 80 AD patients and 45 healthy control subjects was performed. NLR, PLR, and the number of peripheral blood eosinophils were compared between AD patients and healthy controls, and correlations between these indexes and clinical characteristics were analyzed. Results NLR, PLR, and eosinophils in AD patients were all significantly higher than in healthy individuals. Among AD patients, NLR (p<0.001) and PLR (p<0.001), as contrasted with eosinophils (p=0.146), were correlated positively with SCORAD index. Additionally, an NLR level of 1.75 was determined as the predictive cut-off value of severe AD (SCORAD ≥51) (sensitivity 94.7%, specificity 58.6%, the area under the receiver-operating characteristic curve (AUROC) 0.778, p=0.001). For eosinophils, the sensitivity and specificity were 78.9% and 62.1%, respectively, and the AUROC was only 0.685 (p=0.032) in predicting high SCORAD. Conclusions NLR and PLR reflect inflammatory response and disease severity in AD patients. PMID:28306706

Barrier function and natural moisturizing factor levels after cumulative exposure to a fruit-derived organic acid and a detergent: different outcomes in atopic and healthy skin and relevance for occupational contact dermatitis in the food industry.

PubMed

Angelova-Fischer, Irena; Hoek, Anne-Karin; Dapic, Irena; Jakasa, Ivone; Kezic, Sanja; Fischer, Tobias W; Zillikens, Detlef

2015-12-01

Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Immunomodulatory Effects of Deokgu Thermomineral Water Balneotherapy on Oxazolone-Induced Atopic Dermatitis Murine Model

PubMed Central

Lee, Young Bok; Kim, Su Jin; Park, Sae Mi; Lee, Kyung Ho; Han, Hyung Jin; Yu, Dong Soo; Woo, So Youn; Yun, Seong Taek; Hamm, Se-Yeong; Kim, Hong Jig

2016-01-01

Background Although the therapeutic mechanism of balneotherapy for atopic dermatitis has not been clarified, many atopic patients who visit thermomineral springs have shown clinical improvements. Objective This study was aimed to evaluate the immunomodulatory effect of thermomineral water balneotherapy on the atopic dermatitis murine model. Methods The oxazolone-induced atopic dermatitis murine model was used to evaluate the therapeutic effect of balneotherapy with Deokgu thermomineral water compared with distilled water. Histologic evaluation and confocal microscopic imaging were performed to analyze the lesional expression of cluster-of-differentiation (CD)4 and forkhead box p3 (Foxp3). Lesional mRNA expression of interleukin (IL) 33, thymic stromal lymphopoietin (TSLP), and Foxp3 was evaluated by real-time reverse transcription polymerase chain reaction. Results Compared with the distilled water bath group, confocal microscopic evaluation of CD4 and Foxp3 merged images showed increased expression of regulatory T cells in the thermomineral balneotherapy group. The lesional mRNA level of IL-33 showed a reduced trend in the thermomineral balneotherapy group, whereas the level of mRNA of Foxp3 was increased. TSLP showed a decreased trend in both distilled water and thermomineral water bath groups. There was a trend of reduced expression in lesional IL-33 mRNA but increased cell count of CD4+ Foxp3+ regulatory T cells in thermomineral balneotherapy compared with distilled water bath. Conclusion Therefore, thermomineral balneotherapy can be an effective and safe adjuvant therapeutic option for atopic dermatitis. PMID:27081266

Immunomodulatory Effects of Deokgu Thermomineral Water Balneotherapy on Oxazolone-Induced Atopic Dermatitis Murine Model.

PubMed

Lee, Young Bok; Kim, Su Jin; Park, Sae Mi; Lee, Kyung Ho; Han, Hyung Jin; Yu, Dong Soo; Woo, So Youn; Yun, Seong Taek; Hamm, Se-Yeong; Kim, Hong Jig; Kim, Jin-Wou

2016-04-01

Although the therapeutic mechanism of balneotherapy for atopic dermatitis has not been clarified, many atopic patients who visit thermomineral springs have shown clinical improvements. This study was aimed to evaluate the immunomodulatory effect of thermomineral water balneotherapy on the atopic dermatitis murine model. The oxazolone-induced atopic dermatitis murine model was used to evaluate the therapeutic effect of balneotherapy with Deokgu thermomineral water compared with distilled water. Histologic evaluation and confocal microscopic imaging were performed to analyze the lesional expression of cluster-of-differentiation (CD)4 and forkhead box p3 (Foxp3). Lesional mRNA expression of interleukin (IL) 33, thymic stromal lymphopoietin (TSLP), and Foxp3 was evaluated by real-time reverse transcription polymerase chain reaction. Compared with the distilled water bath group, confocal microscopic evaluation of CD4 and Foxp3 merged images showed increased expression of regulatory T cells in the thermomineral balneotherapy group. The lesional mRNA level of IL-33 showed a reduced trend in the thermomineral balneotherapy group, whereas the level of mRNA of Foxp3 was increased. TSLP showed a decreased trend in both distilled water and thermomineral water bath groups. There was a trend of reduced expression in lesional IL-33 mRNA but increased cell count of CD4(+) Foxp3(+) regulatory T cells in thermomineral balneotherapy compared with distilled water bath. Therefore, thermomineral balneotherapy can be an effective and safe adjuvant therapeutic option for atopic dermatitis.

Efficacy trial of bioresonance in children with atopic dermatitis.

PubMed

Schöni, M H; Nikolaizik, W H; Schöni-Affolter, F

1997-03-01

Single case reports and uncontrolled studies claim significant improvements in patients with atopic diseases treated with bioresonance therapy, also called biophysical information therapy (BIT). To assess the efficacy of this alternative method of treatment, we performed a conventional double-blind parallel group study in children hospitalized for long-lasting atopic dermatitis. Over a period of 1.5 year, 32 children with atopic dermatitis, age range 1.5-16.8 years and hospitalized for 4-6 weeks at the Alpine Children's Hospital Davos, Switzerland, were randomized according to sex, age and severity of the skin disease to receive conventional inpatient therapy and either a putatively active or a sham (placebo) BIT treatment. Short- and long-term outcome within 1 year were assessed by skin symptom scores, sleep and itch scores, blood cell activation markers of allergy, and a questionnaire. Hospitalization and conventional therapy in a high altitude climate resulted in immediate and sustained amelioration of the disease state in both the BIT-treated and sham-treated groups. BIT had no significant additive measurable effect on the outcome variables determined in this study. The statement by protagonists of this alternative form of therapy that BIT can considerably influence or even cure atopic dermatitis was not confirmed using for the first time a conventional double-blind study design. Considering the high costs and false promises caused by the promotors of this kind of therapy, it is concluded that BIT has no place in the treatment of children with atopic dermatitis.

Vitamin D-deficient osteomalacia due to excessive self-restrictions for atopic dermatitis

PubMed Central

Shikino, Kiyoshi; Ikusaka, Masatomi; Yamashita, Tomoko

2014-01-01

A 34-year-old Japanese woman presented with a 2-year history of generalised bone pain, muscle weakness and gait disturbance. The patient had been following a restricted diet (without fish or dairy products) and avoiding ultraviolet exposure for 8 years to manage her worsening atopic dermatitis. Physical examination revealed generalised bone tenderness and bilateral symmetric proximal muscle weakness. Vitamin D-deficient osteomalacia was diagnosed based on the laboratory examination findings, which indicated high serum alkaline phosphatase, high intact parathyroid hormone, and low 25-hydroxyvitamin D levels. Her symptoms improved after oral active vitamin D and calcium administration. To the best our knowledge, this case is the first report of vitamin D-deficient osteomalacia in an adult patient due to excessive dietary restriction for managing atopic dermatitis. We emphasise the importance of increasing awareness of vitamin D deficiency as a risk factor for the development of osteomalacia, and caution against excessive avoidance of sun exposure and dietary restriction. PMID:25100811

Vitamin D-deficient osteomalacia due to excessive self-restrictions for atopic dermatitis.

PubMed

Shikino, Kiyoshi; Ikusaka, Masatomi; Yamashita, Tomoko

2014-07-04

A 34-year-old Japanese woman presented with a 2-year history of generalised bone pain, muscle weakness and gait disturbance. The patient had been following a restricted diet (without fish or dairy products) and avoiding ultraviolet exposure for 8 years to manage her worsening atopic dermatitis. Physical examination revealed generalised bone tenderness and bilateral symmetric proximal muscle weakness. Vitamin D-deficient osteomalacia was diagnosed based on the laboratory examination findings, which indicated high serum alkaline phosphatase, high intact parathyroid hormone, and low 25-hydroxyvitamin D levels. Her symptoms improved after oral active vitamin D and calcium administration. To the best our knowledge, this case is the first report of vitamin D-deficient osteomalacia in an adult patient due to excessive dietary restriction for managing atopic dermatitis. We emphasise the importance of increasing awareness of vitamin D deficiency as a risk factor for the development of osteomalacia, and caution against excessive avoidance of sun exposure and dietary restriction. 2014 BMJ Publishing Group Ltd.

Family functioning and illness perception of parents of children with atopic dermatitis, living without skin symptoms, but with psychosomatic symptoms.

PubMed

Rodríguez-Orozco, Alain R; Kanán-Cedeño, E G; Guillén Martínez, E; Campos Garibay, M J

2011-03-01

Emotional factors and a recurrent psychosomatic environment, have been implicated in the evolution of atopic dermatitis. These, in turn, affect the disease. This study was under taken to evaluate the functioning of families with a child that has atopic dermatitis without skin symptoms and the parents' perceptions of their child's disease.Semi-quantitative and cross-sectional study in which questionnaires were applied: one to study family functioning (Espejel et al. scale) and the second to determine aspects of parental perception of their child's atopic dermatitis. Pearson's correlation was used to analyze the correlation between the categories of the Family Function Scale.The most affected categories of family functioning were authority, handling of disruptive conduct, communication, and negative affect. The most significant positive correlations between the categories of family functioning were: authority and support, r=0.867, p<.001; disruptive conduct and communication, r=0.798, p<.001; and support and communication, r=0.731, p<.001. Of the parents, 66.4% thought that the pharmacotherapy used for their child's atopic dermatitis was not effective, and 33.3% of parents stated that the disease had affected their child's daily activities.In families of children with atopic dermatitis, various family environment factors facilitate the recurrence of symptoms even when no cutaneous lesions have been found on the child. The identification and use of family resources to face this disease are aspects that should be taken into consideration during the psychotherapeutic management of these families, putting emphasis on the most affected functional categories of these families in a strategy that should be implanted in a multi-disciplinary context.

Multifactorial skin barrier deficiency and atopic dermatitis: Essential topics to prevent the atopic march.

PubMed

Egawa, Gyohei; Kabashima, Kenji

2016-08-01

Atopic dermatitis (AD) is the most common inflammatory skin disease in the industrialized world and has multiple causes. Over the past decade, data from both experimental models and patients have highlighted the primary pathogenic role of skin barrier deficiency in patients with AD. Increased access of environmental agents into the skin results in chronic inflammation and contributes to the systemic "atopic (allergic) march." In addition, persistent skin inflammation further attenuates skin barrier function, resulting in a positive feedback loop between the skin epithelium and the immune system that drives pathology. Understanding the mechanisms of skin barrier maintenance is essential for improving management of AD and limiting downstream atopic manifestations. In this article we review the latest developments in our understanding of the pathomechanisms of skin barrier deficiency, with a particular focus on the formation of the stratum corneum, the outermost layer of the skin, which contributes significantly to skin barrier function. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Association of Severe Atopic Dermatitis with month of birth in Armenian pediatric patients.

PubMed

Sargsyan, Anna; Gupta, Jayanta; Ghosh, Debajyoti

2018-04-26

Atopic dermatitis (AD) is a chronic relapsing skin disease which affects 15-20% of children worldwide.(1) It is also considered as a major risk factor for developing other atopic diseases including food allergy, asthma and allergic rhinitis later in life - a phenomenon known as the "atopic march". Multiple factors, including season of birth and associated perinatal environmental conditions, have been known to play important roles in the manifestation of AD.(2) Moreover, about 20% of patients with AD have moderate-to-severe disease, which is associated with significantly lower quality of life, imposing considerable burden on the nation's health-care resources.(3) Therefore, studying severe AD patients might be very important in managing overall AD-related disease burden. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Updates on the earlier treatments for atopic dermatitis].

PubMed

Jelen, G

1998-01-01

The GERDA classes have the function of updating our knowledge of dermato-allergology. One of the themes tackled this year was the treatment of atopic dermatitis. Apart from consideration of treatment or exception with cortisone, it seemed to be of interest to find the relevance of "old treatments" for atopic dermatitis, either preventive or symptomatic. Preventive treatment made reference to correction of food factors (diet in infants, removal of maternal allergens, supplementation on fatty acids) and of environmental factors especially the fight against house dust mites by use of anti-mite mattress covers. Miracle treatments of atopy do not always exist. Thus there is often need for, besides local corticosteroid therapy, an external symptomatic treatment where the emphasis is on the struggle against skin microbiology, the fight against pruritic inflammatory conditions and above all the battle against xerosis. Knowledge of the physiology of the stratum corneum gives better understanding of the effect of emollients and moisturizers in restoration of the cutaneous barrier, of which dysfunction is one of the elements of atopic dermatitis.

Which plant for which skin disease? Part 1: Atopic dermatitis, psoriasis, acne, condyloma and herpes simplex.

PubMed

Reuter, Juliane; Wölfle, Ute; Weckesser, Steffi; Schempp, Christoph

2010-10-01

Plant extracts and isolated compounds are increasingly used in cosmetics and food supplements to improve skin conditions. We first introduce the positive plant monographs with dermatological relevance of the former German Commission E. Subsequently clinical studies with botanicals for atopic dermatitis, psoriasis, acne, condylomata acuminata and herpes simplex are discussed. The best studies have been conducted with atopic dermatitis and psoriasis patients. Mahonia aquifolium, Hypericum perforatum, Glycyrrhiza glabra and certain traditional Chinese therapies have been shown to be effective in the treatment of atopic dermatitis. Mahonia aquifolium, Indigo naturalis and Capsicum frutescens are effective treatments for psoriasis. Green tea extract and tea tree oil have been investigated in the treatment of acne. Podophyllin and green tea extract are effective treatments for condylomata acuminata. Balm mint and a combination of sage and rhubarb have been shown to be effective in the treatment of herpes simplex in proof of concept studies. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

Perinatal risk factors for sensitization, atopic dermatitis and wheezing during the first year of life (PIPO study).

PubMed

Hagendorens, M M; Bridts, C H; Lauwers, K; van Nuijs, S; Ebo, D G; Vellinga, A; De Clerck, L S; Van Bever, H P; Weyler, J J; Stevens, W J

2005-06-01

To evaluate the influence of perinatal environmental factors on early sensitization, atopic dermatitis and wheezing during the first year. Information on pregnancy-related factors, parental atopic history, environmental factors and the clinical course of the infant until age one was gathered by questionnaires, as part of a prospective birth cohort study (Prospective study on the Influence of Perinatal factors on the Occurrence of asthma and allergies [PIPO-study]). Quantification of total and specific IgE was performed in 810 children and their parents. Early sensitization was found in 107/810 (13%) of the infants. Multiple regression analysis showed that specific IgE in fathers was a risk factor for early sensitization in their daughters (adjusted odds ratios (OR(adj)) 2.21 (95% confidence interval (CI) 1.10-4.49); P=0.03), whereas in boys, day care attendance was shown to be protective for early sensitization (OR(adj) 0.38 (95% CI 0.20-0.71); P=0.001). Atopic dermatitis occurred in 195/792 infants (25%). Specific IgE in the mother (OR(adj) 1.52 (95% CI 1.06-2.19); P=0.02) and in the infant (OR(adj) 4.20 (95% CI 2.63-6.68); P<0.001) were both risk factors for the occurence of atopic dermatitis, whereas postnatal exposure to cats was negatively associated with atopic dermatitis (OR(adj) 0.68 (0.47-0.97); P=0.03). Postnatal exposure to cigarette smoke (OR(adj) 3.31 (95% CI 1.79-6.09); P<0.001) and day care attendance (OR(adj) 1.96 (95% CI 1.18-3.23); P=0.009) were significantly associated with early wheezing, which occurred in 25% (197/795) of the infants. The effect of paternal sensitization and day care attendance on sensitization is gender dependent. Maternal sensitization predisposes for atopic dermatitis, whereas postnatal exposure to cats had a protective effect.

Increased numbers of CD4+ and CD8+ T cells in lesional skin of cats with allergic dermatitis.

PubMed

Roosje, P J; van Kooten, P J; Thepen, T; Bihari, I C; Rutten, V P; Koeman, J P; Willemse, T

1998-07-01

The aim of this study was to characterize T cells in the skin of cats with an allergic dermatitis histologically compatible with atopic dermatitis, since T cells play an important role in the pathogenesis of atopic dermatitis in humans. We observed a significantly greater number of T cells in lesional skin of domestic short-haired cats with allergic dermatitis (n = 10; median age 5.8 years) than in the skin of healthy control animals (n = 10; median age 5.0 years). In the skin of the healthy control animals, one or two CD4+ cells and no CD8+ cells were found. A predominant increase of CD4+ T cells and a CD4+/CD8+ ratio (mean +/- SD: 3.9 +/- 2.0) was found in the lesional skin of 10 cats with allergic dermatitis. The CD4+/CD8+ cell ratio in the skin of healthy control animals could not be determined because of the absence of CD8+ cells. The CD4+/CD8+ cell ratio in the peripheral blood of 10 cats with allergic dermatitis (mean +/- SD: 1.9 +/- 0.4) did not differ significantly from that in 10 healthy control animals (2.2 +/- 0.4). The CD4+/CD8+ cell ratio and predominance of CD4+ T cells in the lesional skin of cats with allergic dermatitis is comparable to that found in atopic dermatitis in humans. In addition, the observed increase of CD4+ T cells in the nonlesional skin of cats with allergic dermatitis compared to the skin of healthy cats is similar to what is seen in humans. Cytokines produced by T cells and antigen-specific T cells are important mediators in the inflammatory cascade resulting in atopic dermatitis in humans. This study is a first step to investigate their role in feline allergic dermatitis.

Probiotics and prebiotics in dermatology.

PubMed

Baquerizo Nole, Katherine L; Yim, Elizabeth; Keri, Jonette E

2014-10-01

The rapid increase in the medical use of probiotics and prebiotics in recent years has confirmed their excellent safety profile. As immune modulators, they have been used in inflammatory skin conditions, such as atopic dermatitis. We review the literature regarding the use of probiotics and prebiotics in dermatology. Probiotics and prebiotics appear to be effective in reducing the incidence of atopic dermatitis in infants, but their role in atopic dermatitis treatment is controversial. Their role in acne, wound healing, and photoprotection is promising, but larger trials are needed before a final recommendation can be made. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Atopy patch tests in young adult patients with atopic dermatitis and controls: dose-response relationship, objective reading, reproducibility and clinical interpretation.

PubMed

Bygum, Anette; Mortz, Charlotte Gotthard; Andersen, Klaus Ejner

2003-01-01

The clinical interpretation and reproducibility of atopy patch tests was studied in 23 selected young adult patients with atopic dermatitis and 25 healthy controls using standard inhalant allergens. Non-invasive measurements were used for objective assessment of test reactions and the participants were retested after 6 weeks. Ten of 19 (53%) evaluable patients with atopic dermatitis had at least one positive atopy patch test. However, there was no clear clinical relevance of the atopy patch test results when related to patient history and distribution of dermatitis. Reproducible and dose-dependent results were obtained with Dermatophagoides pteronyssinus, grass and cat with a reproducibility rate of 0.69 to 0.81 in patients and 0.60-0.96 in controls. A unique finding was a significant positive correlation between a positive atopy patch test, allergen dose and increase in transepidermal water loss and erythema, while measurement of capacitance did not distinguish between positive and negative reactions. The results of the present study do not support the routine use of atopy patch tests in the evaluation of adult patients with atopic dermatitis.

Efficacy of a novel phosphodiesterase inhibitor, E6005, in patients with atopic dermatitis: An investigator-blinded, vehicle-controlled study.

PubMed

Ohba, Fuminori; Matsuki, Shunji; Imayama, Shuhei; Matsuguma, Kyoko; Hojo, Seiichiro; Nomoto, Maiko; Akama, Hideto

2016-10-01

Phosphodiesterase type 4 (PDE4) inhibition is a well-known anti-inflammatory mechanism. However, the clinical use of PDE4 inhibitors has been compromised by the occurrence of mechanism-associated adverse reactions, which often limit the maximum tolerated dose. To minimize systemic exposure, a topically active PDE4 inhibitor with low transdermal bioavailability could be clinically useful. The purpose of this study was to evaluate the efficacy of a novel topical PDE4 inhibitor, E6005, in patients with atopic dermatitis. This randomized, investigator-blinded, vehicle-controlled, multiple ascending dose study included 40 adult male patients with atopic dermatitis, who were randomly assigned to 10 days of treatment with either E6005 ointment (0.01, 0.03, 0.1 or 0.2%) or vehicle ointment. Of 81 patients screened, 40 who had typical lesions on their posterior trunk were randomized into the study. One patient receiving 0.03% E6005 treatment discontinued because of acute gout and one receiving vehicle treatment discontinued because of progression of atopic dermatitis. The targeted lesion severity scores decreased in a concentration-dependent manner in patients treated with E6005. This drop was significant in the 0.2% E6005 ointment treatment group (mean percent change: -54.30%, p = 0.007). E6005 ointment showed anti-inflammatory efficacy in adult patients with atopic dermatitis.

Vitamin E supplementation in canine atopic dermatitis: improvement of clinical signs and effects on oxidative stress markers.

PubMed

Plevnik Kapun, A; Salobir, J; Levart, A; Tavčar Kalcher, G; Nemec Svete, A; Kotnik, T

2014-12-06

Low levels of plasma vitamin E concentrations were found in canine atopic dermatitis (CAD). The present study was aimed at determining the effect of an eight-week vitamin E supplementation on clinical response (Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) scores and pruritus intensity) in dogs with atopic dermatitis. Levels of oxidative stress markers (plasma malondialdehyde and total antioxidant capacity (TAC), blood glutathione peroxidase and erythrocyte superoxide dismutase, plasma and skin vitamin E concentrations) were also determined. Twenty-nine dogs with CAD were included in the study. Fourteen received vitamin E (8.1 IU/kg once daily, orally) and 15 received mineral oil as placebo (orally). All dogs were treated with antihistamine fexofenadine. Levels of oxidative stress markers (with the exception of skin vitamin E), CADESI-03 and pruritus intensity were determined at the beginning, then every two weeks. Skin vitamin E was determined at the beginning and at the end of the treatment. Significantly higher plasma levels of vitamin E and TAC were observed in the vitamin E group than in the placebo group. CADESI-03 scores determined throughout the treatment in the vitamin E group were significantly lower than in the placebo group. The findings of this study support the supplementation of vitamin E in dogs with atopic dermatitis. British Veterinary Association.

Occurrence and clinical features of sensitization to Pityrosporum orbiculare and other allergens in children with atopic dermatitis.

PubMed

Lindgren, L; Wahlgren, C F; Johansson, S G; Wiklund, I; Nordvall, S L

1995-07-01

One hundred and nineteen consecutive cases of children with atopic dermatitis aged 4-16 years (73 girls) from a pediatric dermatology outpatient clinic were included in a study of atopic sensitization. Structured interviews and clinical investigations were performed. IgE antibodies to common inhalant allergens, Pityrosporum orbiculare, Candida albicans, Tricophyton rubrum and Staphylococcus aureus were detected. Specific IgE antibodies frequently occurred to pollens, animal epithelia, C. albicans, house dust mites and moulds, whereas specific IgE antibodies to potential skin allergens were less prevalent. Twenty-six children (21.8%) had IgE antibodies to P. orbiculare, 14 (11.8%) to T. rubrum and 3 (2.5%) to S. aureus. Atopic dermatitis in children with one or several RAST positivities was worse, with a more chronic course, higher total eczema score, more frequent distribution in the head-neck-face regions and more itch compared to the children without serum detectable IgE antibodies. Severe itch disturbing nightly sleep was the only clinical feature that characterised P. orbiculare-positive cases. Allergy to P. orbiculare appears to be of little importance in early childhood atopic dermatitis but is likely to carry a poor prognosis.

[Profile of sensitization to allergens in children with atopic dermatitis assisting to Allergology Service of University Hospital, Nuevo Leon, Mexico].

PubMed

Yong-Rodríguez, Adrián; Macías-Weinmann, Alejandra; Palma-Gómez, Samuel; Arias-Cruz, Alfredo; Pérez-Vanzzini, Rafael; Gutiérrez-Mujica, José Julio; González-Díaz, Sandra Nora

2015-01-01

Sensitization to allergens in atopic dermatitis patients is a risk factor for developing asthma and allergic rhinitis in the future,as well as an aggravating factor in the course of the disease. Recent studies have attributed the activity of the proteases of some antigens to cause a grater defect in the epithelial barrier and a more severe disease. To know the sensitization to allergens pattern in children with atopic dermatitis attended at Allergology Service of University Hospital of UANL, Mexico, and to know if these children have higher sensitization to antigens with proteolytic activity. A retrospective study was done reviewing the skin prick test reports done in our service to children ranging from 5 months to 16 years old, diagnosed with atopic dermatitis during a period of 2 years, from January 2012 to January 2014. The frequency of sensitization to aeroallergens and food were analyzed as well as the weal size (≥6mm) on the skin in response to each particular allergen in the case of food skin prick test. Reports of skin tests of 66 children, 30 boys and 36 girls, were included; 37 of children were sensitized to more than one allergen,18/66 had asthma and/or allergic rhinitis, 40/66 60% skin prick tests were positive to high activity protease aeroallergens (Dermatophagoides pteronyssinus/Dermatophagoides farinae). Regarding food, sensitization was seen in 38 children; fruits and vegetables were the two most common foods. Only seven children had skin prick weal bigger than 6 mm, mainly to egg, fish and cow's milk. Children with atopic dermatitis are often sensitized to high protease activity aeroallergens, polysensitization is very common and the association with airway allergy is seen early in life. Sensitization to food is also common in these patients, but only a small percentage showed a response large enough to be associated with disease severity.

The Genome-Wide Expression Profile of Saussurea lappa Extract on House Dust Mite-Induced Atopic Dermatitis in Nc/Nga Mice.

PubMed

Lim, Hye-Sun; Ha, Hyekyung; Shin, Hyeun-Kyoo; Jeong, Soo-Jin

2015-09-01

Saussurea lappa has been reported to possess anti-atopic properties. In this study, we have confirmed the S. lappa's anti-atopic properties in Nc/Nga mice and investigated the candidate gene related with its properties using microarray. We determined the target gene using real time PCR in in vitro experiment. S. lappa showed the significant reduction in atopic dermatitis (AD) score and immunoglobulin E compared with the AD induced Nc/Nga mice. In the results of microarray using back skin obtained from animals, we found that S. lappa's properties are closely associated with cytokine-cytokine receptor interaction and the JAK-STAT signaling pathway. Consistent with the microarray data, real-time RT-PCR confirmed these modulation at the mRNA level in skin tissues from S. lappa-treated mice. Among these genes, PI3Kca and IL20Rβ were significantly downregulated by S. lappa treatment in Nc/Nga mouse model. In in vitro experiment using HaCaT cells, we found that the S. lappa components, including alantolactone, caryophyllene, costic acid, costunolide and dehydrocostus lactone significantly decreased the expression of PI3Kca but not IL20Rβ in vitro. Therefore, our study suggests that PI3Kca-related signaling is closely related with the protective effects of S. lappa against the development of atopic-dermatitis.

Oral supplementation of Lithospermum erythrorhizon prevents the development of atopic dermatitis with reducing ceramide degradation in the epidermis of NC/Nga mice.

PubMed

Kim, JungMin; Kim, YoungRan; Seo, DaeBang; Kim, SungHan; Lee, SangJun; Cho, Yunhi

2009-09-01

Lithospermum erythrorhizon Sieb. et Zucc. (LE) is widely used in the treatment of abnormal skin conditions, but its systemic efficacy, especially in atopic dermatitis (AD), is not clear. To examine the systemic efficacy of LE on the clinical manifestation of AD-like skin lesions, NC/Nga mice, a murine model of AD, were fed a control diet (group CA: atopic control) or a diet with a 70% ethanol extract from 5% LE (group LE) for 10 weeks. In group LE, the clinical manifestation of AD-like skin lesions was prevented as the level of serum IgE, epidermal hyperproliferation, and the number and duration of scratching episodes, which were greater in group CA, were significantly reduced to a similar level of the normal control group of BALB/c mice (group C). In addition, the level of ceramides, the major lipid maintaining the epidermal barrier, in the epidermis of group LE was increased, and was inversely associated with a decreased protein level of ceramidase, an enzyme of ceramide degradation. However, the mRNA and the protein levels of serine palmitoyl transferase (enzyme for de novo ceramide synthesis) in groups C, CA and LE did not differ. It was demonstrated that oral supplementation with LE extract prevented the development of atopic dermatitis with reducing ceramide degradation coupled with a low expression of ceramidase protein.

Current status of atopic dermatitis in Japan

PubMed Central

Chiba, Takahito; Takeuchi, Satoshi

2011-01-01

Atopic dermatitis (AD) is a common, chronic or chronically relapsing, severely pruritic, eczematous skin disease. AD is the second most frequently observed skin disease in dermatology clinics in Japan. Prevalence of childhood AD is 12-13% in mainland Japan; however, it is only half that (about 6%) in children from Ishigaki Island, Okinawa. Topical steroids and tacrolimus are the mainstay of treatment. However, the adverse effects and emotional fear of long-term use of topical steroids have induced a "topical steroid phobia" in patients throughout the world. Undertreatment can exacerbate facial/periocular lesions and lead to the development of atopic cataract and retinal detachment due to repeated scratching/rubbing/patting. Overcoming topical steroid phobia is a key issue for the successful treatment of AD through education, understanding and cooperation of patients and their guardians. PMID:22053299

Atopic March from Atopic Dermatitis to Asthma-Like Lesions in NC/Nga Mice Is Accelerated or Aggravated by Neutralization of Stratum Corneum but Partially Inhibited by Acidification.

PubMed

Lee, Hae-Jin; Lee, Noo Ri; Jung, Minyoung; Kim, Dong Hye; Choi, Eung Ho

2015-12-01

Prolonged and/or repeated damage to the skin barrier followed by atopic dermatitis (AD) is an initial step in atopic march that ultimately progresses to respiratory allergy. Maintaining normal stratum corneum (SC) acidity has been suggested as a therapeutic or preventive strategy for barrier impairment caused by skin inflammation. We determined whether a representative AD murine model, NC/Nga mice, develops airway inflammation after repeated epicutaneous application followed by inhalation of house dust mite (HDM), implying atopic march, and whether prolongation of non-proper SC acidity accelerates respiratory allergy. HDM was applied to the skin of NC/Nga mice, accompanied by the application of neutral cream (pH 7.4) or acidic cream (pH 2.8) for 6 weeks. Intranasal inhalation of HDM was administered daily during the last 3 days. Repeated epicutaneous applications followed by inhalation of HDM in NC/Nga mice induced an atopic march-like progression from AD lesions to respiratory allergy. Concurrent neutral cream treatment accelerated or aggravated the allergic inflammation in the skin and respiratory system, whereas an acidic cream partially alleviated these symptoms. Collectively, we developed an atopic march in NC/Nga mice by HDM application, and found that prevention of a neutral environment in the SC may be an interventional method to inhibit the march.

Atopic and Contact Dermatitis of the Vulva.

PubMed

Pichardo-Geisinger, Rita

2017-09-01

Pruritus, or itch, is a common vulvar complaint that is often treated empirically as a yeast infection; however, yeast infections are just one of the many conditions that can cause vulvar itch. Ignoring other conditions can prolong pruritus unnecessarily. Atopic dermatitis, irritant contact dermatitis, and allergic contact dermatitis are extremely common noninfectious causes of vulvar itch that are often underdiagnosed by nondermatologists. Identifying these conditions and treating them appropriately can significantly improve a patient's quality of life and appropriately decrease health care expenditures by preventing unnecessary additional referrals or follow-up visits and decreasing pharmaceutical costs. Copyright © 2017 Elsevier Inc. All rights reserved.

House dust and forage mite allergens and their role in human and canine atopic dermatitis.

PubMed

Nuttall, T J; Hill, Peter B; Bensignor, E; Willemse, T

2006-08-01

This article reviews the literature regarding the role of house dust and forage mite allergens in canine atopic dermatitis. The presence of immunoglobulin E (IgE) to these mites, especially to Dermatophagoides farinae, is common in both normal and atopic dogs. Exposure of dogs to the different mites is described both in the direct environment and in the coat of animals for house dust mites and in the food for forage mites. Allergens causing allergic disease in dogs seem to be different from those in humans. Dogs seem to react to high molecular weight allergens, compared to the low molecular weight group 1 and group 2 proteases that are commonly implicated in humans with atopic diseases. Despite numerous published studies dealing with this subject, a number of questions still need to be addressed to better understand the exact role of these mites in the pathogenesis of canine atopic dermatitis and to improve the quality of the allergens used in practice.

The history of atopic dermatitis.

PubMed

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.

Inhibitory effect of arazyme on the development of atopic dermatitis-like lesions in BALB/c and Nc/Nga mice.

PubMed

Kim, In Sik; Lee, Na Rae; Baek, Seung Yeop; Kim, Eun Jeong; Kim, Jung Seok; Jeong, Tae-Sook; Shin, Dong-Ha; Park, Ho-Yong; Lee, Ji-Sook

2015-05-01

Arazyme is a metalloprotease released by Aranicola proteolyticus that was shown to inhibit cytokine release in HaCaT and endothelial cells. However, the regulatory effects of arazyme in atopic dermatitis remain to be fully understood. In the present study, the anti‑inflammatory effects of arazyme in BALB/c and Nc/Nga mice induced with 2,4‑dinitrochlrobenzene (DNCB) were investigated. BALB/c mice were sensitized with DNCB and were subsequently administered arazyme for 4 weeks either orally, dorsally or orally/dorsally. Arazyme administration significantly reduced epidermal thickening and infiltration of inflammatory cells into the dermis compared with the DNCB group. However, serum immunoglobulin E (IgE) levels were not altered by arazyme treatment. Additionally, the level of secretion of interleukins (IL)‑4, ‑5 and ‑13 in the splenocytes of BALB/c mice was elevated following stimulation with concanavalin A, while the increase of IL‑4 and IL‑13 was inhibited by arazyme. Administration of arazyme (25 mg/kg in phosphate‑buffered saline) to Nc/Nga mice that had been sensitized with DNCB for 6 weeks reduced the skin severity score compared with that in the DNCB group and inhibited the histological manifestations of atopic dermatitis‑like skin lesions. In addition, the serum IgE levels were reduced in the arazyme‑treated NC/Nga mice relative to the DNCB group. Collectively, these results indicated that arazyme attenuates the development of atopic dermatitis‑like lesions via lowering the levels of IgE and inflammatory cytokines. The results of the present study will aid in the development of effective therapeutic strategies for the treatment of allergic diseases, including atopic dermatitis.

Anti-hyaluronidase Activity in Vitro and Amelioration of Mouse Experimental Dermatitis by Tomato Saponin, Esculeoside A.

PubMed

Zhou, Jian-Rong; Kanda, Yurina; Tanaka, Anna; Manabe, Hideyuki; Nohara, Toshihiro; Yokomizo, Kazumi

2016-01-20

The increasing incidence of atopic dermatitis during recent decades has prompted the development of safe and effective agents for prevention of atopic diseases. Esculeoside A, a glycoside of spirosolane type, is identified as a major component in ripe tomato fruits. The present study investigated the effects of esculeoside A and its aglycon esculeogenin A on hyaluronidase activity in vitro and antiallergy in experimental dermatitis mice. Esculeogenin A/esculeoside A (esculeogenin A equivalent) with an IC50 of about 2 μM/9 μM dose-dependently inhibited hyaluronidase activity measured by a modified Morgan-Elson method. Oral treatment with esculeoside A 10 mg/kg of experimental dermatitis mice for 4 weeks significantly decreased the skin clinical score to 2.5 without any detectable side effects compared with 6.75 of the control. The scratching frequency of esculeoside A 100 mg/kg application was decreased significantly as 107.5 times compared with 296.67 times of the control. Thus, the present study showed that esculeoside A/esculeogenin A significantly blocks hyaluronidase activity in vitro and that esculeoside A ameliorates mouse experimental dermatitis.

Defining intrinsic vs. extrinsic atopic dermatitis.

PubMed

Karimkhani, Chante; Silverberg, Jonathan I; Dellavalle, Robert P

2015-06-16

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition characterized by eczematous lesions, i.e. ill-demarcated erythematous patches and plaques. AD is commonly associated with elevated immunoglobulin E (IgE) and atopic disorders, such as asthma, hay fever, and food allergies. Rackemann and Mallory were some of the first to distinguish between asthma based on the presence ("extrinsic") or absence ("intrinsic") of allergy. This distinction has subsequently been applied to AD based on the presence ("extrinsic") or absence ("intrinsic") of increased IgE and atopic disease. Although the distinction between intrinsic and extrinsic AD is widely used, it remains controversial.

Protective role of 6-formylindolo[3,2-b]carbazole (FICZ), an endogenous ligand for arylhydrocarbon receptor, in chronic mite-induced dermatitis.

PubMed

Kiyomatsu-Oda, Mari; Uchi, Hiroshi; Morino-Koga, Saori; Furue, Masutaka

2018-06-01

Chronic eczema such as atopic dermatitis imposes significant socio-econo-psychologic burdens on the affected individuals. In addition to conventional topical treatments, phototherapy is recommended for patients with extensive lesions. Although immunosuppression is believed to explain its primary effectiveness, the underlying mechanisms of phototherapy remain unsolved. Ultraviolet irradiation generates various tryptophan photoproducts including 6-formylindolo[3,2-b]-carbazole (FICZ). FICZ is known to be a potent endogenous agonist for aryl hydrocarbon receptor (AHR); however, the biological role of FICZ in chronic eczema is unknown. To investigate the effect of FICZ on chronic eczema such as atopic dermatitis. We stimulated HaCaT cells and normal human epidermal keratinocytes (NHEKs) with or without FICZ and then performed quantitative reverse transcriptase polymerase chain reaction, immunofluorescence, and siRNA treatment. We used the atopic dermatitis-like NC/Nga murine model and treated the mice for 2 weeks with either Vaseline ® as a control, FICZ ointment, or betamethasone 17-valerate ointment. The dermatitis score, transepidermal water loss, histology, and expression of skin barrier genes and proteins were evaluated. FICZ significantly upregulated the gene expression of filaggrin in both HaCaT cells and NHEKs in an AHR-dependent manner, but did not affect the gene expression of other barrier-related proteins. In addition, FICZ improved the atopic dermatitis-like skin inflammation, clinical scores, and transepidermal water loss in NC/Nga mice compared with those of control mice. On histology, FICZ significantly reduced the epidermal and dermal thickness as well as the number of mast cells. Topical FICZ also significantly reduced the gene expression of Il22. These findings highlight the beneficial role of FICZ-AHR and provide a new strategic basis for developing new drugs for chronic eczema. Copyright © 2018 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

Treatment of canine atopic dermatitis with cetirizine, a second generation antihistamine: A single-blinded, placebo-controlled study

PubMed Central

2004-01-01

Abstract Cetirizine and placebo were administered orally as individual agents to 23 dogs with atopic dermatitis. The pruritus was satisfactorily reduced in 4/22 (18%) dogs that completed the trial with cetirizine. Two dogs vomited after administration of the active drug. PMID:15206590

Structured Parent Education in the Management of Childhood Atopic Dermatitis: The Berlin Model.

ERIC Educational Resources Information Center

Wenninger, Kerstin; Kehrt, Rainer; von Ruden, Ursula; Lehmann, Christine; Binder, Christiane; Wahn, Ulrich; Staab, Doris

2000-01-01

Describes the goals and content of the Berlin education program for parents and children with atopic dermatitis (AD). Program included six group sessions concerning medical, nutritional, and psychological issues. Program aimed to contribute towards a comprehensive, family-oriented management of childhood AD. Data showed the program had a positive…

Recall bias in childhood atopic diseases among adults in the Odense Adolescence Cohort Study.

PubMed

Mortz, Charlotte G; Andersen, Klaus E; Bindslev-Jensen, Carsten

2015-11-01

Atopic dermatitis (AD) is a common disease in childhood and an important risk factor for the later development of other atopic diseases. Many publications on childhood AD use questionnaires based on information obtained in adulthood, which introduce the possibility of recall bias. In a prospective cohort study, recall bias was evaluated in 1,501 unselected schoolchildren (mean age 14 years) evaluated for the first time in 1995 with a standardized questionnaire combined with a clinical examination and repeated in 2010. The lifetime prevalence of AD was 34.1% including data obtained both during school age and 15 years later, compared with 23.6% including data only from adulthood. The most important factors for remembering having had AD in childhood were: (i) long duration of dermatitis in childhood; (ii) adult hand eczema; and (iii) concomitant atopic disease. Recall bias for childhood AD affected the results of logistic regression on adult hand eczema and is a significant problem in retrospective epidemiological questionnaire studies evaluating previous AD as a risk factor for development of other diseases.

House dust mites on skin, clothes, and bedding of atopic dermatitis patients.

PubMed

Teplitsky, Valery; Mumcuoglu, Kosta Y; Babai, Ilan; Dalal, Ilan; Cohen, Rifka; Tanay, Amir

2008-08-01

Atopic dermatitis is a common allergic condition in children, often associated with a positive skin reaction to house dust mite allergens. To determine the presence of house dust mites on the skin, clothes, and bedding of patients with atopic dermatitis. Nineteen patients with atopic dermatitis were examined during a 2-year period. Samples from affected and healthy skin surfaces were obtained with adhesive tape, and dust samples from bedding and clothes were collected with a vacuum cleaner at the start of the study and 3-6 weeks later, and examined for the presence of house dust mites. The findings were compared with those of 21 healthy controls. The most common mite species on skin were Dermatophagoides pteronyssinus and Dermatophagoides farinae, which were found in nine patients and three controls. The patient group showed a significantly larger percentage of samples with mites than did the control group (34.9% and 7.9%, respectively) (P < 0.001), and a significantly larger percentage of individuals with at least one positive sample (84.2% and 14.2%, respectively) (P < 0.0001). No correlation was found between the number of mites on the skin and clothes/bedding of patients, or between patients and controls with regard to the number of mites on the clothes and bedding. Patients with atopic dermatitis showed a higher prevalence of mites on their skin than did healthy individuals, which could be involved in allergic sensitization and disease exacerbation.

Tacrolimus treatment of atopic eczema/dermatitis syndrome.

PubMed

Thestrup-Pedersen, Kristian

2003-10-01

Atopic dermatitis is today the most common chronic disease of children in Europe, the US and Japan. The 'golden standard' of therapy is topical glucocorticosteroids and emollients. The steroids have been on the market for four decades, are efficacious, but only advised for short-term treatment due to their risks of side effects. More than 16,000 persons suffering from atopic dermatitis have been enrolled in clinical studies of tacrolimus. One third of patients with moderate to severe atopic dermatitis experience over 90% improvement in their disease over a 12-week treatment period and up to 70% of patients have over 50% improvement. A 1-year treatment leads to more than 90% improvement in 75% of patients. The most pronounced side effect is a burning sensation occurring in up to 60% of patients. Atopic dermatitis is a chronic skin disease leading to a demand for long-term treatment control. Such treatment options have not previously been available--except for emollients which are not efficacious for controlling skin inflammation. Tacrolimus and pimecrolimus are new treatment options, free from the potential side effects of topical steroids, which are known for their efficacy in short-term treatment. The new treatment modalities prevent the eczema from relapsing and at the same time they control active eczema. The future will see a shift towards the long-term use of tacrolimus which is able to control the skin inflammation and, hopefully, shorten the course of the eczema.

Analysis of MAST-CLA Results as a Diagnostic Tool in Allergic Skin Diseases

PubMed Central

Shin, Jung Won; Jin, Seon-pil; Lee, Jong Hee

2010-01-01

Background Urticaria and atopic dermatitis are representative allergic skin diseases that can be mediated by IgE. Measuring levels of specific IgE can be used to confirm causative agents of these skin diseases. Objective To analyze results from the multiple allergosorbent test chemiluminescent assay (MAST-CLA), which measures specific IgE in the presence of a causative agent/allergen, in IgE-mediated skin diseases. Methods A total of 404 patients with urticaria, atopic dermatitis or pruritus were enrolled in the present study. Positive rates of specific IgE as well as total serum IgE from the MAST-CLA were compared. Results Positive rates of specific IgE were highest in atopic dermatitis patients, followed by urticaria, and then pruritus, with 57.0%, 37.1%, and 20.8%, respectively (p<0.05). House dust mite species were the most common allergens in both atopic dermatitis and urticaria skin diseases. There were no differences in the overall MAST-CLA results between acute and chronic urticaria. The relative positive rate of inhalant allergen was significantly higher in adult than in child atopic dermatitis patients. Conclusion Results from the MAST-CLA showed diversity among the three disease groups, and within each disease group, with different positive rates of specific IgE, a different mean allergen number per patient, and so on. Therefore, we concluded that MAST-CLA could be a useful diagnostic tool for various allergic skin diseases. PMID:20548878

Is the Atopy Patch Test Reliable in the Evaluation of Food Allergy-Related Atopic Dermatitis?

PubMed

Mansouri, Mahboubeh; Rafiee, Elham; Darougar, Sepideh; Mesdaghi, Mehrnaz; Chavoshzadeh, Zahra

2018-01-01

Aeroallergens and food allergens are found to be relevant in atopic dermatitis. The atopy patch test (APT) can help to detect food allergies in children with atopic dermatitis. This study evaluates if the APT is a valuable tool in the diagnostic workup of children with food allergy-related atopic dermatitis. 42 children between 6 months and 12 years of age were selected at the Mofid Children Hospital. Atopic dermatitis was diagnosed, and the severity of the disease was determined. At the test visit, the patients underwent a skin prick test (SPT), APT, and serum IgE level measurement for cow's milk, egg yolk, egg white, wheat, and soy. We found a sensitivity of 91.7%, a specificity of 72.7%, a positive predictive value (PPV) of 88%, a negative predictive value (NPV) of 80%, and an accuracy of 85.7% for APT performed for cow's milk. APT performed for egg yolk had a sensitivity and a NPV of 100%, while the same parameters obtained with egg white were 84.2 and 75%, respectively. The sensitivity, specificity, and NPV of the APT for wheat were 100, 75, and 100%, respectively. The sensitivity, PPV, and NPV of the APT for soy were 87.5, 70, and 87.5%, respectively. Our data demonstrate that the APT is a reliable diagnostic tool to evaluate suspected food allergy-related skin symptoms in childhood and infancy. © 2018 S. Karger AG, Basel.

Cyclosporine in veterinary dermatology.

PubMed

Palmeiro, Brian S

2013-01-01

Cyclosporine is an immunomodulatory medication that is efficacious and approved for atopic dermatitis in dogs and allergic dermatitis in cats; it has also been used to successfully manage a variety of immune-mediated dermatoses in dogs and cats. This article reviews the use of cyclosporine in veterinary dermatology including its mechanism of action, pharmacokinetics, drug interactions, side effects, and relevant clinical updates. Dermatologic indications including atopic/allergic dermatitis, perianal fistulas, sebaceous adenitis, and other immune-mediated skin diseases are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

Atopic dermatitis and vitamin D: facts and controversies*

PubMed Central

Mesquita, Kleyton de Carvalho; Igreja, Ana Carolina de Souza Machado; Costa, Izelda Maria Carvalho

2013-01-01

Patients with atopic dermatitis have genetically determined risk factors that affect the barrier function of the skin and immune responses that interact with environmental factors. Clinically, this results in an intensely pruriginous and inflamed skin that allows the penetration of irritants and allergens and predisposes patients to colonization and infection by microorganisms. Among the various etiological factors responsible for the increased prevalence of atopic diseases over the past few decades, the role of vitamin D has been emphasized. As the pathogenesis of AD involves a complex interplay of epidermal barrier dysfunction and dysregulated immune response, and vitamin D is involved in both processes, it is reasonable to expect that vitamin D's status could be associated with atopic dermatitis' risk or severity. Such association is suggested by epidemiological and experimental data. In this review, we will discuss the evidence for and against this controversial relationship, emphasizing the possible etiopathogenic mechanisms involved. PMID:24474104

Prevalence and features of canine atopic dermatitis in Hungary.

PubMed

Tarpataki, Noémi; Pápa, Kinga; Reiczigel, J; Vajdovich, P; Vörösi, K

2006-09-01

Medical records of 600 dogs diagnosed with atopic dermatitis were reviewed and evaluated with reference to history, geographical distribution, breed predilection, clinical signs and positive reactions to allergens as determined by intradermal skin testing (IDT) manufactured by Artuvetrin Laboratories. In 66.6% of dogs, the age of onset of atopic dermatitis was between 4 months and 3 years. Dogs living in the garden suburb of Budapest were more sensitive to house dust mites, fleas and moulds, and dogs from the western part of Hungary were more sensitive to weeds than to other allergens (p < 0.01). Positive reactions were most common to Dermatophagoides farinae followed by human dander. The breed distribution found in the present study was consistent with that reported in the literature, except for the breeds Hungarian Vizsla, Pumi, French bulldog, Doberman Pinscher and Bobtail which were over-represented among atopic dogs compared to the breed distribution of the general dog population of a large city in Hungary. Breeds with verified adverse reaction to food were Cocker spaniels, French bulldogs, Bullmastiffs, Bull terriers, St. Bernards, Tervurens, West Highland White terriers and American Staffordshire terriers (p < 0.05). The clinical signs of atopic dermatitis and their occurrence are in accordance with the data described in the literature.

[Clinical symptomps, diagnosis and therapy of feline allergic dermatitis].

PubMed

Favrot, C; Rostaher, A; Fischer, N

2014-07-01

Allergies are often suspected in cats and they are mainly hypersensitivity reactions against insect bites, food- or environmental allergens. Cats, with non flea induced atopic dermatitis, normally present with one oft he following reaction patterns: miliary dermatitis, eosinophilic dermatitis, selfinduced alopecia or head and neck excoriations. None of these reaction patterns is nevertheless pathognomonic for allergic dermatitis, therefore the diagnosis is based on the one hand on the exclusion of similar diseases on the other hand on the successful response on a certain therapy. Recently a study on the clinical presentation of cats with non flea induced atopic dermatitis was published. In this study certain criteria for diagnosing atopy in cats were proposed. For therapy of allergic cats cyclosporin, glucocorticoids, antihistamines, hypoallergenic diets and allergen specific immunotherapy are used. This article should provide a recent overview on the clinical symptoms, diagnosis and therapy of feline allergic dermatitis.

Ceramidastin, a novel bacterial ceramidase inhibitor, produced by Penicillium sp. Mer-f17067.

PubMed

Inoue, Hiroyuki; Someno, Tetsuya; Kato, Taira; Kumagai, Hiroyuki; Kawada, Manabu; Ikeda, Daishiro

2009-02-01

Decrease of ceramide in the skin is one of the aggravating factors of atopic dermatitis. The skin is often infected by ceramidase-producing bacteria, such as Pseudomonas aeruginosa. The bacterial ceramidase then degrades ceramide in the skin. To develop anti-atopic dermatitis drugs, we searched for ceramidase inhibitors, which led to the discovery of ceramidastin, a novel inhibitor of bacterial ceramidase, from the culture broth of Penicillium sp. Mer-f17067. Ceramidastin inhibited the bacterial ceramidase with an IC(50) value of 6.25 microg ml(-1). Here we describe the isolation, physicochemical properties, structure determination and biological activity of ceramidastin.

The Epithelial Cell-derived Atopic Dermatitis Cytokine TSLP Activates Neurons to Induce Itch

PubMed Central

Wilson, Sarah R.; Thé, Lydia; Batia, Lyn M.; Beattie, Katherine; Katibah, George E.; McClain, Shannan P.; Pellegrino, Maurizio; Estandian, Daniel M.; Bautista, Diana M.

2014-01-01

Summary Atopic dermatitis (AD) is a chronic itch and inflammatory disorder of the skin that affects one in ten people. Patients suffering from severe AD eventually progress to develop asthma and allergic rhinitis, in a process known as the “atopic march.” Signaling between epithelial cells and innate immune cells via the cytokine Thymic Stromal Lymphopoietin (TSLP) is thought to drive AD and the atopic march. Here we report that epithelial cells directly communicate to cutaneous sensory neurons via TSLP to promote itch. We identify the ORAI1/NFAT calcium signaling pathway as an essential regulator of TSLP release from keratinocytes, the primary epithelial cells of the skin. TSLP then acts directly on a subset of TRPA1-positive sensory neurons to trigger robust itch behaviors. Our results support a new model whereby calcium-dependent TSLP release by keratinocytes activates both primary afferent neurons and immune cells to promote inflammatory responses in the skin and airways. PMID:24094650

Recent Advances in Pharmacotherapeutic Paradigm of Mild to Recalcitrant Atopic Dermatitis.

PubMed

Hussain, Zahid; Sahudin, Shariza; Thu, Hnin Ei; Shuid, Ahmad Nazrun; Bukhari, Syed Nasir Abbas; Kumolosasi, Endang

2016-01-01

Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms. Based on the available clinical evidence, topical corticosteroids (TCs) are among the most commonly prescribed agents; however, these should be selected with care. In cases of steroid phobia, persistent adverse effects or chronic use, topical calcineurin inhibitors can be considered as a promising adjunct to TCs. Recent advances in the pharmacotherapeutic paradigm of atopic diseases exploring the therapeutic dominance of nanocarrier-mediated delivery is also discussed in this evidence-based review with regard to the treatment of AD. The present review summarizes the available clinical evidence, highlighting the current and emerging trends in the treatment of AD and providing evidence-based recommendations for the clinicians and health care professionals. Available evidence for the management of pediatric and adult atopic dermatitis (AD; atopic eczema) of all severities is explored. The management of other types of dermatitis, such as irritant contact dermatitis, seborrheic dermatitis, neurodermatitis, perioral dermatitis, stasis dermatitis, and allergic contact dermatitis are outside the scope of current review article. The presented studies were appraised using a unified system called the "Strength of Recommendation Taxonomy (SORT)", which was developed by the editors of several US family medicine and primary care journals (i.e., American Family Physician, Family Medicine, Journal of Family Practice, and BMJ USA).1 The searched studies were graded using a 3-point scale based on the quality of methodology (e.g., randomized control trial, case control series, clinical cohort studies, case series, etc.) and key emphasis of the trial (i.e., diagnosis, treatment/prevention/ screening, or prognosis) as follows: I. Good-quality patient-oriented evidence (i.e., evidence assessing consequences that matter to patients: mortality, morbidity, improvement in signs and symptom, quality of life, and socioeconomic factors); II. Limited-quality patient-oriented evidence; and III. Other evidence such as consensus guidelines, expert opinion, case control trial, or disease-related information. Recommendations for nonpharmacological and pharmacological approaches were established based on the best available evidence and are graded as follows: A. Recommendations based on consistent and good-quality patient-oriented evidence; B. Recommendations based on inconsistent or limited-quality patient-oriented evidence; and C. Recommendations based on consensus, expert opinion, case control evidence, or disease-related information.

The Effect of Environmentally Friendly Wallpaper and Flooring Material on Indoor Air Quality and Atopic Dermatitis: A Pilot Study

PubMed Central

Na, Jung Im; Byun, Sang Young; Jeong, Mi Young; Park, Kyoung Chan

2014-01-01

Background Formaldehyde (FA) and other volatile organic compounds (VOCs) are considered among the main causes of atopic aggravation. Their main sources include wallpapers, paints, adhesives, and flooring materials. Objective To assess the effects of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis severity. Methods Thirty patients with atopic dermatitis were enrolled in this study. To improve air quality, the wallpaper and flooring in the homes of the subjects were replaced with plant- or silica-based materials. The indoor air concentration of FA and the total VOCs (TVOCs) were measured before remodeling and 2, 6, and 10 weeks thereafter. Pruritus and the severity of atopic eczema were evaluated by using a questionnaire and the eczema area and severity index (EASI) score before and at 4, 8, and 12 weeks after remodeling. The subjects were instructed to continue their therapy for atopic dermatitis. Results The houses of 24 subjects were remodeled; all subjects completed the study. The concentration of FA in ambient air significantly decreased within 2 weeks after remodeling. The TVOC level showed a decrease at week 2 but increased again at weeks 6 and 10. The reduction of pruritus and EASI score was statistically significant in patients whose baseline EASI score was >3. Conclusion Replacing the wallpaper and flooring of houses with environmentally friendly material reduced FA in ambient air and improved pruritus and the severity of atopic eczema. The improvement of pruritus and eczema was statistically significant in patients whose baseline EASI score was >3. PMID:25473219

Infections and atopy: an exploratory study for a meta-analysis of the "hygiene hypothesis".

PubMed

Randi, G; Altieri, A; Chatenoud, L; Chiaffarino, F; La Vecchia, C

2004-12-01

According to the "hygiene hypothesis" selected allergic diseases could be prevented by exposure to infectious agents during early childhood. This study was performed to assess the feasibility of a future meta-analysis on the "hygiene hypothesis" and atopic diseases. Differences concerning the potential association with a history of infectious events, in terms of magnitude and homogeneity of global risk estimates between the three major atopic diseases (i.e. atopic dermatitis, asthma and allergic rhinitis) were examined. We conducted a preliminary analysis on a sample of articles published on this topic and cited in a recent and authoritative review. The ranges of relative risks estimates (between 0.6 and 0.8) were similar for atopic dermatitis, allergic rhinitis and asthma. Compared with asthma and allergic rhinitis, reported global risk estimates were more stable for atopic dermatitis (lowest heterogeneity). Our analysis suggests that three main categories of indirect markers of exposure to infection can be identified: 1) geographical gradient, 2) indices of potential contact with infectious agents (such as number of siblings) and 3) history of infectious events. In this exploratory study, we chose articles cited in a single review and obtained a preliminary quantification of the association between infections and atopic diseases. The association with indirect markers of infection corresponded to 20% protection for atopic dermatitis, 30% for allergic rhinitis and 40% for asthma. In a subsequent meta-analysis, diseases should be considered separately and differences between types of exposures should be taken into account as one of the major end-points, with attention to time since exposure and disease onset.

Daily intake of Jeju groundwater improves the skin condition of the model mouse for human atopic dermatitis.

PubMed

Tanaka, Akane; Jung, Kyungsook; Matsuda, Akira; Jang, Hyosun; Kajiwara, Naoki; Amagai, Yosuke; Oida, Kumiko; Ahn, Ginnae; Ohmori, Keitaro; Kang, Kyung-goo; Matsuda, Hiroshi

2013-03-01

Drinking water is an important nutrient for human health. The mineral ingredients included in drinking water may affect the physical condition of people. Various kinds of natural water are in circulation as bottled water in developed countries; however, its influence on clinical conditions of patients with certain diseases has not been fully evaluated. In this study, effects of the natural groundwater from Jeju Island on clinical symptoms and skin barrier function in atopic dermatitis (AD) were evaluated. NC/Tnd mice, a model for human AD, with moderate to severe dermatitis were used. Mice were given different natural groundwater or tap water for 8 weeks from 4 weeks of age. Clinical skin severity scores were recorded every week. Scratching analysis and measurement of transepidermal water loss were performed every other week. The pathological condition of the dorsal skin was evaluated histologically. Real-time polymerase chain reaction analysis was performed for cytokine expression in the affected skin. The epidermal hyperplasia and allergic inflammation were reduced in atopic mice supplied with Jeju groundwater when compared to those supplied with tap water or other kinds of natural groundwater. The increase in scratching behavior with the aggravation of clinical severity of dermatitis was favorably controlled. Moreover, transepidermal water loss that reflects skin barrier function was recovered. The early inflammation and hypersensitivity in the atopic skin was alleviated in mice supplied with Jeju groundwater, suggesting its profitable potential on the daily care of patients with skin troubles including AD. © 2013 Japanese Dermatological Association.

Potential role of reduced environmental UV exposure as a driver of the current epidemic of atopic dermatitis.

PubMed

Thyssen, Jacob P; Zirwas, Matthew J; Elias, Peter M

2015-11-01

The basis for the sudden and dramatic increase in atopic dermatitis (AD) and related atopic diseases in the second half of the 20th century is unclear. The hygiene hypothesis proposes that the transition from rural to urban living leads to reduced childhood exposure to pathogenic microorganisms. Hence instead of having the normal TH1 bias and immune tolerance because of repeated exposure to pathogens, urban dwellers have TH2 cell immune activity and atopic disease in a more sterile environment. Various other environmental exposures have been implicated in the explosion of AD (and atopic disorders in general), including breast-feeding, tobacco smoking, alcohol consumption, and exposure to domesticated furry pets. Notably, the key role of a compromised barrier of neonatal skin as a predisposing factor in the development of childhood AD has recently been demonstrated. In this article we review the salubrious effects of suberythemogenic doses of UVB irradiation for the skin barrier. We then discuss how the lack of sufficient UVB exposure could have contributed to the rapid increase in the incidence of AD in developed countries. This hypothesis offers a separate but not competing partial explanation, which should be viewed as not discounting the role of the etiopathogenic factors that also could influence the prevalence of atopic disorders. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. All rights reserved.

Plasma and skin vitamin E concentrations in canine atopic dermatitis.

PubMed

Plevnik Kapun, Alja; Salobir, Janez; Levart, Alenka; Tavčar Kalcher, Gabrijela; Nemec Svete, Alenka; Kotnik, Tina

2013-01-01

Altered homeostasis of vitamin E has been demonstrated in human atopic dermatitis. Data on plasma and skin vitamin E concentrations in canine atopic dermatitis (CAD) are not available. To determine vitamin E concentrations in plasma and skin of atopic dogs. Vitamin E concentrations in plasma and full-thickness skin biopsies of 15 atopic dogs were related to CAD extent and severity index (CADESI-03) scores and compared to the equivalent concentrations in 17 healthy dogs. Statistically significant differences of measured parameters between the two groups were determined by the nonparametric Mann Whitney U test and correlations between CADESI-03 scores and vitamin E concentrations were evaluated by the Spearman rank test. A value of P < 0.05 was considered significant. Plasma concentrations of vitamin E were significantly lower in atopic dogs than in healthy dogs, with median values of 29.8 and 52.9 μmol/L, respectively. Skin vitamin E values did not differ significantly between patients and healthy controls. The median concentration of skin vitamin E in atopic dogs was higher than that in healthy dogs. No significant correlations were found between CADESI-03 score and plasma vitamin E or skin vitamin E concentrations. Significantly lower plasma vitamin E concentrations in atopic dogs than in healthy controls indicate altered homeostasis of vitamin E in CAD. Further investigation into vitamin E supplementation in CAD is warranted.

Use of aromatherapy products and increased risk of hand dermatitis in massage therapists.

PubMed

Crawford, Glen H; Katz, Kenneth A; Ellis, Elliot; James, William D

2004-08-01

To determine the 12-month prevalence of hand dermatitis among massage therapists, to investigate a potential association between hand dermatitis and the use of aromatherapy products, and to study potential associations with other known risk factors for hand dermatitis. Mailed survey. Philadelphia, Pa. Members of a national massage therapy organization who live in the greater Philadelphia region. Self-reported and symptom-based prevalences of hand dermatitis. The number of respondents was 350 (57%). The 12-month prevalence of hand dermatitis in subjects was 15% by self-reported criteria and 23% by a symptom-based method. In multivariate analysis, statistically significant independent risk factors for self-reported hand dermatitis included use of aromatherapy products in massage oils, lotions, or creams (odds ratio, 3.27; 95% confidence interval, 1.53-7.02; P =.002) and history of atopic dermatitis (odds ratio, 8.06; 95% confidence interval, 3.39-19.17; P<.001). The prevalence of hand dermatitis in massage therapists is high. Significant independent risk factors include use of aromatherapy products in massage oils, creams, or lotions and history of atopic dermatitis.

The alkylphenols 4-nonylphenol, 4-tert-octylphenol and 4-tert-butylphenol aggravate atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Sadakane, Kaori; Ichinose, Takamichi; Takano, Hirohisa; Yanagisawa, Rie; Koike, Eiko; Inoue, Ken-ichiro

2014-08-01

Phthalate esters in plastics act as adjuvants for immunoglobulin production, which aggravates allergic disease. However, the effects of alkylphenols (used as plasticizers and surfactants) on atopic dermatitis have not been studied in detail. Therefore, the goal of the present study was to investigate the effects of the alkylphenols 4-nonylphenol (NP), 4-tert-octylphenol (OP) and 4-tert-butylphenol (BP) in a murine model of atopic dermatitis. NC/Nga mice were intraperitoneally administered NP, OP or BP and were subcutaneously injected with mite allergen in one ear to induce atopic dermatitis-like skin lesions (ADSLs). The condition of the skin was observed, and the levels of immunoglobulin in serum and inflammatory cytokines in lesions were determined. NP exacerbated mite allergen-induced ADSLs according to dose. OP and BP also significantly exacerbated skin lesions but not as a function of dose. Alkylphenols tended to increase the levels of IgE and antigen-specific IgG1 in serum. Further, the treatment of the alkylphenols increased the expression in lesions of inflammatory cytokines, interleukin-4 and monocyte chemotactic protein-3. Thymic stromal lymphopoietin levels increased according to ADSL severity. In contrast, the levels of the T-helper 1 cytokines (interleukin-18 and interferon-gamma) decreased. NP, OP or BP may enhance T-helper 2-type immune responses in NC/Nga mice, which aggravates mite allergen-induced ADSLs. Therefore, the uptake of very low levels of alkylphenols may contribute to the increase in the incidence of atopic dermatitis. Copyright © 2013 John Wiley & Sons, Ltd.

Psychodermatologic Effects of Atopic Dermatitis and Acne: A Review on Self-Esteem and Identity.

PubMed

Nguyen, Catherine M; Koo, John; Cordoro, Kelly M

2016-01-01

Atopic dermatitis (AD) and acne vulgaris are among the most-prevalent skin diseases in children. Both have been well documented in the literature to have significant negative effects on quality of life. Herein, we discuss the results of a comprehensive literature review aimed at assessing the impact of acne and AD on self-esteem and identity. We highlight clinical tools for their assessment and offer coping strategies for patients and families. Multiple factors including relationships with parents and classmates, sports participation, and the sex of the patient contribute to the development of self-esteem and identity in individuals with AD and acne. Atopic dermatitis was found to have significant behavioral effects on children, ultimately resulting in a lack of opportunity to develop proper coping. AD had a more-prominent role in identity formation and gender roles in girls. Acne vulgaris was found to have a more direct effect on self-esteem, self-confidence and identity, especially in girls. The Cutaneous Body Image Scale is reviewed and offered as an easy and reliable tool to evaluate a patient's mental perception of the appearance of their skin. Coping strategies that may be offered to patients and families include empowerment and cognitive adaptation. © 2016 Wiley Periodicals, Inc.

[Hurt eczematiforme column (chronicle) of the breast after implementation of a surgical clip].

PubMed

Motton, S; Gardinal, I; Soulé-Tholy, M; Viraben, R; Hoff, J; Leguevaque, P

2011-04-01

We report a case of atopic dermatitis in relation with a surgical titanium clip. Such a complication has only been reported once in the literature. We advocate to ask the patients about query atopic manifestations especially contact dermatitis to metal before any procedure involving metallic implants. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Clinical use of a ceramide-based moisturizer for treating dogs with atopic dermatitis

PubMed Central

Jung, Ji-young; Nam, Eui-hwa; Park, Seol-hee; Han, Seung-hee

2013-01-01

In humans, skin barrier dysfunction is thought to be responsible for enhanced penetration of allergens. Similar to conditions seen in humans, canine atopic dermatitis (CAD) is characterized by derangement of corneocytes and disorganization of intercellular lipids in the stratum corenum (SC) with decreased ceramide levels. This study was designed to evaluate the effects of a moisturizer containing ceramide on dogs with CAD. Dogs (n = 20, 3~8 years old) with mild to moderate clinical signs were recruited and applied a moisturizer containing ceramide for 4 weeks. Transepidermal water loss (TEWL), skin hydration, pruritus index for canine atopic dermatitis (PICAD) scores, and canine atopic dermatitis extent and severity index (CADESI) scores of all dogs were evaluated. Skin samples from five dogs were also examined with transmission electron microscopy (TEM) using ruthenium tetroxide. TEWL, PICAD, and CADESI values decreased (p < 0.05) and skin hydration increased dramatically over time (p < 0.05). Electron micrographs showed that the skin barrier of all five dogs was partially restored (p < 0.05). In conclusion, these results demonstrated that moisturizer containing ceramide was effective for treating skin barrier dysfunction and CAD symptoms. PMID:23814473

2% Crisaborole topical ointment for the treatment of mild-to-moderate atopic dermatitis.

PubMed

Cheape, Alice C; Murrell, Dedee F

2017-05-01

Crisaborole 2% topical ointment is an anti-inflammatory, non-steroidal phosphodiesterase 4 inhibitor which is currently under investigation for its potential role in the treatment of atopic dermatitis and psoriasis. Areas covered: So far, 7 trials have been completed in atopic dermatitis. The 2% strength appeared to be the superior dosing regimen. Pruritus improved significantly within one week. The improvements in objective efficacy assessments in crisaborole-treated patients were also statistically significant compared to the vehicle. Expert commentary: Crisaborole has several key features in its mode of action which distinguish it from existing treatments for atopic dermatitis (AD), notably its activity against the phosphodiesterase E4 (PDE4) pathway, regulating cyclic AMP (cAMP) levels. This is less immunosuppressive than other pathways and has no effect on skin thinning. The pathway interrupts the itch sensation (pruritus) which means that the itch-scratch cycle, the bane in the life of patients with AD, is interrupted, usually as early as a few days into treatment. Hence, with the promising safety profile demonstrated, early treatment of mild to moderate AD patients might help to control AD better and improve quality of life for patients.

[The medical rehabilitation of the children presenting with atopic dermatitis (a literature review)].

PubMed

Kotenko, K V; Khan, M A; Lyan, N A; Vakhova, E L; Novikova, E V

Atopic dermatitis takes the predominant position in the structure of skin pathologies in the children of various age. Both the scientifically based forecasts and the data of numerous investigations give evidence not only of the significant increase in the number of patients presenting with this condition but also of the growing severity of this disease. Taken together, these facts account for the serious medico-social importance of the problems arising in connection with this pathology. The introduction of the eliminative actions, a hypoallergenic diet, local and systemic pharmacotherapeutic modalities do not always allow to prevent or arrest the inflammatory process and achieve the long-standing remission. The high frequency of undesirable reactions to the pharmacological products turns the attention of many clinicians to the application of the non-pharmacological factors and methods for the treatment of atopic dermatitis in the children. The main objectives of physical therapy in the case of atopic dermatitis include the normalization of the state of the central and vegetative nervous system, the achievement of hyposensitization, sedative, anti-toxic, and anti-inflammatory effects, as well as the application of the dissolving, trophic, and antipruritogenic agents, strengthening of the general health status of the children.

The effective management of atopic dermatitis in school-age children.

PubMed

Ward, Sue

The terms atopic eczema and atopic dermatitis (AD) are synonymous. In this article, the latter term is used. AD can affect all age groups but is most commonly associated with children. It is a dry-skin condition, the severity of which can vary from person to person. It is not contagious. In mild forms of the condition the skin is dry, hot and itchy, while in more severe cases the skin can be broken, raw and bleeding, or produce vesicles and papules that may become eroded.

IMPACT OF ATOPIC DERMATITIS ON THE QUALITY OF LIFE OF PEDIATRIC PATIENTS AND THEIR GUARDIANS

PubMed Central

Campos, Amanda Letícia Bezerra; de Araújo, Filipe Moreira; dos Santos, Maria Amélia Lopes; dos Santos, Alex de Assis Santos; Pires, Carla Andréa Avelar

2017-01-01

ABSTRACT Objective: To evaluate the impact of atopic dermatitis on the quality of life of pediatric patients in the age group of 5-16 years, and their parents, assisted at the Dermatology Department of Universidade do Estado do Pará in 2015. Methods: A cross-sectional study including 51 patients and their guardians, to whom two questionnaires about the quality of life were applied, the Children’s Dermatology Life Quality Index (CDLQI) and the Dermatitis Family Impact (DFI). To evaluate the severity of the disease, the researchers applied the Severity Scoring of Atopic Dermatitis (SCORAD) index. The Pearson Product-Moment Correlation Coefficient (PPMCC) evaluated the correlation between CDLQI, DFI, SCORAD, and the contingency coefficient C evaluated the association between the qualitative variables, considering p<0.05 significant. Results: Of the patients, 55% were female. The average age was 9.5±3.2 years, and 41% had family income up ≤1 minimum wage. The average score was 5.4±5.1 for CDLQI, 6.6±4.5 for DFI, and 28.3±19.8 for SCORAD. The correlation among the scores CDLQI, DFI, and SCORAD was significant by the PPMCC (p<0,001). Conclusions: Atopic dermatitis affects the quality of life of both children and their guardians, and indicates the importance of including the study of quality of life as a complement to clinical evaluation. PMID:28977306

Measuring the impact of dermatological conditions on family and caregivers: a review of dermatology-specific instruments.

PubMed

Sampogna, F; Finlay, A Y; Salek, S S; Chernyshov, P; Dalgard, F J; Evers, A W M; Linder, D; Manolache, L; Marron, S E; Poot, F; Spillekom-van Koulil, S; Svensson, Å; Szepietowski, J C; Tomas-Aragones, L; Abeni, D

2017-09-01

The patient is the centre of a web of relationships, and the impact of his/her disease on family members and caregivers must be taken into account. The aim of this study was to identify the specific instruments that measure the impact of a dermatological disease on the quality of life (QoL) of family members, by performing a systematic search of the literature. Fifteen papers were identified, describing the creation and validation of nine instruments. Four of them concerned atopic dermatitis (Dermatitis Family Index, DFI; Parents' Index QoL Atopic Dermatitis, PiQoL-AD; QoL in primary caregivers of children with atopic dermatitis, QPCAD; Childhood Atopic Dermatitis Impact Scale, CADIS), two measured the impact of psoriasis in family members (Psoriasis Family Index, PFI; FamilyPso), one the impact of epidermolysis bullosa (Epidermolysis Bullosa Burden of Disease, EB-BoD), one of ichthyosis (Family Burden Ichthyosis, FBI), and one was generic for dermatological conditions (Family Dermatology Life Quality Index, FDLQI). The European Academy of Dermatology and Venereology quality of life taskforce recommends that the impact of a skin disease on family and caregivers should be measured as part of any thorough evaluation of the burden of a disease. Guidelines are given to choose the most appropriate instruments. © 2017 European Academy of Dermatology and Venereology.

Recent considerations in the use of recombinant interferon gamma for biological therapy of atopic dermatitis.

PubMed

Brar, Kanwaljit; Leung, Donald Y M

2016-01-01

Atopic dermatitis (AD) is the most common inflammatory skin disease in the general population. There are different endophenotypes of AD that likely have a unique immune and molecular basis, such as those who are predisposed to eczema herpeticum, or Staphylococcus aureus infections. In this review, we highlight the endophenotypes of AD where reduced interferon gamma expression may be playing a role. Additionally, we review the potential role of recombinant interferon gamma therapy in the treatment of atopic dermatitis and the particular phenotypes that may benefit from this treatment. Recombinant interferon gamma treatment will likely benefit the pediatric population with AD, as well as those with susceptibilities for skin infections. Future studies are needed to elucidate whether IFN-γ may reduce the prevalence of skin infection in AD.

[Burden of atopic dermatitis in adults].

PubMed

Misery, L

2017-12-01

Atopic dermatitis may have a very important impact on adults. Visible lesions, but especially near-permanent pruritus or sometimes pain for decades, necessarily have consequences on all aspects of everyday life, including sleep, and professional, social, family and emotional life. Financial consequences are also possible. Poorly known, stigmatisation can be real. Treatments can be very demanding. Thus, the quality of life can be greatly altered and atopic dermatitis could be a heavy burden. The psychological consequences can be major. Co-morbidity appears more and more as a major problem. Patients can therefore be caught in an infernal circle, consequences of the disease aggravating the disease. The best way out is probably to have very effective and well-tolerated treatments. © 2017 Elsevier Masson SAS. Tous droits réservés.

A Pragmatic Approach to Patch Testing Atopic Dermatitis Patients: Clinical Recommendations Based on Expert Consensus Opinion.

PubMed

Chen, Jennifer K; Jacob, Sharon E; Nedorost, Susan T; Hanifin, Jon M; Simpson, Eric L; Boguniewicz, Mark; Watsky, Kalman L; Lugo-Somolinos, Aida; Hamann, Carsten R; Eberting, Cheryl Lee; Silverberg, Jonathan I; Thyssen, Jacob P

2016-01-01

Allergic contact dermatitis (ACD) may complicate the clinical course of atopic dermatitis (AD), and patch testing remains the criterion standard for diagnosing ACD. To date, there have been no guidelines or consensus recommendations on when and how to patch test individuals with AD. Failure to patch test when appropriate may result in overlooking an important and potentially curable complicating comorbidity. In this article, we present consensus recommendations regarding when to perform patch testing in the AD patient, best practices, and common pitfalls. Patch testing should be considered in AD patients with dermatitis that fails to improve with topical therapy; with atypical/changing distribution of dermatitis, or pattern suggestive of ACD; with therapy-resistant hand eczema in the working population; with adult- or adolescent-onset AD; and/or before initiating systemic immunosuppressants for the treatment of dermatitis. A suggested patch testing algorithm for AD patients is provided.

Efficacy and Tolerability of Steroid-Free, Over-the-Counter Treatment Formulations in Infants and Children With Atopic Dermatitis

PubMed Central

Weber, Teresa M.; Herndon, James H.; Ewer, Melissa; Stephens, Thomas J.; Flick, Iris; Filbry, Alexander; Neufang, Gitta; Schoelermann, Andrea M.

2015-01-01

ABSTRACT Background Two steroid-free, over-the-counter skin protectant products have been developed for the care and treatment of atopic dermatitis (AD)—Eucerin Eczema Relief Body Crème (Body Cream) for daily skin moisturization and Eucerin Eczema Relief Instant Therapy cream (Instant Therapy) for treatment of AD flare-ups. We tested the efficacy and tolerability of these formulations in infants and children with AD. Methods Study 1: Body Cream was applied twice daily to the lower legs of 64 children with a history of AD (aged 3 months to 12 years) for 14 days. Study 2: Instant Therapy was applied to active lesions and surrounding skin of 29 children (aged 3 months to 12 years) with active atopic lesions. Assessments were performed at baseline and Days 7 and 14. Symptoms were assessed using the Atopic Dermatitis Severity Index in Study 2. Results Body Cream significantly improved skin hydration and reduced itching, burning/stinging, erythema, and tactile roughness. Instant Therapy significantly improved skin hydration and AD symptoms, notably pruritus, erythema, and lichenification. Both products were safe and well tolerated. Discussion Body Cream and Instant Therapy were effective and well tolerated in the treatment of AD in children. These products provide steroid-free, nonprescription therapy for the maintenance and treatment of acute eczema and were proven effective and safe in infants as young as 3 months. PMID:25699134

The Role of Interleukins 4 and/or 13 in the Pathophysiology and Treatment of Atopic Dermatitis.

PubMed

Silverberg, Jonathan I; Kantor, Robert

2017-07-01

Moderate to severe atopic dermatitis (AD) can be debilitating and often requires use of systemic immunosuppressant therapy to achieve adequate disease control. There are currently no US Food and Drug Administration-approved systemic agents for the long-term treatment of AD. Recent insight has identified the T helper 2 cytokines, interleukins 4 and 13, as playing a major role in the pathogenesis of AD. There are multiple novel biologic agents in development that target interleukins 4 and/or 13 for the treatment of moderate to severe AD. The age of targeted biologics for AD has arrived. Copyright © 2017 Elsevier Inc. All rights reserved.

[Percutaneous sensitization to almond oil in infancy and study of ointments in 27 children with food allergy].

PubMed

Guillet, G; Guillet, M H

2000-10-01

A five month old child with atopic dermatitis developed contact dermatitis to almond with positive patch test, positive prick test, and class 4 anti-almond IgE. Focal lesions of persistent eczema were correlated with application of almond oil for 2 month on cheeks and buttocks. The child had not ingested almond and her mother did not report almond intake during her breast-feeding. This observation points to the problems of possible percutaneous sensitisation to food proteins. The study of skin ointments containing components of food origin in 27 food sensitized atopic patients confirm that the choice of an ointment for lesional skin is of importance.

Anti-Interleukin-31 Receptor A Antibody for Atopic Dermatitis.

PubMed

Ruzicka, Thomas; Hanifin, Jon M; Furue, Masutaka; Pulka, Grazyna; Mlynarczyk, Izabela; Wollenberg, Andreas; Galus, Ryszard; Etoh, Takafumi; Mihara, Ryosuke; Yoshida, Hiroki; Stewart, Jonathan; Kabashima, Kenji

2017-03-02

Interleukin-31 may play a role in the pathobiologic mechanism of atopic dermatitis and pruritus. We wanted to assess the efficacy and safety of nemolizumab (CIM331), a humanized antibody against interleukin-31 receptor A, in the treatment of atopic dermatitis. In this phase 2, randomized, double-blind, placebo-controlled, 12-week trial, we assigned adults with moderate-to-severe atopic dermatitis that was inadequately controlled by topical treatments to receive subcutaneous nemolizumab (at a dose of 0.1 mg, 0.5 mg, or 2.0 mg per kilogram of body weight) or placebo every 4 weeks or an exploratory dose of 2.0 mg of nemolizumab per kilogram every 8 weeks. The primary end point was the percentage improvement from baseline in the score on the pruritus visual-analogue scale (on which a negative change indicates improvement) at week 12. Secondary end points included changes in the score on the Eczema Area and Severity Index (EASI, on which a negative change indicates improvement), and body-surface area of atopic dermatitis. Of 264 patients who underwent randomization, 216 (82%) completed the study. At week 12, among the patients who received nemolizumab every 4 weeks, changes on the pruritus visual-analogue scale were -43.7% in the 0.1-mg group, -59.8% in the 0.5-mg group, and -63.1% in the 2.0-mg group, versus -20.9% in the placebo group (P<0.01 for all comparisons). Changes on the EASI were -23.0%, -42.3%, and -40.9%, respectively, in the nemolizumab groups, versus -26.6% in the placebo group. Respective changes in body-surface area affected by atopic dermatitis were -7.5%, -20.0%, and -19.4% with nemolizumab, versus -15.7% with placebo. Among the patients receiving nemolizumab every 4 weeks, treatment discontinuations occurred in 9 of 53 patients (17%) in the 0.1-mg group, in 9 of 54 (17%) in the 0.5-mg group, and in 7 of 52 (13%) in the 2.0-mg group, versus in 9 of 53 (17%) in the placebo group. In this phase 2 trial, nemolizumab at all monthly doses significantly improved pruritus in patients with moderate-to-severe atopic dermatitis, which showed the efficacy of targeting interleukin-31 receptor A. The limited size and length of the trial preclude conclusions regarding adverse events. (Funded by Chugai Pharmaceutical; XCIMA ClinicalTrials.gov number, NCT01986933 .).

Crisaborole Topical

MedlinePlus

Crisaborole is used to treat eczema (atopic dermatitis; a skin condition which causes the skin to be ... itchy and to sometimes develop red, scaly rashes ). Crisaborole is in a class of medications called phosphodiesterase ...

Increased numbers of peripheral blood CD34+ cells in dogs with canine atopic dermatitis.

PubMed

Bruet, Vincent; Lieubeau, Blandine; Herve, Julie; Roussel, Anne; Imparato, Laëtitia; Desfontis, Jean-Claude; Bourdeau, Patrick

2015-06-01

The bone marrow may be involved in human atopic diseases, as shown by the release of CD34+ cells into the peripheral blood. The aim was to determine the numbers of CD34+ cells in atopic dogs. The following three groups of dogs were studied: 27 dogs with nonfood-induced atopic dermatitis (NFICAD); 16 dogs with nonallergic inflammatory diseases; and 13 healthy control dogs. Dogs with NFICAD were selected after fulfilment of Favrot's criteria and exclusion of other pruritic dermatoses, including flea infestation and adverse reaction to foods. The Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 and a Visual Analog Scale (VAS) score for pruritus were used to quantify clinical signs. A phycoerythrin-conjugated anticanine CD34 antibody was used to stain peripheral blood CD34+ cells, and these were enumerated using a flow cytometer. The CD34+ cell counts were compared between groups and tested (in the NFICAD group) for correlation with the severity of clinical signs. The numbers of peripheral CD34+ cells in dogs with NFICAD (median 1.7) were statistically higher than in dogs with other nonallergic inflammatory diseases (median 1.0; P = 0.01) and healthy control dogs (median 0.9; P = 0.009). In dogs with NFICAD, there was no correlation between CD34+ cell numbers and CADESI-03 scores or owner-assessed pruritus (VAS score). The results of this study suggest the possible involvement of CD34+ cells in dogs with NFICAD. The role of CD34+ cells in the aetiopathogenesis of canine atopic dermatitis remains to be determined. © 2014 ESVD and ACVD.

Treatment of canine atopic dermatitis with a commercial homeopathic remedy: A single-blinded, placebo-controlled study

PubMed Central

Scott, Danny W.; Miller, William H.; Senter, David A.; Cook, Christopher P.; Kirker, J. Edward; Cobb, Shaun M.

2002-01-01

A commercial homeopathic remedy and a placebo were administered orally as individual agents to 18 dogs with atopic dermatitis. The pruritus was reduced by less than 50% in only 2/18 dogs; 1 of these dogs was receiving the homeopathic remedy, the other was receiving the placebo. One dog vomited after administration of the homeopathic remedy. PMID:12170834

GUIDELINES OF CARE FOR THE MANAGEMENT OF ATOPIC DERMATITIS

PubMed Central

Eichenfield, Lawrence F.; Tom, Wynnis L.; Berger, Timothy G.; Krol, Alfons; Paller, Amy S.; Schwarzenberger, Kathryn; Bergman, James N.; Chamlin, Sarah L.; Cohen, David E.; Cooper, Kevin D.; Cordoro, Kelly M.; Davis, Dawn M.; Feldman, Steven R.; Hanifin, Jon M.; Margolis, David J.; Silverman, Robert A.; Simpson, Eric L.; Williams, Hywel C.; Elmets, Craig A.; Block, Julie; Harrod, Christopher G.; Begolka, Wendy Smith; Sidbury, Robert

2014-01-01

Atopic dermatitis (AD) is a common and chronic, pruritic inflammatory skin condition that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this second of four sections, treatment of AD with non-pharmacological interventions and pharmacological topical therapies are reviewed. Where possible, suggestions on dosing and monitoring are given based on available evidence. PMID:24813302

Inhibitory effects of Drynaria fortunei extract on house dust mite antigen-induced atopic dermatitis in NC/Nga mice.

PubMed

Sung, Yoon-Young; Kim, Dong-Seon; Yang, Won-Kyung; Nho, Kyoung Jin; Seo, Hyeong Seok; Kim, Young Sang; Kim, Ho Kyoung

2012-10-31

Drynaria fortunei (Kunze) J. Sm has been widely used in traditional medicine for the treatment of inflammation, hyperlipidemia, arteriosclerosis, rheumatism, and bone healing. We investigated the anti-inflammatory effects of a 70% ethanol extract of Drynaria fortunei (DFE). We evaluated the anti-inflammatory effects of topically applied DFE on house dust mite Dermatophargoides farinae-induced atopic dermatitis-like skin lesions in NC/Nga mice. Treatment of NC/Nga mice with DFE reduced the dermatitis score, ear thickness, and serum levels of IgE, IgG1, and IL-6. Histopathological analyses of ear and skin lesions showed inhibition of the thickening of the epidermis and reduced epidermal/dermal infiltration of inflammatory cells. In ear lesions, mRNA expression levels of IL-4, IL-6, and tumor necrosis factor-α were reduced by DFE treatment. DFE inhibited the development of dermatitis-like skin lesions in NC/Nga mice. These results suggest that DFE may be a therapeutic candidate for the treatment of AD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Progressive muscle relaxation therapy for atopic dermatitis: objective assessment of efficacy.

PubMed

Bae, Byung Gi; Oh, Sang Ho; Park, Chang Ook; Noh, Seongmin; Noh, Ji Yeon; Kim, Kyung Ran; Lee, Kwang Hoon

2012-01-01

The aims of this study were to validate the efficacy of progressive muscle relaxation (PMR) in patients with atopic dermatitis and to evaluate the serological parameters that may serve as objective measures of the efficacy of PMR. A total of 25 patients with atopic dermatitis were randomly assigned to either a PMR group (n = 15) or a control group (n = 10). Serum levels of nerve growth, neuropeptide Y, and Th2 cytokines (IL-4, IL-5, and IL-13) were measured at baseline and after one month. At baseline, only anxiety was positively correlated with pruritus score (state anxiety: R = 0.496, p = 0.014; trait anxiety: R = 0.423, p = 0.04). Serum levels of neuropeptide Y were inversely related to the State-Trait Anxiety Inventory (STAI) (state anxiety: R = -0.475, p = 0.019; trait anxiety: R = -0.418, p = 0.042) and pruritus scores (R = -0.451, p = 0.035). After one month of PMR therapy, the degree of pruritus and loss of sleep was significantly decreased in the PMR group (p < 0.001), but not among controls. State anxiety scores showed significant improvement after treatment only in the PMR group (p = 0.005). There were no significant changes in the serological parameters in either group. Reductions in Eczema Area and Severity Index (EASI) scores were significant, but similar, in both groups. PMR may be a useful adjunctive modality for the management of atopic dermatitis through the reduction of anxiety. No change was found in biological parameters, but it was observed that neuropeptide Y may be related to high levels of anxiety in atopic dermatitis at baseline.

Twice-daily versus once-daily applications of pimecrolimus cream 1% for the prevention of disease relapse in pediatric patients with atopic dermatitis.

PubMed

Ruer-Mulard, Mireille; Aberer, Werner; Gunstone, Anthony; Kekki, Outi-Maria; López Estebaranz, Jose Luis; Vertruyen, André; Guettner, Achim; Hultsch, Thomas

2009-01-01

The aim of this study is to compare twice-daily and once-daily applications of pimecrolimus cream 1% for prevention of atopic dermatitis relapses in pediatric patients. This multicenter trial enrolled 300 outpatients aged 2 to 17 years, with mild-to-severe atopic dermatitis. The patients were initially treated with twice-daily topical pimecrolimus until complete clearance or for up to 6 weeks (open-label period). Those who achieved a decrease of at least 1 point in the Investigator's Global Assessment score were then randomized to double-blind treatment with pimecrolimus cream 1% either twice daily or once daily for up to 16 weeks. Study medication was discontinued during periods of disease remission (Investigator's Global Assessment = 0). The primary efficacy end point of the double-blind phase was disease relapse (worsening requiring topical corticosteroids or additional/alternative therapy and confirmed by Investigator's Global Assessment score > or = 3 and pruritus score > or = 2). Of the 300 patients enrolled in the study, 268 were randomized to treatment with pimecrolimus cream 1% either twice daily or once daily (n = 134 in each group). The relapse rate was lower in the twice-daily dose group (9.9%) than that in the once-daily dose group (14.7%), but analysis of the time to disease relapse, using a Cox proportional model to adjust for confounding variables, did not show a statistically significant difference between treatment arms (hazard ratio: 0.64; 95% CI: 0.31-1.30). Treatment of active atopic dermatitis lesions with pimecrolimus cream 1% twice daily, followed by the once-daily dosing regimen, was sufficient to prevent subsequent atopic dermatitis relapses over 16 weeks in pediatric patients.

Efficacy of ultra-micronized palmitoylethanolamide in canine atopic dermatitis: an open-label multi-centre study.

PubMed

Noli, Chiara; Della Valle, M Federica; Miolo, Alda; Medori, Cristina; Schievano, Carlo

2015-12-01

Palmitoylethanolamide is a naturally occurring bioactive lipid, produced on-demand by damage-exposed cells. Palmitoylethanolamide is documented to counteract inflammation, itch and pain. The aim of this 8-week study was to evaluate the efficacy of oral ultra-micronized palmitoylethanolamide (PEA-um) in dogs with moderate atopic dermatitis. Clinicians from 39 veterinary clinics enrolled 160 dogs with nonseasonal atopic dermatitis and moderate pruritus. This was a multi-centre open-label study. On days 0 (D0) and 56 (D56), owners evaluated pruritus with a Visual Analog Scale (VAS) and completed a validated Quality of Life (QoL) questionnaire. Veterinarians assessed the severity of skin lesions using the Canine Atopic Dermatitis Lesion Index (CADLI). Mean pruritus VAS score decreased from 5.7 ± 0.08 cm (range 3.8-7.9 cm) to 3.63 ± 0.19 cm (range 0.1-9.2 cm) (P < 0.0001). At D56, 58% of dogs showed a greater than 2 cm reduction from baseline and 30% showed an absent-to-very mild pruritus (VAS ≤ 2 cm). Mean total CADLI at D56 decreased significantly (P < 0.0001); in 62% of dogs this score reached a value in the remission range (≤5). Mean total QoL score was significantly decreased (P < 0.0001) with 45% of dogs reaching QoL values described for healthy animals. Tolerability was good-to-excellent with only four dogs reporting treatment associated reversible adverse events. PEA-um appears to be effective and safe in reducing pruritus and skin lesions, and in improving QoL in dogs with moderate atopic dermatitis and moderate pruritus. © 2015 Innovet Italia Srl. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the ESVD and ACVD.

A systematic review on the off-label use of montelukast in atopic dermatitis treatment.

PubMed

Chin, Weng Khong; Lee, Shaun Wen Huey

2018-05-18

Background Atopic dermatitis (AD) is the most common form of eczema. As leukotriene mediators are involved in the inflammatory phase of atopic dermatitis, montelukast has been suggested as a possible therapy. Aim of the review To evaluate the safety and efficacy of montelukast off-label use for the treatment atopic dermatitis. Method A search was performed from database inception until March 2018 in six electronic databases for randomized-controlled-trials examining the use of montelukast for AD. Results Among 301 articles screened, 11 studies met the inclusion criteria and were included in the review. The study populations consist of paediatric and adult subjects with moderate-to-severe AD. Montelukast use was shown to improve symptoms such as pruritus in four studies. Another 2 studies reported that montelukast could improve symptoms similar to the standard regimen of topical steroid and oral antihistamine. However, five studies reported that montelukast had no effects in symptoms alleviation. The use of montelukast was associated with a similar safety profile to placebo and well-tolerated with minimal adverse effects. Conclusion There is limited evidence to suggest that the off-label use of montelukast is effective in treating moderate-to-severe AD. Further research with larger study populations employing standardized endpoint measuring instrument is warranted to further investigate the off-label use of montelukast in AD treatment. Until then, the use of conventional treatments including optimal daily skin hydration should remain the mainstay in the management of atopic dermatitis. In fact, for moderate-to-severe condition, steroid sparing immune-suppressants should still be used clinically until more effective and safer alternative is discovered.

Filaggrin genotype and skin diseases independent of atopic dermatitis in childhood.

PubMed

Bager, Peter; Wohlfahrt, Jan; Thyssen, Jacob Pontoppidan; Melbye, Mads

2016-03-01

Filaggrin gene (FLG) mutations compromise skin barrier functions and increase risk of atopic dermatitis. We aimed to study effects on other skin diseases using unique data from the Danish registers. FLG genotyping of a population-based sample of 1547 children with extracted DNA and information on skin diseases from the Danish National Birth Cohort and Health Register, with 18 years follow-up during years 1996-2013. Odds ratios (OR) and hazard ratios (HR) were estimated using logistic regression and Cox regression, respectively, and adjusted for physician-diagnosed atopic dermatitis. FLG mutations were associated with increased risk of dry skin (OR 1.9, CI 1.1-3.1), and a decreased risk of fungal skin infections at age <18 months (OR 0.2, CI 0.1-0.8). There was no association with wart treatments (HR 1.0, CI 0.6-1.7). FLG mutations were associated with an increased risk of atopic dermatitis (OR 3.3, CI 2.1-5.3), dermatology consultations for allergy or rash (HR 2.2, CI 1.4-3.5), basic dermatology consultations at age <5 years (HR 2.2, CI 1.7-2.9), urticaria at age <18 months (OR 2.9, CI 1.0-7.9), and other rash at age <18 months (OR 2.1, CI 1.2-3.8). FLG mutations may predispose to skin disease in young children including urticaria, and rash not recognized as atopic dermatitis although equally frequent. In clinical practice, FLG genotyping may help indicate the use of moisturizers to reduce skin problems. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessment of a correlation between Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and selected biophysical skin measures (skin hydration, pH, and erythema intensity) in dogs with naturally occurring atopic dermatitis.

PubMed

Zając, Marcin; Szczepanik, Marcin P; Wilkołek, Piotr M; Adamek, Łukasz R; Pomorski, Zbigniew J H; Sitkowski, Wiesław; Gołyński, Marcin

2015-04-01

Atopic dermatitis is a common allergic skin disease in dogs. The aim of this study was to examine the possibility of a correlation between biophysical skin variables: skin hydration (SH), skin pH, and erythema intensity measured in 10 different body regions and both total Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and CADESI measured in a given region (CADESI L). The study was conducted using 33 dogs with atopic dermatitis. The assessment of the biophysical variables was done in 10 body regions: the lumbar region, right axillary fossa, right inguinal region, ventral abdominal region, right lateral thorax region, internal surface of the auricle, interdigital region of right forelimb, cheek, bridge of nose, and lateral site of antebrachum. Positive correlations were found between SH and CADESI L for the following regions: the inguinal region (r = 0.73) and the interdigital region (r = 0.82), as well as between total CADESI and SH on digital region (r = 0.52). Also, positive correlations were reported for skin pH and CADESI L in the lumbar region (r = 0.57), the right lateral thorax region (r = 0.40), and the lateral antebrachum (r = 0.35). Positive correlations were found in the interdigital region between erythema intensity and the total CADESI-03 (r = 0.60) as well as the CADESI L (r = 0.7). The results obtained suggest that it may be possible to use skin hydration, pH, and erythema intensity to assess the severity of skin lesion but positive correlation was only found in < 13.3% of possible correlations and usage of these measures in dogs is limited.

Gamisasangja-tang suppresses pruritus and atopic skin inflammation in the NC/Nga murine model of atopic dermatitis.

PubMed

Park, Bo-Kyung; Park, Yang-Chun; Jung, In Chul; Kim, Seung-Hyung; Choi, Jeong June; Do, Moonho; Kim, Sun Yeou; Jin, Mirim

2015-05-13

Gamisasangja-tang (GST) is a traditional herbal formula prescribed for patients with intractable pruritus in association with various inflammatory skin diseases. To evaluate the effects of GST on pruritic skin inflammation and investigate its cellular and molecular mechanisms. We orally administered GST to NC/Nga (NC) mice, an animal model of atopic dermatitis. Scratching frequency and the dermatitis index were evaluated, and histological examination was performed using hematoxylin and eosin and toluidine blue staining. The levels of interleukin (IL)-31 and T-helper cell type 2 (TH2) cytokines were determined in both the dorsal skin and cultured splenocytes by real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. The serum levels of chemokines and immunoglobulin E (IgE) were determined by ELISA. Changes in the inflammatory cell population were analyzed by a hemocytometer. GST significantly lowered scratching frequency and inhibited increases in dermatitis index, thickness of epidermis/dermis and infiltration of chemokine (C-C motif) receptor 3 (CCR3)(+) and cluster of differentiation (CD)117(+)/FcεRIα (Fc fragment of IgE, high affinity I, receptor for; alpha polypeptide)(+) cells in atopic skin. Both IL-31 mRNA expression and production were significantly reduced by GST, which was accomrease in the levels of IL-4, IL-5, and IL-13. Further, GST treatment suppressed the secretion of eotaxin, TARC (thymus and activation-regulated chemokine), IgE, and increases in the number of basophils and eosinophils in the blood. GST may have potential as an effective treatment for pruritic skin disease such as atopic dermatitis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Assessment of a correlation between Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and selected biophysical skin measures (skin hydration, pH, and erythema intensity) in dogs with naturally occurring atopic dermatitis

PubMed Central

Zając, Marcin; Szczepanik, Marcin P.; Wilkołek, Piotr M.; Adamek, Łukasz R.; Pomorski, Zbigniew J.H.; Sitkowski, Wiesław; Gołyński, Marcin

2015-01-01

Atopic dermatitis is a common allergic skin disease in dogs. The aim of this study was to examine the possibility of a correlation between biophysical skin variables: skin hydration (SH), skin pH, and erythema intensity measured in 10 different body regions and both total Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) and CADESI measured in a given region (CADESI L). The study was conducted using 33 dogs with atopic dermatitis. The assessment of the biophysical variables was done in 10 body regions: the lumbar region, right axillary fossa, right inguinal region, ventral abdominal region, right lateral thorax region, internal surface of the auricle, interdigital region of right forelimb, cheek, bridge of nose, and lateral site of antebrachum. Positive correlations were found between SH and CADESI L for the following regions: the inguinal region (r = 0.73) and the interdigital region (r = 0.82), as well as between total CADESI and SH on digital region (r = 0.52). Also, positive correlations were reported for skin pH and CADESI L in the lumbar region (r = 0.57), the right lateral thorax region (r = 0.40), and the lateral antebrachum (r = 0.35). Positive correlations were found in the interdigital region between erythema intensity and the total CADESI-03 (r = 0.60) as well as the CADESI L (r = 0.7). The results obtained suggest that it may be possible to use skin hydration, pH, and erythema intensity to assess the severity of skin lesion but positive correlation was only found in < 13.3% of possible correlations and usage of these measures in dogs is limited. PMID:25852229

Prevalence of common skin diseases and their associated factors among military personnel in Korea: a cross-sectional study.

PubMed

Bae, Jung Min; Ha, Beomman; Lee, Hongsun; Park, Chang Keun; Kim, Hyun Joon; Park, Young Min

2012-10-01

This study was conducted to clarify the prevalence of common skin diseases and their associated factors among military personnel in Korea. Four dermatologists visited adjacent military units and examined soldiers. A structured questionnaire that included questions about known skin diseases, demographic information, and questions for the Perceived Stress Index was completed for each participant. The soldiers that had been diagnosed with a skin disease answered one additional questionnaire (Skindex-29) which assess the influence of an individual's skin disease on daily life. Of 1,321 soldiers examined, 798 (60.4%) had one or more skin diseases. The three most common skin problems were acne (35.6%), tinea pedis (15.2%) and atopic dermatitis (5.1%). The diseases closely related to the period of military service were acne, tinea pedis, viral warts and corns. The diseases related to the amount of stress were atopic dermatitis, seborrheic dermatitis, and acne. The most troublesome skin diseases were atopic dermatitis, tinea cruris, and seborrheic dermatitis. These results demonstrated that the prevalence of skin disease among military personnel in Korea is very high, and that some of the skin disorders may have a significant influence on their daily lives.

Prevalence of Common Skin Diseases and Their Associated Factors among Military Personnel in Korea: A Cross-sectional Study

PubMed Central

Bae, Jung Min; Ha, Beomman; Lee, Hongsun; Park, Chang Keun; Kim, Hyun Joon

2012-01-01

This study was conducted to clarify the prevalence of common skin diseases and their associated factors among military personnel in Korea. Four dermatologists visited adjacent military units and examined soldiers. A structured questionnaire that included questions about known skin diseases, demographic information, and questions for the Perceived Stress Index was completed for each participant. The soldiers that had been diagnosed with a skin disease answered one additional questionnaire (Skindex-29) which assess the influence of an individual's skin disease on daily life. Of 1,321 soldiers examined, 798 (60.4%) had one or more skin diseases. The three most common skin problems were acne (35.6%), tinea pedis (15.2%) and atopic dermatitis (5.1%). The diseases closely related to the period of military service were acne, tinea pedis, viral warts and corns. The diseases related to the amount of stress were atopic dermatitis, seborrheic dermatitis, and acne. The most troublesome skin diseases were atopic dermatitis, tinea cruris, and seborrheic dermatitis. These results demonstrated that the prevalence of skin disease among military personnel in Korea is very high, and that some of the skin disorders may have a significant influence on their daily lives. PMID:23091325

[Recent advances in research on Malassezia microbiota in humans].

PubMed

Sugita, Takashi; Zhang, Enshi; Tanaka, Takafumi; Nishikawa, Akemi; Tajima, Mami; Tsuboi, Ryoji

2013-01-01

Malassezia species of lipophilic yeasts account for most fungal microbiota. Although they colonize healthy skin, they are also associated with several skin diseases, including pityriasis versicolor, seborrheic dermatitis, Malassezia folliculitis, and atopic dermatitis. To date, 14 members of the Malassezia genus have been identified. Of these, both M. globosa and M. restricta predominate, regardless of skin-disease type. Comprehensive analysis of fungal microbiota in the skin of patients with atopic dermatitis using an rRNA clone library method revealed that fungal microbiota cluster according to disease severity. The external ear canal and sole of the foot are colonized by specific Malassezia microbiota.

[Role of Langerhans cells in the physiopathology of atopic dermatitis].

PubMed

Bieber, T

1995-12-01

The demonstration of IgE receptors on the surface of epidermal dendritic cells and on other antigen presenting cells is a crucial element in the understanding of the pathophysiological role of these cells in the genesis of atopic disease, and especially the atopic dermatitis (AD). The sensibilisation phase to an aeroallergen at the level of nasal or bronchial mucosa and even at the skin may be mediated by dendritic cells expressing Fc epsilon RI. Distinct forms of AD may then represent the equivalent of the ellicitation phase of the classical allergic contact dermatitis. Fc epsilon RI would lead, via specific IgE, to an efficient antigen capture, to the activation of the dendritic cells and finally to an antigen presentation. Thus, AD may represent the paradigma of an IgE-mediated type IV reaction.

Relationship and probabilistic stratification of EASI and oSCORAD severity scores for atopic dermatitis.

PubMed

Hurault, G; Schram, M E; Roekevisch, E; Spuls, P I; Tanaka, R J

2018-06-26

The Harmonizing Outcome Measures for Eczema (HOME) recommended the Eczema Area and Severity Index (EASI) as the core outcome instrument for measuring the clinical signs of atopic dermatitis (AD). However, EASI may not have been used in previous clinical trials, and other scores, e.g. SCORAD (SCORing Atopic Dermatitis), the objective component of SCORAD (oSCORAD) and the Investigator Global Assessment (IGA), remain widely used. It is useful to establish a method to convert these scores into EASI to compare the results from different studies effectively. Indeed, EASI and oSCORAD have been found to be strongly correlated (r S pearman =0.92) 7 , suggesting a possibility to find a relationship between the two scores. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood.

PubMed

Bandier, Josefine; Ross-Hansen, Katrine; Carlsen, Berit C; Menné, Torkil; Linneberg, Allan; Stender, Steen; Szecsi, Pal B; Meldgaard, Michael; Thyssen, Jacob P; Johansen, Jeanne D

2013-12-01

Loss-of-function mutations in the filaggrin gene (FLG) are associated with xerosis, atopic dermatitis, and early onset of hand eczema. Irritant exposure is a risk factor for occupational hand eczema, and FLG mutations increase the risk of occupational irritant contact dermatitis on the hands in hospital cohorts. It is unknown whether FLG mutations affect the level of irritant exposure. To evaluate whether exposure to occupational irritants was dependent on FLG mutations, atopic dermatitis, and age at hand eczema onset. Randomly chosen Danish adults completed a questionnaire on general health and occupational exposures. Genotyping for FLG mutations (R501X, 2282del4, and R2447X) and patch testing were performed. Overall, 38.7% of subjects reported present or previous occupational exposure to irritants. Among individuals who reported hand eczema onset before entering their work life, 50.6% (45/89) of FLG non-mutation carriers became exposed to irritants, as compared with 28.6% (4/14) of heterozygous and 0% (0/6) of homozygous mutation carriers (p = 0.006). Avoidance was conspicuous among mutation carriers reporting childhood hand eczema and atopic dermatitis (odds ratio 0.08, 95% confidence interval 0.01-0.65). Carriers of FLG mutations who have had hand eczema onset in childhood avoid occupational exposure to irritants; the association is most marked with homozygous mutation status combined with atopic dermatitis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Guidelines of Care for the Management of Atopic Dermatitis Part 4: Prevention of Disease Flares and Use of Adjunctive Therapies and Approaches

PubMed Central

Sidbury, Robert; Tom, Wynnis L.; Bergman, James N.; Cooper, Kevin D.; Silverman, Robert A.; Berger, Timothy G.; Chamlin, Sarah L.; Cohen, David E.; Cordoro, Kelly M.; Davis, Dawn M.; Feldman, Steven R.; Hanifin, Jon M.; Krol, Alfons; Margolis, David J.; Paller, Amy S.; Schwarzenberger, Kathryn; Simpson, Eric L.; Williams, Hywel C.; Elmets, Craig A.; Block, Julie; Harrod, Christopher G.; Begolka, Wendy Smith; Eichenfield, Lawrence F.

2015-01-01

Atopic dermatitis (AD) is a common, chronic inflammatory dermatosis that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this final section, treatments for flare prevention and adjunctive and complementary therapies and approaches are reviewed. Suggestions on utilization are given based on available evidence. PMID:25264237

Characterization of Allergen Exposure in Homes

DTIC Science & Technology

1991-01-17

dust mixture.6 Dust mite allergens have been associated causatively with asthma, atopic dermatitis , and rhini- tis. 7 Studies from several countries...Asthma: A Controlled Trial. The Lancet 1976; ***:333-335. 10. Tuft L. Importance of Inhalant Allergens in Atopic Dermatitis . The Journal of Investigative...surface concentration. Correlation between units for cat antigen Fel d 1 was strong. However, the more conventional unit of mass of antigen per unit area

Preliminary psycometric assessment of the Brazilian version of the DISABKIDS Atopic Dermatitis Module.

PubMed

Deon, Keila Cristiane; Santos, Danielle Maria de Souza Sério dos; Bullinger, Monika; Santos, Claudia Benedita dos

2011-12-01

To assess preliminary psychometric properties of the Brazilian Portuguese version of a questionnaire for measuring health-related quality of life in children and adolescents with atopic dermatitis. Cross-sectional study with a sample consisting of 52 children and adolescents aged 8 to 18 diagnosed with atopic dermatitis, and their parents or caregivers, selected at the dermatology department of a university hospital in the city of São Paulo, Southeast Brazil, in 2009. Construct validity, internal consistency and agreement between the responses of children and adolescents and their parents or caregivers were assessed in the Brazilian Portuguese version of the DISABKIDS-Atopic Dermatitis Module (ADM). Adequate internal consistency was found with Cronbach's alpha coefficients of 0.7024/0.8124 and 0.7239/0.8604. The multitrait multimethod analysis for assessing convergent validity showed measures higher than 0.30 for all items. The analysis showed good discriminant validity. Agreement between child self-report and parent proxy-report was evaluated using intra-class correlation with measures impact and social stigma of disease of 0.8173 and 0.7629, respectively. The study results showed that the DISABKIDS-ADM can be used by Brazilian researchers after its complete validation as it showed adequate preliminary psychometric properties and can be considered a valid, reliable instrument.

Genome-wide association study identifies two new susceptibility loci for atopic dermatitis in the Chinese Han population.

PubMed

Sun, Liang-Dan; Xiao, Feng-Li; Li, Yang; Zhou, Wen-Ming; Tang, Hua-Yang; Tang, Xian-Fa; Zhang, Hui; Schaarschmidt, Heidi; Zuo, Xian-Bo; Foelster-Holst, Regina; He, Su-Min; Shi, Mei; Liu, Qiang; Lv, Yong-Mei; Chen, Xi-Lan; Zhu, Kun-Ju; Guo, Yi-Feng; Hu, Da-Yan; Li, Ming; Li, Min; Zhang, Yan-Hong; Zhang, Xin; Tang, Jian-Ping; Guo, Bi-Rong; Wang, Hua; Liu, Yuan; Zou, Xiao-Yan; Zhou, Fu-Sheng; Liu, Xiao-Yan; Chen, Gang; Ma, Lin; Zhang, Shu-Mei; Jiang, Ai-Ping; Zheng, Xiao-Dong; Gao, Xing-Hua; Li, Pan; Tu, Cai-Xia; Yin, Xian-Yong; Han, Xiu-Ping; Ren, Yun-Qing; Song, Shun-Peng; Lu, Zhi-Yong; Zhang, Xing-Lian; Cui, Yong; Chang, Jing; Gao, Min; Luo, Xiao-Yan; Wang, Pei-Guang; Dai, Xing; Su, Wei; Li, Hui; Shen, Chun-Pin; Liu, Sheng-Xiu; Feng, Xiao-Bo; Yang, Chun-Jun; Lin, Guo-Shu; Wang, Zai-Xing; Huang, Jian-Qing; Fan, Xing; Wang, Yan; Bao, Yi-Xiao; Yang, Sen; Liu, Jian-Jun; Franke, Andre; Weidinger, Stephan; Yao, Zhi-Rong; Zhang, Xue-Jun

2011-06-12

Atopic dermatitis is a chronic, relapsing form of inflammatory skin disorder that is affected by genetic and environmental factors. We performed a genome-wide association study of atopic dermatitis in a Chinese Han population using 1,012 affected individuals (cases) and 1,362 controls followed by a replication study in an additional 3,624 cases and 12,197 controls of Chinese Han ethnicity, as well as 1,806 cases and 3,256 controls from Germany. We identified previously undescribed susceptibility loci at 5q22.1 (TMEM232 and SLC25A46, rs7701890, P(combined) = 3.15 × 10(-9), odds ratio (OR) = 1.24) and 20q13.33 (TNFRSF6B and ZGPAT, rs6010620, P(combined) = 3.0 × 10(-8), OR = 1.17) and replicated another previously reported locus at 1q21.3 (FLG, rs3126085, P(combined) = 5.90 × 10(-12), OR = 0.82) in the Chinese sample. The 20q13.33 locus also showed evidence for association in the German sample (rs6010620, P = 2.87 × 10(-5), OR = 1.25). Our study identifies new genetic susceptibility factors and suggests previously unidentified biological pathways in atopic dermatitis.

Treatment of pruritus in mild-to-moderate atopic dermatitis with a topical non-steroidal agent.

PubMed

Veraldi, Stefano; De Micheli, Paolo; Schianchi, Rossana; Lunardon, Luisa

2009-06-01

Atopiclair (Zarzenda) is a topical non-steroidal anti-inflammatory agent for the treatment of allergic diseases of the skin. Three main ingredients are contained in this product: glycyrrhetinic acid, telmesteine and Vitis vinifera extracts. Other ingredients include: allantoin, alpha-bisabolol, capryloyl glycine, hyaluronic acid, shea butter and tocopheryl acetate. Two previous randomized, double-blind, vehicle-controlled clinical studies provided evidence that Atopiclair is effective in the treatment of atopic dermatitis. This article presents an open, multicenter, sponsor-free, study on the anti-pruritic activity of this product in adult patients with mild-to-moderate atopic dermatitis. The Median Visual Analogue Scale (VAS) values were: at the start of the study (TO), median VAS was 48.5 mm; three weeks later (T1), median VAS was 34.1 mm (-14.4 mm from baseline); six weeks later (T2), median VAS was 24.6 mm (-23.9 mm from baseline). Statistical analysis revealed that differences between TO versus T1, TO versus T2 and T1 versus T2 were highly significant (p<0.001). Side effects (local burning) were relatively common, although mild in severity. On the basis of the results of this study, Atopiclair showed efficacy in relief of pruritus in adult patients with mild-to-moderate atopic dermatitis.

Total and Toxocara canis larval excretory/secretory antigen- and allergen-specific IgE in atopic and non-atopic dogs.

PubMed

Zwickl, Lena L M N; Joekel, Deborah E; Fischer, Nina M; Rostaher, Ana; Thamsborg, Kristian; Deplazes, Peter; Favrot, Claude

2018-06-01

Total IgE concentrations are higher in dogs than in humans. Persistent Toxocara canis larval infection is prevalent in dogs and is associated with substantial specific antibody reactions. A correlation, however, between total IgE and T. canis-specific antibody levels in dogs has not been evaluated. To determine the relationship between total IgE, T. canis-specific IgG and IgE, and allergen-specific IgE levels in atopic and non-atopic dogs, and to evaluate possible confounding factors. Sera of 30 atopic and 30 non-atopic client-owned dogs. Total IgE, T. canis-specific antibody and allergen-specific IgE levels were evaluated by ELISA. Total IgE, T. canis-specific antibody and allergen-specific IgE levels were significantly higher in non-atopic compared to atopic dogs. A positive correlation was demonstrated between T. canis-specific IgG and T. canis-specific IgE; T. canis-specific IgG and total IgE; T. canis-specific IgE and total IgE; and allergen-specific IgE and total IgE. No differences were detected on the basis of age, gender, vaccination status; deworming or season between atopic and non-atopic dogs. Previous immunomodulatory treatment and cause of atopy did not influence antibody levels of atopic dogs. Toxocara canis-specific IgE appears to be a major component of total IgE in dogs. Total and T. canis-specific IgE levels are higher in non-atopic compared to atopic dogs. It is speculated that T. canis infection may have a protective effect against the development of canine atopic dermatitis and/or that elevations in total serum IgE level are often not associated with atopic dermatitis. © 2018 ESVD and ACVD.

Food-Related Contact Dermatitis, Contact Urticaria, and Atopy Patch Test with Food.

PubMed

Walter, Alexandra; Seegräber, Marlene; Wollenberg, Andreas

2018-06-07

A wide variety of foods may cause or aggravate skin diseases such as contact dermatitis, contact urticaria, or atopic dermatitis (AD), both in occupational and private settings. The mechanism of action underlying allergic disease to food, food additives, and spices may be immunologic and non-immunologic. The classification and understanding of these reactions is a complex field, and knowledge of the possible reaction patterns and appropriate diagnostic test methods is essential. In addition, certain foods may cause worsening of atopic dermatitis lesions in children. The atopy patch test (APT) is a well-established, clinically useful tool for assessing delayed type reactions to protein allergens in patients and may be useful to detect protein allergens relevant for certain skin diseases. The APT may even detect sensitization against allergens in intrinsic atopic dermatitis patients, who show negative skin prick test and negative in vitro IgE test results against these allergens. Native foods, SPT solutions on filter paper, and purified allergens in petrolatum have been used for APT. The European Task Force on Atopic Dermatitis (ETFAD) has worked on standardizing this test in the context of AD patients, who are allergic to aeroallergens and food. This recommended, standardized technique involves test application at the upper back of children and adults; use of large, 12-mm Finn chambers; avoidance of any pre-treatment such as tape stripping or delipidation; standardized amounts of purified allergens in petrolatum; and use of the standardized ETFAD reading key. The APT may not be the best working or best standardized of all possible skin tests, but it is the best test that we currently have available in this niche.

Epidermal Overexpression of Xenobiotic Receptor PXR Impairs the Epidermal Barrier and Triggers Th2 Immune Response.

PubMed

Elentner, Andreas; Schmuth, Matthias; Yannoutsos, Nikolaos; Eichmann, Thomas O; Gruber, Robert; Radner, Franz P W; Hermann, Martin; Del Frari, Barbara; Dubrac, Sandrine

2018-01-01

The skin is in daily contact with environmental pollutants, but the long-term effects of such exposure remain underinvestigated. Many of these toxins bind and activate the pregnane X receptor (PXR), a ligand-activated transcription factor that regulates genes central to xenobiotic metabolism. The objective of this work was to investigate the effect of constitutive activation of PXR in the basal layer of the skin to mimic repeated skin exposure to noxious molecules. We designed a transgenic mouse model that overexpresses the human PXR gene linked to the herpes simplex VP16 domain under the control of the keratin 14 promoter. We show that transgenic mice display increased transepidermal water loss and elevated skin pH, abnormal stratum corneum lipids, focal epidermal hyperplasia, activated keratinocytes expressing more thymic stromal lymphopoietin, a T helper type 2/T helper type 17 skin immune response, and increased serum IgE. Furthermore, the cutaneous barrier dysfunction precedes development of the T helper type 2/T helper type 17 inflammation in transgenic mice, thereby mirroring the time course of atopic dermatitis development in humans. Moreover, further experiments suggest increased PXR signaling in the skin of patients with atopic dermatitis when compared with healthy skin. Thus, PXR activation by environmental pollutants may compromise epidermal barrier function and favor an immune response resembling atopic dermatitis. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Signs of atopic dermatitis and contact dermatitis affected by distinct H2-haplotype in the NC/Nga genetic background.

PubMed

Ohkusu-Tsukada, Kozo; Ito, Daiki; Okuno, Yuki; Tsukada, Teruyo; Takahashi, Kimimasa

2018-02-07

We recently advocated in favour of naming a novel H2-haplotype consisting of K d , D/L dm7 , I-A k and I-E k in the atopic dermatitis (AD) mouse model NC/Nga as "H-2 nc ." The role of the H2-haplotype in AD development was investigated in H2 b -congenic NC/Nga mice (NC.h2 b/b and NC.h2 b/nc ) established by backcrossing. A severe 2,4-dinitrofluorobenzene (DNFB)-induced dermatitis in NC/Nga was alleviated partially in NC.h2 b/nc and significantly in NC.h2 b/b . The AD phenotype was correlated with thymic stromal lymphopoietin (TSLP)-epidermal expression levels and serum levels of total IgE and IL-18/IL-33. Histologically, allergic contact dermatitis (ACD) was accompanied by lymphocytes and plasma cells-infiltrating perivasculitis in NC.h2 b/nc and NC.h2 b/b and clearly differed from AD accompanied by neutrophils, eosinophils and macrophages-infiltrating diffuse suppurative dermatitis in NC/Nga. Interestingly, IFN-γ/IL-17 production from autoreactive CD4 + T-cells remarkably increased in DNFB-sensitised NC.h2 b/b but not in NC/Nga. Our findings suggest that AD or ACD may depend on haplotype H-2 nc or H-2 b , respectively, in addition to the NC/Nga genetic background.

Modulation of Interleukin-8 and staphylococcal flora by Avène hydrotherapy in patients suffering from chronic inflammatory dermatoses.

PubMed

Casas, C; Ribet, V; Alvarez-Georges, S; Sibaud, V; Guerrero, D; Schmitt, A-M; Redoulès, D

2011-02-01

A number of studies argue in favour of an important role of microbial colonization, in particular of Staphylococcus aureus, in triggering atopic dermatitis (AD) flare-up and psoriasis, in particular through the superantigenic properties of toxins generated by S. aureus. The aim of this study was to assess the efficacy of a 3-week Avène hydrotherapy on the skin surface of patients suffering from psoriasis or atopic dermatitis. Skin samples were taken from healthy subjects or atopic (n = 18) or psoriatic patients (n = 39) undergoing hydrotherapy at Avène at the beginning (D0) and the end of treatment (D18). The severity of the dermatosis was evaluated according to SCORing Atopic Dermatitis (SCORAD) or Psoriasis Area Severity Index (PASI) scores at D0 and D18. Marker of inflammation interleukin 8 (IL-8), S. aureus colonization (protein A) and enterotoxins were assessed in skin samples using RT-PCR. At D0, significant differences were observed between healthy subjects and atopic or psoriatic patients in all the parameters evaluated (IL-8, protein A). At the end of the hydrotherapy, a significant decrease in SCORAD was associated with a significant reduction of IL-8, S. aureus colonization and enterotoxin D in patients with atopic dermatitis. Similarly, a significant decrease in PASI was associated with a significant reduction of IL-8, S. aureus colonization and enterotoxin N in patients with psoriasis. This study demonstrates the positive effects of Avène hydrotherapy on the skin of patients suffering from chronic dermatosis, with decreased inflammation and reduced colonization by S. aureus. © 2010 The Authors. JEADV © 2010 European Academy of Dermatology and Venereology.

Vitamin D and Atopic Dermatitis in Childhood

PubMed Central

Vestita, Michelangelo; Filoni, Angela; Congedo, Maurizio; Foti, Caterina

2015-01-01

Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD. PMID:25973433

Atopic Dermatitis: A Disease of Altered Skin Barrier and Immune Dysregulation

PubMed Central

Boguniewicz, Mark; Leung, Donald YM

2011-01-01

Summary Atopic dermatitis (AD) is an important chronic or relapsing inflammatory skin disease that often precedes asthma and allergic disorders. New insights into the genetics and pathophysiology of AD point to an important role of structural abnormalities in the epidermis as well as immune dysregulation not only for this skin disease but also for the development of asthma and allergies. Patients with AD have a unique predisposition to colonization or infection by microbial organisms, most notably Staphylococcus aureus and herpes simplex virus. Measures directed at healing and protecting the skin barrier and addressing the immune dysregulation are essential in the treatment of patients with AD and early intervention may improve outcomes for both the skin disease as well as other target organs. PMID:21682749

ASSESSMENT OF A STABLE COSMETIC PREPARATION BASED ON ENZYMATIC INTERESTERIFIED FAT, PROPOSED IN THE PREVENTION OF ATOPIC DERMATITIS.

PubMed

Kowalska, Malgorzata; Mendrycka, Mariola; Zbikowska, Anna; Kowalska, Dorota

2017-03-01

Atopic dermatitis is one of the most common skin disorders seen in infants, children and adults. Proper prevention might slow the atopic symptoms. The purpose of the work was a sensory analysis, an evaluation of moistening properties and stability of emulsions based on an enzymatic interesterified fat blend (mutton tallow and walnut oil) and homogenized at different revolutions and different contents of thickener. The emulsions were evaluated with respect to sensory and skin moisturizing properties by 78 respondents. Stability tests, particle size, distribution, dispersity index, morphology structure of the emulsions were determinated too. Taking into consideration all properties of the emulsions, emulsion IV (containing 0.9 g carboxymethyl cellulose and homogenized at 18000 rpm) and emulsion V (1.5 g of carboxymethyl cellulose and homogenized at 24000 rpm) were found to be of optimum composition. The emulsions exhibited good stability, were highly rated in sensory terms and displayed optimum moistening properties. It has been proven that model emulsions based on interesterified fats containing partial acylglicerols, with optimum carboxymethyl cellulose content and specific revolutions at the time of homogenization are an opportunity for developing preparations targeted at skins requiring special care (e.g., with atopic dermatitis or psoriasis). The work proved the use of enzymatic process to create the emulsifier, which represents the innovative contribution of this work. Also it showed an additional application of enzymatic interesterified fats which since has been used only in food industries.

Use of ustekinumab for severe refractory atopic dermatitis in a young teenager.

PubMed

Wlodek, C; Hewitt, H; Kennedy, C T

2016-08-01

When conventional systemic immunosuppressive treatments fail in the setting of severe eczema, unlike in psoriasis, there are limited treatment options and only anecdotal evidence to help guide clinicians. There is a growing body of evidence for the use of certain biologic agents for moderate to severe eczema. We report the youngest case to date successfully and safely treated with ustekinumab for severe refractory atopic dermatitis. © 2016 British Association of Dermatologists.

Cost-effectiveness of Maintenance Treatment with a Barrier-strengthening Moisturizing Cream in Patients with Atopic Dermatitis in Finland, Norway and Sweden.

PubMed

Norrlid, Hanna; Hjalte, Frida; Lundqvist, Adam; Svensson, Åke; Tennvall, Gunnel Ragnarson

2016-02-01

Atopic dermatitis is a chronic skin disorder with high prevalence, especially in the Nordic countries. Effective maintenance therapy during symptom-free episodes may prolong the time to eczema relapse according to a previously published clinical trial. The present study evaluates the cost-effectiveness of a barrier-strengthening moisturizer containing 5% urea, compared with a moisturizer with no active ingredients during eczema-free periods. A health economic microsimulation model, based on efficacy data from the randomized clinical trial, analysed the cost-effectiveness of the barrier-strengthening treatment in Finland, Norway and Sweden. The barrier-strengthening moisturizer was cost-saving compared with the moisturizer with no active ingredients in all 3 countries. The result was confirmed in all but one sensitivity analysis. In conclusion, the barrier-strengthening moisturizer is cost-effective as maintenance therapy for patients with atopic dermatitis compared with a moisturizer with no active ingredients.

[Hypnotherapy of atopic dermatitis in an adult. Case report].

PubMed

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.

Accumulation of immunoglobulin G against Dermatophagoides farinae tropomyosin in dorsal root ganglia of NC/Nga mice with atopic dermatitis-like symptoms.

PubMed

Otsu, Ayaka; Kawasaki, Hiroaki; Tominaga, Mitsutoshi; Shigenaga, Ayako; Matsuda, Hironori; Takahashi, Nobuaki; Nakajima, Tadaaki; Naito, Hisashi; Baba, Takeshi; Ogawa, Hideoki; Tomooka, Yasuhiro; Yamakura, Fumiyuki; Takamori, Kenji

2017-04-15

Atopic dermatitis (AD), a chronic inflammatory skin disease, manifests as intractable itch, but its underlying mechanisms are poorly understood. This study assessed the relationship between immunoglobulin G (IgG) and dorsal root ganglia (DRG) in NC/Nga mice, a model of AD that manifests AD-like symptoms including itch. Immunohistochemical analysis showed large amounts of IgG in DRG extracts of NC/Nga mice with AD-like dermatitis, with a large fraction of the IgG distributed in satellite glial cells of the DRG. Proteomic analysis showed that this IgG was reactive against tropomyosin of Dermatophagoides farinae. These findings indicate that the accumulation of anti-tropomyosin IgG in DRG of atopic NC/Nga mice may be associated with the pathogenesis of AD-like symptoms, including itch. Copyright © 2017 Elsevier Inc. All rights reserved.

Preparation of hydrogels for atopic dermatitis containing natural herbal extracts by gamma-ray irradiation

NASA Astrophysics Data System (ADS)

Lim, Youn-Mook; An, Sung-Jun; Kim, Hae-Kyoung; Kim, Yun-Hye; Youn, Min-Ho; Gwon, Hui-Jeong; Shin, Junhwa; Nho, Young-Chang

2009-07-01

Atopic dermatitis (AD) is a familial and chronic inflammatory pruritic skin disease that affects a large number of children and adults in industrialized countries. It is known that one of the prominent features of AD and chronic pruritus is partially due to the histamine released from mast cell. In this work, hydrogel patches with natural herbal extracts were prepared by "freezing and thawing", and a gamma irradiation. It showed eminent healing results as a consequence of long-term moisturizing effects and natural herbal extracts on atopic wounds. Besides its non-toxicity and human harmlessness, it can be easily attached to or detached from the skin without any trace and help patients to feel refreshment when attached. Based on this work, the hydrogel patches we made can be potentially used as an alternative remedy for not only pruritus in AD, but other dermatitis.

Aggravation of atopic dermatitis in breast-fed infants by tree nut-related foods and fermented foods in breast milk.

PubMed

Uenishi, Toshiaki; Sugiura, Hisashi; Tanaka, Toshihiro; Uehara, Masami

2011-02-01

Ninety-two exclusively breast-fed Japanese infants with atopic dermatitis were studied to see whether tree nut-related foods (chocolate and coffee) and fermented foods (cheese, yogurt, bread, soy sauce, miso soup and fermented soy beans) eaten by their mothers affected their skin condition. Of the 92 infants, 67 (73%) showed improvement of skin lesions when their mothers avoided these foods and showed aggravation of skin lesions when these foods were reintroduced. The predominant offending foods were chocolate, yogurt, soy sauce and miso soup. A long-term maternal exclusion of the trigger foods brought about progressive improvement of skin lesions in the majority of the infants. These findings suggest that tree nut-related foods and fermented foods are important offending foods of atopic dermatitis in breast-fed infants. © 2010 Japanese Dermatological Association.

Chemical Composition and Inhibitory Effect of Lentinula edodes Ethanolic Extract on Experimentally Induced Atopic Dermatitis in Vitro and in Vivo.

PubMed

Choi, Eun-Ju; Park, Zee-Yong; Kim, Eun-Kyung

2016-07-29

The ethanolic extract of Lentinula edodes was partially analyzed and then characterized for its efficacy in treating atopic dermatitis. Polyphenols were determined to be the major antioxidant component in the extract (6.12 mg/g), followed by flavonoids (1.76 mg/g), β-carotene (28.75 μg/g), and lycopene (5.25 μg/g). An atopic dermatitis (AD) model was established and epidermal and dermal ear thickness, mast cell infiltration, and serum immunoglobulin levels were measured after oral administration of the L. edodes extract for 4 weeks. L. edodes extract decreased Dermatophagoides farinae extract (DFE) and 4-dinitrochlorobenzene (DNCB)-induced expression of several inflammatory cytokines in the ears, cervical lymph nodes, and splenocytes. Consequently, L. edodes extract may have therapeutic potential in the treatment of AD attributable to its immunomodulatory effects.

The Role of Airborne Proteins in Atopic Dermatitis

PubMed Central

Hostetler, Sarah Grim; Kaffenberger, Benjamin; Hostetler, Todd

2010-01-01

Atopic dermatitis is a common, chronic skin condition. A subpopulation of patients may have cutaneous exposure to common airborne proteins exacerbating their disease through direct proteolytic activity, direct activation of proteinase-activated receptor-2 itch receptors, and immunoglobulin E binding. The most common airborne proteins significant in atopic dermatitis include house dust mites, cockroach, pet dander, and multiple pollens. The literature on atopy patch testing, skin-prick testing, and specific IgE is mixed, with greater support for the use of atopy patch test. Patients with airborne proteins contributing to their disease typically have lesions predominately on air-exposed skin surfaces including the face, neck, and arms; a history of exacerbations after exposure to airborne proteins; severe disease resistant to conventional therapies; and concurrent asthma. Treatment strategies include airborne protein avoidance, removal of airborne proteins from the skin, and barrier repair. Further research is needed to establish the benefit of allergen-specific immunotherapy. PMID:20725535

A twin study of perfume-related respiratory symptoms.

PubMed

Elberling, J; Lerbaek, A; Kyvik, K O; Hjelmborg, J

2009-11-01

Respiratory symptoms from environmental perfume exposure are main complaints in patients with multiple chemical sensitivities and often coincide with asthma and or eczema. In this population-based twin study we estimate the heritability of respiratory symptoms related to perfume and if co-occurrences of the symptoms in asthma, atopic dermatitis, hand eczema or contact allergy are influenced by environmental or genetic factors common with these diseases. In total 4,128 twin individuals (82%) responded to a questionnaire. The heritability of respiratory symptoms related to perfume is 0.35, 95%CI 0.14-0.54. Significant associations (p<0.05) between perfume-related respiratory symptoms and asthma, atopic dermatitis, hand eczema or contact allergy are not attributable to shared genetic or shared environmental/familial factors, except possibly for atopic dermatitis where genetic pleiotropy with respiratory symptoms to perfume is suggested by an estimated genetic correlation of 0.39, 95%CI 0.09-0.72.

Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFÉ).

PubMed

de Bruin-Weller, M; Thaçi, D; Smith, C H; Reich, K; Cork, M J; Radin, A; Zhang, Q; Akinlade, B; Gadkari, A; Eckert, L; Hultsch, T; Chen, Z; Pirozzi, G; Graham, N M H; Shumel, B

2018-05-01

Atopic dermatitis is a chronic inflammatory skin disease that may require systemic therapy. Ciclosporin A (CsA) is a widely used, potent immunosuppressant but it is not effective in all patients with atopic dermatitis, and side-effects limit its use. Dupilumab, a fully human anti-interleukin 4 receptor-alpha monoclonal antibody, inhibits signaling of IL-4 and IL-13, key drivers of Type 2/Th2-mediated inflammation, and is approved in the U.S.A. and the European Union for the treatment of inadequately-controlled moderate-to-severe atopic dermatitis in adults. To evaluate efficacy and safety of dupilumab with concomitant topical corticosteroids (TCS) in adults with atopic dermatitis with inadequate response to/intolerance of CsA, or for whom CsA treatment was medically inadvisable. In this 16-week, double-blind, randomized, placebo-controlled, phase III trial, patients were randomized 1 : 1 : 1 to subcutaneous dupilumab 300 mg weekly (qw) or every 2 weeks (q2w) or placebo. All received concomitant medium-potency TCS from Week -2 through Week 16; dosage could be tapered if lesions cleared, or stopped for adverse reactions to TCS. In total, 390 patients were screened, 325 were randomized, and 318 completed the trial. Treatment groups had similar baseline characteristics. Significantly more patients in the dupilumab qw + TCS and q2w + TCS groups achieved ≥ 75% improvement from baseline in the Eczema Area and Severity Index at Week 16 vs. the placebo + TCS group (primary end point) (59·1% and 62·6% vs. 29·6%, respectively; P < 0·001 vs. placebo + TCS, both doses). Other clinical outcomes and atopic dermatitis symptoms were significantly improved in the dupilumab qw + TCS and q2w + TCS groups, including pruritus, pain, sleep disturbance, symptoms of anxiety and depression, and quality of life (QoL). Treatment groups had similar overall rates of adverse events (qw + TCS, q2w + TCS and placebo + TCS groups: 69·1%, 72·0% and 69·4%, respectively) and serious adverse events (1·8%, 1·9% and 1·9%, respectively). Conjunctivitis was more frequent with dupilumab + TCS; skin infections were more frequent with placebo + TCS. Dupilumab + TCS significantly improved signs and symptoms of atopic dermatitis and QoL in adults with a history of inadequate response to/intolerance of CsA, or for whom CsA treatment was medically inadvisable. No new safety signals were identified. © 2017 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

Japanese guideline for atopic dermatitis.

PubMed

Katayama, Ichiro; Kohno, Yoichi; Akiyama, Kazuo; Ikezawa, Zenro; Kondo, Naomi; Tamaki, Kunihiko; Kouro, Osamu

2011-03-01

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 a 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.

Effect of prolonged breast-feeding on risk of atopic dermatitis in early childhood.

PubMed

Hong, Soyoung; Choi, Won-Jun; Kwon, Ho-Jang; Cho, Yoon Hee; Yum, Hye Yung; Son, Dong Koog

2014-01-01

The effect of breast-feeding on the risk of developing atopic disease remains controversial. This study is an investigation of the effect of breast-feeding on current atopic dermatitis (AD) among Korean children. This cross-sectional study of children's histories of current AD and environmental factors was completed by the subjects' parents. The subjects included 10,383 children aged 0-13 years in Seoul, Korea, in 2008. The diagnostic criteria of the International Study of Asthma and Allergies in Childhood were applied in this study. Adjustments were performed for age, gender, maternal education, smoking in the household, relocation to a new house within 1 year of birth, and parental history of atopic disease. After adjustment for confounders, age and duration of maternal education were found to be inversely associated with the prevalence of AD. Among subjects aged ≤5 years, the prevalence of AD was positively associated with the duration of breast-feeding (p < 0.001). However, there was no significant association between AD and breast-feeding among children >5 years of age. Regardless of parental history of atopic diseases, breast-feeding >12 months was a significant risk factor for AD. The effect of breast-feeding differed by age group. Prolonged breast-feeding increased the risk of AD in children <5 years of age, regardless of parental history of atopic diseases.

Oral administration of Lactobacillus delbrueckii subspecies bulgaricus OLL1073R-1 suppresses inflammation by decreasing interleukin-6 responses in a murine model of atopic dermatitis.

PubMed

Kano, Hiroshi; Kita, Junko; Makino, Seiya; Ikegami, Shuji; Itoh, Hiroyuki

2013-06-01

The oral intake of Lactobacillus spp. can provide beneficial effects to the host by modulating the immune response. Atopic dermatitis (AD) is an allergic inflammatory disease mediated by various immune responses. In this study, we examined the effect of a Lactobacillus strain, Lactobacillus delbrueckii ssp. bulgaricus OLL1073R-1 (OLL1073R-1), on AD development in a murine model of AD that was developed by the topical application of mite antigen in NC/Nga mice. The oral intake of heat-killed OLL1073R-1 cells inhibited both the development of dermatitis and the elevation of an acute inflammation marker, serum amyloid A. Another bacterial strain, Lactobacillus rhamnosus OLL2984, exerted no inhibitory effects on dermatitis. The oral intake of heat-killed OLL1073R-1 cells also attenuated secretion of IL-6 from lymph node cells in response to mite antigen and reduced IL-6 levels in inflamed tissues, such as auricles. Production of IFN-γ or IL-4 was not influenced by OLL1073R-1 intake. We also found that inhibition of IL-6 signaling by gp130-Fc (a fusion protein consisting of the extracellular portion of glycoprotein 130 fused to the Fc region of human IgG1) markedly decreased the severity of dermatitis in NC/Nga mice. Moreover, secretion of IL-6 by lymph node cells was augmented in NC/Nga mice compared with that in BALB/c mice. These results indicate that IL-6 plays an essential role in the development of dermatitis in the NC/Nga mouse model of AD, and that OLL1073R-1 inhibits dermatitis, at least in part, by suppressing the IL-6 response. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Hand dermatitis--differential diagnoses, diagnostics, and treatment options.

PubMed

Mahler, Vera

2016-01-01

The pathogenesis of hand dermatitis is multifactorial, and includes factors such as genetic predisposition and exposure. A high incidence rate is associated with female gender, contact allergy, atopic dermatitis, and wet work. The most important risk factors for the persistence of hand dermatitis include its extent, contact allergic or atopic etiology, childhood dermatitis, and early onset (before the age of 20). The cost of illness of hand dermatitis corresponds to this seen in moderate to severe psoriasis. The diagnostic workup of hand dermatitis and its differential diagnoses requires a detailed assessment of occupational and recreational exposure. In case of possible work-related triggers, early notification of the accident insurer should be sought (via the dermatologist's report). Exposure to a contact allergen is a contributing factor in one-half of all cases of hand dermatitis. It is therefore imperative that all patients with hand dermatitis persisting for more than three months undergo patch testing. Successful and sustainable treatment of hand dermatitis starts with the proper identification and elimination of individual triggers, including the substitution of identified contact allergens and irritants, as well as optimizing preventive measures. Graded therapy taking the clinical severity into account is essential. Validated instruments may be used to monitor therapeutic efficacy. © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Theobroma cacao extract attenuates the development of Dermatophagoides farinae-induced atopic dermatitis-like symptoms in NC/Nga mice.

PubMed

Kang, Heerim; Lee, Chang Hyung; Kim, Jong Rhan; Kwon, Jung Yeon; Son, Myoung-Jin; Kim, Jong-Eun; Lee, Ki Won

2017-02-01

Cacao beans from Theobroma cacao are an abundant source of polyphenols, particularly flavonoids. Previous studies demonstrated that cacao flavanols decrease pro-inflammatory cytokines resulting in the alleviation of allergic symptoms. We sought to investigate the effects of cacao extract (CE) on Dermatophagoides farinae extract (DFE)-induced atopic dermatitis (AD)-like symptoms. CE attenuated DFE-induced AD-like symptoms as assessed by skin lesion analyses, dermatitis score, and skin thickness. Histopathological analysis revealed that CE suppressed DFE-induced immune cell infiltration into the skin. These observations occurred concomitantly with the downregulation of inflammatory markers including serum immunoglobulin (Ig) E, chemokine; thymus and activation-regulated chemokine and macrophage-derived chemokine as well as the skin-derived cytokines interleukin (IL)-4, IL-5, and interferon-γ. CE also significantly alleviated transepidermal water loss and increased skin hydration. These results suggest that CE, a natural phytochemical-rich food, has potential therapeutic efficacy for the treatment of AD. Copyright © 2016. Published by Elsevier Ltd.

Filaggrin-stratified transcriptomic analysis of pediatric skin identifies mechanistic pathways in patients with atopic dermatitis.

PubMed

Cole, Christian; Kroboth, Karin; Schurch, Nicholas J; Sandilands, Aileen; Sherstnev, Alexander; O'Regan, Grainne M; Watson, Rosemarie M; McLean, W H Irwin; Barton, Geoffrey J; Irvine, Alan D; Brown, Sara J

2014-07-01

Atopic dermatitis (AD; eczema) is characterized by a widespread abnormality in cutaneous barrier function and propensity to inflammation. Filaggrin is a multifunctional protein and plays a key role in skin barrier formation. Loss-of-function mutations in the gene encoding filaggrin (FLG) are a highly significant risk factor for atopic disease, but the molecular mechanisms leading to dermatitis remain unclear. We sought to interrogate tissue-specific variations in the expressed genome in the skin of children with AD and to investigate underlying pathomechanisms in atopic skin. We applied single-molecule direct RNA sequencing to analyze the whole transcriptome using minimal tissue samples. Uninvolved skin biopsy specimens from 26 pediatric patients with AD were compared with site-matched samples from 10 nonatopic teenage control subjects. Cases and control subjects were screened for FLG genotype to stratify the data set. Two thousand four hundred thirty differentially expressed genes (false discovery rate, P < .05) were identified, of which 211 were significantly upregulated and 490 downregulated by greater than 2-fold. Gene ontology terms for "extracellular space" and "defense response" were enriched, whereas "lipid metabolic processes" were downregulated. The subset of FLG wild-type cases showed dysregulation of genes involved with lipid metabolism, whereas filaggrin haploinsufficiency affected global gene expression and was characterized by a type 1 interferon-mediated stress response. These analyses demonstrate the importance of extracellular space and lipid metabolism in atopic skin pathology independent of FLG genotype, whereas an aberrant defense response is seen in subjects with FLG mutations. Genotype stratification of the large data set has facilitated functional interpretation and might guide future therapy development. Copyright © 2014 The Authors. Published by Mosby, Inc. All rights reserved.

Atopic Dermatitis (Eczema): An Appraisal

PubMed Central

Hudson, Arthur L.

1962-01-01

Atopic (spontaneous) allergies and nonatopic (induced) allergies are often confused. The meaning of these terms is definite, but the occurrence of either (in a given individual) may depend upon his autonomic nervous system control. The evidence that allergens produce the cutaneous changes in atopic dermatitis is flimsy, and neurodermatitis would be a more appropriate term since the entity falls into that pattern of skin changes. Treatment carried out, from infancy sometimes to old age, consists of careful management of the patient in the physical and emotional spheres, avoidance of external irritation and the use of a multiplicity of anti-pruritic, anti-inflammatory and sedative agents. PMID:13955448

Deciphering the Complexities of Atopic Dermatitis: Shifting Paradigms in Treatment Approaches

PubMed Central

Leung, Donald Y. M.; Guttman-Yassky, Emma

2014-01-01

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It often precedes the development of food allergy and asthma. Recent insights into AD reveal abnormalities in terminal differentiation of the epidermal epithelium leading to a defective stratum corneum, which allows enhanced allergen penetration and systemic IgE sensitization. Atopic skin is also predisposed to colonization or infection by pathogenic microbes, most notably Staphylococcus aureus and herpes simplex virus (HSV). Causes of this abnormal skin barrier are complex and driven by a combination of genetic, environmental and immunologic factors. These factors likely account for the heterogeneity of AD onset, severity and natural history of this skin disease. Recent studies suggest prevention of AD can be achieved by early interventions protecting the skin barrier. Onset of lesional AD requires effective control of local and systemic immune activation for optimal management. Early intervention may improve long term outcomes for AD and reduce the systemic allergen sensitization leading to associated allergic diseases in the gastrointestinal and respiratory tract. PMID:25282559

Prurigo, pruritic folliculitis, and atopic eruption of pregnancy: Facts and controversies.

PubMed

Roth, Maria Magdalena; Cristodor, Patricia; Kroumpouzos, George

2016-01-01

Prurigo (PP) and pruritic folliculitis of pregnancy (PFP) are poorly characterized entities. Traditionally classified under specific dermatoses of pregnancy, they were reclassified under a new umbrella entity, atopic eruption of pregnancy (AEP), which also includes atopic dermatitis (AD) that can worsen or present for the first time in pregnancy. Still, several aspects of AEP have not been adequately elucidated. It needs to be clarified whether it is the intrinsic ("nonallergic" or "atopiform dermatitis") or extrinsic (immunoglobulin E-associated) AD that is affected by pregnancy. Future studies need to examine the postpartum prognosis of AD that develops for the first time during gestation. A revision of diagnostic criteria of AEP will allow a more accurate estimate of its prevalence, as well as clarification of the relationship between AD and specific dermatoses, such as PP and PFP. In this context, this review discusses the history, epidemiologic data, clinicopathologic features, and management of these entities. Copyright © 2016 Elsevier Inc. All rights reserved.

Diagnosis, comorbidity, and psychosocial impact of atopic dermatitis.

PubMed

Davis, Dawn Marie; Waldman, Andrea; Jacob, Sharon; LeBovidge, Jennifer; Ahluwalia, Jusleen; Tollefson, Megha; Jetter, Nathan; Spergel, Jonathan

2017-09-01

Atopic dermatitis (AD) is a chronic inflammatory skin disease, with a remitting relapsing course. The central diagnostic features of AD include pruritus, xerosis, eczematous lesions with a characteristic morphology and distribution, and a personal or family history of atopic disease. Several clinical studies have emphasized the link between AD and other atopic disorders including asthma, allergic rhinitis, and food allergies. More recent studies indicate possible links between AD and other nonatopic disorders, including ADHD, sleep disturbance, and mental health disorders, suggesting an even more profound impact of this disease. Furthermore, the social, emotional, and personal impact of AD for patients and their caregivers is substantial. Understanding both the clinical characteristics and implications of AD is critical to lessening the psychosocial, clinical, and economic burden of this disease. ©2017 Frontline Medical Communications.

Oral and subcutaneous therapy of canine atopic dermatitis with recombinant feline interferon omega.

PubMed

Litzlbauer, Petra; Weber, Karin; Mueller, Ralf S

2014-03-01

Canine atopic dermatitis (CAD) is a common allergic skin disease that has been treated with subcutaneously administered interferons (IFN). Recombinant feline IFN-ω (rFeIFN-ω) was reported to be efficacious for CAD. Whether dogs develop neutralizing antibodies against rFeIFN-ω during long-term treatment and whether orally administered IFNs are efficacious in CAD is unknown. The aim of this study was to evaluate the potential development of antibodies against rFeIFN-ω in atopic dogs and to compare subcutaneous and oral IFN therapy. Twenty-six atopic dogs were randomly assigned to two groups. The first group (n=15) received eight subcutaneous injections of rFeIFN-ω (Virbagen® omega, Virbac, Carros, France) over four months, the second group (n=11) received rFeIFN-ω daily orally. Concurrent medication was permitted, except systemically acting glucocorticoids and cyclosporin, which had to be withdrawn at least two weeks prior to the study. Serum samples for antibody detection were collected before and after the study. On days 0, 60 and 120 skin lesions and pruritus were evaluated using a validated lesion score (Canine Atopic Dermatitis Extent and Severity Index=CADESI) and a validated pruritus score. Concurrent medications were recorded. For every visit a total score, consisting of CADESI, pruritus score and medication score was created. For antibody detection an indirect ELISA, using Virbagen® omega as antigen, was performed. Comparison of pruritus scores, CADESI and total scores between days 0 and 120 showed improvement in both groups, however, significant improvement could only be detected in the oral group with CADESI and total scores (61%, P=0.04 and 36%, P=0.02 respectively). Serum antibodies against rFeIFN-ω could not be detected in any of the dogs. In this study antibody production could not be demonstrated. It suggests better efficacy with oral IFN administration, which should be further verified in larger, randomized, controlled studies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effect of (E)-2-(3,4-dimethoxyphenyl)-4-oxo-4H-chromen-7-yl-3-(3,4-dimethoxyphenyl) acrylate on the development of atopic dermatitis-like lesions.

PubMed

Kim, In Sik; Song, Gyu-Yong; Kim, Dong-Hee; Cho, Soo Hyun; Yun, Chi-Young; Lee, Ji-Sook

2012-09-24

In this study, we synthesized a novel chemical, (E)-2-(3,4-dimethoxyphenyl)-4-oxo-4H-chromen-7-yl-3-(3,4-dimethoxyphenyl) acrylate (CSH) and investigated the effect of CSH on atopic dermatitis (AD) by evaluating the anti-inflammatory effect of CSH on immune cells in vitro and on atopic dermatitis-like lesions in vivo. Human monocytic THP-1 cells and human eosinophilic EoL-1 cells were treated with house dust mite extract in the absence and presence of CSH. Nc/Nga mice were sensitized to 2,4-dinitrochlorobenzne (DNCB) for 5 weeks and then orally and dorsally administered with CSH or dexamethasone for 3 weeks. CSH inhibited the secretion of monocyte chemotactic protein-1 (MCP-1), interleukin (IL)-6 and IL-8 due to house dust mite extract in THP-1 cells. CSH also suppressed the secretion of MCP-1 and IL-8 in EoL-1 cells. In vivo, the skin severity score decreased after CSH treatment as compared to the control group. CSH suppressed the inflammatory cell infiltration into the dermis and thickened the epidermis. CSH reduced serum IgE level as compared to the control group. The levels of IL-4, IL-5, IL-13 and eotaxin in mouse splenocytes increased after treatment with concanavalin A and the increase of the cytokines was decreased by pre-treatment with CSH. The inhibitory effects of CSH on atopic lesions of DNCB-treated Nc/Nga mice were similar to those of dexamethasone, despite differing degrees depending on results evaluated in this study. These results may contribute to the development of a therapeutic drug for the treatment of AD. Copyright © 2012 Elsevier Inc. All rights reserved.

Review: The role of antibodies, autoantigens and food allergens in canine atopic dermatitis.

PubMed

Pucheu-Haston, Cherie M; Bizikova, Petra; Eisenschenk, Melissa N C; Santoro, Domenico; Nuttall, Tim; Marsella, Rosanna

2015-04-01

Canine atopic dermatitis (AD) is considered to be an immunoglobulin E (IgE)-mediated hypersensitivity response to environmental allergens. The role of other antibody isotypes and nonenvironmental allergens in disease pathogenesis remains unclear. The objective of this review is to provide an update on advances in the understanding of the relevance of specific antibody isotypes, autoallergens and nonenvironmental allergens in the pathogenesis of canine AD. Citation databases, abstracts and proceedings from international meetings published between 2001 and 2013 were reviewed. Where necessary, older articles were included for background information. Neither total nor allergen-specific IgE necessarily correlates with clinical disease in canine AD. Some dogs exhibit clinical signs that are indistinguishable from AD but have no demonstrable allergen-specific IgE (atopic-like dermatitis). Allergen-specific immunoglobulin G may be demonstrated in canine AD, but there is no evidence that this isotype plays a role in disease development. Although humans with AD may develop serum IgE against autoallergens, this finding has not been substantiated in the dog. In contrast, adverse food reactions are frequently co-associated with AD in the dog. Ingestion of food and environmental allergens may trigger exacerbations of AD. Determination of the role of IgE in the pathogenesis of canine AD still requires clarification. Clinical trials and research studies must distinguish atopic dogs with allergen-specific IgE or skin test reactivity from those without. There is no convincing evidence demonstrating a pathogenic role for either allergen-specific immunoglobulin G or autoallergens in canine AD, but food items may be triggers for disease flares in certain individuals. © 2015 ESVD and ACVD.

GUIDELINES OF CARE FOR THE MANAGEMENT OF ATOPIC DERMATITIS

PubMed Central

Sidbury, Robert; Davis, Dawn M.; Cohen, David E.; Cordoro, Kelly M.; Berger, Timothy G.; Bergman, James N.; Chamlin, Sarah L.; Cooper, Kevin D.; Feldman, Steven R.; Hanifin, Jon M.; Krol, Alfons; Margolis, David J.; Paller, Amy S.; Schwarzenberger, Kathryn; Silverman, Robert A.; Simpson, Eric L.; Tom, Wynnis L.; Williams, Hywel C.; Elmets, Craig A.; Block, Julie; Harrod, Christopher G.; Begolka, Wendy Smith; Eichenfield, Lawrence F.

2014-01-01

Atopic dermatitis (AD) is a chronic, pruritic inflammatory dermatosis that affects up to 25% of children and 2-3% of adults. This guideline addresses important clinical questions that arise in AD management and care, providing recommendations based on the available evidence. In this third of four sections, treatment of AD with phototherapy and systemic immunomodulators, antimicrobials, and antihistamines is reviewed, including indications for use and the risk-benefit profile of each treatment option. PMID:24813298

Nuclear microprobe investigation of the penetration of ultrafine zinc oxide into human skin affected by atopic dermatitis

NASA Astrophysics Data System (ADS)

Szikszai, Z.; Kertész, Zs.; Bodnár, E.; Borbíró, I.; Angyal, A.; Csedreki, L.; Furu, E.; Szoboszlai, Z.; Kiss, Á. Z.; Hunyadi, J.

2011-10-01

Skin penetration is one of the potential routes for nanoparticles to gain access into the human body. Ultrafine metal oxides, such as titanium dioxide and zinc oxide are widely used in cosmetic and health products like sunscreens. These oxides are potent UV filters and the particle size smaller than 200 nm makes the product more transparent compared to formulations containing coarser particles. The present study continues the work carried out in the frame of the NANODERM: “Quality of skin as a barrier to ultrafine particles” European project and complements our previous investigations on human skin with compromised barrier function. Atopic dermatitis (a type of eczema) is an inflammatory, chronically relapsing, non-contagious skin disease. It is very common in children but may occur at any age. The exact cause of atopic dermatitis is unknown, but is likely due to a combination of impaired barrier function together with a malfunction in the body's immune system. In this study, skin samples were obtained from two patients suffering from atopic dermatitis. Our results indicate that the ultrafine zinc oxide particles, in a hydrophobic basis gel with an application time of 2 days or 2 weeks, have penetrated deeply into the stratum corneum in these patients. On the other hand, penetration into the stratum spinosum was not observed even in the case of the longer application time.

Crisaborole Ointment 2%: A Review in Mild to Moderate Atopic Dermatitis.

PubMed

Hoy, Sheridan M

2017-12-01

Crisaborole ointment 2% (Eucrisa™) is a novel, anti-inflammatory inhibitor of phosphodiesterase 4 (PDE4) that is available in the USA for the topical treatment of mild to moderate atopic dermatitis in patients aged ≥ 2 years. In two short-term (28 days), identically designed, multicentre, phase III studies in this patient population, topical therapy with crisaborole ointment 2% reduced disease severity and pruritus severity compared with vehicle, with the effect established early and sustained over the course of treatment. Improvements in the other signs of atopic dermatitis (erythema, exudation, excoriation, induration/papulation, and lichenification) were also seen. Crisaborole ointment 2% was generally well tolerated in the short-term studies, with its favorable safety profile maintained over the longer term (up to 52 weeks) in a multicentre, extension study. Most treatment-emergent adverse events (TEAEs) were of mild to moderate severity and considered unrelated to the study medication. Moreover, the incidence of application-site pain following short- and longer-term topical therapy with crisaborole ointment 2% was low. In conclusion, crisaborole ointment 2% is an effective and generally well tolerated new topical option for the management of mild to moderate atopic dermatitis in patients aged ≥ 2 years, with the potential to effectively treat this patient population over the longer term without the safety concerns associated with other current topical anti-inflammatory agents.

Capsiate Inhibits DNFB-Induced Atopic Dermatitis in NC/Nga Mice through Mast Cell and CD4+ T-Cell Inactivation.

PubMed

Lee, Ji H; Lee, Yun S; Lee, Eun-Jung; Lee, Ji H; Kim, Tae-Yoon

2015-08-01

Capsaicin has many biological effects, such as antioxidant, anticancer, and antiangiogenic effects, but it is rarely used because of its high pungency. Capsiate, a nonpungent capsaicin analog, also has multiple biological effects, similar to those of capsaicin, but does not cause irritation. However, the effect of capsiate on allergic responses and immune cells has not been well studied. In this study, we investigated the effect of capsiate on atopic dermatitis, mouse CD4+ T cells, and mast cell activation. Capsiate inhibited DNFB-induced atopic dermatitis in NC/Nga mice. Topical treatment with capsiate suppressed serum IgE levels and cytokine and chemokine expression in the skin of DNFB-treated NC/Nga mice. In addition, it suppressed the activation of CD4+ T cells and mast cells, which are implicated in allergic diseases. Capsiate inhibited the differentiation of naïve CD4+ T cells into T helper type 1 (Th1), Th2, and Th17 cells. Treatment with capsiate inhibited the expression of pro-inflammatory cytokines and degranulation from activated bone marrow-derived mast cells through the inhibition of extracellular signal-regulated kinase signal pathways. Consistent with these results, treatment with capsiate inhibited passive cutaneous anaphylaxis. Taken together, our results suggest that capsiate might be a good candidate molecule for the treatment of allergic diseases such as atopic dermatitis.

The efficacy of cyclosporine A in cats with presumed atopic dermatitis: a double blind, randomised prednisolone-controlled study.

PubMed

Wisselink, Marinus A; Willemse, Ton

2009-04-01

The objective of this study was to compare the efficacy of cyclosporine A (CsA) and prednisolone in feline atopic dermatitis (AD) in a randomised, controlled double blind study. Twenty-nine cats with feline AD were randomly allocated to two groups. Eleven cats were treated orally with prednisolone (1mg/kg SID) and 18 were treated with CsA (5mg/kg/day) for 4 weeks. At day 0 (D0) and D28, skin lesions were graded by means of the canine atopic dermatitis extent and severity index (CADESI). Skin biopsies and intradermal allergy tests were performed at D0 and blood samples for haematology and serum biochemistry were collected at D0 and D28. During the trial the cat owners were asked to evaluate the intensity of the pruritus once weekly on a linear analog scale and to record side effects. Based on the CADESI there was no significant difference between the two groups in the amount of remission (P=0.0562) or in the number of cats that improved by >25% (P=0.0571). The effect of CsA and prednisolone on pruritus as evaluated by the owners was not significantly different (P=0.41) between the two groups. No serious side effects were observed. The conclusion was that CsA is an effective alternative to prednisolone therapy in cats with presumed atopic dermatitis.

Elevated blood eosinophils in early infancy are predictive of atopic dermatitis in children with risk for atopy.

PubMed

Rossberg, Siri; Gerhold, Kerstin; Geske, Thomas; Zimmermann, Kurt; Menke, Georg; Zaino, Mohammad; Wahn, Ulrich; Hamelmann, Eckard; Lau, Susanne

2016-11-01

Accessible markers to predict the development of atopic diseases are highly desirable but yet matter of debate. We investigated the role of blood eosinophils at 4 weeks and 7 months of life and their association with developing atopic dermatitis (AD) in a birth cohort of children with atopic heredity. Infant blood samples for eosinophil counts were taken from 559 infants at 4 weeks and from 467 infants at 7 month of life with at least one atopic parent. Elevation of blood eosinophils was defined as ≥ 5% of total leukocytes and the asscociation for the occurrence of AD was assessed by entering 2 × 2 tables and the odds ratios were estimated followed by hypothesis testing against the alternate working hypothesis: odds ratio < > 1. Survival analysis was carried out estimating the Kaplan-Meier product limit estimator from the life-time table of AD score and time to AD manifestation stratified by the eosinophil binary score. Elevated blood eosinophils observed at 4 weeks were significantly associated with the occurrence of AD in the whole cohort at the age of 7 months (p = 0.007), 1 year (p = 0.004), 2 years (p = 0.007) and 3 years (p = 0.006) of life. AD occurred app. 12 weeks earlier in infants with elevated blood eosinophils at 4 weeks of life. Blood eosinophil counts ≥5% at 7 months of life failed to show significance for AD; for eosinophils at 4.5% a significant association at 7 months (p = 0.005), and 1 year of life (p = 0.039), 2 years (p = 0.033) and 3 years (p = 0.034) was observed. Elevated blood eosinophils at age 4 weeks have a predictive value for the onset of atopic dermatitis in infancy and early childhood in children with high risk for atopy. Early eosinophil counts may therefore be helpful for counseling parents to provide infant skincare but furthermore identify individuals for interventional trials aiming at allergy prevention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparing high altitude treatment with current best care in Dutch children with moderate to severe atopic dermatitis (and asthma): study protocol for a pragmatic randomized controlled trial (DAVOS trial).

PubMed

Fieten, Karin B; Zijlstra, Wieneke T; van Os-Medendorp, Harmieke; Meijer, Yolanda; Venema, Monica Uniken; Rijssenbeek-Nouwens, Lous; l'Hoir, Monique P; Bruijnzeel-Koomen, Carla A; Pasmans, Suzanne G M A

2014-03-26

About 10 to 20% of children in West European countries have atopic dermatitis (AD), often as part of the atopic syndrome. The full atopic syndrome also consists of allergic asthma, allergic rhinitis and food allergy. Treatment approaches for atopic dermatitis and asthma include intermittent anti-inflammatory therapy with corticosteroids, health education and self-management training. However, symptoms persist in a subgroup of patients. Several observational studies have shown significant improvement in clinical symptoms in children and adults with atopic dermatitis or asthma after treatment at high altitude, but evidence on the efficacy when compared to treatment at sea level is still lacking. This study is a pragmatic randomized controlled trial for children with moderate to severe AD within the atopic syndrome. Patients are eligible for enrolment in the study if they are: diagnosed with moderate to severe AD within the atopic syndrome, aged between 8 and 18 years, fluent in the Dutch language, have internet access at home, able to use the digital patient system Digital Eczema Center Utrecht (DECU), willing and able to stay in Davos for a six week treatment period. All data are collected at the Wilhelmina Children's Hospital and DECU. Patients are randomized over two groups. The first group receives multidisciplinary inpatient treatment during six weeks at the Dutch Asthma Center in Davos, Switzerland. The second group receives multidisciplinary treatment during six weeks at the outpatient clinic of the Wilhelmina Children's Hospital, Utrecht, the Netherlands. The trial is not conducted as a blind trial. The trial is designed with three components: psychosocial, clinical and translational. Primary outcomes are coping with itch, quality of life and disease activity. Secondary outcomes include asthma control, medication use, parental quality of life, social and emotional wellbeing of the child and translational parameters. The results of this trial will provide evidence for the efficacy of high altitude treatment compared to treatment at sea level for children with moderate to severe AD. Current Controlled Trials ISRCTN88136485.

Comparing high altitude treatment with current best care in Dutch children with moderate to severe atopic dermatitis (and asthma): study protocol for a pragmatic randomized controlled trial (DAVOS trial)

PubMed Central

2014-01-01

Background About 10 to 20% of children in West European countries have atopic dermatitis (AD), often as part of the atopic syndrome. The full atopic syndrome also consists of allergic asthma, allergic rhinitis and food allergy. Treatment approaches for atopic dermatitis and asthma include intermittent anti-inflammatory therapy with corticosteroids, health education and self-management training. However, symptoms persist in a subgroup of patients. Several observational studies have shown significant improvement in clinical symptoms in children and adults with atopic dermatitis or asthma after treatment at high altitude, but evidence on the efficacy when compared to treatment at sea level is still lacking. Methods/Design This study is a pragmatic randomized controlled trial for children with moderate to severe AD within the atopic syndrome. Patients are eligible for enrolment in the study if they are: diagnosed with moderate to severe AD within the atopic syndrome, aged between 8 and 18 years, fluent in the Dutch language, have internet access at home, able to use the digital patient system Digital Eczema Center Utrecht (DECU), willing and able to stay in Davos for a six week treatment period. All data are collected at the Wilhelmina Children’s Hospital and DECU. Patients are randomized over two groups. The first group receives multidisciplinary inpatient treatment during six weeks at the Dutch Asthma Center in Davos, Switzerland. The second group receives multidisciplinary treatment during six weeks at the outpatient clinic of the Wilhelmina Children’s Hospital, Utrecht, the Netherlands. The trial is not conducted as a blind trial. The trial is designed with three components: psychosocial, clinical and translational. Primary outcomes are coping with itch, quality of life and disease activity. Secondary outcomes include asthma control, medication use, parental quality of life, social and emotional wellbeing of the child and translational parameters. Discussion The results of this trial will provide evidence for the efficacy of high altitude treatment compared to treatment at sea level for children with moderate to severe AD. Trial Registration Current Controlled Trials ISRCTN88136485. PMID:24670079

IL-33 promotes gastrointestinal allergy in a TSLP-independent manner

PubMed Central

Han, Hongwei; Roan, Florence; Johnston, Laura K.; Smith, Dirk E.; Bryce, Paul J.; Ziegler, Steven F.

2017-01-01

Atopic dermatitis (AD) often precedes asthma and food allergy, indicating that epicutaneous sensitization to allergens may be important in the induction of allergic responses at other barrier surfaces. Thymic stromal lymphopoietin (TSLP) and IL-33 are two cytokines that may drive type 2 responses in the skin; both are potential targets in the treatment of allergic diseases. We tested the functional role of IL-33 and the interplay between IL-33 and TSLP in mouse models of atopic march and gastrointestinal allergy. IL-33-driven allergic disease occurred in a TSLP-independent manner. In contrast, mice lacking IL-33 signaling were protected from onset of allergic diarrhea in TSLP-driven disease. Epithelial-derived IL-33 was important in this model, since specific loss of IL-33 expression in the epithelium attenuated cutaneous inflammation. Notably, the development of diarrhea following sensitization with TLSP plus antigen was ameliorated even when IL-33 was blocked after sensitization. Thus, IL-33 plays an important role during early cutaneous inflammation and during challenge. These data reveal critical roles for IL-33 in the “atopic march” that leads from atopic dermatitis to gastrointestinal allergy. PMID:28656964

[What's new in the management of atopic dermatitis in children and adolescents ?

PubMed

Czernielewski, Justine; Comte Krieger, Émilie; Christen-Zaech, Stéphanie

2018-03-28

A better understanding of the atopic dermatitis (AD) pathogenesis and the need for more efficient and safer treatments in severe AD promoted the development of new therapies. Several underwent and are still undergoing clinical trials, but due to safety reasons, they include mainly adults for now. AD is however predominant in childhood with a prevalence 20 % in children compared to only 5 % in adults. Regarding the pediatric population, the new pipeline relies on two selective immunosuppressive agents, notably crisaborole (phosphodiesterase-4 inhibitor) and dupilumab (IL-4 and IL-13 inhibitor). In order to strengthen the medical treatment, therapeutic patient education plays a supportive role in the global approach, allowing an optimized care. The Lausanne model of the Pediatric Dermatology Unit is described in this article.

Improving the patient-clinician and parent-clinician partnership in atopic dermatitis management.

PubMed

Mancini, Anthony J; Paller, Amy S; Simpson, Eric L; Ellis, Charles N; Eichenfield, Lawrence F

2012-09-01

Long-term adherence to carefully developed, individualized strategies is necessary for the optimum treatment outcomes in patients with atopic dermatitis (AD). However, the parents of children with AD frequently lack sufficient information about the disease and its treatment, hold incorrect and sometimes harmful beliefs about these issues, and too often do not follow through consistently with the treatment plan. The health care provider is the primary source of such education, so an effective provider relationship is fundamental to adherence. In addition to the provision of correct information and the correction of misinformation, clinicians must be aware of and must address barriers to adherence with AD therapy, especially parent anxiety about the safety of topical medications (corticosteroids and topical calcineurin inhibitors). Copyright © 2012 Elsevier Inc. All rights reserved.

A Study Comparing the Quality of Life of Patients in the Treatment of Eczema by Pediatric Generalists and Specialists

ClinicalTrials.gov

2018-01-09

Eczema; Dermatitis; Dermatitis, Atopic; Genetic Disease, Inborn; Hypersensitivity; Hypersensitivity, Immediate; Immune System Diseases; Skin Diseases; Skin Diseases, Eczematous; Skin Diseases, Genetic

OA01.24. A study of effect of neem oil on clinical signs of canine atopy

PubMed Central

Joshi, Shraddha

2012-01-01

Purpose: Due to growing nuclear nature of urban families, pets like dogs are becoming popular companions. A skin disorder is common in dogs and is a concern for human coming in contact. Natural remedies need to be assessed for long term safety of dogs and humans. There is evidence that in dogs, Neem oil can help with fleas, ticks, intestinal parasites and mange mites. According to Ayurvedic medicine. Neem oil improves the clinical signs of skin disorders. To study its action in canines, further work was required on the efficacy of Neem oil in the treatment of canine atopy. Method: Effect of a preparation of Neem oil on canine atopy was assessed in a open, placebo-controlled trial. Privately owned dogs were used and the clinical signs of atopic dermatitis were evaluated by the owners. For a period of 3 weeks, the dogs daily received application with Neem oil (n = 9) or vehicle (n = 8). During the trial, all dogs were cleaned with the use of regular bathing shampoo in order to maintain hygiene. To assess the severity of atopic dermatitis, the clinical signs scored were itching, redness, scaling, thickening and stripping of skin. The severity of the signs of atopic dermatitis was scored by the owners by marking with a cross a 10cm, horizontal line. Result: For all five clinical signs, the group-mean improvement, expressed as change of severity score over time, was greater in the test group than in the controls. Within each group, the changes for the five clinical signs were added up to arrive at an overall index of improvement of atopic dermatitis. The extra improvement caused by the application of Neem oil was significant. Conclusion: Neem oil can be considered as effective and is beneficial for dogs with atopic dermatitis.

A homozygous nonsense mutation in the gene for Tmem79, a component for the lamellar granule secretory system, produces spontaneous eczema in an experimental model of atopic dermatitis.

PubMed

Sasaki, Takashi; Shiohama, Aiko; Kubo, Akiharu; Kawasaki, Hiroshi; Ishida-Yamamoto, Akemi; Yamada, Taketo; Hachiya, Takayuki; Shimizu, Atsushi; Okano, Hideyuki; Kudoh, Jun; Amagai, Masayuki

2013-11-01

Flaky tail (ma/ma Flg(ft/ft)) mice have a frameshift mutation in the filaggrin (Flg(ft)) gene and are widely used as a model of human atopic dermatitis associated with FLG mutations. These mice possess another recessive hair mutation, matted (ma), and develop spontaneous dermatitis under specific pathogen-free conditions, whereas genetically engineered Flg(-/-) mice do not. We identified and characterized the gene responsible for the matted hair and dermatitis phenotype in flaky tail mice. We narrowed down the responsible region by backcrossing ma/ma mice with wild-type mice and identified the mutation using next-generation DNA sequencing. We attempted to rescue the matted phenotype by introducing the wild-type matted transgene. We characterized the responsible gene product by using whole-mount immunostaining of epidermal sheets. We demonstrated that ma, but not Flg(ft), was responsible for the dermatitis phenotype and corresponded to a Tmem79 gene nonsense mutation (c.840C>G, p.Y280*), which encoded a 5-transmembrane protein. Exogenous Tmem79 expression rescued the matted hair and dermatitis phenotype of Tmem79(ma/ma) mice. Tmem79 was mainly expressed in the trans-Golgi network in stratum granulosum cells in the epidermis in both mice and humans. The Tmem79(ma/ma) mutation impaired the lamellar granule secretory system, which resulted in altered stratum corneum formation and a subsequent spontaneous dermatitis phenotype. The Tmem79(ma/ma) mutation is responsible for the spontaneous dermatitis phenotype in matted mice, probably as a result of impaired lamellar granule secretory system and altered stratum corneum barrier function. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Exploration into the Genetics of Food Allergy

DTIC Science & Technology

2013-10-01

pathogenesis of allergic contact dermatitis ,1 atopic dermatitis (AD),2 allergic drug reactions,3 immediate hypersensitivity reactions (eg, ana...of basophils. Basophils have been shown to contribute to many human disease states, including allergic diseases ( contact dermatitis , AD...MC Jr. Basophilic leukocytes in allergic contact dermatitis . J Exp Med 1972;135:235-54. 2. Ito Y, Satoh T, Takayama K, Miyagishi C, Walls AF, Yokozeki

Therapeutic effects of combination using glucosamine plus tacrolimus (FK-506) on the development of atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Kim, C-H; Cheong, K A; Park, C D; Lee, A-Y

2012-05-01

Tacrolimus (FK-506) has been found to exhibit potent inhibitory effects on spontaneously developed dermatitis. We previously showed that glucosamine prevents the development of Atopic dermatitis (AD)-like skin lesions in NC/Nga mice. The aims of our study were to investigate the synergistic therapeutic efficacy of combination of glucosamine plus FK-506 in dermatophagoides farina (Df)-induced AD-like skin lesions in NC/Nga mice and to determine the underlying therapeutic mechanisms. The Df-induced NC/Nga mice with a clinical score of 8 were used for treatment with glucosamine (500 mg/kg) alone, FK-506 (1.0 mg/kg) or in combination. The synergistic effects of combination therapy were evaluated by dermatitis scores, skin histology and immunological parameters such as IgE, Th2-mediated cytokines and chemokines, CD3(+) T cells and CLA(+) T cells. Combined therapy using glucosamine plus FK-506 improved the development of AD-like skin lesions as exemplified by a significant decrease in total skin symptom severity scores. The suppression of dermatitis by combined therapy was accompanied by a decrease in the plasma level of IgE and in the splenic level of IL-5, IL-13, TARC and eotaxin. Histological finding indicated that the dermal infiltration of inflammatory cells including mast cells and eosinophils was greatly reduced. Particularly, immunohistological evaluation reveals a reduction in CD3(+) T cells and CLA(+) cells in the combined therapy. Our findings suggest that combination therapy of glucosamine plus FK-506 was more synergistic efficacy than single-modality treatment with either alone to improve the development of established dermatitis in NC/Nga mice model. This combined immunosuppressive therapy may provide an effective therapeutic strategy for the treatment of AD. © 2011 The Authors. Scandinavian Journal of Immunology © 2011 Blackwell Publishing Ltd.

Lower Prevalence of Atopic Dermatitis and Allergic Sensitization among Children and Adolescents with a Two-Sided Migrant Background.

PubMed

Ernst, Sinja Alexandra; Schmitz, Roma; Thamm, Michael; Ellert, Ute

2016-02-26

In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to specific IgE antibodies in children and adolescents with and without a migrant background. Using data of the population-based German Health Interview and Examination Survey for children and adolescents (KiGGS;n = 17,450; 0-17 years), lifetime and 12-month prevalence of atopic diseases and point prevalence of 20 common allergic sensitizations were investigated among migrants compared to non-migrants. Multiple regression models were used to estimate the association of atopic disease and allergic sensitization with migrant background. In multivariate analyses with substantial adjustment we found atopic dermatitis about one-third less often (OR 0.73, 0.57-0.93) in participants with a two-sided migrant background. Statistically significant associations between allergic sensitizations and a two-sided migrant background remained for birch (OR 0.73, 0.58-0.90), soybean (OR 0.72, 0.54-0.96), peanut (OR 0.69, 0.53-0.90), rice (OR 0.64, 0.48-0.87), potato (OR 0.64, 0.48-0.85), and horse dander (OR 0.58, 0.40-0.85). Environmental factors and living conditions might be responsible for the observed differences.

78 FR 42006 - Oral Dosage Form New Animal Drugs; Nicarbazin; Oclacitinib; Zilpaterol

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

..., where applicable. DATES: This rule is effective July 15, 2013. FOR FURTHER INFORMATION CONTACT: George K... associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age. 200... maintenance therapy. (2) Indications for use. For control of pruritus associated with allergic dermatitis and...

Occupational contact dermatitis in blue-collar workers: results from a multicentre study from the Danish Contact Dermatitis Group (2003-2012).

PubMed

Schwensen, Jakob F; Menné, Torkil; Veien, Niels K; Funding, Anne T; Avnstorp, Christian; Østerballe, Morten; Andersen, Klaus E; Paulsen, Evy; Mørtz, Charlotte G; Sommerlund, Mette; Danielsen, Anne; Andersen, Bo L; Thormann, Jens; Kristensen, Ove; Kristensen, Berit; Vissing, Susanne; Nielsen, Niels H; Thyssen, Jacob P; Johansen, Jeanne D

2014-12-01

Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce. To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group. A retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations. The blue-collar workers often had occupational hand dermatitis (p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) (p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work. Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Parthenium dermatitis manifesting clinically as polymorphic light eruption and prurigo nodularis- like lesions with vasculitis-like picture on histopathology

PubMed Central

Lakshmi, Chembolli; Srinivas, C. R.; Pillai, Suma B.; Shanthakumari, S.

2011-01-01

Parthenium dermatitis is a widespread and distressing dermatoses in rural and urban India caused by the air borne allergen of the Compositae weed Parthenium hysterophorus. Parthenium dermatitis has been thought to be mediated solely by type IV hypersensitivity, but recently a combined immediate (type I) and delayed (type IV) hypersensitivity mechanism has been postulated in the initiation and perpetuation of parthenium dermatitis, especially in sensitized subjects with an atopic diathesis. Initially, the exposed sites of the body are involved. Later in the course of the disease, unexposed sites may get involved. Various clinical presentations have been described in parthenium dermatitis. Typically, it presents as an air borne contact dermatitis (ABCD) involving the eyelids and nasolabial folds Other presentations include a photodermatitis (essentially a pseudo photodermatitis), atopic dermatitis, seborrheic dermatitis, exfoliative dermatitis, hand dermatitis. Photosensitive lichenoid dermatitis and prurigo nodularis are rarer presentations. Uncommon presentations have been described in parthenium dermatitis. They include prurigo nodularis-like lesions and photosensitive lichenoid eruption. Three cases are presented, two of whom presented as polymorphic-like lesions and one as prurigo nodularis. All three patch tested positive to parthenium on Day 2. Prick testing was positive in two of the three patients. Parthenium dermatitis mimicking polymorphic light eruption has not been reported. Histopathology revealed vasculitis in the lesional skin in two of the patients. Although leukocytoclastic vasculitis has been reported earlier from the prick-tested site, this is the first report demonstrating the presence of vasculitis in lesional skin of parthenium dermatitis. PMID:23130236

Safety and efficacy of topical E6005, a phosphodiesterase 4 inhibitor, in Japanese adult patients with atopic dermatitis: results of a randomized, vehicle-controlled, multicenter clinical trial.

PubMed

Furue, Masutaka; Kitahara, Yasumi; Akama, Hideto; Hojo, Seiichiro; Hayashi, Nobukazu; Nakagawa, Hidemi

2014-07-01

The safety and efficacy of topical E6005, a novel phosphodiesterase 4 inhibitor, in Japanese adults with atopic dermatitis were evaluated. A total of 78 patients were randomized to receive either the 0.2% E6005 ointment or vehicle control (without E6005) at an allocation ratio of 2:1. The randomization phase of 4 weeks was followed by an extension phase of 8 weeks. In the extension phase, all 67 subjects who completed the randomization phase were treated with 0.2% E6005 ointment. The 4-week application of topical E6005 twice daily was safe and well tolerated. The safety profile for up to 12 weeks was similar to that for the first 4 weeks. No deaths or other serious adverse effects were observed during the entire study period of 12 weeks. Plasma E6005 was undetectable in all subjects at all sampling points while very low plasma concentrations of an E6005 metabolite were detected in 47% of subjects receiving E6005 treatment. At the end of week 4, Eczema Area and Severity Index (EASI), Severity Scoring Atopic Dermatitis (SCORAD)-objective, SCORAD-C (visual analog scales for pruritus and sleep loss), itch Behavioral Rating Scale, and the severity of the targeted eczematous lesions in the topical E6005 group showed trends toward improvement compared with those in the vehicle group (not statistically significant). However, the group receiving topical E6005 for 12 weeks showed significant score reductions from baselines for EASI (P = 0.030), SCORAD-objective (P < 0.001) and SCORAD-C (P = 0.038). These results further support the development of topical E6005 for the treatment of atopic dermatitis. © 2014 Japanese Dermatological Association.

Atopic dermatitis guideline. Position paper from the Latin American Society of Allergy, Asthma and Immunology.

PubMed

Sánchez, Jorge; Páez, Bruno; Macías, A; Olmos, C; de Falco, A

2014-01-01

As in other regions, the incidence of atopic dermatitis in Latin America has been increasing in recent years. Although there are several clinical guidelines, many of their recommendations cannot be universal since they depend on the characteristics of each region. Thus, we decided to create a consensus guideline on atopic dermatitis applicable in Latin America and other tropical regions, taking into account socio-economic, geographical, cultural and health care system characteristics. The Latin American Society of Allergy Asthma and Immunology (SLAAI) conducted a systematic search for articles related to the pathophysiology, diagnosis and treatment of dermatitis using various electronic resources such as Google, Pubmed, EMBASE (Ovid) and Cochrane data base. We have also looked for all published articles in Latin America on the subject using LILACS (Latin American and Caribbean Literature on Health Sciences) database. Each section was reviewed by at least two members of the committee, and the final version was subsequently approved by all of them, using the Delphi methodology for consensus building. Afterward, the final document was shared for external evaluation with physicians, specialists (allergists, dermatologists and pediatricians), patients and academic institutions such as universities and scientific societies related to the topic. All recommendations made by these groups were taken into account for the final drafting of the document. There are few original studies conducted in Latin America about dermatitis; however, we were able to create a practical guideline for Latin America taking into account the particularities of the region. Moreover, the integral management was highlighted including many of the recommendations from different participants in the health care of this disease (patients, families, primary care physicians and specialists). This practical guide presents a concise approach to the diagnosis and management of atopic dermatitis that can be helpful for medical staff, patients and their families in Latin America.

Efficacy of proactive long-term maintenance therapy of canine atopic dermatitis with 0.0584% hydrocortisone aceponate spray: a double-blind placebo controlled pilot study.

PubMed

Lourenço, Ana M; Schmidt, Vanessa; São Braz, Berta; Nóbrega, Diana; Nunes, Telmo; Duarte-Correia, José H; Matias, Daniela; Maruhashi, Emi; Rème, Christophe A; Nuttall, Tim

2016-04-01

Long-term remission between flares of canine atopic dermatitis (CAD) can be difficult to achieve. Therefore, additional strategic forms of treatment are needed in order to target flare prevention. The concept of proactive therapy is recommended in the European guidelines for the treatment of human atopic eczema. To evaluate the efficacy of a proactive treatment regimen with a 0.0584% hydrocortisone aceponate (HCA) spray for CAD. Client-owned dogs with spontaneous atopic dermatitis (AD) (n = 41). This pilot study was conducted as a randomised, placebo-controlled, double-blinded clinical trial with an end-point of treatment failure. Dogs were treated once daily to remission, then randomly assigned to receive either the HCA spray (n = 21) or a placebo (n = 20) spray on two consecutive days each week. All dogs were on appropriate flea control. No topical or systemic anti-inflammatory or antimicrobial agents were permitted. Intention-to-treat analysis was used. At Day 0, all the dogs were in remission or had mild AD based on their Canine Atopic Dermatitis Extent and Severity Index, version 3 (CADESI-03) scores. The time to relapse was significantly higher in the HCA group (median 115 d; range 31-260 d) compared to the placebo group (median 33 d; range 15-61 d) (P < 0.0001). No adverse events were attributable to the HCA spray. Four dogs were lost to follow-up and four were withdrawn after receiving prohibited medication. These results indicate that proactive long-term therapy of CAD with an HCA spray administered on two consecutive days each week is effective and well-tolerated. © 2016 ESVD and ACVD.

Oral administration of Uncariae rhynchophylla inhibits the development of DNFB-induced atopic dermatitis-like skin lesions via IFN-gamma down-regulation in NC/Nga mice.

PubMed

Kim, Dong-Young; Jung, Jung-A; Kim, Tae-Ho; Seo, Sang-Wan; Jung, Sung-Ki; Park, Cheung-Seog

2009-04-21

Uncariae rhynchophylla (UR) is an herb which has blood pressure lowering and anti-inflammatory effects and has been prescribed traditionally to treat stroke and vascular dementia. In the present study, we examined whether UR suppress Atopic dermatitis (AD)-like skin lesions in NC/Nga mice treated with 2, 4-dinitrofluorobenzene (DNFB) under SPF conditions. The effect of UR in DNFB- treated NC/Nga mice was determined by measuring the skin symptom severity, levels of serum IgE, and of the amounts of IL-4 and IFN-gamma secreted by activated T cells in draining lymph nodes. Oral administration of UR to DNFB-treated NC/Nga mice was found to inhibit ear thickness increases and the skin lesions induced by DNFB. IFN-gamma production by CD4+ T cells from the lymph nodes of DNFB-treated NC/Nga mice was significantly inhibited by UR treatment, although levels of IL-4 and total IgE in serum were not. UR may suppress the development of AD-like dermatitis in DNFB-treated NC/Nga mice by reducing IFN-gamma production.

Melatonin inhibits the development of 2,4-dinitrofluorobenzene-induced atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Kim, Tae-Ho; Jung, Jung-A; Kim, Gun-Dong; Jang, An-Hee; Ahn, Hyun-Jong; Park, Yong Seek; Park, Cheung-Seog

2009-11-01

Atopic dermatitis (AD) is a common disease in children, and epicutaneous treatment with a chemical hapten such as 2,4-dinitrofluorobenzene (DNFB) evokes an AD-like reaction in NC/Nga mice under specific pathogen-free conditions. Melatonin (N-acetyl-5-methoxytryptamine) is synthesized by the pineal gland, has several different physiologic functions, which include seasonal reproduction control, immune system modulation, free radical scavenging, and inflammatory suppression. In the present study, we investigated whether melatonin suppresses DNFB-induced AD-like skin lesions in NC/Nga mice. The topical administration of melatonin to DNFB-treated NC/Nga mice was found to inhibit ear thickness increases and the skin lesions induced by DNFB. Furthermore, interleukin (IL)-4 and interferon (IFN)-gamma secretion by activated CD4(+) T cells from the draining lymph nodes of DNFB-treated NC/Nga mice were significantly inhibited by melatonin, and total IgE levels in serum were reduced. Our findings suggest that melatonin suppresses the development of AD-like dermatitis in DNFB-treated NC/Nga mice by reducing total IgE in serum, and IL-4 and IFN-gamma production by activated CD4(+) T cells.

Gentle cleansing and moisturizing for patients with atopic dermatitis and sensitive skin.

PubMed

Cheong, Wai Kwong

2009-01-01

Atopic dermatitis is a common condition characterized by pruritus, inflammation, and dryness of the skin. Inflammation disrupts the barrier function of the stratum corneum, predisposing the skin to be dry, and increases susceptibility to irritants and secondary bacterial infection. Sensitive skin is common, reported by 40-50% of women and 30% of men in the US, Europe, and Japan. Basic requirements in managing eczema and sensitive skin include effective cleansers that do not compromise skin barrier integrity, alleviation of skin dryness, and restoration of skin barrier function through the use of therapeutic moisturizers. The selection of a skin cleanser is therefore an important part of managing these conditions. Studies have reported clinical improvement with the use of soap-free cleansers in combination with topical treatments. While topical corticosteroids and immunosuppressive agents are mainstays of treatment for atopic dermatitis, therapeutic moisturizers are important adjuncts. Moisturizers improve skin hydration, reduce susceptibility to irritation, restore the integrity of the stratum corneum, and enhance the efficacy of topical corticosteroids.

Novel Therapeutic Approaches to Atopic Dermatitis.

PubMed

Osinka, Katarzyna; Dumycz, Karolina; Kwiek, Bartłomiej; Feleszko, Wojciech

2018-06-01

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases. The number of people affected by AD is relatively high and seems to be rising. Although mild and moderate forms of the disease can be well controlled by the use of emollients, topical corticosteroids, and topical calcineurin inhibitors, treatment of severe is still a huge challenge. The new hope is biologic drugs, magic bullets in allergy, targeted at different points of the complex pathomechanism of inflammation in AD. In this review, novel biologic therapies are discussed, including recombinant monoclonal antibodies directed against various interleukin pathways (such as IL-4, IL-13, TSLP, IL-31, and IL-12/23), on immunoglobulin E, molecules acting as T cells, B cells, etc. Of biological drugs, the most promising seems to be anti-IL-4/IL-13 therapy (dupilumab-the biological agent) and phosphodiesterase-4 inhibitor (crisaborole-a small molecule). A deep understanding of the AD pathomechanism provides a new perspective for tailor-made treatment of severe atopic dermatitis.

From consumerism to active dependence: Patterns of medicines use and treatment decisions among patients with atopic dermatitis.

PubMed

Nørreslet, M; Bissell, P; Traulsen, J M

2010-01-01

In this article, findings from in-depth interviews with 12 people diagnosed with atopic dermatitis (AD) are described. The findings describe the range of strategies used to manage atopic dermatitis, including use of conventional medicines. A strong theme identified in informants' accounts centred on concerns about the risks of illness and long-term use of conventional medicines, which acted as a strong incentive for patients to seek alternatives to conventional treatments. However, despite their significant efforts to do so, patients were eventually forced to return to and rely on conventional medicines because of their efficacy in alleviating and treating symptoms. These findings are discussed in relation to the sociological literature on consumerism, risk and reflexivity in health. We argue that our findings exemplify how living with and managing a chronic illness may not be straightforward and the choices of treatment at hand may be limited. Consequently, this may limit the potential opportunities accruing from adopting a reflexive or consumerist approach to managing illness.

Atopic Dermatitis Susceptibility Variants in Filaggrin Hitchhike Hornerin Selective Sweep

PubMed Central

Eaaswarkhanth, Muthukrishnan; Xu, Duo; Flanagan, Colin; Rzhetskaya, Margarita; Hayes, M. Geoffrey; Blekhman, Ran; Jablonski, Nina G.; Gokcumen, Omer

2016-01-01

Human skin has evolved rapidly, leaving evolutionary signatures in the genome. The filaggrin (FLG) gene is widely studied for its skin-barrier function in humans. The extensive genetic variation in this gene, especially common loss-of-function (LoF) mutations, has been established as primary risk factors for atopic dermatitis. To investigate the evolution of this gene, we analyzed 2,504 human genomes and genotyped the copy number variation of filaggrin repeats within FLG in 126 individuals from diverse ancestral backgrounds. We were unable to replicate a recent study claiming that LoF of FLG is adaptive in northern latitudes with lower ultraviolet light exposure. Instead, we present multiple lines of evidence suggesting that FLG genetic variation, including LoF variants, have little or no effect on fitness in modern humans. Haplotype-level scrutinization of the locus revealed signatures of a recent selective sweep in Asia, which increased the allele frequency of a haplotype group (Huxian haplogroup) in Asian populations. Functionally, we found that the Huxian haplogroup carries dozens of functional variants in FLG and hornerin (HRNR) genes, including those that are associated with atopic dermatitis susceptibility, HRNR expression levels and microbiome diversity on the skin. Our results suggest that the target of the adaptive sweep is HRNR gene function, and the functional FLG variants that involve susceptibility to atopic dermatitis, seem to hitchhike the selective sweep on HRNR. Our study presents a novel case of a locus that harbors clinically relevant common genetic variation with complex evolutionary trajectories. PMID:27678121

House Dust Mite Prevalence in the House of Patients with Atopic Dermatitis in Mashhad, Iran.

PubMed

Ziyaei, Toktam; Berenji, Fariba; Jabbari-Azad, Farahzad; Fata, Abdolmajid; Jarahi, Lida; Fereidouni, Mohammad

2017-06-01

Being exposed to house dust mites intensifies atopic dermatitis. This study has investigated the contamination rate with Dermatophagoides mites in patient's residential home with atopic dermatitis. In this cross-sectional study, 40 patients took part with atopic dermatitis (positive or negative for mites by prick Dermal Test). Samples were collected from 3 locations (living room, bedroom and bed) by vacuum cleaner. Dust samples (transferred to freezer -20 °C) were examined by direct method and flotation. The data were analyzed using statistical SPSS vr.20 software. Twenty patients of positive prick test included 8 (40%) male and 12 (60%) female. The results of direct observation of mites: 7 cases (35%) in bedding sheets, 6 cases (30%) bedrooms' carpet, 3 cases (15%) living room's carpet. Twenty patients of negative prick test included 8 (40%) male and 12 (60%) female. Only mites were found (5%) in living room's carpets of negative prick test patients. Dermatophagoides pteronyssinus was more frequent than Dermatophagoides farina e. (98% vs 83%). Fifty-five percent of residential homes of prick test positive patients and only 5% of residential homes of prick test negative patients were positive for mite. Sunshine provided home had fewer mites than home where sunshine is not provided. Prick test positive patients used handmade carpets more than machine made ones. In positive prick test patients, mites were found in bed sheet and bedroom's carpet more than negative prick test patient's sheets and carpets.

Vitamin D in Atopic Dermatitis, Chronic Urticaria and Allergic Contact Dermatitis

PubMed Central

Quirk, Shannon K; Rainwater, Ellecia; Shure, Anna K; Agrawal, Devendra K

2016-01-01

Summary Vitamin D influences allergen-induced pathways in the innate and adaptive immune system, and its potential immunomodulatory role in allergic skin disorders has been explored. This comprehensive review article provides an overview of the role of vitamin D in three common dermatologic conditions: atopic dermatitis (AD), chronic urticaria, and allergic contact dermatitis (ACD). Whereas the literature regarding vitamin D and AD has resulted in mixed findings, several studies have described an inverse relationship between vitamin D levels and AD severity, and improvement in AD with vitamin D supplementation. Similarly, several studies report an inverse relationship between vitamin D levels and severity of chronic urticaria. Although current research in humans remains limited, an increased likelihood of ACD has been demonstrated in vitamin D-deficient mice. Additional well-designed clinical trials will be necessary to determine whether vitamin D supplementation should be recommended for prevention or adjuvant treatment of these common dermatologic conditions. PMID:27014952

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

PubMed

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 <4.9 years of age were invited to follow-up assessment 8 years later and 40 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.

Cost-effectiveness model for a specific mixture of prebiotics in The Netherlands.

PubMed

Lenoir-Wijnkoop, I; van Aalderen, W M C; Boehm, G; Klaassen, D; Sprikkelman, A B; Nuijten, M J C

2012-02-01

The objective of this study was to assess the cost-effectiveness of the use of prebiotics for the primary prevention of atopic dermatitis in The Netherlands. A model was constructed using decision analytical techniques. The model was developed to estimate the health economic impact of prebiotic preventive disease management of atopic dermatitis. Data sources used include published literature, clinical trials and official price/tariff lists and national population statistics. The comparator was no supplementation with prebiotics. The primary perspective for conducting the economic evaluation was based on the situation in The Netherlands in 2009. The results show that the use of prebiotics infant formula (IMMUNOFORTIS(®)) leads to an additional cost of € 51 and an increase in Quality Adjusted Life Years (QALY) of 0.108, when compared with no prebiotics. Consequently, the use of infant formula with a specific mixture of prebiotics results in an incremental cost-effectiveness ratio (ICER) of € 472. The sensitivity analyses show that the ICER remains in all analyses far below the threshold of € 20,000/QALY. This study shows that the favourable health benefit of the use of a specific mixture of prebiotics results in positive short- and long-term health economic benefits. In addition, this study demonstrates that the use of infant formula with a specific mixture of prebiotics is a highly cost-effective way of preventing atopic dermatitis in The Netherlands.

Transmission of vaccinia virus, possibly through sexual contact, to a woman at high risk for adverse complications.

PubMed

Said, Maria A; Haile, Charles; Palabindala, Venkataraman; Barker, Naomi; Myers, Robert; Thompson, Ruth; Wilson, Lucy; Allan-Martinez, Frances; Montgomery, Jay; Monroe, Benjamin; Tack, Danielle; Reynolds, Mary; Damon, Inger; Blythe, David

2013-12-01

Severe adverse events, including eczema vaccinatum (EV), can result after smallpox vaccination. Persons at risk for EV include those with underlying dermatologic conditions, such as atopic dermatitis. We investigated a case of vaccinia infection, possibly acquired during sexual contact with a recently vaccinated military service member, in a female Maryland resident with atopic dermatitis. The U.S. Department of Defense's Vaccine Healthcare Centers Network (VHCN) and the Centers for Disease Control and Prevention (CDC) worked in conjunction with the patient's physician and the Maryland Department of Health and Mental Hygiene (DHMH) to confirm the diagnosis, ensure treatment, and prevent further transmission. Specimens collected from the patient were tested at the DHMH laboratories and were positive by real-time polymerase chain reaction for nonvariola orthopoxvirus. Testing at the CDC verified the presence of vaccinia-specific DNA signatures. Continuing spread of the patient's lesions led to the administration of vaccinia immune globulin and strict infection control measures to prevent tertiary transmission to vulnerable family members, also with atopic dermatitis. VHCN contacted the service member to reinforce vaccination site care and hygiene. This case underscores the importance of prevaccination education for those receiving the smallpox vaccine to protect contacts at risk for developing severe adverse reactions. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Prenatal exposure to selenium may protect against wheezing in children by the age of 3.

PubMed

Baïz, Nour; Chastang, Julie; Ibanez, Gladys; Annesi-Maesano, Isabella

2017-03-01

It has been suggested that human in utero exposure to heavy metals such as selenium can reduce the prevalence of childhood asthma and allergic diseases. However, data on this topic are scarce. The objective of the present study was to assess the putative associations between maternal selenium level during pregnancy and the risk of asthma, wheezing, allergic rhinitis, and atopic dermatitis in children from the EDEN birth cohort by the age of 1 and 3 years. Plasma selenium concentrations were measured in maternal blood during mid-pregnancy (24-28 weeks of gestation) in 861 mothers. Cohort children were followed up from birth to 3 years using health questionnaires filled out by the parents for asthma, wheezing, allergic rhinitis, and atopic dermatitis. Maternal plasma selenium was related to the childhood outcomes by the age of 1 and 3 years. Our results showed a significant negative association between a high maternal plasma selenium level during pregnancy and the risk of wheezing in the child by the age of 1 and 3 years. However, maternal plasma selenium during pregnancy was not associated with the prevalence of asthma, allergic rhinitis or atopic dermatitis. The results of this study suggest that the level of fetal exposure to maternal selenium could have an influence on the risk of wheezing in infancy and potentially on the risk of developing asthma later in life.

Probiotics and Atopic Dermatitis: An Overview.

PubMed

Rather, Irfan A; Bajpai, Vivek K; Kumar, Sanjay; Lim, Jeongheui; Paek, Woon K; Park, Yong-Ha

2016-01-01

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.

Silver-loaded seaweed-based cellulosic fiber improves epidermal skin physiology in atopic dermatitis: safety assessment, mode of action and controlled, randomized single-blinded exploratory in vivo study.

PubMed

Fluhr, Joachim W; Breternitz, Maria; Kowatzki, Doreen; Bauer, Andrea; Bossert, Joerg; Elsner, Peter; Hipler, Uta-Christina

2010-08-01

The epidermal part of the skin is the major interface between the internal body and the external environment. The skin has a specific physiology and is to different degrees adapted for protection against multiple exogenous stress factors. Clothing is the material with the longest and most intensive contact to human skin. It plays a critical role especially in inflammatory dermatoses or skin conditions with an increased susceptibility of bacterial and fungal infections like atopic dermatitis. Previously, we have shown a dose-dependent antibacterial and antifungal activity of silver-loaded seaweed-based cellulosic fibres. We studied the mode of action of silver-loaded seaweed-based cellulosic fiber and performed a broad safety assessment. The principal aim was to analyse the effects of wearing the textile on epidermal skin physiology in 37 patients with atopic dermatitis in a controlled, randomized single-blinded in vivo study. Furthermore, the sensitization potential was tested in a patch test in 111 panellists. We could demonstrate in vitro a dose-dependent scavenging of induced reactive oxygen species by silver-loaded seaweed-based cellulosic fibers. Safety assessment of these fibres showed no detectable release of silver ions. Furthermore, ex vivo assessment after 24 h application both in healthy volunteers and patients with atopic dermatitis by sequential tape stripping and subsequently raster electron microscopy and energy dispersive microanalysis analysis revealed no detectable amounts of silver in any of stratum corneum layers. Serum analysis of silver showed no detectable levels. The in vivo patch testing of 111 volunteers revealed no sensitization against different SeaCell Active (SeaCell GmbH, Rudolstadt, Germany) containing fabrics. The in vivo study on 37 patients with known atopic dermatitis and mild-to-moderate eczema on their arms were randomly assigned to either silver-loaded seaweed fibre T-shirts or to cotton T-shirts for 8 weeks. A significant reduction in Staphylococcus aureus colonization was detectable for the silver T-shirts compared with cotton T-shirts without any changes in non-pathogenic surface bacteria colonization. Furthermore, a more pronounced improvement in barrier function (transepidermal water loss) was observed in mildly involved eczema areas during the first 4 weeks of the study. Stratum corneum hydration and surface pH improved in both treatment groups over time. The tested silver-loaded seaweed fibre can be regarded as safe and seams to be suited for application in bio-active textiles in atopic dermatitis based on its positive in vivo activity.

Patient acceptability, efficacy, and skin biophysiology of a cream and cleanser containing lipid complex with shea butter extract versus a ceramide product for eczema.

PubMed

Hon, K L; Tsang, Y C; Pong, N H; Lee, Vivian W Y; Luk, N M; Chow, C M; Leung, T F

2015-10-01

To investigate patient acceptability, efficacy, and skin biophysiological effects of a cream/cleanser combination for childhood atopic dermatitis. Paediatric dermatology clinic at a university teaching hospital in Hong Kong. Consecutive paediatric patients with atopic dermatitis who were interested in trying a new moisturiser were recruited between 1 April 2013 and 31 March 2014. Swabs and cultures from the right antecubital fossa and the worst eczematous area, disease severity (SCORing Atopic Dermatitis index), skin hydration, and transepidermal water loss were obtained prior to and following 4-week usage of a cream/cleanser containing lipid complex with shea butter extract (Ezerra cream; Hoe Pharma, Petaling Jaya, Malaysia). Global or general acceptability of treatment was documented as 'very good', 'good', 'fair', or 'poor'. A total of 34 patients with atopic dermatitis were recruited; 74% reported 'very good' or 'good', whereas 26% reported 'fair' or 'poor' general acceptability of treatment of the Ezerra cream; and 76% reported 'very good' or 'good', whereas 24% reported 'fair' or 'poor' general acceptability of treatment of the Ezerra cleanser. There were no intergroup differences in pre-usage clinical parameters of age, objective SCORing Atopic Dermatitis index, pruritus, sleep loss, skin hydration, transepidermal water loss, topical corticosteroid usage, oral antihistamine usage, or general acceptability of treatment of the prior emollient. Following use of the Ezerra cream, mean pruritus score decreased from 6.7 to 6.0 (P=0.036) and mean Children's Dermatology Life Quality Index improved from 10.0 to 8.0 (P=0.021) in the 'very good'/'good' group. There were no statistically significant differences in the acceptability of wash (P=0.526) and emollients (P=0.537) with pre-trial products. When compared with the data of another ceramide-precursor moisturiser in a previous study, there was no statistical difference in efficacy and acceptability between the two products. The trial cream was acceptable in three quarters of patients with atopic dermatitis. Patients who accepted the cream had less pruritus and improved quality of life than the non-accepting patients following its usage. The cream containing shea butter extract did not differ in acceptability or efficacy from a ceramide-precursor product. Patient acceptability is an important factor for treatment efficacy. There is a general lack of published clinical trials to document the efficacy and skin biophysiological effects of many of the proprietary moisturisers.

Clinical efficacy of Avène hydrotherapy measured in a large cohort of more than 10,000 atopic or psoriatic patients.

PubMed

Merial-Kieny, C; Mengual, X; Guerrero, D; Sibaud, V

2011-02-01

Atopic dermatitis (AD) and psoriasis are chronic skin conditions. Local or systemic treatments are effective, but their effects are transient. Hydrotherapy, used alone or in combination with other treatments, could be considered as one form of care in providing effective management of these dermatoses. The objective of this observational study was to evaluate the benefit of a 3-week treatment at Avène Hydrotherapy Centre in a very large cohort of patients suffering from atopic dermatitis and psoriasis and to assess the treatment benefits on patients undergoing hydrotherapy for two consecutive years. This 8-year observational study analysed 14,328 records of patients having a dermatological disease and who came to Avène Hydrotherapy Centre for a 3-week treatment between 2001 and 2009. Among them, patients were suffering from atopic dermatitis (n = 5916) and psoriasis (n = 4887). On admission on D0 (day 0) and at the end of cure on D18 (day 18), the severity of AD and psoriasis were evaluated by SCORing Atopic Dermatitis (SCORAD) and Psoriasis Area and Severity Index (PASI), respectively. In order to assess the cumulative effect of the hydrotherapy treatment, the evolution of SCORAD or PASI of patients who came 2 years in a row was also calculated. A significant improvement in SCORAD was observed between D0 and D18 (-41.6%) (P < 0.0001) and similarly, a significant reduction in PASI was noted between D0 and D18 (-54.4%) (P < 0.0001) after 3-weeks of hydrotherapy. PASI 50 and PASI 75 were 64.3% and 19.5%, respectively. For atopic patients (n = 1102) or patients suffering from psoriasis (n = 833) who came for two consecutive years, a significant SCORAD and PASI improvement was observed on D0 of the second year when compared with D0 of the previous year (P < 0.0001). This study is the first observational study in such a large cohort demonstrating the benefit of a 3-week treatment at the Avène Hydrotherapy Centre for atopic and psoriatic patients. © 2010 The Authors. JEADV © 2010 European Academy of Dermatology and Venereology.

Translational Animal Models of Atopic Dermatitis for Preclinical Studies



PubMed Central

Martel, Britta C.; Lovato, Paola; Bäumer, Wolfgang; Olivry, Thierry

2017-01-01

There is a medical need to develop new treatments for patients suffering from atopic dermatitis (AD). To improve the discovery and testing of novel treatments, relevant animal models for AD are needed. Generally, these animal models mimic different aspects of the pathophysiology of human AD, such as skin barrier defects and Th2 immune bias with additional Th1 and Th22, and in some populations Th17, activation. However, the pathomechanistic characterization and pharmacological validation of these animal models are generally incomplete. In this paper, we review animal models of AD in the context of preclinical use and their possible translation to the human disease. Most of these models use mice, but we will also critically evaluate dog models of AD, as increasing information on disease mechanism show their likely relevance for the human disease. PMID:28955179

Evaluation of a Parental Questionnaire to Identify Atopic Dermatitis in Infants and Preschool Children

PubMed Central

von Kobyletzki, Laura B.; Janson, Staffan; Hasselgren, Mikael; Bornehag, Carl-Gustaf; Svensson, Åke

2012-01-01

Aim. To develop and validate a questionnaire for detecting atopic dermatitis in infants and small children from the age of 2 months. Methods. Parents to 60 children answered a written questionnaire prior to a physical examination and individual semistructured interview. Qualitative and quantitative analyses of validity, sensitivity, specificity, and predictive values of the questionnaire were performed. Results. A total of 27 girls and 33 boys, aged 2 to 71 months, 35 with and 25 without physician-diagnosed eczema, participated. Validation of the questionnaire by comparisons with physicians' diagnoses showed a sensitivity of 0.91 (95% CI 0.77–0.98) and a specificity of 1 (95% CI 0.86–1). Conclusions. Three questions in a parental questionnaire were sufficient for diagnosing eczema in infants and small children. PMID:22500189

Inpatient management of atopic dermatitis.

PubMed

Cathcart, Shelley D; Theos, Amy

2011-01-01

Atopic dermatitis (AD) is a common chronic inflammatory skin disease that is generally managed on an outpatient basis. However, a significant percentage of patients may develop complications severe enough to require inpatient treatment. The most common complications of AD that may require hospital admission include erythroderma, eczema herpeticum, and systemic bacterial infection. Hospital admission can also be useful for chronic and severe disease that has not responded to standard therapy or in situations where nonadherence is suspected as the cause of treatment failure. In these cases, inpatient treatment can offer an opportunity for caretaker education and allow for an objective evaluation of a patient's response to a structured treatment plan. This article will review the indications for inpatient management of AD and the therapies that can be used to acutely manage severe disease and associated complications. © 2011 Wiley Periodicals, Inc.

[Allergic sensitization profile in 0-5 year old children with wheezing and/or atopic dermatitis].

PubMed

Carvajal Urueña, I; Díaz Vázquez, C; Cano Garcinuño, A; García Merino, A; Morell Bernabé, J J; Pascual Pérez, J M; Jiménez Cortés, A; Blanco González, J; Montón Alvarez, J L; Pérez Porcuna, X; Torregrosa Bertet, M J; Callén Blecua, M

2010-01-01

Although allergic diseases are frequent in childhood, few studies have characterised the IgE sensitization profile among young children with allergic-like symptoms. To determine the prevalence and the type of allergic sensitization, as well as the demographic and environmental factors related to both characteristics, among 0-5 year old children presenting with wheezing and/or atopic dermatitis. Collaborative cross-over study developed in the paediatric setting of 20 Spanish Primary Health Care Centres. An allergology evaluation including blood determination of specific IgE antibodies to common inhalant and food allergens was performed on 468 children who presented with wheezing and/or atopic dermatitis. Allergic sensitization was detected in 32.4% of the children with wheezing (95% confidence interval, 95%CI, 26.3-38.6%), in 54.8% of the children who had atopic dermatitis (95%CI, 42.1-67.6%) and in 39.2% of the children with both processes (95%CI, 32.0-46.4%). The risk of allergic sensitization was sex related (male versus female adjusted odds ratio, OR(A), 1.91, 95%CI, 1.24-2.95), and also related to the age (3-5 versus 0-2 year old OR(A) 1.96, 95%CI, 1.27-3.0), type of early feeding (maternal milk versus infant formula OR(A) 0.51, 95%CI, 0.31-0.84) and geoclimatic area (OR(A) Continental versus Atlantic 2.26, 95%CI, 1.30-3.93). Compared to the Atlantic area, the Continental area the sensitization was lower to mites (OR(A) 0.16, 95%CI, 0.07-0.36) and higher to grass (OR(A) 4.65, 95%CI 1.99-10.86), cow milk (OR(A) 5.17, 95%CI, 1.71-15.62) and egg (OR(A) 5.26, 95%CI, 2.04-13.62), whereas in the Mediterranean area the sensitization was lower to mites (OR(A) 0.29, 95%CI, 0.13-0.64) and higher to cow milk (OR(A) 3.81, 95%CI, 1.20-12.14) and egg (OR(A) 5.24, 95%CI, 1.94-14.20). A significant proportion of small children treated at the paediatric primary health care centres due to wheezing and/or atopic dermatitis had allergic sensitization. There appears to be a geoclimatic variation in the prevalence of sensitization to inhalant and food allergens among young children with allergic like symptoms who live in Spain. Copyright (c) 2009 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Epidermal barrier defects link atopic dermatitis with altered skin cancer susceptibility.

PubMed

Cipolat, Sara; Hoste, Esther; Natsuga, Ken; Quist, Sven R; Watt, Fiona M

2014-05-05

Atopic dermatitis can result from loss of structural proteins in the outermost epidermal layers, leading to a defective epidermal barrier. To test whether this influences tumour formation, we chemically induced tumours in EPI-/- mice, which lack three barrier proteins-Envoplakin, Periplakin, and Involucrin. EPI-/- mice were highly resistant to developing benign tumours when treated with 7,12-dimethylbenz(a)anthracene (DMBA) and 12-O-tetradecanoylphorbol-13-acetate (TPA). The DMBA response was normal, but EPI-/- skin exhibited an exaggerated atopic response to TPA, characterised by abnormal epidermal differentiation, a complex immune infiltrate and elevated serum thymic stromal lymphopoietin (TSLP). The exacerbated TPA response could be normalised by blocking TSLP or the immunoreceptor NKG2D but not CD4+ T cells. We conclude that atopy is protective against skin cancer in our experimental model and that the mechanism involves keratinocytes communicating with cells of the immune system via signalling elements that normally protect against environmental assaults.DOI: http://dx.doi.org/10.7554/eLife.01888.001. Copyright © 2014, Cipolat et al.

Anti-allergic effects of Vernonia amygdalina leaf extracts in hapten-induced atopic dermatitis-like disease in mice.

PubMed

Ngatu, Nlandu Roger; Okajima, Maiko K; Yokogawa, Maki; Hirota, Ryoji; Takaishi, Mikiro; Eitoku, Masamitsu; Muzembo, Basilua Andre; Sabah, Asif Bhati; Saruta, Takao; Miyamura, Mitsuhiko; Kaneko, Tatsuo; Sano, Shigetoshi; Suganuma, Narufumi

2012-12-01

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritic and eczematous skin lesions. In this study, AD-like disease was induced in NC/Nga mice so as to evaluate the anti-allergic effects of Vernonia amygdalina leaf extracts (VAM). Forty NC/Nga mice were purchased for each of the two protocols (prophylactic and curative) of the study. Mice were randomly divided in groups of five or six after sensitization with 5% trinitrochlorobenzene (TNCB): aqueous extracts (VAM1), methanolic extracts (VAM2), hydrocortisone (HCT), buffer for the control (TNCB) and the normal mice (NORM) groups. As for HCT, VAM1 and VAM2-pretreated mice showed significantly lower number of scratching behavior episodes (p < 0.01; vs. TNCB) following TNCB challenge. In addition, VAM1, VAM2 exerted a significant inhibitory effect on the development of AD skin symptoms (vs. TNCB group; p < 0.001), the production of IgE, TNF-alpha (p < 0.05), IL-5 and IFN-gamma (p < 0.01) (vs. TNCB group) and on the increase in ear thickness (p < 0.05) in prophylactic protocol. In the AD curative protocol, topical VAM1, VAM2 markedly improved skin lesions such as erythema/hemorrhage (p < 0.05), scaling/dryness, erosion/excoriation (p < 0.01) (vs. TNCB mice). Furthermore, a significant decrease in ear thickness was noted in VAM1, VAM2, HCT groups (vs. TNCB group; p < 0.05) as well as the serum total IgE, MCP-1 (p < 0.01) and eotaxin (p < 0.05). VAM2 also improved chronic eczema dermatitis skin symptoms in a patient. Results from this report suggest that VAM extracts, known as ERK pathway inhibitor, prevent and improve atopic/eczema dermatitis syndrome.

The effect of encasings on quality of life in adult house dust mite allergic patients with rhinitis, asthma and/or atopic dermatitis.

PubMed

Terreehorst, I; Duivenvoorden, H J; Tempels-Pavlica, Z; Oosting, A J; de Monchy, J G R; Bruijnzeel-Koomen, C A F M; van Wijk, R Gerth

2005-07-01

Environmental control has been put forward as an integral part of the management of house dust mite (HDM) allergy in sensitized patients. To validate this statement allergic disorders involved in HDM allergy--allergic asthma, rhinitis and atopic eczema/dermatitis syndrome (AEDS)--should be taken together and studied in terms of the efficacy of environmental control. Because a generic quality of life questionnaire exceeds the border of disease, this may be used as major outcome parameter. To study the effects of bedding encasings in HDM allergic patients with asthma, rhinitis and AEDS. A total of 224 adult HDM allergic patients with rhinitis and/or asthma and/or dermatitis were randomly allocated impermeable or nonimpermeable encasings for mattress, pillow and duvet. Short form 36 (SF-36) was filled in at baseline and after 12 months. Lower physical (P = 0.01) and emotional (P < 0.001) sumscores were seen in females. Also, the presence of asthma resulted in lower physical sumscore (P = 0.01). However, no effect was seen of encasings on either sumscore. Bedding encasings do not improve quality of life in a mixed population of subjects with combinations with rhinitis, asthma and atopic dermatitis and sensitized to HDMs.

Manifestation of atopic dermatitis-like skin in TNCB-induced NC/Nga mice is ameliorated by topical treatment of substance P, possibly through blockade of allergic inflammation.

PubMed

Choi, Hyeongwon; Kim, Dong-Jin; Nam, Seungwoo; Lim, Sunki; Hwang, Jae-Sung; Park, Ki Sook; Hong, Hyun Sook; Shin, Min Kyung; Chung, Eunkyung; Son, Youngsook

2018-04-01

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus and eczematous lesion. In this study, topically applied substance P (SP) significantly alleviated AD-like clinical symptoms in 2, 4, 6-trinitrochlorobenzene (TNCB)-induced dermatitis in NC/Nga mice. This effect was nullified by pretreatment of the neurokinin-1 receptor (NK-1R) antagonist CP99994. SP treatment significantly reduced the infiltration of mast cells and CD3-positive T cells as well as inflammatory cytokines, such as tumor necrosis factor-α (TNF-α) and thymic stromal lymphopoietin (TSLP), in AD-like skin lesions and decreased the levels of IgE and thymus and activation-regulated chemokine in serum. This SP-induced alleviation of allergic inflammatory responses was also confirmed as reduced activation in the axillary lymph nodes (aLN) and spleen, suggesting the systemic effect of SP on immune responses in TNCB-induced NC/Nga mice. Furthermore, SP-mediated TSLP reduction was confirmed in human keratinocyte culture under pro-inflammatory TNF-α stimulation. Taken together, these results suggest that topically administered SP may have potential as a medication for atopic dermatitis. © 2017 The Authors. Experimental Dermatology Published by John Wiley & Sons Ltd.

SH2 domain-containing adaptor protein B expressed in dendritic cells is involved in T-cell homeostasis by regulating dendritic cell-mediated Th2 immunity.

PubMed

Ahmed, Md Selim; Kang, Myeong-Ho; Lee, Ezra; Park, Yujin; Jeong, Yideul; Bae, Yong-Soo

2017-01-01

The Src homology 2 domain-containing adaptor protein B (SHB) is widely expressed in immune cells and acts as an important regulator for hematopoietic cell function. SHB silencing induces Th2 immunity in mice. SHB is also involved in T-cell homeostasis in vivo . However, SHB has not yet been studied and addressed in association with dendritic cells (DCs). The effects of SHB expression on the immunogenicity of DCs were assessed by Shb gene silencing in mouse bone marrow-derived DCs (BMDCs). After silencing, surface phenotype, cytokine expression profile, and T-cell stimulation capacity of BMDCs were examined. We investigated the signaling pathways involved in SHB expression during BMDC development. We also examined the immunogenicity of SHB-knockdown (SHB KD ) BMDCs in a mouse atopic dermatitis model. SHB was steadily expressed in mouse splenic DCs and in in vitro -generated BMDCs in both immature and mature stages. SHB expression was contingent on activation of the mitogen- activated protein kinase/Foxa2 signaling pathway during DC development. SHB KD increased the expression of MHC class II and costimulatory molecules without affecting the cytokine expression of BMDCs. When co-cultured with T cells, SHB KD in BMDCs significantly induced CD4 + T-cell proliferation and the expression of Th2 cytokines, while the regulatory T cell (Treg) population was downregulated. In mouse atopic dermatitis model, mice inoculated with SHB KD DCs developed more severe symptoms of atopic dermatitis compared with mice injected with control DCs. SHB expression in DCs plays an important role in T-cell homeostasis in vivo by regulating DC-mediated Th2 polarization.

Yogurt consumption in infancy is inversely associated with atopic dermatitis and food sensitization at 5 years of age: A hospital-based birth cohort study.

PubMed

Shoda, Tetsuo; Futamura, Masaki; Yang, Limin; Narita, Masami; Saito, Hirohisa; Ohya, Yukihiro

2017-05-01

Several studies have suggested that habitual yogurt consumption is associated with favorable outcomes for health issues in children. However, the effects of yogurt consumption on allergic diseases and sensitization in children remain poorly understood. This prospective birth cohort study aimed to investigate for associations between habitual yogurt consumption in infancy and development of allergic diseases/sensitization at 5 years of age. Data were obtained from the Tokyo Children's Health, Illness and Development (T-CHILD) study. A total of 1550 children were born to the recruited women. Consumption of yogurt by children during infancy was determined by using questionnaires completed at 12 months of age. Outcome data for children were collected from the questionnaires and medical check-ups completed at 5 years of age. Possible associations between habitual yogurt consumption in infancy and allergic diseases/sensitization were analyzed by multiple logistic regression analyses. We analyzed the data for 1166 children whose parents responded at 5 years of age. Habitual yogurt consumption in infancy and atopic dermatitis at 5 years of age were significantly associated (UKWP criteria: aOR, 0.70; 95% CI, 0.51-0.97; P=0.03). Children with habitual yogurt consumption in infancy were less likely to be sensitized to food allergens (aOR, 0.53; 95% CI, 0.31-0.93; P=0.03), but no associations were seen in regard to any other allergens. Our study demonstrated that habitual consumption of yogurt in infancy has the potential to prevent development of atopic dermatitis and food sensitization, but not other allergic diseases, at 5 years of age. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

The suppressive effect of puerarin on atopic dermatitis-like skin lesions through regulation of inflammatory mediators in vitro and in vivo.

PubMed

Lee, Ji-Hyun; Jeon, Yong-Deok; Lee, Young-Mi; Kim, Dae-Ki

2018-04-15

Atopic dermatitis (AD) is one of the common inflammatory immune disorders. Puerarin is the main isoflavonoid obtained from the root of Pueraria lobata and has been known have ameliorative effects on diverse inflammatory diseases. However, the effects of puerarin on AD have not been uncovered. 2,4-dinitrochlorobenzene (DNCB) was used to induce atopic dermatitis(AD)-like skin lesions on BALB/c mice for 17 days. Further, the BALB/c mice were orally administered puerarin. Puerarin ameliorated DNCB-induced AD-like symptoms in the mice by regulating skin thickness, degranulation of mast cells, and serum immunoglobulin E (IgE). Human keratinocytes (HaCaT cells) were also used to clarify the effects of puerarin on the secretion of pro-inflammatory cytokines. Puerarin inhibited the secretion of inflammatory cytokines and chemokines. The aim of this study was to investigate the protective and alleviative effect of puerarin on AD in vitro and in vivo. The results in this study indicated that puerarin ameliorates AD-like skin lesion and skin inflammation via regulation of various atopic and inflammatory mediators. Therefore, puerarin might be useful in treating AD and other skin diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

Conctact dermatitis: some important topics.

PubMed

Pigatto, P D

2015-11-01

Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. The gold standard for diagnosis is patch testing. The prevalence of positive patch tests in referred patients with suspected ACD ranges from 27 to 95.6%. The relationship between ACD and atopic dermatitis (AD) is complicated with conflicting reports of prevalence in the literature; however, in a patient with dermatitis not responding to traditional therapies, or with new areas of involvement, ACD should be considered as part of the work-up.

Immunophenotyping of the cutaneous cellular infiltrate after atopy patch testing in cats with atopic dermatitis.

PubMed

Roosje, P J; Thepen, T; Rutten, V P M G; van den Brom, W E; Bruijnzeel-Koomen, C A F M; Willemse, T

2004-10-01

Cats with spontaneously occurring atopic dermatitis have clinical and immunocytochemical characteristics compatible with these in humans with atopic dermatitis (AD). The atopy patch test (APT) has proven to be a valuable tool in elucidating the disease process in humans. Additionally, the APT is very specific and bypasses the problem of conflicting results due to differences in chronicity of lesions of AD patients. We adapted the APT for use in cats to explore the suitability of the APT as a tool to study the onset of allergic inflammation in cats with atopic dermatitis. APT were performed in AD cats (n = 6) and healthy cats (n = 10). All cats were patch tested with two allergens in three different dilutions and a diluent control. The allergens for the APT were selected from positive intradermal test and /or prick test results and consisted of: Dermatophagoides farinae, D. pteronyssinus, Tyrophagus putrescentiae, and a grass pollen mixture. APT were read after 10, 24 and 48 h, and punch biopsies for immunohistochemical evaluation were collected at these time points. Macroscopically positive APT reactions were observed in three out of six cats at 24 and/or 48 h with allergen concentrations of 25,000 and 100,000 NU/ml. Reactions were not observed at negative control sites and neither in control animals. A significantly increased number of IL-4+, CD4+, CD3+, MHC class II+ and CD1a+ cells was found in one AD cat with positive APT reactions. Five out of six AD cats had significantly increased IL-4+ T cell numbers at 24 and/or 48 h. Our data indicate that in cats, macroscopically positive patch test reactions can be induced, which have a cellular infiltrate similar to that in lesional skin. We found a high specificity and a macroscopically positive APT reaction in half of the cats, which is similar to what is seen in humans. Hence, the APT in cats might be a useful tool in studying the immunopathogenesis of feline atopic dermatitis.

Prevalence and factors associated to peanut allergy in Mexican school children.

PubMed

Bedolla-Barajas, M; Valdez-López, F; Alcalá-Padilla, G; Bedolla-Pulido, T I; Rivera-Mejia, V; Morales-Romero, J

In our country, the prevalence and the factors associated to peanut allergy are unknown, a health problem that has been emerging worldwide. To establish the prevalence and the factors that are associated to peanut allergy amongst school children. This is a population-based cross-sectional study. We included 756 children aged 6-7 years. The children's parents were questioned about their peanut intake habits. A structured questionnaire was applied, it included questions regarding peanut intake; family and personal history of asthma; rhinitis; and atopic dermatitis. Allergic reactions to peanuts were registered as: probable, convincing and systematic. The statistical analyses included logistical regression models to look for associated factors. Males were 356/756 (47.1%). Peanut allergy prevalence: probable reaction: 14/756 (1.8%), convincing reaction: 8/756 (1.1%) and systemic reaction: 3/756 (0.4%). Through multivariate analysis, the presence of symptoms of allergic rhinitis (OR=4.2 95% CI 1.3-13.2) and atopic dermatitis (OR=5.2; 95% CI 1.4-19.5) during the previous year, showed significant association to probable peanut reaction. The former year, the presence of atopic dermatitis was the only variable that was substantially associated to a convincing reaction (OR=7.5; 95% CI 1.4-38.4) and to a systematic reaction (OR=45.1; 95% CI 4.0-510.0), respectively. The reported prevalence of peanut allergy was consistent with that found in previous studies; symptoms of allergic rhinitis and atopic dermatitis were identified as associated factors to peanut allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Evaluation of cyclosporine-sparing effects of polyunsaturated fatty acids in the treatment of canine atopic dermatitis.

PubMed

Müller, M R; Linek, M; Löwenstein, C; Röthig, A; Doucette, K; Thorstensen, K; Mueller, R S

2016-04-01

A randomised, double-blinded, placebo-controlled multicentre trial was conducted in 36 dogs with atopic dermatitis to evaluate the cyclosporine-sparing effect of polyunsaturated fatty acids. Dogs were stable on their individual cyclosporine dosage and received either a mainly omega-3 fatty acid product with a minor omega-6 fatty acid fraction or placebo, orally for 12 weeks. Dogs were examined every 4 weeks and the Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) was determined by a clinician. Pruritus, quality of life, global condition and coat quality were scored by the owner. If the dog's CADESI-03 and/or pruritus score improved by at least 25% compared with the previous visit, the cyclosporine dosage was decreased by approximately 25%. If the scores deteriorated by at least 25%, the cyclosporine dosage was increased by the same percentage. The median daily cyclosporine dosage/kg bodyweight decreased in the active group from 4.1 mg to 2.6 mg and in the placebo group from 3.5 mg to 3.3 mg over the study period. The difference between the two groups was significant (P = 0.009). The improvement in median pruritus score from inclusion to completion was significantly greater in the active group than in the placebo group (P = 0.04). There was no significant difference in CADESI-03 changes between groups (P = 0.38). The results of this study indicate a cyclosporine-sparing effect of a mainly omega-3 fatty acid supplement in dogs with atopic dermatitis. Copyright © 2016. Published by Elsevier Ltd.

Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials.

PubMed

Harima-Mizusawa, Naomi; Kamachi, Keiko; Kano, Mitsuyoshi; Nozaki, Daisuke; Uetake, Tatsuo; Yokomizo, Yuji; Nagino, Takayuki; Tanaka, Akira; Miyazaki, Kouji; Nakamura, Shinichiro

2016-01-01

This study aimed to examine whether daily intake of citrus juice containing heat-killed Lactobacillus plantarum YIT 0132 (LP0132-fermented juice) alleviates symptoms of atopic dermatitis. This was a natural extension of our previous study in which LP0132 was shown to enhance IL-10 production in vitro and LP0132-fermented juice was found to alleviate symptoms and enhance quality of life (QOL) in patients with Japanese cedar pollinosis. In two open trials, Trial 1 and Trial 2, 32 and 18 adult patients with mild to moderate atopic dermatitis consumed LP0132-fermented juice for 8 weeks. Skin conditions and QOL were subjectively evaluated using Skindex-16 before intake of the juice (Pre-treatment), 8 weeks after starting intake (Treatment) and 8 weeks after termination of intake (Post-treatment). Blood parameters were also analyzed. Comparison of the Treatment and Post-treatment time points with the Pre-treatment time point revealed significant reductions in the Skindex-16 overall score and the 3 domain subscores (symptoms, emotions, and functioning domains) in both trials. Moreover, blood levels of eosinophil cationic protein (ECP), total immunoglobulin E (IgE) and specific IgEs for Japanese cedar and cypress pollen were significantly attenuated in Trial 2. The findings suggest that daily intake of citrus fermented juice containing heat-killed LP0132 has beneficial effects on symptoms and QOL in patients with mild to moderate atopic dermatitis due to an immunomodulatory effect via attenuation of IgE and ECP.

Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials

PubMed Central

HARIMA-MIZUSAWA, Naomi; KAMACHI, Keiko; KANO, Mitsuyoshi; NOZAKI, Daisuke; UETAKE, Tatsuo; YOKOMIZO, Yuji; NAGINO, Takayuki; TANAKA, Akira; MIYAZAKI, Kouji; NAKAMURA, Shinichiro

2015-01-01

This study aimed to examine whether daily intake of citrus juice containing heat-killed Lactobacillus plantarum YIT 0132 (LP0132-fermented juice) alleviates symptoms of atopic dermatitis. This was a natural extension of our previous study in which LP0132 was shown to enhance IL-10 production in vitro and LP0132-fermented juice was found to alleviate symptoms and enhance quality of life (QOL) in patients with Japanese cedar pollinosis. In two open trials, Trial 1 and Trial 2, 32 and 18 adult patients with mild to moderate atopic dermatitis consumed LP0132-fermented juice for 8 weeks. Skin conditions and QOL were subjectively evaluated using Skindex-16 before intake of the juice (Pre-treatment), 8 weeks after starting intake (Treatment) and 8 weeks after termination of intake (Post-treatment). Blood parameters were also analyzed. Comparison of the Treatment and Post-treatment time points with the Pre-treatment time point revealed significant reductions in the Skindex-16 overall score and the 3 domain subscores (symptoms, emotions, and functioning domains) in both trials. Moreover, blood levels of eosinophil cationic protein (ECP), total immunoglobulin E (IgE) and specific IgEs for Japanese cedar and cypress pollen were significantly attenuated in Trial 2. The findings suggest that daily intake of citrus fermented juice containing heat-killed LP0132 has beneficial effects on symptoms and QOL in patients with mild to moderate atopic dermatitis due to an immunomodulatory effect via attenuation of IgE and ECP. PMID:26858928

House Dust Mite Prevalence in the House of Patients with Atopic Dermatitis in Mashhad, Iran

PubMed Central

Ziyaei, Toktam; Berenji, Fariba; Jabbari-Azad, Farahzad; Fata, Abdolmajid; Jarahi, Lida; Fereidouni, Mohammad

2017-01-01

Background: Being exposed to house dust mites intensifies atopic dermatitis. This study has investigated the contamination rate with Dermatophagoides mites in patient’s residential home with atopic dermatitis. Methods: In this cross-sectional study, 40 patients took part with atopic dermatitis (positive or negative for mites by prick Dermal Test). Samples were collected from 3 locations (living room, bedroom and bed) by vacuum cleaner. Dust samples (transferred to freezer −20 °C) were examined by direct method and flotation. The data were analyzed using statistical SPSS vr.20 software. Results: Twenty patients of positive prick test included 8 (40%) male and 12 (60%) female. The results of direct observation of mites: 7 cases (35%) in bedding sheets, 6 cases (30%) bedrooms’ carpet, 3 cases (15%) living room’s carpet. Twenty patients of negative prick test included 8 (40%) male and 12 (60%) female. Only mites were found (5%) in living room’s carpets of negative prick test patients. Dermatophagoides pteronyssinus was more frequent than Dermatophagoides farinae. (98% vs 83%). Conclusion: Fifty-five percent of residential homes of prick test positive patients and only 5% of residential homes of prick test negative patients were positive for mite. Sunshine provided home had fewer mites than home where sunshine is not provided. Prick test positive patients used handmade carpets more than machine made ones. In positive prick test patients, mites were found in bed sheet and bedroom’s carpet more than negative prick test patient’s sheets and carpets. PMID:29062855

Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic.

PubMed

Rosenbaum, Brooke E; Klein, Rebecca; Hagan, Paa Gyasi; Seadey, Mark-Young; Quarcoo, Naa Larteley; Hoffmann, Rachel; Robinson, Maria; Lartey, Margaret; Leger, Marie C

2017-01-01

Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. We conducted a chart review of new patients presenting to the Korle Bu Teaching Hospital dermatology clinic during 2014. Among the 529 patients studied, 700 discrete diagnoses were made. The most commonly diagnosed skin conditions were infections (24.6%) and dermatitis (24.6%); atopic dermatitis (8.4%), acne vulgaris (5.3%) and scabies (5.1%) were the most common specific diagnoses. Among infants, children, and adolescents, the most common diagnosis was atopic dermatitis (31.7%, 30.0%, and 14.9%, respectively). Acne vulgaris (12.0%) was the most common skin condition diagnosed in young adults. Irritant contact dermatitis (6.9%) was most common among adults. Lichen planus (9.9%) was the most commonly diagnosed skin condition in the senior population. Diagnoses made by dermatologists differed from the referral diagnosis documented by primary care providers for 65.8% of patients. The most frequently recommended treatments were antihistamines (47.8%) and topical steroids (38.4%). Only 18 diagnostic biopsies were performed. Our study summarizes the skin diseases seen and management practices of Ghanaian dermatologists in a specialized clinic at a large public teaching hospital. The results of this study can help to guide future dermatology education and development efforts in Ghana.

Sesquiterpene lactone dermatitis in the young: is atopy a risk factor?

PubMed

Paulsen, Evy; Otkjaer, Aksel; Andersen, Klaus E

2008-07-01

Screening for Compositae contact allergy has documented fairly high prevalence in adults, and recent studies indicate that the allergy may be more common in children than previously believed. However, detailed information on sensitization in this age group is sparse. The objective of this study was to present another 2 cases in children and review the literature. Screening with sesquiterpene lactone (SL) mix has shown prevalence of 0.5% and 1.8% in 2 studies, while screening with 2 different Compositae mixes detected 4.2% and 2.6% positives among children and adolescents. All individual case reports describe sensitization in atopic children, and the largest screening study showed a prevalence of Compositae mix sensitization that was significantly higher in children with atopic dermatitis compared with non-atopics. Compositae sensitization should be considered in children with a family or personal history of atopy, summer-related, or -exacerbated dermatitis of any kind, and a history of plant exposure. Screening with SL mix is recommended but should be supplemented with plant extracts based on exposure history. Compositae weeds, especially dandelions, seem to be important sensitizers in children.

Efficacy of a Cream Containing Ceramides and Magnesium in the Treatment of Mild to Moderate Atopic Dermatitis: A Randomized, Double-blind, Emollient- and Hydrocortisone-controlled Trial.

PubMed

Koppes, Sjors A; Charles, Frank; Lammers, Laureen; Frings-Dresen, Monique; Kezic, Sanja; Rustemeyer, Thomas

2016-11-02

The aim of this randomized controlled trial was to assess the efficacy of a cream containing ceramides and magnesium (Cer-Mg) in the treatment of mild to moderate atopic dermatitis and to compare it with hydrocortisone and a commonly used emollient (unguentum leniens; cold cream). A total of 100 patients, randomized into 2 groups, were treated for 6 weeks simultaneously (left vs. right side of the body) with either Cer-Mg and hydrocortisone (group I) or Cer-Mg and emollient (group II). The primary outcome was a reduction in severity of lesions as assessed by (local) SCORAD (SCORing Atopic Dermatitis). Levels of trans-epidermal water loss (TEWL), skin hydration, and natural moisturizing factors (NMF) were then measured. After 6 weeks, group I showed comparable significant improvement in SCORAD and TEWL, while in group II, the decrease in SCORAD and TEWL was significantly greater after Cer-Mg compared with emollient. Finally, Cer-Mg cream was more effective in improving skin hydration and maintenance of levels of NMF than hydrocortisone and emollient.

Environmental risk factors and their role in the management of atopic dermatitis

PubMed Central

Kantor, Robert; Silverberg, Jonathan I.

2016-01-01

Introduction The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors. Areas covered We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD. Expert commentary The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures. PMID:27417220

Atopic Dermatitis in Children: Clinical Features, Pathophysiology and Treatment

PubMed Central

Lyons, Jonathan J.; Milner, Joshua D.; Stone, Kelly D.

2014-01-01

Atopic dermatitis (AD) is a chronic, relapsing, highly pruritic skin condition resulting from disruption of the epithelial barrier and associated immune dysregulation in the skin of genetically predisposed hosts. AD generally develops in early childhood, has a characteristic age-dependent distribution and is commonly associated with elevated IgE, peripheral eosinophilia and other allergic diseases. Staphylococcus aureus colonization is common and may contribute to disease progression and severity. Targeted therapies to restore both impaired skin barrier and control inflammation are required for optimal outcomes for patients with moderate to severe disease. Pruritus is universal among patients with AD and has a dominant impact on diminishing quality of life. Medications such as anti-histamines have demonstrated poor efficacy in controlling AD-associated itch. Education of patients regarding the primary underlying defects and provision of a comprehensive skin care plan is essential for disease maintenance and management of flares. PMID:25459583

Environmental risk factors and their role in the management of atopic dermatitis.

PubMed

Kantor, Robert; Silverberg, Jonathan I

2017-01-01

The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors. Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD. Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.

Effect of cat and daycare exposures on the risk of asthma in children with atopic dermatitis.

PubMed

Gaffin, Jonathan M; Spergel, Jonathan M; Boguniewicz, Mark; Eichenfield, Lawrence F; Paller, Amy S; Fowler, Joseph F; Dinulos, James G; Tilles, Stephen A; Schneider, Lynda C; Phipatanakul, Wanda

2012-01-01

Atopic dermatitis (AD) in young children is often followed by the development of asthma (atopic march). The role of environmental exposures is unclear in this high-risk population. We aimed to determine the predictive relationship between indoor allergen exposures, particularly pets, rodents, and cockroaches, to the development of asthma in a prospective pediatric cohort. Children with AD and a family history of allergy were followed prospectively with questionnaire ascertainment of environmental exposure to cats, dogs, cockroaches, rats, and mice. Asthma was diagnosed by study physicians based on caregiver reports of symptoms continually assessed over the course of the study period. Fifty-five of the 299 children developed asthma by the end of the study. Cat exposure had a strong and independent effect to reduce the risk of developing asthma across all analyses (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.05-0.53). Dog, mouse, rat, and cockroach exposures did not significantly influence the development of asthma. Daycare exposure had the largest risk reduction for the development of asthma (OR, 0.08; 95% CI, 0.03-0.19). Maternal asthma (OR, 2.93; 95% CI, 1.29-6.67), baseline body mass index (OR, 1.23; 95% CI, 1.08-1.42), and specific immunoglobulin E to house-dust mix at 3 years were each independent risk factors for the development of asthma. In children with AD, cat and daycare exposure may reduce the risk of developing early childhood asthma.

The influence of childhood atopic dermatitis on health of mothers, and its impact on Asian families.

PubMed

Ho, Roger C M; Giam, Y C; Ng, T P; Mak, Anselm; Goh, Daniel; Zhang, Melvyn W B; Cheak, Alicia; Van Bever, Hugo P

2010-05-01

This study examines maternal perceptions of paediatric atopic dermatitis (AD) on family and determines risk factors including severity of AD, maternal physical and mental health (MH), quality of life of patients and sociodemographics which predict a negative family impact. A cross-sectional assessment using the Dermatitis Family Impact Questionnaire Scale to assess the impact of AD on family, Infant's Dermatitis Quality of Life Index (<5-yrs old) or Children's Dermatitis Life Quality Index (5-17 yrs old) was used to measure health-related quality of life (HRQOL) of paediatric patients with AD. A 12-item Short-Form Health Survey (SF-12) was used to assess physical and MH of their mothers. Risk factors of adverse family impact were assessed using multiple regression analysis. One hundred and four patients with AD and their mothers were studied. Their mean ages (+/-s.d.) were respectively 6.4 +/- 4.3 and 37.2 +/- 6.6 yrs. In multiple regression analysis, Severity Scoring of Atopic Dermatitis (SCORAD) appeared to be associated with negative family impact and the association remained significant after adjustment for bio-psycho-social factors and HRQOL of patients. The association remained insignificant after adjustment for physical and MH of the mothers. Our results show that the severity of paediatric AD leads to negative family impact through reduction of physical and MH of the mothers, and is independent of patients' HRQOL and sociodemographics. The current approach for managing paediatric AD in Asian society could include early multidisciplinary intervention, aiming at enhancing physical and MH of mothers while minimizing negative impact on family and social isolation. Further research will be welcomed as the results of this study mainly applied to Asian society which could be different to populations from other geographic areas.

Profiling of epidermal lipids in a mouse model of dermatitis: Identification of potential biomarkers

PubMed Central

Franco, Jackeline; Ferreira, Christina; Paschoal Sobreira, Tiago J.; Sundberg, John P.

2018-01-01

Lipids are important structural and functional components of the skin. Alterations in the lipid composition of the epidermis are associated with inflammation and can affect the barrier function of the skin. SHARPIN-deficient cpdm mice develop a chronic dermatitis with similarities to atopic dermatitis in humans. Here, we used a recently-developed approach named multiple reaction monitoring (MRM)-profiling and single ion monitoring to rapidly identify discriminative lipid ions. Shorter fatty acyl residues and increased relative amounts of sphingosine ceramides were observed in cpdm epidermis compared to wild type mice. These changes were accompanied by downregulation of the Fasn gene which encodes fatty acid synthase. A profile of diverse lipids was generated by fast screening of over 300 transitions (ion pairs). Tentative attribution of the most significant transitions was confirmed by product ion scan (MS/MS), and the MRM-profiling linear intensity response was validated with a C17-ceramide lipid standard. Relative quantification of sphingosine ceramides CerAS(d18:1/24:0)2OH, CerAS(d18:1/16:0)2OH and CerNS(d18:1/16:0) discriminated between the two groups with 100% accuracy, while the free fatty acids cerotic acid, 16-hydroxy palmitic acid, and docosahexaenoic acid (DHA) had 96.4% of accuracy. Validation by liquid chromatography tandem mass spectrometry (LC-MS/MS) of the above-mentioned ceramides was in agreement with MRM-profiling results. Identification and rapid monitoring of these lipids represent a tool to assess therapeutic outcomes in SHARPIN-deficient mice and other mouse models of dermatitis and may have diagnostic utility in atopic dermatitis. PMID:29698466

Eat dirt and avoid atopy: the hygiene hypothesis revisited.

PubMed

Patki, Anil

2007-01-01

The explosive rise in the incidence of atopic diseases in the Western developed countries can be explained on the basis of the so-called "hygiene hypothesis". In short, it attributes the rising incidence of atopic dermatitis to reduced exposure to various childhood infections and bacterial endotoxins. Reduced exposure to dirt in the clean environment results in a skewed development of the immune system which results in an abnormal allergic response to various environmental allergens which are otherwise innocuous. This article reviews the historical aspects, epidemiological and immunological basis of the hygiene hypothesis and implications for Indian conditions.

Inhibitory Effect of Valencene on the Development of Atopic Dermatitis-Like Skin Lesions in NC/Nga Mice.

PubMed

Yang, In Jun; Lee, Dong-Ung; Shin, Heung Mook

2016-01-01

Valencene (VAL) isolated from Cyperus rotundus possesses various biological effects such as antiallergic and antimelanogenesis activity. We investigated the effect of VAL on atopic dermatitis (AD) skin lesions and their molecular mechanisms. We topically applied VAL to 1-chloro-2,4-dinitrobenzene (DNCB) sensitized NC/Nga mice. Modified scoring atopic dermatitis index, scratching behavior, and histological/immunohistochemical staining were used to monitor disease severity. RT-PCR, western blotting, and enzyme-linked immunosorbent assay were used to determine the level of IgE, proinflammatory cytokines/chemokines production, and skin barrier proteins expression. Topical application of VAL significantly reduced AD-like symptoms and recovered decreased expression of filaggrin in DNCB-sensitized NC/Nga mice. The levels of serum IgE, IL-1β, IL-6, and IL-13 in skin/splenic tissue were reduced. In vitro studies using TNF-α and IFN-γ treated HaCaT cells revealed that VAL inhibited the exaggerated expression of Th2 chemokines including TARC/CCL17, MDC/CCL22, and proinflammatory chemokines such as CXCL8, GM-CSF, and I-CAM through blockade of the NF-κB pathway. In addition, expression of the skin barrier protein, involucrin, was also increased by VAL treatment. VAL inhibited the production and expression of proinflammatory cytokines IL-1β and IL-6 in LPS-stimulated RAW 264.7 cells. These results suggest that VAL may serve as a potential therapeutic option for AD.

Prenatal exposure to selenium may protect against wheezing in children by the age of 3

PubMed Central

Chastang, Julie; Ibanez, Gladys; Annesi‐Maesano, Isabella

2016-01-01

Abstract Introduction It has been suggested that human in utero exposure to heavy metals such as selenium can reduce the prevalence of childhood asthma and allergic diseases. However, data on this topic are scarce. The objective of the present study was to assess the putative associations between maternal selenium level during pregnancy and the risk of asthma, wheezing, allergic rhinitis, and atopic dermatitis in children from the EDEN birth cohort by the age of 1 and 3 years. Methods Plasma selenium concentrations were measured in maternal blood during mid‐pregnancy (24–28 weeks of gestation) in 861 mothers. Cohort children were followed up from birth to 3 years using health questionnaires filled out by the parents for asthma, wheezing, allergic rhinitis, and atopic dermatitis. Maternal plasma selenium was related to the childhood outcomes by the age of 1 and 3 years. Results Our results showed a significant negative association between a high maternal plasma selenium level during pregnancy and the risk of wheezing in the child by the age of 1 and 3 years. However, maternal plasma selenium during pregnancy was not associated with the prevalence of asthma, allergic rhinitis or atopic dermatitis. Conclusions The results of this study suggest that the level of fetal exposure to maternal selenium could have an influence on the risk of wheezing in infancy and potentially on the risk of developing asthma later in life. PMID:28250923

Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?

PubMed

Shenefelt, Philip D

2003-01-01

Biofeedback can improve cutaneous problems that have an autonomic nervous system component. Examples include biofeedback of galvanic skin resistance (GSR) for hyperhidrosis and biofeedback of skin temperature for Raynaud's disease. Hypnosis may enhance the effects obtained by biofeedback. Cognitive-behavioral methods may resolve dysfunctional thought patterns (cognitive) or actions (behavioral) that damage the skin or interfere with dermatologic therapy. Responsive diseases include acne excoriée, atopic dermatitis, factitious cheilitis, hyperhidrosis, lichen simplex chronicus, needle phobia, neurodermatitis, onychotillomania, prurigo nodularis, trichotillomania, and urticaria. Hypnosis can facilitate aversive therapy and enhance desensitization and other cognitive-behavioral methods. Hypnosis may improve or resolve numerous dermatoses. Examples include acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also reduce the anxiety and pain associated with dermatologic procedures.

Therapeutic effect of tyndallized Lactobacillus rhamnosus IDCC 3201 on atopic dermatitis mediated by down-regulation of immunoglobulin E in NC/Nga mice.

PubMed

Lee, Seung-Hun; Yoon, Jong-Min; Kim, Young-Hoo; Jeong, Dong-Gu; Park, Soobong; Kang, Dae-Jung

2016-07-01

The therapeutic effect of oral administration of Lactobacillus rhamnosus IDCC 3201 tyndallizate (RHT3201) on atopic dermatitis (AD)-like skin lesions in NC/Nga mice were investigated. After induction of dermatitis in NC/Nga mice with house-dust mite extract, each group was fed RHT3201 with 1 × 10(8) , 1 × 10(9) , or 1 × 10(10) cells orally once a day for 8 weeks. Dermatitis scores and frequency of scratching were improved by oral feeding with RHT3201. In contrast to the control group, RHT3201-fed mice showed significantly down-regulated mast cell numbers and serum immunoglobulin E (IgE) concentrations had significantly less IL4 in their axillary lymph node cells. The therapeutic effect of RHT3201 was found to be dose-dependent. These findings indicate that RHT3201 has potential for treating AD. © 2016 The Societies and John Wiley & Sons Australia, Ltd.

A method to induce stable atopic dermatitis-like symptoms in NC/Nga mice housed with skin-lesioned mice.

PubMed

Takano, N; Arai, I; Kurachi, M

2006-03-01

Itching is a characteristic symptom in various forms of dermatosis, especially atopic dermatitis; consequently it is a major diagnostic criterion. All features are similar to events seen in patients, hence NC/Nga mice are considered to be a suitable model of human atopic dermatitis. However, there were data spreads in commencing time and the degree of skin lesions in NC/Nga mice. In the present study, we attempted to improve experimental conditions to induce stable skin lesions and to establish a more appropriate method. Methods NC/Nga mice were kept together with skin-lesioned mice during the experiment period (mixed-NC mice). The dermatitis scores of face, ears and rostral back were assessed. Scratching behaviour was measured using an apparatus, MicroAct (Neuroscience, Tokyo, Japan). Transepidermal water loss (TEWL) and serum total IgE levels were also measured. To observe the presence of mites, the skin of the rostral backs of the mixed-NC mice was stripped using cellulose tape. We also investigated the effects of fipronil (Wako, Osaka, Japan), an acaricidal compound, on skin lesions and scratching behaviour of these mixed-NC mice. In mixed-NC mice, skin lesions appeared from 2 weeks, worsened gradually and reached peak levels of a dermatitis score in 8 weeks. Scratching behaviour increased significantly from day 3. TEWL also increased from day 3, but total IgE increased from day 7. Mites were observed on the rostral backs of mixed-NC mice from day 3, and all mice had these mites on day 28. Giving pretreatment with fipronil (Wako), the skin lesions and scratching behaviour of mixed-NC mice was significantly suppressed. The findings of the present study suggest that the method of being kept together with skin-lesioned mice can induce stable skin lesions and scratching behaviour at an early stage, without skin lesions. This method could help investigate a more stable evaluation of the effects on symptoms of atopic dermatitis, and mechanisms of the itching. It was considered that parasitism of mites, not allergic reactions, was the pathogenesis of skin lesions and scratching behaviour in mixed-NC mice.

Patterns of aeroallergen sensitization predicting risk for asthma in preschool children with atopic dermatitis.

PubMed

Calamelli, Elisabetta; Ricci, Giampaolo; Neri, Iria; Ricci, Lorenza; Rondelli, Roberto; Pession, Andrea; Patrizi, Annalisa

2015-06-01

Atopic dermatitis (AD) is a chronic inflammatory skin disorder mostly affecting young children. Although several studies aimed to identify the risk factors for asthma in AD children, many aspects still need to be clarified. The aim of this study was to investigate the possible risk factors for asthma at school age in 99 children with early-onset and IgE-mediated AD. All children performed clinical evaluation and total and specific IgE assay for a panel of inhalant and food allergens at two different times (t1 and t2) during preschool, and asthma diagnosis was assessed at one follow-up visit (t3) at school age. At t3, 39% of children had developed asthma. Of the variables compared, the sensitization to more than one class of inhalant allergens at t2 (mean age = 30 months) was associated with asthma, with grass (OR = 3.24, p = 0.020) and cat sensitization (OR = 2.74, p = 0.043) as independent risk factors. The sensitization pattern of a child with early-onset AD, also within the first 2-3 years of life, can reflect his risk to develop asthma. Therefore, testing these children for the more common allergens during this time frame should be recommended to predict the evolution of atopic diseases.

Climate change and atopic dermatitis: is there a link?

PubMed

Nguyen, Giang Huong; Andersen, Louise Kronborg; Davis, Mark Denis P

2018-06-05

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease with a growing health concern, because of its high prevalence and associated low quality of life. The etiology of AD is multifactorial with interaction between various factors such as genetic predisposition, immune, and importantly, environmental factors. Since climate change is associated with a profound shift in environmental factors, we suggest that AD is being influenced by climate change. This review highlights the effects of ultraviolet light, temperature, humidity, pollens, air pollutants, and their interaction between them contributing to the epidemiology and pathophysiology of AD. © 2018 The International Society of Dermatology.

Diagnosis of Atopic Dermatitis: Mimics, Overlaps, and Complications

PubMed Central

Siegfried, Elaine C.; Hebert, Adelaide A.

2015-01-01

Atopic dermatitis (AD) is one of the most common skin diseases affecting infants and children. A smaller subset of adults has persistent or new-onset AD. AD is characterized by pruritus, erythema, induration, and scale, but these features are also typical of several other conditions that can mimic, coexist with, or complicate AD. These include inflammatory skin conditions, infections, infestations, malignancies, genetic disorders, immunodeficiency disorders, nutritional disorders, graft-versus-host disease, and drug eruptions. Familiarity of the spectrum of these diseases and their distinguishing features is critical for correct and timely diagnosis and optimal treatment. PMID:26239454

Pigmentary changes and atopic dermatitis in a patient with Seckel syndrome.

PubMed

Brackeen, Amy; Babb-Tarbox, Michelle; Smith, Jennifer

2007-01-01

Seckel syndrome is a very rare form of primordial dwarfism characterized by antenatal and postnatal growth delay, proportionate extreme short stature, a prominent beak-like nose, hypoplasia of the malar area, small chin, microcephaly, deformed ears lacking lobules, skeletal malformations, mental retardation, and developmental delay. This syndrome has been described with associated disorders of orthopedic, neurologic, hematologic, cardiac, and ocular systems; however, only a few reports mention dermatologic involvement. We describe a 5-year-old girl with classic Seckel syndrome who presented with moderately severe atopic dermatitis and diffuse hypopigmented macules and papules.

Alternative, Complementary, and Forgotten Remedies for Atopic Dermatitis

PubMed Central

Goddard, Allison L.; Lio, Peter A.

2015-01-01

Atopic dermatitis, perhaps more than other dermatologic diseases, has garnered much attention in the realm of alternative medicine. This may be because its etiopathogenesis is incompletely understood, it is increasingly common, and it waxes and wanes often without clear precipitants, opening up many opportunities for misinterpretation. Herein we explore the evidence for a number of different alternative and complementary therapies, from textiles to vitamin supplements. By definition, none have enough data to be deemed “effective” in a conventional sense, but it is hopeful that some show promising evidence that may one day lead to mainstream acceptance with further research. PMID:26257817

Canine and feline atopic dermatitis: a review of the diagnostic options.

PubMed

Rees, C A

2001-11-01

Atopic dermatitis is an inherited pruritic skin disease in dogs and cats. This pruritic skin condition is due to the animal having an allergic reaction to environmental allergens. The environmental allergens that an individual dog or cat is allergic to are specific for that individual animal. Management options for affected dogs and cats include identification of the offending environmental allergens and subsequent avoidance of that allergen, or allergen-specific immunotherapy. Several diagnostic tests are available to veterinarians to try to identify these allergens. The pros and cons of each of these diagnostic tests will be addressed.

Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative).

PubMed

Chalmers, J R; Simpson, E; Apfelbacher, C J; Thomas, K S; von Kobyletzki, L; Schmitt, J; Singh, J A; Svensson, Å; Williams, H C; Abuabara, K; Aoki, V; Ardeleanu, M; Awici-Rasmussen, M; Barbarot, S; Berents, T L; Block, J; Bragg, A; Burton, T; Bjerring Clemmensen, K K; Creswell-Melville, A; Dinesen, M; Drucker, A; Eckert, L; Flohr, C; Garg, M; Gerbens, L A A; Graff, A L B; Hanifin, J; Heinl, D; Humphreys, R; Ishii, H A; Kataoka, Y; Leshem, Y A; Marquort, B; Massuel, M-A; Merhand, S; Mizutani, H; Murota, H; Murrell, D F; Nakahara, T; Nasr, I; Nograles, K; Ohya, Y; Osterloh, I; Pander, J; Prinsen, C; Purkins, L; Ridd, M; Sach, T; Schuttelaar, M-L A; Shindo, S; Smirnova, J; Sulzer, A; Synnøve Gjerde, E; Takaoka, R; Vestby Talmo, H; Tauber, M; Torchet, F; Volke, A; Wahlgren, C-F; Weidinger, S; Weisshaar, E; Wollenberg, A; Yamaga, K; Zhao, C Y; Spuls, P I

2016-07-01

This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group and small group discussions. Small groups were allocated a priori to ensure representation of different stakeholders and countries. Decisions were voted on using electronic keypads. For the patient-reported symptoms, the group agreed by vote that itch, sleep loss, dryness, redness/inflamed skin and irritated skin were all considered essential aspects of AE symptoms. Many instruments for capturing patient-reported symptoms were discussed [including the Patient-Oriented SCOring Atopic Dermatitis index, Patient-Oriented Eczema Measure (POEM), Self-Administered Eczema Area and Severity Index, Itch Severity Scale, Atopic Dermatitis Quickscore and the Nottingham Eczema Severity Score] and, by consensus, POEM was selected as the preferred instrument to measure patient-reported symptoms. Further work is needed to determine the reliability and measurement error of POEM. Further work is also required to establish the importance of pain/soreness and the importance of collecting information regarding the intensity of symptoms in addition to their frequency. Much of the discussion on quality of life concerned the Dermatology Life Quality Index and Quality of Life Index for Atopic Dermatitis; however, consensus on a preferred instrument for measuring this domain could not be reached. In summary, POEM is recommended as the HOME core outcome instrument for measuring AE symptoms. © 2016 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

The structure and function of the epidermal barrier in patients with atopic dermatitis – treatment options. Part two

PubMed Central

Czarnecka-Operacz, Magdalena; Adamski, Zygmunt

2018-01-01

Atopic dermatitis (AD) is a chronic and recurrent disease induced by underlying defects of the epidermal barrier and immunological disorders, typical of atopic diseases. The genetic and immunological mechanisms (outlined in the previous paper) affecting the dysfunction of the barrier are intensified by environmental factors, e.g. airborne and food allergens, infections and stress. For this reason, proper skin care, which prevents further damage and restores the epidermal barrier is of such importance in the field of AD therapy. Appropriate therapy is based on emollients which, coupled with anti-inflammatory and antipruritic treatment, should be used as the first-line therapy. The aim of the present paper is to outline the effects of the abovementioned factors on the dysfunction of the epidermal barrier as well as to emphasize the importance of proper atopic skin care in maintaining the integrity of the barrier and preventing exacerbation of the disease. PMID:29760610

A (S)-(+)-decursin derivative, (S)-(+)-3-(3,4-dihydroxy-phenyl)-acrylic acid 2,2-dimethyl-8-oxo-3,4-dihydro-2H,8H-pyrano[3,2-g]-chromen-3-yl-ester, attenuates the development of atopic dermatitis-like lesions in NC/Nga mice.

PubMed

Kim, In Sik; Kim, Dong-Hee; Yun, Chi-Young; Lee, Ji-Sook

2013-03-01

(S)-(+)-decursin is a biological coumarin compound isolated from Angelica gigas Nakai. (S)-(+)-decursin and its analogue have a variety of pharmacological activities. In the present study, the anti-inflammatory effect of a (S)-(+)-decursin derivative, (S)-(+)-3-(3,4-dihydroxy-phenyl)-acrylic acid 2,2-dimethyl-8-oxo-3,4-dihydro-2H,8H-pyrano [3,2-g]-chromen-3-yl-ester (Compound 6, C6), on in vitro and in vivo atopic dermatitis was investigated. C6 suppressed the secretion of IL-6, IL-8, and monocyte chemotactic protein-1 increase by the house dust mite extract in the eosinophilic leukemia cell line and THP-1 cells. C6 inhibited the production of TARC, IL-6, and IL-8 increase by IFN-γ and TNF-α in the human keratinocyte cell line. In the in vivo experiment, NC/Nga mice were sensitized to 2,4-dinitrochlorobenzene, and then C6 or dexamethasone (Dex) were orally and dorsally administered for three weeks. C6 treatment reduced the skin severity score compared with that of the control group. C6 inhibited the thickening of the epidermis and inflammatory cell infiltration into the dermis by evaluating the histological examination. The serum immunoglobulin E (IgE) level decreased in the C6-treated group compared with that of the control group. The inhibitory effect of C6 on IgE concentration was similar to that of Dex. The levels of IL-4, IL-5, IL-13, and eotaxin increased after treatment with concanavalin A in mouse splenocytes. The cytokine levels of the C6-treated group were lower than those of the control group. Taken together, C6 may attenuate atopic dermatitis-like lesions through its anti-inflammatory effect, such as inhibition of IgE and inflammatory cytokines, and it may be valuable as a therapeutic drug for the treatment of atopic dermatitis.

[Association of polymorphisms in toll-like receptor genes with atopic dermatitis in the Republic of Bashkortostan].

PubMed

Gimalova, G F; Karunas, A S; Fedorova, Iu Iu; Gumennaia, É R; Levasheva, S V; Khismatullina, Z R; Prans, E; Koks, S; Étkina, É I; Khusnutdinova, É K

2014-01-01

Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease developing as a result of the interaction between genetic predisposition and environmental factors. Considerable role in allergic diseases development is played by polymorphisms of genes of pattern-recognition receptors (PRR) which are capable of recognizing conservative standard molecular structures (patterns) unique for large pathogen groups. In this study polymorphic variants of PRR genes--Toll-like receptors (TLR1, TLR2, TLR4, TLR5, TLR6, TLR9, TLR10), NOD-like receptors (NOD1, NOD2), lipopolysaccharide receptor CD14 gene, and C11orf30 and LRRC32 genes, located in 11q13.5 region, have been investigated in AD patients and control subjects from the Republic of Bashkortostan. An association of TLR1 (rs5743571 and rs5743604), TLR6 (rs5743794) and TLR10 (rs11466617) with AD was found. Our results confirm an important role of the innate immune system in the pathogenesis of AD and the significance of polymorphisms within the Toll-like receptor 2 subfamily genes in AD development.

Azuki bean (Vigna angularis) extract inhibits the development of experimentally induced atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Collantes, Therese Marie; Rho, Mun-Chual; Kwon, Hyoung-Jun; Jung, Bock-Gie; Alfajaro, Mia Madel; Kim, Deok-Song; Kim, Hyun-Jeong; Hosmillo, Myra; Park, Jun-Gyu; Son, Kyu-Yeol; Park, Sang-Ik; Kang, Mun-Il; Park, Su-Jin; Lee, Seung Woong; Lee, Woo-Song; Cho, Kyoung-Oh

2012-06-01

The present study investigated the effects of azuki bean (Vigna angularis) extract (VAE) on the progress of atopic dermatitis (AD)-like skin lesions in NC/Nga mice induced by 1-chloro-2,4-dinitrobenzene. The efficacy of VAE in NC/Nga mice was determined by measuring gross and histological skin lesions, serum IgE levels, eosinophil ratio in peripheral leucocytes, and mRNA expression levels of interleukin (IL)-4, tumour necrosis factor (TNF)-α and interferon (IFN)-γ in splenocytes. Continuous ingestion of VAE inhibited the development of the AD-like skin lesions in a dose-dependent manner. In the VAE-treated mice, the numbers of mast cells in the skin, eosinophil ratio in peripheral leucocytes, relative mRNA expression of inflammatory cytokines in the spleen, and serum IgE levels were significantly reduced. Results suggest that VAE can inhibit the development of AD-like skin lesions in NC/Nga mice by regulating immune mediators and cells, and may be an effective alternative therapy for AD. Copyright © 2011 Elsevier Ltd. All rights reserved.

The impact of atopic dermatitis on quality of life.

PubMed

Lifschitz, Carlos

2015-01-01

Approximately 5-20% of children worldwide suffer from atopic dermatitis (AD), a kind of dermatitis characterized as an inflammatory, relapsing, noncontagious and itchy skin disorder. Children often develop AD during their first year of life. An increased rate of sensitization to both food and aeroallergens has been shown to coexist in patients with AD. Sensitization to well-known allergens such as cow's milk protein can occur on average in 50% of children with AD. In general, quality of life (QoL) is perceived as the quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. QoL is a broad concept that includes such things as standard of living, community, and family life. Patients with skin diseases experience a wide range of symptoms ranging from trivial problems to major handicaps which affect their lives. The misery of living with AD cannot be overstated for it may have a profoundly negative effect on the health-related QoL of children and their families in many cases. Physicians taking care of children with AD should consult parents on how their child's illness has impacted their lifestyle and recommend professional intervention if deemed necessary. © 2015 S. Karger AG, Basel.

Illness perception and quality of life in patients with contact dermatitis.

PubMed

Benyamini, Yael; Goner-Shilo, Daphna; Lazarov, Aneta

2012-10-01

People's subjective perceptions of illness are important determinants of their ways of coping with health threats and the ensuing physical and mental outcomes, including quality of life (QoL), which has been consistently reported to be impaired by contact dermatitis. To investigate the relationships of subjective illness perceptions and dermatological QoL in atopic, contact and occupational dermatitis patients and a comparison group of patients with other dermatological diseases. Three hundred and three patients of four diagnostic groups filled in the Brief Illness Perception Questionnaire and the Skindex-16 (+ occupational impact items) Dermatological QoL questionnaire before clinical examination and patch testing. Perceptions of serious consequences, greater symptom burden and more uncertainty and worry were associated with lower QoL (r(s) > 0.50). Overall, patients reported low personal control over their condition and low understanding of the disease (3.5 and 4.8, respectively, on a 0-10 scale). QoL was most impaired among occupational dermatitis patients (mean = 46) and least impaired among patients who were later diagnosed as suffering from conditions other than contact dermatitis (mean = 62). Identifying critical components of illness perceptions in patients with atopic, contact and occupational dermatitis may enable the design of consultations and interventions to fit patients' perceptions, which could affect their QoL. © 2012 John Wiley & Sons A/S.

Association of rheumatoid arthritis with allergic diseases: A nationwide population-based cohort study.

PubMed

Lai, Ning-Sheng; Tsai, Tzung-Yi; Koo, Malcolm; Lu, Ming-Chi

2015-01-01

Low-grade inflammation conditions, e.g., type 2 diabetes, have been shown to be associated with an increased risk of rheumatoid arthritis (RA). However, the association between other chronic inflammatory conditions, e.g., asthma, allergic rhinitis, and atopic dermatitis, is still unclear. To investigate the risk of RA in patients with allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, by using a nationwide health claims database. The Taiwan National Health Insurance Research Database was used to assemble a cohort of 170,570 patients ages 20 years old and older diagnosed with allergic diseases, including asthma, allergic rhinitis, or atopic dermatitis. A comparison cohort of 170,238 patients was constructed from the same data base, with frequency matching for sex, 10-year age group, and year of insurance enrollment. Cox proportional hazards regression analyses were conducted to assess the association between the allergic diseases and incident RA. Asthma (adjusted hazard ratio [AHR] 1.67, [95% confidence interval {CI}], 1.32-2.62) and allergic rhinitis (AHR 1.62 [95% CI, 1.33-1.98]) were significantly associated with the incident RA. These associations remained significant even after excluding patients who had concurrent diagnoses of asthma and allergic rhinitis. Patients with more than one allergic disease had an increased risk of developing RA (AHR 1.98 [95% CI, 1.50-2.62]). Subgroup analysis further indicated that middle-aged and elderly female patients with more than one allergic disease exhibited a high risk of developing RA. Significant associations between common allergic diseases and incident RA was found in this population-based cohort study. Our findings provided support to the hypothesis that allergic diseases and RA might share a similar underlying etiologic pathway related to chronic inflammatory responses.

Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial.

PubMed

Blauvelt, Andrew; de Bruin-Weller, Marjolein; Gooderham, Melinda; Cather, Jennifer C; Weisman, Jamie; Pariser, David; Simpson, Eric L; Papp, Kim A; Hong, H Chih-Ho; Rubel, Diana; Foley, Peter; Prens, Errol; Griffiths, Christopher E M; Etoh, Takafumi; Pinto, Pedro Herranz; Pujol, Ramon M; Szepietowski, Jacek C; Ettler, Karel; Kemény, Lajos; Zhu, Xiaoping; Akinlade, Bolanle; Hultsch, Thomas; Mastey, Vera; Gadkari, Abhijit; Eckert, Laurent; Amin, Nikhil; Graham, Neil M H; Pirozzi, Gianluca; Stahl, Neil; Yancopoulos, George D; Shumel, Brad

2017-06-10

Dupilumab (an anti-interleukin-4-receptor-α monoclonal antibody) blocks signalling of interleukin 4 and interleukin 13, type 2/Th2 cytokines implicated in numerous allergic diseases ranging from asthma to atopic dermatitis. Previous 16-week monotherapy studies showed that dupilumab substantially improved signs and symptoms of moderate-to-severe atopic dermatitis with acceptable safety, validating the crucial role of interleukin 4 and interleukin 13 in atopic dermatitis pathogenesis. We aimed to evaluate the long-term efficacy and safety of dupilumab with medium-potency topical corticosteroids versus placebo with topical corticosteroids in adults with moderate-to-severe atopic dermatitis. In this 1-year, randomised, double-blinded, placebo-controlled, phase 3 study (LIBERTY AD CHRONOS), adults with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids were enrolled at 161 hospitals, clinics, and academic institutions in 14 countries in Europe, Asia-Pacific, and North America. Patients were randomly assigned (3:1:3) to subcutaneous dupilumab 300 mg once weekly (qw), dupilumab 300 mg every 2 weeks (q2w), or placebo via a central interactive voice/web response system, stratified by severity and global region. All three groups were given concomitant topical corticosteroids with or without topical calcineurin inhibitors where inadvisable for topical corticosteroids. Topical corticosteroids could be tapered, stopped, or restarted on the basis of disease activity. Coprimary endpoints were patients (%) achieving Investigator's Global Assessment (IGA) 0/1 and 2-point or higher improvement from baseline, and Eczema Area and Severity Index 75% improvement from baseline (EASI-75) at week 16. Week 16 efficacy and week 52 safety analyses included all randomised patients; week 52 efficacy included patients who completed treatment by US regulatory submission cutoff. This study is registered with ClinicalTrials.gov, NCT02260986. Between Oct 3, 2014, and July 31, 2015, 740 patients were enrolled: 319 were randomly assigned to dupilumab qw plus topical corticosteroids, 106 to dupilumab q2w plus topical corticosteroids, and 315 to placebo plus topical corticosteroids. 623 (270, 89, and 264, respectively) were evaluable for week 52 efficacy. At week 16, more patients who received dupilumab plus topical corticosteroids achieved the coprimary endpoints of IGA 0/1 (39% [125 patients] who received dupilumab plus topical corticosteroids qw and 39% [41 patients] who received dupilumab q2w plus topical corticosteroids vs 12% [39 patients] who received placebo plus topical corticosteroids; p<0·0001) and EASI-75 (64% [204] and 69% [73] vs 23% [73]; p<0·0001). Week 52 results were similar. Adverse events were reported in 261 (83%) patients who received dupilumab qw plus topical corticosteroids, 97 (88%) patients who received dupilumab q2w, and 266 (84%) patients who received placebo, and serious adverse events in nine (3%), four (4%), and 16 (5%) patients, respectively. No significant dupilumab-induced laboratory abnormalities were noted. Injection-site reactions and conjunctivitis were more common in patients treated with dupilumab plus topical corticosteroids-treated patients than in patients treated with placebo plus topical corticosteroids. Dupilumab added to standard topical corticosteroid treatment for 1 year improved atopic dermatitis signs and symptoms, with acceptable safety. Sanofi and Regeneron Pharmaceuticals Inc. Copyright © 2017 Elsevier Ltd. All rights reserved.

The efficacy of whey associated with dodder seed extract on moderate-to-severe atopic dermatitis in adults: A randomized, double-blind, placebo-controlled clinical trial.

PubMed

Mehrbani, Mehrzad; Choopani, Rasool; Fekri, Alireza; Mehrabani, Mitra; Mosaddegh, Mahmoud; Mehrabani, Mehrnaz

2015-08-22

Atopic dermatitis is a common chronic inflammatory skin condition that is on the rise and adversely affects quality of life of the affected individual. Dry skin and pruritus, major characteristics of this disease, are associated with the dysfunction of the skin barrier. Though mild cases of the disease can be controlled with antihistamines and topical corticosteroids, moderate-to-severe cases often require treatment with immunomodulatory drugs, which have many side effects. It is now more common to use complementary and alternative medicines in the treatment of atopic dermatitis. In traditional Iranian medicine, the use of whey with the aqueous extract of field dodder (Cuscuta campestris Yunck.) seeds in severe and refractory cases of atopic dermatitis is common and has no side effects. The aim of this study was to assess the efficacy and safety of whey associated with dodder seed extract in the treatment of moderate-to-severe atopic dermatitis in adults. The study was a randomized, double-blind placebo control trial that was conducted on 52 patients with moderate-to-severe atopic dermatitis for 30 days. In this study patients received freeze dried whey powder with spray dried water extract of field dodder or the placebo for 15 days. At baseline (week zero), after the end of the 15 day treatment period (week three) and 15 days after stopping the drug or placebo (follow-up/week five), patients were evaluated in terms of skin moisture, elasticity, pigmentation, surface pH and sebum content on the forearm with Multi Skin Test Center® MC1000 (Courage & Khazaka, Germany) and the degree of pruritus and sleep disturbance in patients were also recorded. 42 patients completed 30 days of treatment with the medicine and the follow-up period. At the end of the follow-up period a significant increase in skin moisture and elasticity in the group receiving whey with dodder was observed compared with the placebo group (p<0.001). There was a significant difference between the two groups regarding the pruritus after 15 days of receiving treatment or the placebo (p<0.05), and at the end of the 30-day study period the difference was clearly significant (p<0.001). Sleep disturbance showed significant changes at the end of follow-up period (p<0.05). There was no significant difference between the two groups concerning changes in skin pigmentation, however, a significant decrease was observed in the group receiving whey associated with dodder seed extract over time (p<0.001). There were no significant alterations in skin surface pH and the amount of sebum between the two groups. Temporary side effects were reported including anorexia and mild gastrointestinal problems in drug use. It is noteworthy that in this study despite the fact that patients received whey with dodder for just 15 days, moisture and elasticity of the skin continued to increase in the second half of the study (follow-up period). This shows that the effect of whey with dodder is not transient and this drug really helped skin barrier reconstruction and accelerated the healing process of skin. This positively influenced the skin parameters and consequently the improvement of pruritus and sleep disturbance. The results indicate that whey associated with dodder seed extract can serve as a promising alternative for the treatment of moderate-to-severe atopic dermatitis. Iranian Registry of Clinical Trials IRCT2013121415790N1. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Exposure to dogs but not cats is associated to a decrease in the prevalence in atopic dermatitis amongst school-children.

PubMed

Bedolla-Barajas, M; Morales-Romero, J; Bedolla-Pulido, T I; Bedolla-Pulido, T R; Meza-López, C; Pulido-Guillén, N A

2018-02-15

The association regarding the exposure to pets, especially cats and dogs, and the prevalence of allergic diseases is inconsistent. We analyzed the role played by early exposure to dogs or cats in the prevalence of allergic diseases amongst school-aged children. Through a cross-sectional study, we examined 756 children, aged 6-7; these candidates were selected through cluster sampling. We inquired about the exposure that these children had had to dogs and cats, and whether these pets spent most of their time indoors or outdoors during the first year of the child's life. In order to identify the prevalence of allergic diseases and their symptoms, each child's parent completed the International Study of Asthma and Allergies in Childhood questionnaire. Exposure to outdoor dogs was associated to nocturnal coughing, odds ratio (OR) 0.64, with a confidence interval of 95% (95% CI) 0.43-0.95 and with atopic dermatitis (OR: 0.39; 95% CI: 0.20-0.76). Interestingly, exposure to outdoor cats was associated to nocturnal coughing (OR: 0.51; 95% CI: 0.32-0.83) and current rhinitis symptoms (OR: 0.59; 95% CI 0.36-0.97). After carrying out the multivariate analyses, only exposure to dogs, both indoor and outdoor, was significantly associated to a decrease in the prevalence of atopic dermatitis OR 0.40 (95% CI: 0.20-0.79) and OR 0.38 (95% CI: 0.18-0.83), respectively. Our findings suggest that exposure to dogs, whether they be indoor or outdoor pets, is associated to a decreased prevalence in atopic dermatitis. Copyright © 2018 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

Staphylococcus aureus clonal dynamics and virulence factors in children with atopic dermatitis.

PubMed

Lomholt, Hans; Andersen, Klaus Ejner; Kilian, Mogens

2005-11-01

A prospective cohort study was undertaken to determine the clonal dynamics of Staphylococcus aureus colonization and infection during 1 y in children with atopic dermatitis, and to correlate specific clones, accessory gene regulator (agr) groups, and production of virulence factors with eczema activity. Eleven children were examined every 6 wk with swaps taken from active eczema, anterior nose, axillae and perineum, and scoring of eczema activity by severity scoring of atopic dermatitis (SCORAD). Individual S. aureus clonal types were identified and examined for production of superantigens, toxins, and were assigned to agr groups. S. aureus colonization patterns ranged from rare colonization over transient colonization to persistent colonization by a single clone or a dynamic exchange of up to five clones. Production of no single virulence factor including superantigens and toxins was significantly associated with exacerbation of eczema. In four children there was a shift between visits in agr group of colonizing clones. These shifts were associated with an increased SCORAD value of 19 (SE = 7, p = 0.009). Change of clones belonging to the same agr group was not associated with a higher SCORAD value. In 11 of 12 cases with two different clones co-colonizing a child the clones belonged to the same agr group. In conclusion, this limited group of children with atopic dermatitis showed highly variable colonization patterns of S. aureus, and communication between strains by use of agr encoded octa peptides appeared to be active in vivo. Increased severity of eczema was related to a change in agr group and may have been because of inflammation triggered by the takeover of an antigenically different clone, as agr groups represent ancient phylogenetic lineages.

Antimycotics suppress the Malassezia extract-induced production of CXC chemokine ligand 10 in human keratinocytes.

PubMed

Hau, Carren S; Kanda, Naoko; Makimura, Koichi; Watanabe, Shinichi

2014-02-01

Malassezia, a lipophilic yeast, exacerbates atopic dermatitis. Malassezia products can penetrate the disintegrated stratum corneum and encounter subcorneal keratinocytes in the skin of atopic dermatitis patients. Type 1 helper T (Th1) cells infiltrate chronic lesions with atopic dermatitis, and antimycotic agents improve its symptoms. We aimed to identify Malassezia-induced chemokines in keratinocytes and examine whether antimycotics suppressed this induction. Normal human keratinocytes were incubated with a Malassezia restricta extract and antimycotics. Chemokine expression was analyzed by enzyme-linked immunosorbent assays and real-time polymerase chain reaction. Signal transducer and activator of transcription (STAT)1 activity was examined by luciferase assays. The tyrosine-phosphorylation of STAT1 was analyzed by western blotting. The M. restricta extract increased the mRNA and protein expression of Th1-attracting CXC chemokine ligand (CXCL)10 and STAT1 activity and phosphorylation in keratinocytes, which was suppressed by a Janus kinase inhibitor. The antimycotics itraconazole, ketoconazole, luliconazole, terbinafine, butenafine and amorolfine suppressed M. restricta extract-induced CXCL10 mRNA and protein expression and STAT1 activity and phosphorylation. These effects were similarly induced by 15-deoxy-Δ-(12,14) -prostaglandin J2 (15d-PGJ2 ), a prostaglandin D2 metabolite. Antimycotics increased the release of 15d-PGJ2 from keratinocytes. The antimycotic-induced suppression of CXCL10 production and STAT1 activity was counteracted by a lipocalin-type prostaglandin D synthase inhibitor. The antimycotics itraconazole, ketoconazole, luliconazole, terbinafine, butenafine and amorolfine may suppress the M. restricta-induced production of CXCL10 by inhibiting STAT1 through an increase in 15d-PGJ2 production in keratinocytes. These antimycotics may block the Th1-mediated inflammation triggered by Malassezia in the chronic phase of atopic dermatitis. © 2014 Japanese Dermatological Association.

Efficacy of prolonged ingestion of Lactobacillus acidophilus L-92 in adult patients with atopic dermatitis.

PubMed

Yamamoto, Kozo; Yokoyama, Kazuhito; Matsukawa, Takehisa; Kato, Sayaka; Kato, Shinji; Yamada, Kazuhisa; Hirota, Tatsuhiko

2016-07-01

To evaluate the safety and efficacy of prolonged ingestion of Lactobacillus acidophilus L-92 (L-92) on skin symptoms in adult atopic dermatitis (AD) patients, a placebo-controlled double-blinded parallel-group comparison study was performed. This included daily administration of heat-killed and dried L-92 or placebo for 24wk in 50 AD patients who were 16yr old or older. The severity of skin symptoms was evaluated at baseline and at 4, 8, 12, 16, 20, and 24wk during the intervention using the investigator global assessment, eczema area and severity index, and scoring atopic dermatitis. Serum cytokine and blood marker levels were also measured at baseline and at 4, 8, 16, and 24wk during the intervention. No adverse events were reported during the study period. Compared with the placebo group, the L-92 group showed significant decreases in investigator global assessment, eczema area and severity index, and scoring atopic dermatitis. Subjective symptoms in adult AD patients were reduced by intake of L-92. Furthermore, it was suggested that sustained ingestion of L-92 resulted in suppression of scratching behavior and maintenance of remission status of skin symptoms. Sixteen weeks after the study commenced, a significant decrease in lactate dehydrogenase and a significant increase in transforming growth factor-β were observed in the L-92 group compared with the placebo group. In the L-92 group, a significant elevation of IL-12 (p70) level at the end of treatment period compared with before the treatment was observed. This study suggested that L-92 suppresses type-2-helper-T-cell-dominant inflammation by activating regulatory T cells and type 1 helper T cells. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Sustained exogenous expression of therapeutic levels of IFN-gamma ameliorates atopic dermatitis in NC/Nga mice via Th1 polarization.

PubMed

Hattori, Kayoko; Nishikawa, Makiya; Watcharanurak, Kanitta; Ikoma, Akihiko; Kabashima, Kenji; Toyota, Hiroyasu; Takahashi, Yuki; Takahashi, Rei; Watanabe, Yoshihiko; Takakura, Yoshinobu

2010-03-01

The short in vivo half-life of IFN-gamma can prevent the cytokine from inducing immunological changes that are favorable for the treatment of Th2-dominant diseases, such as atopic dermatitis. To examine whether a sustained supply of IFN-gamma is effective in regulating the balance of Th lymphocyte subpopulations, plasmid vector encoding mouse IFN-gamma, pCpG-Mugamma, or pCMV-Mugamma was injected into the tail vein of NC/Nga mice, a model for human atopic dermatitis. A single hydrodynamic injection of a CpG motif reduced pCpG-Mugamma at a dose of 0.14 microg/mouse resulted in a sustained concentration of IFN-gamma in the serum, and the concentration was maintained at >300 pg/ml over 80 d. The pCpG-Mugamma-mediated IFN-gamma gene transfer was associated with an increase in the serum concentration of IL-12, reduced production of IgE, and inhibition of mRNA expression of IL-4, -5, -10, -13, and -17 and thymus and activation-regulated chemokine in the spleen. These immunological changes were not clearly observed in mice receiving two injections of 20 microg pCMV-Mugamma, a CpG-replete plasmid DNA, because of the transient nature of the expression from the vector. The mice receiving pCpG-Mugamma showed a significant reduction in the severity of skin lesions and in the intensity of their scratching behavior. Furthermore, high transepidermal water loss, epidermal thickening, and infiltration of lymphocytes and eosinophils, all of which were obvious in the untreated mice, were significantly inhibited. These results indicate that an extraordinary sustained IFN-gamma expression induces favorable immunological changes, leading to a Th1-dominant state in the atopic dermatitis model.

Two Phase 3 Trials of Dupilumab versus Placebo in Atopic Dermatitis.

PubMed

Simpson, Eric L; Bieber, Thomas; Guttman-Yassky, Emma; Beck, Lisa A; Blauvelt, Andrew; Cork, Michael J; Silverberg, Jonathan I; Deleuran, Mette; Kataoka, Yoko; Lacour, Jean-Philippe; Kingo, Külli; Worm, Margitta; Poulin, Yves; Wollenberg, Andreas; Soo, Yuhwen; Graham, Neil M H; Pirozzi, Gianluca; Akinlade, Bolanle; Staudinger, Heribert; Mastey, Vera; Eckert, Laurent; Gadkari, Abhijit; Stahl, Neil; Yancopoulos, George D; Ardeleanu, Marius

2016-12-15

Dupilumab, a human monoclonal antibody against interleukin-4 receptor alpha, inhibits signaling of interleukin-4 and interleukin-13, type 2 cytokines that may be important drivers of atopic or allergic diseases such as atopic dermatitis. In two randomized, placebo-controlled, phase 3 trials of identical design (SOLO 1 and SOLO 2), we enrolled adults with moderate-to-severe atopic dermatitis whose disease was inadequately controlled by topical treatment. Patients were randomly assigned in a 1:1:1 ratio to receive, for 16 weeks, subcutaneous dupilumab (300 mg) or placebo weekly or the same dose of dupilumab every other week alternating with placebo. The primary outcome was the proportion of patients who had both a score of 0 or 1 (clear or almost clear) on the Investigator's Global Assessment and a reduction of 2 points or more in that score from baseline at week 16. We enrolled 671 patients in SOLO 1 and 708 in SOLO 2. In SOLO 1, the primary outcome occurred in 85 patients (38%) who received dupilumab every other week and in 83 (37%) who received dupilumab weekly, as compared with 23 (10%) who received placebo (P<0.001 for both comparisons with placebo). The results were similar in SOLO 2, with the primary outcome occurring in 84 patients (36%) who received dupilumab every other week and in 87 (36%) who received dupilumab weekly, as compared with 20 (8%) who received placebo (P<0.001 for both comparisons). In addition, in the two trials, an improvement from baseline to week 16 of at least 75% on the Eczema Area and Severity Index was reported in significantly more patients who received each regimen of dupilumab than in patients who received placebo (P<0.001 for all comparisons). Dupilumab was also associated with improvement in other clinical end points, including reduction in pruritus and symptoms of anxiety or depression and improvement in quality of life. Injection-site reactions and conjunctivitis were more frequent in the dupilumab groups than in the placebo groups. In two phase 3 trials of identical design involving patients with atopic dermatitis, dupilumab improved the signs and symptoms of atopic dermatitis, including pruritus, symptoms of anxiety and depression, and quality of life, as compared with placebo. Trials of longer duration are needed to assess the long-term effectiveness and safety of dupilumab. (Funded by Sanofi and Regeneron Pharmaceuticals; SOLO 1 ClinicalTrials.gov number, NCT02277743 ; SOLO 2 ClinicalTrials.gov number, NCT02277769 .).

Dermatology for the Allergist

PubMed Central

Lockey, Richard

2010-01-01

Abstract: Allergists/immunologists see patients with a variety of skin disorders. Some, such as atopic and allergic contact dermatitis, are caused by abnormal immunologic reactions, whereas others, such as seborrheic dermatitis or rosacea, lack an immunologic basis. This review summarizes a select group of dermatologic problems commonly encountered by an allergist/immunologist. PMID:23268431

Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic

PubMed Central

Rosenbaum, Brooke E; Klein, Rebecca; Hagan, Paa Gyasi; Seadey, Mark-Young; Quarcoo, Naa Larteley; Hoffmann, Rachel; Robinson, Maria; Lartey, Margaret; Leger, Marie C

2017-01-01

Introduction Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. Methods We conducted a chart review of new patients presenting to the Korle Bu Teaching Hospital dermatology clinic during 2014. Results Among the 529 patients studied, 700 discrete diagnoses were made. The most commonly diagnosed skin conditions were infections (24.6%) and dermatitis (24.6%); atopic dermatitis (8.4%), acne vulgaris (5.3%) and scabies (5.1%) were the most common specific diagnoses. Among infants, children, and adolescents, the most common diagnosis was atopic dermatitis (31.7%, 30.0%, and 14.9%, respectively). Acne vulgaris (12.0%) was the most common skin condition diagnosed in young adults. Irritant contact dermatitis (6.9%) was most common among adults. Lichen planus (9.9%) was the most commonly diagnosed skin condition in the senior population. Diagnoses made by dermatologists differed from the referral diagnosis documented by primary care providers for 65.8% of patients. The most frequently recommended treatments were antihistamines (47.8%) and topical steroids (38.4%). Only 18 diagnostic biopsies were performed. Conclusion Our study summarizes the skin diseases seen and management practices of Ghanaian dermatologists in a specialized clinic at a large public teaching hospital. The results of this study can help to guide future dermatology education and development efforts in Ghana. PMID:28533848

[Written personalized action plan for atopic dermatitis: a patient education tool].

PubMed

Gabeff, R; Assathiany, R; Barbarot, S; Salinier, C; Stalder, J-F

2014-07-01

Atopic dermatitis (AD) is the most frequent children's chronic skin disease. Management of AD can be difficult because local treatments must be adapted to the skin's condition. Between consultations, sudden changes in the state of the disease can make it difficult to manage local treatment. Parents and children need information that will help them adapt their treatment to the course of their disease. Aiming to enable parents to better treat their atopic child by themselves, we have developed a personalized action plan in order to simplify, personalize, and adapt the medical prescription to the state of the disease. The Personalized Written Action Plan for Atopics (PA2P) is based on the model used in the treatment of asthma, with integrated specificities for AD in children. The aim of this study was to assess the feasibility and pertinence of the PA2P for pediatricians to use in private practice. A total of 479 pediatricians answered a questionnaire sent by e-mail. The vast majority of the respondents gave positive reviews of the tool: 99% of the pediatricians declared the tool to be pertinent, qualifying it as clear and logical. The PA2P appeared to be appropriate for the atopic patient because it improves the families' involvement in the application of local treatment by offering personalized care and by simplifying the doctor's prescription. Finally, 72% of doctors responding to the questionnaire were willing to take part in future studies involving parents. More than a gadget, the PA2P could become a useful tool for therapeutic patient education. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Characterization of atopic skin and the effect of a hyperforin-rich cream by laser scanning microscopy.

PubMed

Meinke, Martina C; Richter, Heike; Kleemann, Anke; Lademann, Juergen; Tscherch, Kathrin; Rohn, Sascha; Schempp, Christoph M

2015-05-01

Atopic dermatitis (AD) is a multifactorial inflammatory skin disease that affects both children and adults in an increasing manner. The treatment of AD often reduces subjective skin parameters, such as itching, dryness, and tension, but the inflammation cannot be cured. Laser scanning microscopy was used to investigate the skin surface, epidermal, and dermal characteristics of dry and atopic skin before and after treatment with an ointment rich in hyperforin, which is known for its anti-inflammatory effects. The results were compared to subjective parameters and transepidermal water loss, stratum corneum moisture, and stratum corneum lipids. Using biophysical methods, in particular laser scanning microscopy, it was found that atopic skin has distinct features compared to healthy skin. Treatment with a hyperforin-rich ointment resulted in an improvement of the stratum corneum moisture, skin surface dryness, skin lipids, and the subjective skin parameters, indicating that the barrier is stabilized and improved by the ointment. But in contrast to the improved skin surface, the inflammation in the deeper epidermis/dermis often continues to exist. This could be clearly shown by the reflectance confocal microscopy (RCM) measurements. Therefore, RCM measurements could be used to investigate the progress in treatment of atopic dermatitis.

Characterization of atopic skin and the effect of a hyperforin-rich cream by laser scanning microscopy

NASA Astrophysics Data System (ADS)

Meinke, Martina C.; Richter, Heike; Kleemann, Anke; Lademann, Juergen; Tscherch, Kathrin; Rohn, Sascha; Schempp, Christoph M.

2015-05-01

Atopic dermatitis (AD) is a multifactorial inflammatory skin disease that affects both children and adults in an increasing manner. The treatment of AD often reduces subjective skin parameters, such as itching, dryness, and tension, but the inflammation cannot be cured. Laser scanning microscopy was used to investigate the skin surface, epidermal, and dermal characteristics of dry and atopic skin before and after treatment with an ointment rich in hyperforin, which is known for its anti-inflammatory effects. The results were compared to subjective parameters and transepidermal water loss, stratum corneum moisture, and stratum corneum lipids. Using biophysical methods, in particular laser scanning microscopy, it was found that atopic skin has distinct features compared to healthy skin. Treatment with a hyperforin-rich ointment resulted in an improvement of the stratum corneum moisture, skin surface dryness, skin lipids, and the subjective skin parameters, indicating that the barrier is stabilized and improved by the ointment. But in contrast to the improved skin surface, the inflammation in the deeper epidermis/dermis often continues to exist. This could be clearly shown by the reflectance confocal microscopy (RCM) measurements. Therefore, RCM measurements could be used to investigate the progress in treatment of atopic dermatitis.

Effect of cat and daycare exposures on the risk of asthma in children with atopic dermatitis

PubMed Central

Gaffin, Jonathan M.; Spergel, Jonathan M.; Boguniewicz, Mark; Eichenfield, Lawrence F.; Paller, Amy S.; Fowler, Joseph F.; Dinulos, James G.; Tilles, Stephen A.; Schneider, Lynda C.

2012-01-01

Atopic dermatitis (AD) in young children is often followed by the development of asthma (atopic march). The role of environmental exposures is unclear in this high-risk population. We aimed to determine the predictive relationship between indoor allergen exposures, particularly pets, rodents, and cockroaches, to the development of asthma in a prospective pediatric cohort. Children with AD and a family history of allergy were followed prospectively with questionnaire ascertainment of environmental exposure to cats, dogs, cockroaches, rats, and mice. Asthma was diagnosed by study physicians based on caregiver reports of symptoms continually assessed over the course of the study period. Fifty-five of the 299 children developed asthma by the end of the study. Cat exposure had a strong and independent effect to reduce the risk of developing asthma across all analyses (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.05–0.53). Dog, mouse, rat, and cockroach exposures did not significantly influence the development of asthma. Daycare exposure had the largest risk reduction for the development of asthma (OR, 0.08; 95% CI, 0.03–0.19). Maternal asthma (OR, 2.93; 95% CI, 1.29–6.67), baseline body mass index (OR, 1.23; 95% CI, 1.08–1.42), and specific immunoglobulin E to house-dust mix at 3 years were each independent risk factors for the development of asthma. In children with AD, cat and daycare exposure may reduce the risk of developing early childhood asthma. PMID:22584195

Atopic Dermatitis: A Common Pediatric Condition and Its Evolution in Adulthood.

PubMed

Gupta, Deepti

2015-11-01

Atopic dermatitis (AD) is a chronic and pruritic inflammatory skin disorder that has a relapsing course and can affect any age group. Patients with AD have higher rates of other allergic disorders, mental health disorders, and skin infections. An important feature of AD for practitioners to recognize is that the clinical presentation varies by age from infancy into adulthood. The goals of treatment and management of AD focuses on restoring and maintaining the skin barrier function, minimizing inflammation, breaking the itch-scratch cycle, and treating possible external triggers and secondary infections that may propagate AD. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevalence and severity of atopic dermatitis in Jeju Island: a cross-sectional study of 4,028 Korean elementary schoolchildren by physical examination utilizing the three-item severity score.

PubMed

Kim, Dae Suk; Lee, Ju Hee; Lee, Kwang Hoon; Lee, Min-Geol

2012-09-01

The objective of this study was to evaluate the precise prevalence of atopic dermatitis (AD) in schoolchildren in Jeju Island in South Korea examined in 2009. Nine elementary schools were randomly selected from Jeju Island and a total of 4,028 schoolchildren were examined by a dermatologist. AD was diagnosed based on the Korean Atopic Dermatitis Research Group criteria for the disease. The severity of AD was measured with the three-item severity score (TIS). The point prevalence of AD was 9.5% overall. The prevalence among higher graders (age 9-12 years) was significantly lower than that in lower graders (age 6-9 years) (7.5% vs. 11.9%, < 0.00001). AD prevalence in girls (11.1%) was higher than that in boys (8.1%) (<0.005). In each grade, more than 50% of those affected had the mild form (TIS score 1 or 2). There were no apparent differences in severity of AD between grades or genders. This is the first Asian study of prevalence in schoolchildren using TIS score for evaluating AD severity.

Allergen-Specific Immunotherapy with Monomeric Allergoid in a Mouse Model of Atopic Dermatitis

PubMed Central

Babakhin, Alexander; Andreev, Sergey; Nikonova, Alexandra; Shilovsky, Igor; Buzuk, Andrey; Elisyutina, Olga; Fedenko, Elena; Khaitov, Musa

2015-01-01

Atopic dermatitis (AD) is a widespread and difficult to treat allergic skin disease and is a tough challenge for healthcare. In this study, we investigated whether allergen-specific immunotherapy (ASIT) with a monomeric allergoid obtained by succinylation of ovalbumin (sOVA) is effective in a mouse model of atopic dermatitis. An experimental model of AD was reproduced by epicutaneous sensitization with ovalbumin (OVA). ASIT was performed with subcutaneous (SC) administration of increasing doses of OVA or sOVA. The levels of anti-OVA antibodies, as well as cytokines, were detected by ELISA. Skin samples from patch areas were taken for histologic examination. ASIT with either OVA or sOVA resulted in a reduction of both the anti-OVA IgE level and the IgG1/IgG2a ratio. Moreover, ASIT with sOVA increased the IFN-γ level in supernatants after splenocyte stimulation with OVA. Histologic analysis of skin samples from the sites of allergen application showed that ASIT improved the histologic picture by decreasing allergic inflammation in comparison with untreated mice. These data suggest that ASIT with a succinylated allergen represents promising approach for the treatment of AD. PMID:26275152

[From a Ph.D. Thesis: Understanding the Past, Predicting the Future].

PubMed

Watanabe, Kenichi

2018-01-01

　Posey et al. have reported multiple molecular diagnoses in 4.5% of cases (101/2076) in which whole-exome sequencing was informative. Distinct disease phenotypes affect different organ systems, whereas overlapping disease phenotypes are more likely to be caused by two genes encoding proteins that interact within the same pathway. My research projects at the Niigata University of Pharmacy have investigated underlying mechanisms involved in human disease, including fatty acid metabolism, diabetic cardiomyopathy, atopic dermatitis, colitis, hepatitis, etc. Three students from abroad graduated this year from the Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences. These students reported on treatments for heart disease, non-alcoholic steatohepatitis and atopic dermatitis, as well as the underlying mechanisms involved in each. The titles of these reports are "Study of the role of cardiac 14-3-3η protein in cardiac inflammation and adverse cardiac remodeling during heart failure in mice", "Non-alcoholic steatohepatitis: onset of mechanisms under diabetic background and treatment strategies" and "The role of HMGB1 and its cascade signaling pathway in atopic dermatitis". It can be concluded from these three theses that oxidative stress and inflammation are among the principal mechanisms underlying these diseases.

Translating Atopic Dermatitis Management Guidelines Into Practice for Primary Care Providers.

PubMed

Eichenfield, Lawrence F; Boguniewicz, Mark; Simpson, Eric L; Russell, John J; Block, Julie K; Feldman, Steven R; Clark, Adele R; Tofte, Susan; Dunn, Jeffrey D; Paller, Amy S

2015-09-01

Atopic dermatitis affects a substantial number of children, many of whom seek initial treatment from their pediatrician or other primary care provider. Approximately two-thirds of these patients have mild disease and can be adequately managed at the primary care level. However, recent treatment guidelines are written primarily for use by specialists and lack certain elements that would make them more useful to primary care providers. This article evaluates these recent treatment guidelines in terms of evaluation criteria, treatment recommendations, usability, accessibility, and applicability to nonspecialists and integrates them with clinical evidence to present a streamlined severity-based treatment model for the management of a majority of atopic dermatitis cases. Because each patient's situation is unique, individualization of treatment plans is critical as is efficient communication and implementation of the plan with patients and caregivers. Specifically, practical suggestions for individualizing, optimizing, implementing, and communicating treatment plans such as choosing a moisturizer formulation, avoiding common triggers, educating patients/caregivers, providing written treatment plans, and scheduling physician follow-up are provided along with a discussion of available resources for patients/caregivers and providers. Copyright © 2015 by the American Academy of Pediatrics.

Psychological comorbidity in patients with chronic tinnitus: analysis and comparison with chronic pain, asthma or atopic dermatitis patients.

PubMed

Zirke, N; Seydel, C; Szczepek, A J; Olze, H; Haupt, H; Mazurek, B

2013-03-01

To determine the prevalence and severity of psychological comorbidity in patients with chronic tinnitus in comparison with other chronic illnesses, namely chronic pain, chronic asthma and atopic dermatitis. Psychological diagnoses were done according to ICD-10 Chapter V(F). Subjective impairment was evaluated using 5 psychometric questionnaires: tinnitus questionnaire, Berlin mood questionnaire, sense of coherence (SOC-L9) and perceived stress questionnaire. Sleep disturbance was measured by the subdomain 'exhaustion' of the Giessen physical complaints inventory. Somatoform or affective disorders were most frequent in all disease groups. Patients with chronic tinnitus had a stronger SOC and better subjective mood, stronger commitment, and less anger and anxious depression than the patients with chronic pain, chronic asthma or atopic dermatitis. However, in patients with higher tinnitus annoyance, psychological comorbidity was similar to that found in patients with other chronic diseases. Besides collecting medical and social history, special psychometric instruments should be used for the diagnosis of tinnitus patients. Based on relative high frequency of psychological comorbidity, we recommend interdisciplinary cooperation between otorhinolaryngologists and other specialists (psychosomatic medicine, psychology or psychiatry) during the treatment of tinnitus patients, especially when high degree of tinnitus annoyance is involved.

Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice

PubMed Central

Lee, Soon-Hee; Heo, Yong

2010-01-01

Historically, German chamomile (GC) oil has been used for treatment of skin disorders. BALB/c mice were sensitized twice a week with 100 µL of 1% 2,4-dinitrochlorobenzene (DNCB) and challenged twice the following week with 100 µL of 0.2% DNCB for atopic dermatitis induction. Thereafter, 3% GC oil was applied daily (70 µL, 6 times week) on the dorsal skin for 4 weeks. Saline or jojoba oil was used for the control mice. Blood was collected after second DNCB challenge, and at 2 and 4 weeks after initiating oil application. Serum IgE levels were significantly lowered in the GC oil application group at the end of the 4-week application period. The GC oil application for 4 weeks resulted in reduction in serum IgG1 level compared with that after 2-week application. The GC oil application group showed a significantly lower serum histamine level than the control group 2 weeks after oil application. Scratching frequency of the GC oil application group was significantly lower than either control groups. This study is to demonstrate GC oil's immunoregulatory potential for alleviating atopic dermatitis through influencing of Th2 cell activation. PMID:20195063

Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice.

PubMed

Lee, Soon-Hee; Heo, Yong; Kim, Young-Chul

2010-03-01

Historically, German chamomile (GC) oil has been used for treatment of skin disorders. BALB/c mice were sensitized twice a week with 100 microL of 1% 2,4-dinitrochlorobenzene (DNCB) and challenged twice the following week with 100 microL of 0.2% DNCB for atopic dermatitis induction. Thereafter, 3% GC oil was applied daily (70 microL, 6 times week) on the dorsal skin for 4 weeks. Saline or jojoba oil was used for the control mice. Blood was collected after second DNCB challenge, and at 2 and 4 weeks after initiating oil application. Serum IgE levels were significantly lowered in the GC oil application group at the end of the 4-week application period. The GC oil application for 4 weeks resulted in reduction in serum IgG1 level compared with that after 2-week application. The GC oil application group showed a significantly lower serum histamine level than the control group 2 weeks after oil application. Scratching frequency of the GC oil application group was significantly lower than either control groups. This study is to demonstrate GC oil's immunoregulatory potential for alleviating atopic dermatitis through influencing of Th2 cell activation.

Pilot Study to Evaluate the Effect of Topical Dimethicone on Clinical Signs and Skin Barrier Function in Dogs with Naturally Occurring Atopic Dermatitis

PubMed Central

Pellicoro, C.; Marsella, R.; Ahrens, K.

2013-01-01

This study investigated the effects of a skin protectant solution (dimethicone 2%) on clinical signs and skin barrier function in canine atopic dermatitis (AD). Eighteen dogs with AD were randomly divided into two groups, one received dimethicone and the other received the vehicle (cyclomethicone) on selected areas (pinnae, groin, and axillae) daily for 4 weeks. Owners and investigators were blinded regarding group allocation. Clinical efficacy was evaluated using a scoring system and skin barrier by measuring the transepidermal water loss. Twelve dogs completed the study (50% drop rate in the vehicle and 20% in the dimethicone). For clinical signs, analysis of variance showed an effect of time (P < 0.005; day 0 > day 28) and region (axillae < groin < pinnae) but no effect of group or group × time interaction. For transepidermal water loss, analysis of variance showed only a main effect of region (axillae > pinnae > groin). Pearson found no correlation between transepidermal water loss and clinical scores. In this pilot study dimethicone had no significant effect on clinical signs and transepidermal water loss in canine atopic dermatitis. PMID:23710417

Bacterial pattern and antibiotic sensitivity in children and adolescents with infected atopic dermatitis

NASA Astrophysics Data System (ADS)

Samosir, C. T.; Ruslie, R. H.; Rusli, R. E.

2018-03-01

Atopic dermatitis (AD) is a pruritic and chronic inflammatory skin disease which affected approximately 20% in children. Bacterial infection is common in AD patients and correlates directly with AD severity. A cross-sectional study was conducted to evaluate the prevalence of bacterial skin infection in AD patients and its relation with severity of AD and also to study bacteria in the infected AD and its antibiotic sensitivity. Samples were 86 children and adolescents with an AD in Helvetia Community Health Center Medan from March 2016 until February 2017. Index of SCORing Atopic Dermatitis (SCORAD) was used to evaluate the severity of AD. Lesion and nonlesional skinwere swabbed to take sterile cultures. All bacteria noted and tested for antibiotic sensitivity. Datawere by using Chi-Square and Mann Whitney test with 95% CI and p-value<0.05 was considered statistically significant. Fifty-six AD patients (65.1%) were bacterial infected. There was a significant relationship between severity of AD and bacterial infection (p = 0.006). Staphylococcus aureus was the leading bacteria from all degrees of AD severity. Isolated Staphylococcus aureuswas sensitive to amoxicillin-clavulanate (93.3%), clindamycin (90%), erythromycin (90%), and gentamicin (90%), while sensitivity to tetracycline was low (20%).

Allergic rhinitis, atopic dermatitis, and asthma are associated with differences in school performance among Korean adolescents.

PubMed

Kim, So Young; Kim, Min-Su; Park, Bumjung; Kim, Jin-Hwan; Choi, Hyo Geun

2017-01-01

Several studies have reported negative relations between allergic diseases and school performance but have not simultaneously considered various allergic diseases, including allergic rhinitis, asthma, and atopic dermatitis, and only examined a limited number of participants. The present study investigated the associations of allergic rhinitis, asthma, and atopic dermatitis with school performance in a large, representative Korean adolescent population. A total of 299,695 7th through 12th grade students participated in the Korea Youth Risk Behaviour Web-based Survey (KYRBWS) from 2009 to 2013. The subjects' history of allergic rhinitis, asthma, and atopic dermatitis and number of school absences due to these diseases in the previous 12 months were examined and compared. School performance was classified into 5 levels. The relations between allergic disorders and school performance were analyzed using multiple logistic regressions with complex sampling and adjusted for the subjects' durations of sleep, days of physical activity, body mass indexes (BMIs), regions of residence, economic levels, parents' education levels, stress levels, smoking status, and alcohol use. A subgroup analysis of the economic groups was performed. Allergic rhinitis was positively correlated with better school performance in a dose-dependent manner (adjusted odds ratios, AOR, [95% confidence interval, CI] = 1.50 [1.43-1.56 > 1.33 [1.28-1.38] > 1.17 [1.13-1.22] > 1.09 [1.05-1.14] for grades A > B > C > D; P < 0.001). Asthma was negatively correlated with better school performance (AOR [95% CI] = 0.74 [0.66-0.83], 0.87 [0.79-0.96], 0.83 [0.75-0.91], 0.93 [0.85-1.02] for performance A, B, C, and D, respectively; P < 0.001). Atopic dermatitis was not significantly correlated with school performance. The subgroup analysis of the students' economic levels revealed associations between allergic diseases and school performance. Compared to other allergic disorders, the asthma group had more school absences due to their symptoms (P < 0.001). School performance was positively correlated with allergic rhinitis and negatively correlated with asthma in Korean adolescents, even after adjusting for other variables. The asthma group had an increased number of school absence days, which presumably contributes to these students' poor school performance.

The role of filaggrin in the skin barrier and disease development.

PubMed

Armengot-Carbo, M; Hernández-Martín, Á; Torrelo, A

2015-03-01

Filaggrin is a structural protein that is fundamental in the development and maintenance of the skin barrier. The function of filaggrin and its involvement in various cutaneous and extracutaneous disorders has been the subject of considerable research in recent years. Mutations in FLG, the gene that encodes filaggrin, have been shown to cause ichthyosis vulgaris, increase the risk of atopic dermatitis and other atopic diseases, and exacerbate certain conditions. The present article reviews the current knowledge on the role of filaggrin in the skin barrier, FLG mutations, and the consequences of filaggrin deficiency. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

Functional polysaccharides from Grifola frondosa aqueous extract inhibit atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Park, Hyeon Soo; Hwang, Yong Hyeon; Kim, Mun Ki; Hong, Gyeong Eun; Lee, Ho Jeong; Nagappan, Arulkumar; Yumnam, Silvia; Kim, Eun Hee; Heo, Jeong Doo; Lee, Sang Joon; Won, Chung Kil; Kim, Gon Sup

2015-01-01

Grifola frondosa (GF), distributed widely in far east Asia including Korea, is popularly used as traditional medicines and health supplementary foods, especially for enhancing the immune functions of the body. To extend the application of GF polysaccharides (GFP) for atopic dermatitis (AD), we investigated the effects of GFP on the 2,4-dinitrochlorobenzene-induced AD-like skin lesion in NC/Nga mice. GFP treatment significantly reduced the dorsa skin dermatitis score and combination treatment with GFP, and dexamethasone has a synergistic effect in AD-like skin lesion by reduced Serum IgE, mast cells infiltration, and cytokines expression. These results indicate that GFP suppressed the AD-like skin lesions by controlling the Th-1/Th-2-type cytokines in NC/Nga mice. These findings strongly suggest that GFP can be useful for AD patients as a novel therapeutic agent and might be used for corticosteroids replacement or supplement agent.

An assessment of the genetic toxicology of novel boron-containing therapeutic agents.

PubMed

Ciaravino, Vic; Plattner, Jacob; Chanda, Sanjay

2013-06-01

Boron-containing compounds are being studied as potential therapeutic agents. As part of the safety assessment of these therapeutic agents, a battery of genetic toxicology studies was conducted. The battery included a bacterial reverse mutation (Ames) assay, an in vitro chromosome aberration assay in peripheral human lymphocytes, and an in vivo rat micronucleus study. The following compounds represent some of the boron-containing compounds that have been advanced to human clinical trials in various therapeutic areas. The borinic picolinate, AN0128, is an antibacterial compound with anti-inflammatory activity that has been studied in clinical trials for acne and the treatment of mild to moderate atopic dermatitis. AN2690 (tavaborole) is a benzoxaborole in Phase 3 clinical trials for the topical treatment of onychomycosis, a fungal infection of the toenails and fingernails. Another benzoxaborole derivative, AN2728, a phosphodiesterase-4 (PDE4) inhibitor, is in Phase 2 clinical trials for the treatment of atopic dermatitis. AN2898, also a PDE4 inhibitor, has been studied in clinical trials for atopic dermatitis and psoriasis. AN3365 is a leucyl-tRNA synthetase inhibitor that has been in clinical development for the treatment of various Gram-negative bacterial infections. These five representative compounds were negative in the three genotoxicity assays. Furthermore, AN2690 has been studied in mouse and rat 2-year bioassays and was not found to have any carcinogenic potential. These results demonstrate that it is possible to design boron-based therapeutic agents with no genetic toxicology liabilities. Copyright © 2013 Wiley Periodicals, Inc.

[The contribution of food and airborne allergens in the pathogenesis of atopic dermatitis].

PubMed

Dynowska, Dorota; Kolarzyk, Emilia; Schlegel-Zawadzka, Małgorzata; Dynowski, Wojciech

2002-01-01

Food hypersensitivity and airborne allergens may play a role in the pathogenesis of atopic dermatitis (AD). The aim of this study was to evaluate the kind of food and airborne allergens which may most often induce and intensify AD lesions and also to assess the variability and the kind of allergens leading to AD. The subjects of this study were 610 persons, aged 3 months-70 years. The clinical status of the patients was estimated by an atopic dermatitis symptom score scale (SCORAD). The laboratory examinations differentiated inflammatory processes from allergic reactions. The skin prick tests (SPT), serum total IgE and specific IgE-antibody levels to chosen food products and standard airborne allergens with the immuno-enzymes method ELISA-DPC were performed. The elevated values of the total IgE were proved in 46.1% children from group 0-15 years and in 31.4% of adolescents and adult persons (above 15 year of age). On the basis of positive SPT and positive specific IgE values it was shown, that most frequent food allergens were: egg protein (13.0%), cow milk (9.5%), egg yolk (8.4%), wheat (3.6%) and chocolate (1.8%). The most often airborne allergens connected with AD were: grass (11.6%), moulds (10.2%), house dust mites (9.3%), pollen like hazel (8.0%) and weeds (6.7%), animal allergens coming from cats (7.2%) and dogs (6.1%). The food hypersensitivity was particularly manifested in children. It may be the predictor of potential future development of allergic disease as well as the indicator of the allergic march.

Effect of olive and sunflower seed oil on the adult skin barrier: implications for neonatal skin care.

PubMed

Danby, Simon G; AlEnezi, Tareq; Sultan, Amani; Lavender, Tina; Chittock, John; Brown, Kirsty; Cork, Michael J

2013-01-01

Natural oils are advocated and used throughout the world as part of neonatal skin care, but there is an absence of evidence to support this practice. The goal of the current study was to ascertain the effect of olive oil and sunflower seed oil on the biophysical properties of the skin. Nineteen adult volunteers with and without a history of atopic dermatitis were recruited into two randomized forearm-controlled mechanistic studies. The first cohort applied six drops of olive oil to one forearm twice daily for 5 weeks. The second cohort applied six drops of olive oil to one forearm and six drops of sunflower seed oil to the other twice daily for 4 weeks. The effect of the treatments was evaluated by determining stratum corneum integrity and cohesion, intercorneocyte cohesion, moisturization, skin-surface pH, and erythema. Topical application of olive oil for 4 weeks caused a significant reduction in stratum corneum integrity and induced mild erythema in volunteers with and without a history of atopic dermatitis. Sunflower seed oil preserved stratum corneum integrity, did not cause erythema, and improved hydration in the same volunteers. In contrast to sunflower seed oil, topical treatment with olive oil significantly damages the skin barrier, and therefore has the potential to promote the development of, and exacerbate existing, atopic dermatitis. The use of olive oil for the treatment of dry skin and infant massage should therefore be discouraged. These findings challenge the unfounded belief that all natural oils are beneficial for the skin and highlight the need for further research. © 2012 Wiley Periodicals, Inc.

Clinical Practice Guidelines for the Management of Atopic Dermatitis 2016.

PubMed

Saeki, Hidehisa; Nakahara, Takeshi; Tanaka, Akio; Kabashima, Kenji; Sugaya, Makoto; Murota, Hiroyuki; Ebihara, Tamotsu; Kataoka, Yoko; Aihara, Michiko; Etoh, Takafumi; Katoh, Norito

2016-10-01

Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. Most patients have an atopic predisposition. The definitive diagnosis of AD requires the presence of all three features: (i) pruritus; (ii) typical morphology and distribution of the eczema; and (iii) chronic and chronically relapsing course. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice. © 2016 Japanese Dermatological Association.

Barrier function and microbiotic dysbiosis in atopic dermatitis

PubMed Central

Seite, Sophie; Bieber, Thomas

2015-01-01

Atopic dermatitis (AD) or atopic eczema is the common inflammatory skin disorder, the prevalence of which has considerably increased during the last 30 years. It affects 15%–30% of children and 2%–10% of adults. AD characteristically alternates between periods of exacerbation or flares and periods of remission, which may be therapeutically induced or spontaneous. Current knowledge about AD includes abnormalities of the skin barrier (physical and chemical), the immune barrier, and more recently, the microbial barrier or microbiota. There is growing evidence for a tight relationship between them. To obtain satisfactory control of this condition, the clinical strategy to manage AD involves prescribing both anti-inflammatory medications and dermocosmetic products. The role of the physician is therefore to advise the patient with regard to hygiene measures aimed to help to improve these three barriers or to prevent any further deterioration. PMID:26396539

Germline hypomorphic CARD11 mutations in severe atopic disease

PubMed Central

Ma, Chi A; Stinson, Jeffrey R; Zhang, Yuan; Abbott, Jordan K; Weinreich, Michael A; Hauk, Pia J; Reynolds, Paul R; Lyons, Jonathan J; Nelson, Celeste G; Ruffo, Elisa; Dorjbal, Batsukh; Glauzy, Salomé; Yamakawa, Natsuko; Arjunaraja, Swadhinya; Voss, Kelsey; Stoddard, Jennifer; Niemela, Julie; Zhang, Yu; Rosenzweig, Sergio D; McElwee, Joshua J; DiMaggio, Thomas; Matthews, Helen F; Jones, Nina; Stone, Kelly D; Palma, Alejandro; Oleastro, Matías; Prieto, Emma; Bernasconi, Andrea R; Dubra, Geronimo; Danielian, Silvia; Zaiat, Jonathan; Marti, Marcelo A; Kim, Brian; Cooper, Megan A; Romberg, Neil D; Meffre, Eric; Gelfand, Erwin W; Snow, Andrew L; Milner, Joshua D

2017-01-01

Few monogenic causes for severe manifestations of common allergic diseases have been identified. Via next generation sequencing on a cohort of patients with severe atopic dermatitis, some with comorbid infections, we found 8 individuals from 4 families with novel heterozygous mutations in CARD11, a scaffolding protein involved in lymphocyte receptor signaling. Disease improved over time in most patients. Transfection of mutant expression constructs into T cell lines demonstrated both loss of function and dominant interfering activity upon antigen receptor-induced NF-κB and mTORC1 activation. Patient T-cells had similar defects, as well as diminished IFN-γ cytokine production. The mTORC1 and IFN-γ production defects could be partially rescued by supplementing with glutamine, which requires CARD11 for import into T cells. Our findings indicate a single hypomorphic gene mutation in CARD11 can cause potentially correctable cellular defects that lead to atopic dermatitis. PMID:28628108

Dietary apigenin attenuates the development of atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Yano, Satomi; Umeda, Daisuke; Yamashita, Shuya; Yamada, Koji; Tachibana, Hirofumi

2009-11-01

One of the flavones, apigenin has various physiological functions including anti-inflammatory activities. Atopic dermatitis (AD) is a chronically relapsing inflammatory disorder that is characterized by pruritic and eczematous skin lesions. To evaluate the anti-allergic effect of apigenin in vivo, we examined the effect of dietary apigenin on picrylchloride (PiCl)-induced AD-like pathology in NC/Nga mice. NC/Nga mice were fed experimental diets containing apigenin from Day 18 after sensitized with PiCl for 4 weeks. Dietary apigenin significantly alleviated the development of skin lesions, accompanied by lower serum immunoglobulin (Ig) G1 and IgE levels in NC/Nga mice. Interferon (IFN)-gamma mRNA expression level in spleen cells from NC/Nga mice was reduced by apigenin feeding. Moreover, interleukin 4-induced signal transducers and activators of transcription 6 phosphorylation in primary spleen cells from BALB/c mice was inhibited by treatment with apigenin. These results suggest that apigenin attenuates exacerbation of AD-like symptoms in part through the reduction of serum IgE level and IFN-gamma expression in NC/Nga mice.

Clinical comparison of human and canine atopic dermatitis using human diagnostic criteria (Japanese Dermatological Association, 2009): proposal of provisional diagnostic criteria for canine atopic dermatitis.

PubMed

Terada, Yuri; Nagata, Masahiko; Murayama, Nobuo; Nanko, Hiroko; Furue, Masutaka

2011-08-01

Atopic dermatitis (AD) is a common skin disease encountered in both humans and dogs. Canine AD can be used in the analysis of naturally occurring AD; however, details of clinical comparison have been lacking. The purpose of this study is to compare those clinical features using the human diagnostic criteria (Japanese Dermatological Association, 2009). Fifty-one dogs with canine AD were evaluated by the human criteria. Prior to this study, canine AD was basically diagnosed by the fulfillment of two authentic canine AD criteria and a positive reaction against Dermatophagoides farinae in serum immunoglobulin E levels and/or in intradermal tests. Among the human AD criteria items, behavior corresponding to pruritus was observed in all 51 dogs. Skin lesions corresponding to eczematous dermatitis were seen in 50 dogs, and symmetrical distribution of skin lesions was noted in all 51 dogs. A chronic or chronically relapsing course was observed in 50 dogs. Based on these results, the concordance rate for the criteria was 96% (49/51). Differential diagnoses of AD were also investigated in the same manner. The concordance rate for the criteria was 0% (0/69) in scabies, 2% (1/50) in pyoderma, 0% (0/50) in demodicosis, 0% (0/9) in cutaneous lymphoma, 0% (0/2) in ichthyosis, 25% (2/7) in flea allergy, 48% (24/50) in seborrheic dermatitis and 75% (3/4) in food allergy. Canine AD is thus indicated as a valuable counterpart to human AD in clinical aspects. In addition, the human AD criteria could be applicable, with some modification, as provisional diagnostic criteria for canine AD. © 2011 Japanese Dermatological Association.

[Key points for the management of dermatitis in Latin America. The SLAAI Consensus].

PubMed

Sánchez, Jorge; Páez, Bruno; Macías-Weinmann, Alejandra; De Falco, Alicia

2015-01-01

The incidence of atopic dermatitis in Latin America, as in other regions, has been increasing in recent years. The SLAAI consensus is based on a systematic search for articles related to dermatitis, with focus in the pathophysiology and treatment and its impact on Latin America, and reviewed using the Delphi methodology (Revista Alergia Mexico 2014;61:178-211). In this article we highlight the key points of consensus and particular considerations in Latin America.

Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review.

PubMed

Zafrir, Yaron; Trattner, Akiva; Hodak, Emmillia; Eldar, Oren; Lapidoth, Moshe; Ben Amitai, Dan

2018-01-01

Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature. The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files. Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively). Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background. © 2017 Wiley Periodicals, Inc.

Nemolizumab in moderate-to-severe atopic dermatitis: Randomized, phase II, long-term extension study.

PubMed

Kabashima, Kenji; Furue, Masutaka; Hanifin, Jon M; Pulka, Grazyna; Wollenberg, Andreas; Galus, Ryszard; Etoh, Takafumi; Mihara, Ryosuke; Nakano, Miwa; Ruzicka, Thomas

2018-05-09

Nemolizumab, an anti-interleukin-31 receptor A monoclonal antibody, improved pruritus, dermatitis, and sleep in adults with moderate-to-severe atopic dermatitis inadequately controlled by topical treatments in a phase II, 12-week, randomized, double-blind, placebo-controlled study (Part A) (NCT01986933). To assess long-term efficacy and safety of nemolizumab injected subcutaneously every 4 weeks (Q4W) or every 8 weeks (Q8W) in a 52-week double-blind extension (Part B). During Part B, patients continued previous nemolizumab dose (0.1, 0.5, or 2.0 mg/kg Q4W or 2.0 mg/kg Q8W). Part B endpoints included percentage improvement from baseline in pruritus visual analogue scale (VAS) and dermatitis scores (including Eczema Area and Severity Index [EASI]). Overall, 216/264 patients completed Part A and 191 entered Part B; 131 completed Part B. In 153 patients randomized to nemolizumab in Part A, improvement from baseline in pruritus VAS was maintained/increased from Week 12 to 64, with greatest improvement in the 0.5-mg/kg Q4W group (percentage change from baseline at Week 64: -73.0, -89.6, -74.7, and -79.1 in the 0.1-, 0.5-, and 2.0-mg/kg Q4W and 2.0-mg/kg Q8W groups, respectively). Improvement from baseline in dermatitis scores was also maintained/increased to Week 64 (percent change in EASI score: -68.5, -75.8, -78.9, and -69.3 in the 0.1-, 0.5-, and 2.0-mg/kg Q4W and 2.0-mg/kg Q8W groups, respectively). Over 64 weeks, 83-89% had ≥1 adverse event, with no new safety concerns identified. Nemolizumab for up to 64 weeks was efficacious and, overall, well tolerated in patients with moderate-to-severe atopic dermatitis inadequately controlled by topical therapy. Copyright © 2018. Published by Elsevier Inc.

Relationships among plasma granzyme B level, pruritus and dermatitis in patients with atopic dermatitis.

PubMed

Kamata, Yayoi; Kimura, Utako; Matsuda, Hironori; Tengara, Suhandy; Kamo, Atsuko; Umehara, Yoshie; Iizumi, Kyoichi; Kawasaki, Hiroaki; Suga, Yasushi; Ogawa, Hideoki; Tominaga, Mitsutoshi; Takamori, Kenji

2016-12-01

Atopic dermatitis (AD) is a multifactorial inflammatory skin disease characterized by skin barrier dysfunction, allergic inflammation and intractable pruritus resistant to conventional antipruritic treatments, including H 1 -antihistamines. Granzymes (Gzms) are a family of serine proteases expressed by cytotoxic T lymphocytes and natural killer cells that have been shown to modulate inflammation. However, the relationship between Gzms and pathology in AD remains unclear. This study assessed the correlation between plasma GzmB levels and severity of pruritus and dermatitis, in AD patients. Plasma was collected from 46 patients with AD, 24 patients with psoriasis, and 30 healthy controls. AD severity was assessed with the scoring atopic dermatitis (SCORAD) index, psoriasis severity with the psoriasis area and severity index (PASI), and degree of pruritus by visual analogue scale (VAS) score. GzmA, GzmB and gastrin releasing peptide (GRP) levels were measured by enzyme-linked immunosorbent assays. Plasma GzmB concentrations were significantly higher in patients with AD and psoriasis than in healthy controls. Correlation analyses showed that plasma GzmB concentrations positively correlated with SCORAD and serum levels of severity markers such as thymus and activation-regulated chemokine, and lactate dehydrogenase in AD patients. Moreover, plasma levels of GRP, an itch-related peptide, were higher in patients with AD, positively correlating with VAS score and plasma GzmB level. In addition, plasma GzmB concentration was significantly lower in the treatment group than the untreated group with AD. Meanwhile, there were no correlations among GzmB levels, VAS score and PASI score in patients with psoriasis. In contrast to the results of plasma GzmB, plasma GzmA levels were unchanged among AD, psoriasis and healthy groups, and showed no correlations with VAS score and SCORAD index in patients with AD. Plasma GzmB levels may reflect the degree of pruritus and dermatitis in patients with AD. Copyright © 2016 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

Atopic dermatitis in West Highland white terriers is associated with a 1.3-Mb region on CFA 17.

PubMed

Roque, Joana B; O'Leary, Caroline A; Duffy, David L; Kyaw-Tanner, Myat; Gharahkhani, Puya; Vogelnest, Linda; Mason, Kenneth; Shipstone, Michael; Latter, Melanie

2012-03-01

Canine atopic dermatitis (AD) is an allergic inflammatory skin disease that shares similarities with AD in humans. Canine AD is likely to be an inherited disease in dogs and is common in West Highland white terriers (WHWTs). We performed a genome-wide association study using the Affymetrix Canine SNP V2 array consisting of over 42,800 single nucleotide polymorphisms, on 35 atopic and 25 non-atopic WHWTs. A gene-dropping simulation method, using SIB-PAIR, identified a projected 1.3 Mb area of association (genome-wide P = 6 × 10(-5) to P = 7 × 10(-4)) on CFA 17. Nineteen genes on CFA 17, including 1 potential candidate gene (PTPN22), were located less than 0.5 Mb from the interval of association identified on the genome-wide association analysis. Four haplotypes within this locus were differently distributed between cases and controls in this population of dogs. These findings suggest that a major locus for canine AD in WHWTs may be located on, or in close proximity to an area on CFA 17.

Eczema, Atopic Dermatitis, or Atopic Eczema: Analysis of Global Search Engine Trends.

PubMed

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.

Serum allergen-specific immunoglobulin E in atopic and healthy cats: comparison of a rapid screening immunoassay and complete-panel analysis.

PubMed

Diesel, Alison; DeBoer, Douglas J

2011-02-01

Feline and canine atopic dermatitis are thought to have a similar immunopathogenesis. As with dogs, detection of allergen-specific IgE in cat serum merely supports a diagnosis of feline atopy based on compatible history, clinical signs and elimination of other pruritic dermatoses. In this study, a rapid screening immunoassay (Allercept(®) E-Screen 2nd Generation; Heska AG, Fribourg, Switzerland; ES2G) was compared with a complete-panel serum allergen-specific IgE assay (Allercept(®); Heska AG; CP) in healthy cats with no history of skin disease and in atopic cats. The latter had no diagnosis of external parasitism, infection, food hypersensitivity or other skin disease explaining their pruritus, and expressed cutaneous reaction patterns typically associated with feline allergic skin disease (head, neck or pinnal pruritus, miliary dermatitis, self-induced alopecia, eosinophilic granuloma complex). The proportion of cats positive on either the ES2G or the CP assays was not significantly different between the atopic and healthy cat groups. There was, however, strong agreement between the results of the ES2G and CP assay; overall, the two tests were in agreement for 43 of 49 (88%) serum samples. There was also strong agreement when individual allergen groups were evaluated (agreement noted: indoor, 41 of 49 samples; grasses/weeds, 37 of 49 samples; and trees, 41 of 49 samples). These results indicate that although neither test is diagnostic for feline atopic dermatitis, the screening assay is beneficial for predicting the results of a complete-panel serum allergen-specific IgE assay in cats. © 2010 The Authors. Journal compilation © 2010 ESVD and ACVD.

Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment.

PubMed

Kaufman, Bridget P; Guttman-Yassky, Emma; Alexis, Andrew F

2018-04-01

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects diverse ethnic groups with varying prevalence. Despite a predominance of studies in individuals of European ancestry, AD has been found to occur more frequently in Asian and Black individuals than Whites. Therefore, an understanding of the unique clinical features of AD in diverse ethnic groups, as well as the differences in genetic polymorphisms that influence susceptibility to AD and response to current therapies, is paramount for management of an increasingly diverse patient population. In this article, we review key nuances in the epidemiology, pathophysiology, clinical presentation and treatment of AD in non-White ethnic groups, which are largely underappreciated in the literature. We highlight the need for studies evaluating the tissue molecular and cellular phenotypes of AD in non-White patients, as well as greater inclusion of minority groups in clinical trials, to develop targeted treatments for a multi-ethnic population. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Alternatives to animal testing in basic and preclinical research of atopic dermatitis.

PubMed

Löwa, Anna; Jevtić, Marijana; Gorreja, Frida; Hedtrich, Sarah

2018-05-01

Atopic dermatitis (AD) is a chronic inflammatory skin disease of increasing prevalence, especially in industrialized countries. Roughly 25% of the children and 1%-3% of adults are affected. Although significant progress has been made in the understanding of the pathogenesis of AD, many aspects remain poorly understood. Moreover, there is a pressing need for improved therapeutic options. Studies to elucidate the pathophysiological pathways of AD and to identify novel therapeutic targets over the last few decades have been conducted almost exclusively in animal models. However, in vitro approaches such as 3D skin disease models have recently emerged due to an increasing awareness of distinct interspecies-related differences that hamper the effective translation of results from animal models to humans. In addition, there is growing political and social pressure to develop alternatives to animal models according to the 3Rs principle (reduction, refinement and replacement of animal models). © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The effect of wasabi rhizome extract on atopic dermatitis-like symptoms in HR-1 hairless mice.

PubMed

Nagai, Masashi; Okunishi, Isao

2009-04-01

We investigated the effect of wasabi rhizome extract on atopic dermatitis (AD) model mice. The wasabi extract was fed to the HR-1 hairless mice, which develop AD-like symptoms with a special diet (HR-AD diet). The extract was expected to reduce the symptoms induced. Wasabi rhizome-containing HR-AD diet (5% and 10%) reduced the scratching behavior, and the 10% wasabi rhizome HR-AD diet significantly reduced scratching behavior on days 28, 35 and 42. Plasma components (histamine, eotaxin, IgE and thymus and activation-regulated chemokine (TARC)) were decreased in the 10% wasabi rhizome HR-AD diet. In histopathological examinations (toluidine blue (T.B.), major basic protein (MBP), CD4, IL-4, IL-5, eotaxin, TARC and IgE), the wasabi rhizome-containing HR-AD diet (5% and 10%) significantly reduced the number of positive stained cells. These results suggested that the wasabi rhizome extract improved the AD-like symptoms of HR-1 hairless mice.

A Review of Multidisciplinary Interventions in Atopic Dermatitis

PubMed Central

Spielman, Sara C.; LeBovidge, Jennifer S.; Timmons, Karol G.; Schneider, Lynda C.

2015-01-01

Multidisciplinary interventions have been developed for patients with atopic dermatitis (AD) and their families, with the aim of improving outcomes such as disease control, adherence, and quality of life. We reviewed the content of different multidisciplinary approaches to intervention for AD and evidence for their impact on key outcome measures. We also provided data from our multidisciplinary outpatient program for pediatric AD. Studies included in the review suggest benefits of multidisciplinary interventions as models of treatment or adjuncts to standard medical care, with a positive impact on outcomes including disease severity and itching/scratching. There were limitations to existing studies, including heterogeneous methods used to assess quality of life outcomes across studies and lack of controlled studies assessing the outcome of clinical care programs. Further research will be useful in assessing the impact of multidisciplinary interventions on important outcomes such as treatment adherence and sleep, identifying the elements of multidisciplinary interventions that are most critical for improved outcomes, and identifying the best candidates for multidisciplinary intervention approaches. PMID:26239470

Mast cells are dispensable in a genetic mouse model of chronic dermatitis.

PubMed

Sulcova, Jitka; Meyer, Michael; Guiducci, Eva; Feyerabend, Thorsten B; Rodewald, Hans-Reimer; Werner, Sabine

2015-06-01

Chronic inflammatory skin diseases, such as atopic dermatitis, affect a large percentage of the population, but the role of different immune cells in the pathogenesis of these disorders is largely unknown. Recently, we found that mice lacking fibroblast growth factor receptor 1 (Fgfr1) and Fgfr2 (K5-R1/R2 mice) in the epidermis have a severe impairment in the epidermal barrier, which leads to the development of a chronic inflammatory skin disease that shares many features with human atopic dermatitis. Using Fgfr1-/Fgfr2-deficient mice, we analyzed the consequences of the loss of mast cells. Mast cells accumulated and degranulated in the skin of young Fgfr1-/Fgfr2-deficient mice, most likely as a consequence of increased expression of the mast cell chemokine Ccl2. The increase in mast cells occurred before the development of histological abnormalities, indicating a functional role of these cells in the inflammatory skin phenotype. To test this hypothesis, we mated the Fgfr1-/Fgfr2-deficient mice with mast cell-deficient CreMaster mice. Surprisingly, loss of mast cells did not or only mildly affect keratinocyte proliferation, epidermal thickness, epidermal barrier function, accumulation and activation of different immune cells, or expression of different proinflammatory cytokines in the skin. These results reveal that mast cells are dispensable for the development of chronic inflammation in response to a defect in the epidermal barrier. Copyright © 2015 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Predominant genera of fecal microbiota in children with atopic dermatitis are not altered by intake of probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis Bi-07.

PubMed

Larsen, Nadja; Vogensen, Finn K; Gøbel, Rikke; Michaelsen, Kim F; Abu Al-Soud, Waleed; Sørensen, Søren J; Hansen, Lars H; Jakobsen, Mogens

2011-03-01

The effect of probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 on the composition of the Lactobacillus group, Bifidobacterium and the total bacterial population in feces from young children with atopic dermatitis was investigated. The study included 50 children randomized to intake of one of the probiotic strain or placebo. Microbial composition was characterized by denaturing gradient gel electrophoresis, quantitative PCR and, in a subset of subjects, by pyrosequencing of the 16S rRNA gene. The core population of the Lactobacillus group was identified as Lactobacillus gasseri, Lactobacillus fermentum, Lactobacillus oris, Leuconostoc mesenteroides, while the bifidobacterial community included Bifidobacterium adolescentis, Bifidobacterium bifidum, Bifidobacterium longum and Bifidobacterium catenulatum. The fecal numbers of L. acidophilus and B. lactis increased significantly after intervention, indicating survival of the ingested bacteria. The levels of Bifidobacterium correlated positively (P=0.03), while the levels of the Lactobacillus group negatively (P=0.01) with improvement of atopic eczema evaluated by the Severity Scoring of Atopic Dermatitis index. This correlation was observed across the whole study cohort and not attributed to the probiotic intake. The main conclusion of the study is that administration of L. acidophilus NCFM and B. lactis Bi-07 does not affect the composition and diversity of the main bacterial populations in feces. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

The effects of topical sodium cromoglicate on itch and flare in human skin induced by intradermal histamine: a randomised double-blind vehicle controlled intra-subject design trial

PubMed Central

2011-01-01

Background Itch is a prominent feature of many skin diseases, particularly atopic dermatitis and cutaneous mastocytosis. Sodium cromoglicate (SCG), a chromone developed for the treatment of allergic disease has been shown to reduce the severity of itch when applied topically to subjects with atopic dermatitis. The aim of this study was to investigate whether topical sodium cromoglicate can reduce the severity of itch induced by intradermal histamine. Methods SCG was introduced into the skin of healthy volunteers both by iontophoresis and by topical application using a new 4% cutaneous emulsion (Altoderm™). The skin was then challenged with intradermal histamine. Measurements were made of severity of itch, size of wheal and flare and change in blood flux Results SCG significantly reduced the severity of itch (P = 0.0045) and flare (P = 0.0143) when delivered by iontophoresis. SCG 4% cutaneous emulsion significantly reduced severity of itch (P = 0.024) and flare (P = 0.015) in atopic subjects. Trend analysis showed increasing effect on itch with increased concentrations of SCG, which was significant (P = 0.046). There were no effects on wheal or blood flux. Conclusions Topically applied SCG, administered in a new cutaneous emulsion base, significantly reduced the itch and flare caused by intradermal histamine. The effect was greatest in atopic subjects and increased with the concentration of SCG in the emulsion. Trial registration ISRCTN35671014 PMID:21385340

Lifetime Increased Risk of Adult Onset Atopic Dermatitis in Adolescent and Adult Patients with Food Allergy.

PubMed

Yu, Hsu-Sheng; Tu, Hung-Pin; Hong, Chien-Hui; Lee, Chih-Hung

2016-12-27

Food allergy can result in life-threatening anaphylaxis. Atopic dermatitis (AD) causes intense itching and impaired quality of life. Previous studies have shown that patients with classical early-onset AD tend to develop food allergy and that 10% of adults with food allergies have concomitant AD. However, it is not known whether late-onset food allergy leads to adult-onset AD, a recently recognized disease entity. Using an initial cohort of one-million subjects, this study retrospectively followed-up 2851 patients with food allergy (age > 12 years) for 14 years and compared them with 11,404 matched controls. While 2.8% (81) of the 2851 food allergy patients developed AD, only 2.0% (227) of the 11,404 controls developed AD. Multivariate regression analysis showed that food allergy patients were more likely to develop AD (adjusted hazard ratio = 2.49, p < 0.0001). Controls had a 1.99% risk of developing AD, while food allergy patients had a significantly higher risk (7.18% and 3.46% for patients with ≥3 and <3 food allergy claims, respectively) of developing adult-onset AD. This is the first study to describe the chronological and dose-dependent associations between food allergy in adolescence and the development of adult-onset AD.

Late-onset onchocercal skin disease among Ethiopian immigrants.

PubMed

Baum, S; Greenberger, S; Pavlotsky, F; Solomon, M; Enk, C D; Schwartz, E; Barzilai, A

2014-11-01

Onchocerciasis is an infectious disease caused by the filaria Onchocerca volvulus. Very little is known regarding onchocerciasis imported from endemic to nonendemic areas. To evaluate pruritic dermatitis simulating atopic dermatitis in Ethiopian immigrants in Israel. A retrospective study of 27 Ethiopian immigrants to Israel was conducted. Demographics and clinical and laboratory data were collected. Of the group of 27 patients, 10 (37%) were men and 17 (63%) were women. The average age at referral was 29 years. All of the patients emigrated from Kuwara, Ethiopia. Diagnosis was done by either positive skin snip test or immunoglobulin (Ig) G4 serology of onchocerciasis in 14 patients. The most common presentation was a combination of lichenified onchodermatitis with atrophy and depigmentation (36%). Eosinophilia and elevated IgE levels were common. Seventeen patients were treated with a single administration of oral ivermectin 200 μg mg(-1). Thirteen patients responded to the treatment. Immigrants from endemic regions to developed countries presenting with pruritic diseases, especially those with a clinical picture suggestive of atopic dermatitis, should be evaluated for possible onchocerciasis infection. Ivermectin, a relatively safe and low-cost treatment, should be considered even in the absence of a proven disease. Physicians should have a high index of suspicion in patients with the corresponding residential history. © 2014 British Association of Dermatologists.

A Boy with Relentless Pruritus: Job's Syndrome.

PubMed

Khan, Kamran; Wozniak, Susan E; Giannone, Anna Lucia; Abdulmassih, Maria Elena

2016-02-21

Job's syndrome (hyper IgE syndrome) is a very rare primary immunodeficiency disease that has an annual approximate incidence of less than 1/1,000,000. This manuscript aims to provide education regarding diagnosis and management strategies of this syndrome worldwide. A 6-year-old boy was seen at the clinic secondary to persistent pruritus interfering with sleep. At the age of 2 months, the patient developed diffuse eczematous and desquamating skin lesions. He was subsequently diagnosed with atopic dermatitis and managed conservatively. From 2 months to 7 years of age, intermittent exacerbations of dermatitis persisted despite an aggressive treatment regimen. The serum IgE level increased exponentially over a period of 7 years, with a peak value of 57,400 IU/ml. Molecular genetic testing revealed a dominant negative mutation within the SH2 domain of the Signal Transducer and Activator of Transcription (STAT3) gene. The patient was subsequently diagnosed with Job's syndrome. Management included proper skin care, prophylactic antibiotics, immunomodulating agents, and psychotherapy. Job's syndrome can often go unrecognized and masquerade as atopic dermatitis. Therefore, genetic testing for this condition should be obtained in all patients with treatment-refractory AD. Additionally, psychotherapy can be a successful management strategy for the grating psychological impact that can be imposed on children with excessive pruritus.

Allergic contact dermatitis caused by cocamide diethanolamine.

PubMed

Mertens, Sarien; Gilissen, Liesbeth; Goossens, An

2016-07-01

Cocamide DEA (CAS no. 68603-42-9) is a non-ionic surfactant frequently used in industrial, household and cosmetic products for its foam-producing and stabilizing properties. Contact allergy has been reported quite rarely in the past, but recently several cases were published, raising the question of an increase in the frequency of allergic dermatitis caused by this substance. To describe cocamide DEA-allergic patients and their characteristics observed in our department. Medical charts of patients, investigated between 1990 and December 2015, were retrospectively reviewed for cocamide DEA-allergy. Demographic characteristics and patch test results were analyzed. Out of 1767 patients tested, 18 (1%) presented with an allergic reaction to cocamide DEA, all of them at least with hand dermatitis. Twelve patients had (past) occupational exposure to cocamide DEA. Out of the 18 patients, 15 showed (most often) multiple positive reactions and 7 also suffered from atopic dermatitis. Cocamide DEA allergy is relatively rare, despite frequent use, and an increasing trend was not observed. Reactions to cocamidopropyl betaine and cocamide MEA only occurred in some of the subjects tested. Shampoos and liquid hand soaps/cleansers dominated as sources of exposure. All patients presented with an impaired skin barrier due to atopic and/or previous contact dermatitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cow's Milk Allergy Is a Major Contributor in Recurrent Perianal Dermatitis of Infants.

PubMed

El-Hodhod, Mostafa Abdel-Aziz; Hamdy, Ahmad Mohamed; El-Deeb, Marwa Talaat; Elmaraghy, Mohamed O

2012-01-01

Background. Recurrent perianal inflammation has great etiologic diversity. A possible cause is cow's milk allergy (CMA). The aim was to assess the magnitude of this cause. Subjects and Methods. This follow up clinical study was carried out on 63 infants with perianal dermatitis of more than 3 weeks with history of recurrence. Definitive diagnosis was made for each infant through medical history taking, clinical examination and investigations including stool analysis and culture, stool pH and reducing substances, perianal swab for different cultures and staining for Candida albicans. Complete blood count and quantitative determination of cow's milk-specific serum IgE concentration were done for all patients. CMA was confirmed through an open withdrawal-rechallenge procedure. Serum immunoglobulins and CD markers as well as gastrointestinal endoscopies were done for some patients. Results. Causes of perianal dermatitis included CMA (47.6%), bacterial dermatitis (17.46%), moniliasis (15.87%), enterobiasis (9.52%) and lactose intolerance (9.5%). Predictors of CMA included presence of bloody and/or mucoid stool, other atopic manifestations, anal fissures, or recurrent vomiting. Conclusion. We can conclude that cow's milk allergy is a common cause of recurrent perianal dermatitis. Mucoid or bloody stool, anal fissures or ulcers, vomiting and atopic manifestations can predict this etiology.

Fatal methemoglobinemia caused by liniment solutions containing sodium nitrite.

PubMed

Saito, T; Takeichi, S; Yukawa, N; Osawa, M

1996-01-01

We describe a case of fatal methemoglobinemia (MetHb-emia) resulting from application of liniment solution containing large quantities of sodium nitrite. As a remedial treatment of atopic dermatitis, the liniment solution was applied all over the boy's body. Autopsy findings showed no significant macroscopic or microscopic findings except blood tinted chocolate brown color and chronic atopic dermatitis over the whole surface of the body. Quantitation of the methemoglobin (MetHb) in the blood was performed using spectrophotometer; MetHb concentration of the blood was 76%. Ion chromatographic determination revealed a nitrite concentration of 1 mg/L in the serum. Such a liniment solution is not authorized by the Ministry of Public Welfare.

What is really in control of skin immunity: lymphocytes, dendritic cells, or keratinocytes? facts and controversies.

PubMed

Rupec, Rudolf A; Boneberger, Susanne; Ruzicka, Thomas

2010-01-01

The pathophysiology of atopic dermatitis is still under discussion. Although it is widely accepted that environmental factors and a genetic predisposition are essential, the role of the innate and adaptive immune system and the functional cascade of the cells involved is still unclear. A concept that integrates all immune cells as equally essential has allure. In addition, barrier abnormalities due to mutations of the gene coding for filaggrin and down-regulation of antimicrobial peptides, such as LL-37 and beta-defensins 2 and 3, were very recently found to be relevant for the pathogenesis of atopic dermatitis. Copyright 2010 Elsevier Inc. All rights reserved.

Inhibitory effect of kyungohkgo in the development of 2,4-dinitrochlorobenzene-induced atopic dermatitis in NC/Nga mice.

PubMed

Im, Lee-Rang; Ahn, Ji-Young; Kim, Jun-Ho; Xin, Mingjie; Kwon, Se-Uk; Kim, Yun-Kyung; Kim, Dae-Ki; Lee, Young-Mi

2011-02-01

Kyungohkgo (KOG) is one of the most important formulas in traditional oriental medicine. We investigated the remedial effect of KOG on the development of atopic dermatitis (AD) in female NC/Nga mice. AD-like lesion was induced by the application of 2,4-Dinitrochlorobenzene on to the back skin repeatedly; KOG was administered orally (12.5 and 25.0 mg/kg) and topically (0.5 and 1.0 mg/mouse) to NC/Nga mice once a day for all through the period of this experiment and every mouse body weight was periodically taken. The effects of KOG on 2,4-Dinitrochlorobenzene-treated NC/Nga mice were determined by measuring AD-like skin lesions, the infiltration of mast cells and serum immunoglobulin E concentration. After the KOG applications are over, the KOG groups had less skin lesions than the atopy one, their immunoglobulin E levels were significantly downregulated and the infiltration of mast cells in the dorsal skin were reduced. Our results suggest that KOG may be effective in alleviating the development of AD. The inhibition of AD in NC/Nga mice may be influenced by the prevention of mast cell activation.

Common Dermatoses of Infancy

PubMed Central

Gora, Irv

1986-01-01

Within the pediatric population of their practices, family physicians frequently encounter infants with skin rashes. This article discusses several of the more common rashes of infancy: atopic dermatitis, cradle cap, diaper dermatitis and miliaria. Etiology, clinical picture and possible approaches to treatment are presented. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7 PMID:21267297

[Malassezia related diseases].

PubMed

Sei, Yoshihiro

2012-01-01

Genusmalassezia are now divided to fourteen species. Different species will start or aggravate different skin diseases. In the seborrheic dermatitis, M.restricta will play an important role, in the atopic dermatitis, M.globosa and/or M.restricta are major cutaneous microflora. The availability of new tools such as genomic and proteomic analyses has begun to provide a new insight into the pathogenetic mechanisms involved.

Cutaneous Manifestation of Food Allergy.

PubMed

Tam, Jonathan S

2017-02-01

Hypersensitivity reactions to foods can have diverse and highly variable manifestations. Cutaneous reactions, such as acute urticaria and angioedema, are among the most common manifestations of food allergy. However, cutaneous manifestations of food allergy encompass more than just IgE-mediated processes and include atopic dermatitis, contact dermatitis, and even dermatitis herpetiformis. These cutaneous manifestations provide an opportunity to better understand the diversity of adverse immunologic responses to food and the interconnected pathways that produce them. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Indoor Air Pollutants on Atopic Dermatitis.

PubMed

Kim, JaKyoung; Kim, HyungJin; Lim, DaeHyun; Lee, Young-Kyu; Kim, Jeong Hee

2016-12-09

The increasing prevalence of atopic dermatitis (AD) is associated with variations in indoor environments. In Korea, many inner walls of homes are covered with wallpaper: such walls emit indoor air pollutants, including volatile organic compounds (VOCs) and formaldehyde. This randomized, double-blind study investigated the effects of wallpaper on indoor air quality and AD. Thirty-one children (aged three to eight years) with moderate AD were assigned to environmentally-friendly (EF) and polyvinyl chloride (PVC) wallpaper groups. Indoor air concentrations of VOCs, natural VOCs (NVOCs), formaldehyde, and total suspended bacteria were measured before and two (W₂) and eight weeks (W₈) after wallpapering. Scoring Atopic Dermatitis (SCORAD) evaluations and blood tests were performed during the same period. The EF wallpaper and PVC wallpaper groups showed similar trends in the changes in total VOCs (TVOC) and formaldehyde content in the indoor air. However, the EF wallpaper group showed more improvement on the SCORAD at W₂ and W₈ than the PVC wallpaper group. The SCORAD index was positively correlated with several indoor air pollutants. Further, the SCORAD index and NVOC % were negatively correlated. Improved SCORAD index and effects of wallpapering on indoor air quality improvements occurred within a short period of time in both groups. We believe that NVOCs in indoor air after EF wallpapering have a beneficial effect on health.

Prevalence of Allergic Diseases and Risk Factors of Wheezing in Korean Military Personnel

PubMed Central

Lee, Sang Min; Ahn, Jong Seong; Noh, Chang Suk

2011-01-01

The objective of this study was to evaluate the prevalence of asthma, allergic rhinitis, and atopic dermatitis, as well as the risk factors of wheezing among young adults in the Korean military. Young military conscripts in five areas completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. For subjects with current wheeze in one sample area, baseline spirometry and bronchodilator response were measured. For subjects without a significant response to bronchodilator (improvement in FEV1 of more than 200 mL and 12%), methacholine challenge tests (MCT) were also performed. Of 3,359 subjects that completed the questionnaire, 354 (10.5%) had current wheeze, 471 (14.0%) had current allergic rhinitis, and 326 (9.7%) had current eczema. Current wheeze was associated with family history of allergic disease, overweight, current smoking, allergic rhinitis, and atopic dermatitis. Of 36 subjects with current wheeze who underwent PFT with or without MCT in the Anyang area, 24 (66.7%) were confirmed to have current asthma. In conclusion, the prevalence of allergic disease in young adults of Korean military is not low, and the risk factors of wheezing include family history of allergic disease, overweight, current smoking, allergic rhinitis, and atopic dermatitis. PMID:21286010

Usefulness of Sweat Management for Patients with Adult Atopic Dermatitis, regardless of Sweat Allergy: A Pilot Study.

PubMed

Kaneko, Sakae; Murota, Hiroyuki; Murata, Susumu; Katayama, Ichiro; Morita, Eishin

2017-01-01

Background . Sweat is an aggravating factor in atopic dermatitis (AD), regardless of age. Sweat allergy may be involved in AD aggravated by sweating. Objective. We investigated whether sweat exacerbates adult AD symptoms and examined the extent of sweat allergy's involvement. Method. We asked 34 AD patients (17 men, 17 women; mean age: 27.8 years) to record the extent to which sweat aggravated their symptoms on a 10-point numerical scale. Participant responses were compared with histamine release tests (HRT). Furthermore, 24 of the patients received instructions on methods of sweat management, and their outcomes were evaluated on a 10-point scale. Results. Sweat HRT results were class ≥ 2 in 13 patients, but HRT results were not correlated with the patients' self-assessments of symptom aggravation by sweat. One month after receiving sweat management instructions, a low mean score of 4.6 was obtained regarding whether active sweating was good, but a high mean score of 7.0 was obtained in response to whether the sweat management instructions had been helpful. Conclusion . Our investigation showed that patients' negative impressions of sweat might derive from crude personal experiences that are typically linked to sweating. Sweat management for patients with adult atopic dermatitis was extremely useful regardless of sweat allergy.

A review of phosphodiesterase-inhibition and the potential role for phosphodiesterase 4-inhibitors in clinical dermatology.

PubMed

Moustafa, Farah; Feldman, Steven R

2014-05-16

Phosphodiesterase inhibitors are commonly used drugs. Specific phosphodiesterase inhibitors with anti-inflammatory properties are being assessed as dermatological treatments. To describe important aspects of phosphodiesterase inhibition and the safety and efficacy of 2 phosphodiesterase- 4 inhibitors being studied for the treatment of dermatologic diseases We did a non-systematic analysis of literature on phosphodiesterase inhibition followed by a review of published information on apremilast and topical AN2728 and their use for psoriasis and atopic dermatitis. Apremilast and topical AN2728 have modest efficacy in treatment of psoriasis. Apremilast achieved PASI-75 scores ranging from 24-33%. In phase 2 studies, AN2728 had modest efficacy for psoriasis (40% of patients achieved a ≥ 2 grade improvement as assessed by the Overall target Plaque Severity Score). In phase 2 studies of AN2728 use in atopic dermatitis, subjects achieved a 71% improvement from baseline Atopic Dermatitis Severity Index. In all studies, most adverse effects were minimal. The limitations of this paper are the limited number of published studies, the lack of long-term data, and the lack of head -to - head trials directly comparing phosphodiesterase inhibitors with other treatments. Phosphodiesterase inhibitors constitute a widely used class of drugs that may see growing use for inflammatory dermatologic diseases.

Allergen immunotherapy in people, dogs, cats and horses - differences, similarities and research needs.

PubMed

Mueller, R S; Jensen-Jarolim, E; Roth-Walter, F; Marti, E; Janda, J; Seida, A A; DeBoer, D

2018-04-19

In human patients with seasonal allergic rhinoconjunctivitis sensitized to grass pollen, the first successful allergen immunotherapy (AIT) was reported in 1911. Today, immunotherapy is an accepted treatment for allergic asthma, allergic rhinitis and hypersensitivities to insect venom. AIT is also used for atopic dermatitis and recently for food allergy. Subcutaneous, epicutaneous, intralymphatic, oral and sublingual protocols of AIT exist. In animals, most data are available in dogs where subcutaneous AIT is an accepted treatment for atopic dermatitis. Initiating a regulatory response and a production of "blocking" IgG antibodies with AIT are similar mechanisms in human beings and dogs with allergic diseases. Although subcutaneous immunotherapy is used for atopic dermatitis in cats, data for its efficacy is sparse. There is some evidence for successful treatment of feline asthma with AIT. In horses, most studies evaluate the effect of AIT on insect hypersensitivity with conflicting results though promising pilot studies have demonstrated the prophylaxis of insect hypersensitivity with recombinant antigens of biting midges (Culicoides spp.). Optimising AIT using allergoids, peptide immunotherapy, recombinant allergens and new adjuvants with the different administration types of allergen extracts hopefully will further improve compliance and efficacy of this proven treatment modality. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Atopic dermatitis: impact on the quality of life of patients and their partners.

PubMed

Misery, L; Finlay, A Y; Martin, N; Boussetta, S; Nguyen, C; Myon, E; Taieb, C

2007-01-01

The impact of atopic dermatitis (AD) on the patient's quality of life is relatively well known. However, the influence on the patient's spouse has never been studied. To evaluate the impact of AD on the quality of life, sleeping and sexual life of patients and their partners. In this cross-sectional study, patients and their partners completed a number of questionnaires asking about their general health and their quality of life [Short Form 12, Epworth, Dermatology Life Quality Index (DLQI)] and completed an idiosyncratic measure asking about their sexual functioning. AD severity was clinician rated using Scoring atopic dermatitis (SCORAD). A total of 266 patients were included. The mean DLQI score was 8.8. The physical and mental composite 12 scores were 50.7 and 39.5, respectively. These 3 scores were significantly related to SCORAD. A decrease in sexual desire due to AD was noted in 57.5% of patients. The quality of life of partners did not appear to be particularly impaired, but 36.5% reported that the appearance of eczema had an impact on their sex life. The influence of AD on sex life is significant both for the patients and their partners. Copyright (c) 2007 S. Karger AG, Basel.

Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis.

PubMed

Koppes, Sjors A; Engebretsen, Kristiane A; Agner, Tove; Angelova-Fischer, Irena; Berents, Teresa; Brandner, Johanna; Brans, Richard; Clausen, Maja-Lisa; Hummler, Edith; Jakasa, Ivone; Jurakić-Tončic, Ružica; John, Swen M; Khnykin, Denis; Molin, Sonja; Holm, Jan O; Suomela, Sari; Thierse, Hermann-Josef; Kezic, Sanja; Martin, Stefan F; Thyssen, Jacob P

2017-07-01

Contact sensitization is common and affects up to 20% of the general population. The clinical manifestation of contact sensitization is allergic contact dermatitis. This is a clinical expression that is sometimes difficult to distinguish from other types of dermatitis, for example irritant and atopic dermatitis. Several studies have examined the pathogenesis and severity of allergic contact dermatitis by measuring the absence or presence of various biomarkers. In this review, we provide a non-systematic overview of biomarkers that have been studied in allergic contact dermatitis. These include genetic variations and mutations, inflammatory mediators, alarmins, proteases, immunoproteomics, lipids, natural moisturizing factors, tight junctions, and antimicrobial peptides. We conclude that, despite the enormous amount of data, convincing specific biomarkers for allergic contact dermatitis are yet to be described. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Complementary, Alternative and Integrative Medicine for Childhood Atopic Dermatitis.

PubMed

Hon, Kam Lun; Leung, Alexander K C; Leung, Theresa N H; Lee, Vivian W Y

2017-01-01

Atopic Dermatitis (AD) is a chronic relapsing dermatosis associated with itch, sleep disturbance and poor quality of life. Treatment of AD includes the use of emollients, and topical and systemic immunomodulating agents. Many patients also use complementary and alternative medicine (CAM). This article reviews the pathophysiology of AD, clinical trials and recent patents involving various modalities of CAM in the treatment of AD. A Medline/Pubmed search was conducted using Clinical Queries with the key terms "Chinese Medicine OR Complementary and Alternative medicine" AND "Eczema OR Atopic dermatitis". The search strategy included meta-analyses, Randomized Controlled Trials (RCTs), clinical trials, reviews and pertinent references. Patents were searched using the key term "atopic dermatitis" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. Only a few RCTs evaluated the efficacy of Chinese medicinal herbs in treating AD. There was some evidence for other modalities of CAM. Integrative Medicine (IM) usually refers to the various forms of CAM that combine conventional western medicine and Chinese medicine. Supporting evidence for the efficacy of IM in the treatment of AD is presently lacking. Integration is difficult. Western medicine practitioners are often ignorant about CAM and IM. Parents are concerned about the potential side effects of Western medicine and will tend to be non-compliant with the conventional Western component of IM. Recent patents on CAM and IM are reviewed. Most CAM patents are herbal compositions, evidence on their efficacy is generally lacking. AD is a complex disease. The psychodynamics of the child and his/her family is the reason for the often suboptimal outcomes. Both Western and CAM practitioners should collaborate to create a mutually encouraging environment for the advances of IM. CAM and IM publications and patents are reviewed. Evidence of their efficacy is generally lacking. Further research is needed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

High-Fat and Low-Carbohydrate Diets Are Associated with Allergic Rhinitis But Not Asthma or Atopic Dermatitis in Children

PubMed Central

Kim, So Young; Sim, Songyong; Park, Bumjung; Kim, Jin-Hwan; Choi, Hyo Geun

2016-01-01

Background Numerous studies have suggested that nutritional intake is related to allergic diseases. Although conflicting results exist, fat intake is often associated with allergic diseases. We investigated the relationship between allergic diseases and nutritional intake after adjusting for various demographic and socioeconomic factors in a large, representative sample of Korean children. Methods A total of 3,040 participants, aged 4 to 13 years old, were enrolled in the present study from the Korean National Health and Nutrition Examination Survey (KNHANES), 2010–2012. Nutritional intake data, including total calories, protein, fat, carbohydrate, vitamin A, vitamin C, thiamine, riboflavin, and niacin, were retrieved from the survey using the complete 24-hour recall method. The associations between each nutritional factor and allergic rhinitis/asthma/atopic dermatitis were analyzed using simple and multiple logistic regression analyses with complex sampling. Age, sex, body mass index (BMI), number of household members, income level, and region of residence were adjusted for as covariates. Results Of the participants, 22.1%, 6.0%, and 15.5% suffered from allergic rhinitis, asthma, and atopic dermatitis, respectively. Allergic rhinitis was significantly correlated with high-fat and low-carbohydrate diets. The adjusted odds ratio (AOR) was 1.25 (95% CIs = 1.06–1.46, P = 0.007) for fat intake, denoting a 10% increase. Carbohydrate intake (10% increase) was negatively related to allergic rhinitis with an AOR of 0.84 (95% CIs = 0.74–0.95, P = 0.004). No other significant relationships were found between the retrieved nutritional factors and either asthma or atopic dermatitis. Conclusion Allergic rhinitis was related to high-fat and low-carbohydrate diets. Although the underlying mechanisms and causal relationships remain elusive, the present study provides reliable evidence regarding the associations between nutritional factors and allergic rhinitis by considering numerous factors within a large and representative population. PMID:26919190

"Dermatitis" defined.

PubMed

Smith, Suzanne M; Nedorost, Susan T

2010-01-01

The term "dermatitis" can be defined narrowly or broadly, clinically or histologically. A common and costly condition, dermatitis is underresourced compared to other chronic skin conditions. The lack of a collectively understood definition of dermatitis and its subcategories could be the primary barrier. To investigate how dermatologists define the term "dermatitis" and determine if a consensus on the definition of this term and other related terms exists. A seven-question survey of dermatologists nationwide was conducted. Of respondents (n  =  122), half consider dermatitis to be any inflammation of the skin. Nearly half (47.5%) use the term interchangeably with "eczema." Virtually all (> 96%) endorse the subcategory "atopic" under the terms "dermatitis" and "eczema," but the subcategories "contact," "drug hypersensitivity," and "occupational" are more highly endorsed under the term "dermatitis" than under the term "eczema." Over half (55.7%) personally consider "dermatitis" to have a broad meaning, and even more (62.3%) believe that dermatologists as a whole define the term broadly. There is a lack of consensus among experts in defining dermatitis, eczema, and their related subcategories.

Are both early egg introduction and eczema treatment necessary for primary prevention of egg allergy?

PubMed

Matsumoto, Kenji; Mori, Rintaro; Miyazaki, Celine; Ohya, Yukihiro; Saito, Hirohisa

2018-06-01

The Learning Early About Peanut Allergy (LEAP) study proved that early introduction of peanut significantly prevented the development of peanut allergy. However, in regard to similar attempts to prevent egg allergy through early egg introduction, the Prevention of Egg Allergy in High-risk Infants with Eczema (PETIT) study is the only randomized intervention trial to show a statistically significant effect. Meta-analysis of those studies indicated that neither the total amount nor pretreatment of egg showed any effect on egg allergy at the age of 12 months. However, raw egg powder resulted in a significantly higher prevalence of allergic reactions at initial introduction, whereas use of boiled egg was much safer. The prevalence of atopic dermatitis/eczema at introduction of egg correlated significantly with the subsequent prevalence of allergic reactions at initial introduction. In addition, the prevalence of egg allergy in the late introduction group correlated significantly with the prevalence of atopic dermatitis at introduction, even when the atopic dermatitis was proactively treated with a topical corticosteroid ointment. It is definitely true that the number of trials and number of participants in each trial are insufficient for drawing firm conclusions, especially regarding the optimal dose, raw versus boiled, when to start, and for whom to intervene. Therefore we propose various studies that should be performed to generate stronger data and conclusions. However, on the basis of the most recent results, we postulate that simultaneous intervention by both early boiled egg introduction and eczema treatment is probably indispensable for primary prevention of egg allergy. Copyright © 2018 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemokine-like factor 1 (CLFK1) is over-expressed in patients with atopic dermatitis.

PubMed

Yang, Gao-Yun; Chen, Xue; Sun, Ya-Chun; Ma, Chen-Li; Qian, Ge

2013-01-01

Human chemokine-like factor 1 (CKLF1), a recently discovered chemokine, has a broad spectrum of biological functions in immune-mediated diseases. It is highly expressed on Th2 lymphocytes and is a functional ligand for human CCR4. CKLF1 has a major role in the recruitment and activation of leucocytes, which plays an important role in the pathogenesis of allergic diseases. The present study was designed to determine the expression of CKLF1 in skin and serum in patients with atopic dermatitis (AD). The CKLF1 protein expression in skin lesion was analyzed by immunohistochemistry and ELISA. The mRNA expression of CKLF1 in skin lesion was detected by Real-time PCR. The serum levels of CKLF1, IgE, eotaxin, IL-4, IL-5, and IL-13 were measured by ELISA. Histopathological changes in the skin of AD patients showed local inflammation with epidermal thickening and significant inflammatory cellular infiltration. Immunohistochemistry results demonstrated that CKLF1-staining positive cells were located in the epidermal and dermis, and that the CKLF1 expression in AD patients was significantly higher than that in normal control. The CKLF1 mRNA expression in AD patients was significantly higher than that in healthy controls. Serum CKLF1 and IgE levels were significantly increased in AD patients, as were the serum levels of IL-4, IL-5, IL-13 and eotaxin. Both CKLF1 protien and mRNA levels are overexpressed in the skin lesion of AD patients, along with an increase in serum CKLF1 level, indicating that CKLF1 may play an important role in the development of atopic dermatitis.

Influence of antibiotic use in early childhood on asthma and allergic diseases at age 5.

PubMed

Yamamoto-Hanada, Kiwako; Yang, Limin; Narita, Masami; Saito, Hirohisa; Ohya, Yukihiro

2017-07-01

In the past few decades, the prevalence of allergic diseases has increased rapidly worldwide. At the same time, the overuse of antibiotics has been observed, especially in Japan. To elucidate the association of early childhood antibiotic use with allergic diseases in later childhood at 5 years of age. Relevant data were extracted from the hospital-based birth cohort study, the Tokyo Children's Health, Illness and Development Study. To identify signs of asthma and allergic diseases in children, the International Study of Asthma and Allergies in Childhood questionnaire was used. Logistic regression models were applied to estimate the effect of antibiotic use on outcomes in later life. Antibiotic exposure in children within the first 2 years of life was associated with current asthma (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.10-2.70), current atopic dermatitis (aOR 1.40, 95% CI 1.01-1.94), and current allergic rhinitis (aOR 1.65, 95% CI 1. 05-2.58) at 5 years of age. Analysis of the associations by type of antibiotics showed that cephem was associated with current asthma (aOR 1.97, 95% CI 1.23-3.16) and current rhinitis (aOR 1.82, 95% CI 1.12-2.93), and macrolide was associated with current atopic dermatitis (aOR 1.58, 95% CI 1.07-2.33). Our findings suggest that antibiotic use within the first 2 years of life was a risk factor for current asthma, current atopic dermatitis, and current allergic rhinitis in 5-year-old children. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

7,8,4′-Trihydroxyisoflavone Attenuates DNCB-Induced Atopic Dermatitis-Like Symptoms in NC/Nga Mice

PubMed Central

Kim, Heejung; Kim, Jong Rhan; Kang, Heerim; Choi, Jinhwan; Yang, Hee; Lee, Pomjoo; Kim, Jiyoung; Lee, Ki Won

2014-01-01

Atopic dermatitis (AD) is characterized by chronic highly pruritic and relapsing inflammatory skin lesions. Despite its growing prevalence, therapeutic treatments remain limited. Natural immune modulators from herbal extracts or derivatives may be useful for treating AD symptoms. This study examined the effect of 7,8,4′-trihydroxyisoflavone (7,8,4′-THIF), a metabolite of soy isoflavone daidzin, on AD-like symptoms. Repeated epicutaneous application of 2,4-dinitrochlorobenzene (DNCB) was performed on the ear and dorsal skin of NC/Nga mice to induce AD-like symptoms and skin lesions, and 7,8,4′-THIF (200 and 400 nmol) or tacrolimus (100 µg) was applied topically for 3 weeks to assess their anti-pruritic effects. We found that 7,8,4′-THIF alleviated DNCB-induced AD-like symptoms as quantified by skin lesion, dermatitis score, ear thickness, and scratching behavior. Histopathological analysis demonstrated that 7,8,4′-THIF decreased DNCB-induced eosinophil and mast cell infiltration into skin lesions. We also found that 7,8,4′-THIF significantly alleviated DNCB-induced loss of water through the epidermal layer. In addition to reducing the DNCB-induced increase in serum IgE, 7,8,4′-THIF also lowered skin lesion levels of the chemokine thymus and activation regulated chemokine; Th2 cytokines interleukin (IL)-4, IL-5, and IL-13; and Th1 cytokines IL-12 and interferon-γ. These results suggest that 7,8,4′-THIF might be a potential therapeutic candidate for the treatment of atopic dermatitis. PMID:25170825

Protein Linked to Atopic Dermatitis

MedlinePlus

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Quality of Life of Parents of Children with Atopic Dermatitis.

PubMed

Marciniak, Joanna; Reich, Adam; Szepietowski, Jacek C

2017-06-09

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). Fifty children with AD were included in the study (age range 2-24 months) together with their parents. Children's AD was found to influence the quality of life of both parents; however, it had a more significant influence on quality of life of mothers than that of fathers (mean FDLQI: 17.1 ± 5.3 vs. 14.7 ± 5.8 points; p < 0.001). Due to the children's AD, mothers spent more time caring for them and carried out more household duties. Childhood AD had a greater impact on quality of life of fathers through influence on their work or education. The influence of AD on the quality of life of family members is significant, and this should be taken into account in the therapeutic process.

Mapping of a gene responsible for dermatitis in NOA (Naruto Research Institute Otsuka Atrichia) mice, an animal model of allergic dermatitis.

PubMed

Natori, K; Tamari, M; Watanabe, O; Onouchi, Y; Shiomoto, Y; Kubo, S; Nakamura, Y

1999-01-01

The NOA (Naruto Research Institute Otsuka Atrichia) mouse is an animal model of allergic or atopic dermatitis, a condition characterized by ulcerative skin lesions with accumulation of mast cells and increased serum IgE. These features of the murine disease closely resemble human atopy and atopic disorders. We performed linkage analysis in NOA back-cross progeny, as a step toward identifying and isolating a gene responsible for the NOA phenotype. We crossed NOA mice with five other murine strains (C57BL/6J, IQI, C3H/HeJ, DBA/2J, and BALB/cByJ) and then bred back-cross animals. Using microsatellite markers, we scanned the entire genomes of 559 N2 offspring from the five parental strains. Linkage analysis revealed a significant association between ulcerative skin lesions and markers on murine chromosome 14. Statistical analysis indicated that the critical region was assigned to the vicinity of D14Mit236 and D14Mit160.

Evaluation of Lactobacillus rhamnosus strain GG for the prevention of atopic dermatitis in dogs.

PubMed

Marsella, Rosanna

2009-06-01

To evaluate the efficacy of the probiotic Lactobacillus rhamnosus strain GG for the alleviation or prevention of clinical signs of atopic dermatitis (AD) in genetically predisposed dogs. 2 adult Beagles with severe AD and 16 puppies. The 2 adult Beagles were bred twice, with a year between breedings. Lactobacillus rhamnosus GG was administered to the bitch during the second pregnancy and to the puppies of the second litter from 3 weeks to 6 months of age. Both litters were epicutaneously sensitized to Dermatophagoides farinae. Blood samples were collected from puppies every 6 weeks to measure serum titers of allergen-specific IgE. At 6 months of age, all puppies underwent intradermal allergen testing and environmental challenge with D farinae. Clinical signs were scored. In the first litter, at 6 months of age, 7 of 7 puppies were strongly seropositive for IgE against D farinae, 6 had a positive reaction to intradermal testing, and 7 developed severe clinical signs of AD after the environmental challenge. In the second litter, 7 of 9 puppies were seropositive, 3 had a positive reaction to intradermal testing, and 6 developed dermatitis and pruritus after the challenge. The second litter had a significantly lower serum titer of allergen-specific IgE and milder reaction to intradermal testing, compared with the first litter. Clinical scores did not differ between litters. Administration of L rhamnosus GG to puppies appeared to reduce immunologic indicators of AD, although no significant decrease in clinical signs was detected.

Angelicae Dahuricae Radix Inhibits Dust Mite Extract-Induced Atopic Dermatitis-Like Skin Lesions in NC/Nga Mice.

PubMed

Lee, Hoyoung; Lee, Jun Kyoung; Ha, Hyekyung; Lee, Mee-Young; Seo, Chang-Seob; Shin, Hyeun Kyoo

2012-01-01

We examined whether Angelicae Dahuricae Radix (AR) suppresses the development of atopic dermatitis (AD)-like skin lesions induced by Dermatophagoides farinae in NC/Nga mice. To investigate the effect of AR, we measured the AD severity score, measured plasma levels of IgE and histamine, and performed histological analysis in NC/Nga mice. We also confirmed the anti-inflammatory effects of AR by measuring TARC/CCL17 production from LPS-treated RAW 264.7 cells and mRNA levels of TARC and MDC/CCL22 in TNF-α/IFN-γ-treated HaCaT cells. 10 mg/day of AR extract was applied for 4 weeks to NC/Nga mice. Both the AR extract and 0.1% tacrolimus suppressed the development of AD-like skin lesions and reduced dermatitis scores of the back and ear skin. AR extracts caused an inhibition of histological changes induced by repeated application of D. farinae and a reduction of IgE and histamine levels in plasma (P < 0.05). Furthermore, NO production in LPS-treated RAW 264.7 cells was diminished in a dose-dependent manner, and hTARC production and TARC and MDC mRNA levels in TNF-α/IFN-γ-treated HaCaT cells were diminished by AR. The inhibitory effect of AR on NO, TARC and MDC production may be associated with the suppression of AD-like skin lesions in D. farinae-induced NC/Nga mice.

Rosmarinic acid attenuates 2,4-dinitrofluorobenzene-induced atopic dermatitis in NC/Nga mice.

PubMed

Jang, An-Hee; Kim, Tae-Ho; Kim, Gun-Dong; Kim, Jeong Eun; Kim, Ha Jin; Kim, Sung Soo; Jin, Young-Ho; Park, Yong Seek; Park, Cheung-Seog

2011-09-01

Atopic dermatitis (AD) is one of the most common skin diseases, and its incidence is increasing in industrialized countries. Furthermore, the epicutaneous application of a hapten, such as 2,4-dinitrofluorobenzene (DNFB), evokes an AD-like lesion in NC/Nga mice under specific pathogen-free (SPF) conditions. Rosmarinic acid (RA) is a secondary metabolite that is frequently found in herbs, and has anti-inflammatory, anti-oxidant, and anti-microbial effects. In this study, we studied whether RA is an effective treatment against DNFB-induced AD-like skin lesions in NC/Nga mice. RA at 1 or 5 μM was found to suppress the productions of interferon (IFN)-γ and interleukin (IL)-4 significantly by activated CD4(+) T cells. Furthermore, an intraperitoneal injection of RA at 10 or 50 mg/kg significantly inhibited skin lesion development and ear thickness and total serum IgE level increases in DNFB-treated NC/Nga mice. In addition, intraperitoneal administered RA at 10 or 50 mg/kg significantly inhibited the infiltrations of CD4(+) T, CD8(+) T, and mast cells into DNFB-induced skin lesions in NC/Nga mice. This study suggests that RA suppresses the development of AD-like dermatitis in DNFB-treated NC/Nga mice by reducing IFN-γ and IL-4 production by activated T cells and total serum IgE levels. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Direct medical costs associated with atopic diseases among young children in Thailand.

PubMed

Ngamphaiboon, Jarungchit; Kongnakorn, Thitima; Detzel, Patrick; Sirisomboonwong, Krittawan; Wasiak, Radek

2012-01-01

Allergic diseases are the most common childhood illness in Thailand. Their prevalence has been rising over time, with several studies having revealed substantial economic burden. However, no such study had yet been conducted for Thailand. The aim of this study was to estimate direct medical costs associated with atopic diseases among children aged 0-5 years in Thailand. A cost-of-illness model was constructed to estimate the total direct medical costs of atopic diseases comprising atopic dermatitis, chronic rhinitis, asthma (i.e., recurrent wheeze), and cow's milk allergy. The model employed a prevalence-based approach, considering a total number of atopic cases in 2010. Direct medical costs were estimated using a bottom-up analysis with the estimation of the quantity of healthcare resource use and the unit costs. Epidemiological data were obtained from literature and Thai surveys, whereas treatment unit costs were from either a hospital database or Thai standard cost list. Expert opinion informed type, frequency, and quantity of medical resources utilized. Key limitations included lack of data-driven evidences on severity distribution for this particular age group, indirect costs, and medical resource use associated with each condition. Total direct cost was estimated to be THB 27.8 billion (US$899 million). Treatments contributed largest to the total costs (46%), followed by inpatient care (37%), outpatient care (12%), and monitoring and labs (5%). Costs per treated patient were highest in cow's milk allergy (THB 64,383; US$2077), followed by rhinitis (THB 12,669; US$409), asthma (THB 9633; US$312), and atopic dermatitis (THB 5432; US$175). Atopic diseases in young children are associated with substantial burden in direct medical costs to Thailand. These costs can be diminished through nutritional intervention recognized to effectively decrease the incidence of atopic diseases.

Probiotics: Myths or facts about their role in allergy prevention.

PubMed

Krzych-Fałta, Edyta; Furmańczyk, Konrad; Tomaszewska, Aneta; Olejniczak, Dominik; Samoliński, Bolesław; Samolińska-Zawisza, Urszula

2018-01-01

The hygiene hypothesis proposed by Strachan in the 1980s clearly emphasized the role of microorganisms in atopy prevention. The study objective was to assess the preventive role of probiotics in patients with allergic rhinitis, bronchial asthma, atopic dermatitis, and/or food allergy. The methods used in the study were the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires for 6-7- and 13-14-year-olds and the European Community Respiratory Health Survey II (ECRHS II) questionnaire targeted for the 20-44 age group. The study was conducted as part of the cross-sectional Epidemiology of Allergic Diseases in Poland study conducted in 9 Polish regions (8 urban: Warszawa, Lublin, Białystok, Gdańsk, Poznań, Wrocław, Katowice, Kraków, and the rural regions of Zamojski and Krasnostawski counties). The study material was a group of patients diagnosed with food allergy (n = 407), atopic dermatitis (n = 311), allergic rhinitis (n = 1.353), bronchial asthma (n = 505), and healthy volunteers (n = 2,403). Genetic factors play an important role in the allergy development. A family history positive for chronic skin disorders increased the risk of atopic dermatitis and food allergies (OR = 1.456, CI = 1.14-1.85, p = 0.002; and OR = 1.378, CI = 1.05-1.81, p = 0.02, respectively). The consumption of products containing live bacterial cultures showed no preventive effects in any of the evaluated disorders in early childhood. Conversely, over the age of 14 years, probiotic formulations exhibit health-promoting effects and may lower the risk of allergic diseases. The use of probiotics in the Polish population showed no protective effect in the first years of life. The changes in dietary habits introduced during late adolescence demonstrated significantly greater preventive effects of live bacterial cultures against the development of allergic diseases.

Plasmodium berghei infection ameliorates atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Kishi, C; Amano, H; Suzue, K; Ishikawa, O

2014-10-01

Atopic diseases are more prevalent in industrialized countries than in developing countries. In addition, significant differences in the prevalence of allergic diseases are observed between rural and urban areas within the same country. This difference in prevalence has been attributed to what is called the 'hygiene hypothesis'. Although parasitic infections are known to protect against allergic reactions, the mechanism is still unknown. The aim of this study was to investigate whether or not malarial infections can inhibit atopic dermatitis (AD)-like skin lesions in a mouse model of AD. We used NC/Nga mice which are a model for AD. The NC/Nga mice were intraperitoneally infected with 1 × 10(5) Plasmoduim berghei (Pb) XAT-infected erythrocytes. Malarial infections ameliorated AD-like skin lesions in the NC/Nga mice. This improvement was blocked by the administration of anti-asialo GM1 antibodies, which are anti-natural killer (NK) cells. Additionally, adoptive transfer of NK cells markedly improved AD-like skin lesions in conventional NC/Nga mice; these suggest that the novel protective mechanism associated with malaria parasitic infections is at least, in part, dependent on NK cells. We have experimentally demonstrated for the first time that malarial infections ameliorated AD-like skin lesions in a mouse model of AD. Our study could explain in part the mechanism of the 'hygiene hypothesis', which states that parasitic infections can inhibit the development of allergic diseases. © 2014 The Authors. Allergy Published by John Wiley & Sons Ltd.

Molecular Mechanisms of Cutaneous Inflammatory Disorder: Atopic Dermatitis

PubMed Central

Kim, Jung Eun; Kim, Jong Sic; Cho, Dae Ho; Park, Hyun Jeong

2016-01-01

Atopic dermatitis (AD) is a multifactorial inflammatory skin disease resulting from interactions between genetic susceptibility and environmental factors. The pathogenesis of AD is poorly understood, and the treatment of recalcitrant AD is still challenging. There is accumulating evidence for new gene polymorphisms related to the epidermal barrier function and innate and adaptive immunity in patients with AD. Newly-found T cells and dendritic cell subsets, cytokines, chemokines and signaling pathways have extended our understanding of the molecular pathomechanism underlying AD. Genetic changes caused by environmental factors have been shown to contribute to the pathogenesis of AD. We herein present a review of the genetics, epigenetics, barrier dysfunction and immunological abnormalities in AD with a focus on updated molecular biology. PMID:27483258

LIPID ABNORMALITIES AND LIPID-BASED REPAIR STRATEGIES IN ATOPIC DERMATITIS

PubMed Central

Elias, Peter M.

2013-01-01

Prior studies have revealed the key roles played by Th1/Th2 cell dysregulation, IgE production, mast cell hyperactivity, and dendritic cell signaling in the evolution of the chronic, pruritic, inflammatory dermatosis that characterizes atopic dermatitis (AD). We review here increasing evidence that the inflammation in AD results primarily from inherited abnormalities in epidermal structural and enzymatic proteins that impact permeability barrier function. We also will show that the barrier defect can be attributed to a paracellular abnormality due to a variety of abnormalities in lipid composition, transport and extracellular organization. Accordingly, we also review the therapeutic implications of this emerging pathogenic paradigm, including several current and potentially novel, lipid-based approaches to corrective therapy. PMID:24128970

Difficult to control atopic dermatitis

PubMed Central

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

Dendritic Core-Multishell Nanocarriers in Murine Models of Healthy and Atopic Skin

NASA Astrophysics Data System (ADS)

Radbruch, Moritz; Pischon, Hannah; Ostrowski, Anja; Volz, Pierre; Brodwolf, Robert; Neumann, Falko; Unbehauen, Michael; Kleuser, Burkhard; Haag, Rainer; Ma, Nan; Alexiev, Ulrike; Mundhenk, Lars; Gruber, Achim D.

2017-01-01

Dendritic hPG-amid-C18-mPEG core-multishell nanocarriers (CMS) represent a novel class of unimolecular micelles that hold great potential as drug transporters, e.g., to facilitate topical therapy in skin diseases. Atopic dermatitis is among the most common inflammatory skin disorders with complex barrier alterations which may affect the efficacy of topical treatment.

Efficacy of dimetinden and hydroxyzine/chlorpheniramine in atopic dogs: a randomised, controlled, double-blinded trial

PubMed Central

Eichenseer, M.; Johansen, C.; Mueller, R. S.

2013-01-01

Antihistaminic drugs are commonly used as symptomatic therapy of atopic dermatitis in dogs. Unfortunately, their clinical benefit is largely unsubstantiated. In a double-blinded, placebo-controlled, cross-over trial, the influence of dimetinden and of a combination of chlorpheniramine and hydroxyzine on pruritus and lesions was evaluated in 19 dogs. They were treated with either product or a placebo orally for 14 days, each time followed by a 14-day washout period. Before and after each period, the dogs were examined and the Canine Atopic Dermatitis Extent and Severity Index (CADESI) determined by a clinician, and the pruritus and general condition by the owner. Dimetinden improved the pruritus significantly (P=0.014) but not the CADESI (P=0.087), the combination of hydroxyzine and chlorpheniramine improved the CADESI (P=0.049) and pruritus (P=0.05) significantly. Ten of 17 dogs improved by more than 25 per cent in pruritus with the combination of hydroxyzine and chlorpheniramine, 12 of 18 with dimetindenmaleate and only 2 of 19 with placebo. Antihistamines can help to reduce pruritus in atopic dogs, but in most cases, the improvement is limited and additional treatment may be needed. PMID:24114734