Disodium cromoglycate versus diet in the treatment and prevention of nickel-positive pompholyx

In some cases that have been diagnosed as contact allergy to nickel, there are repeated cutaneous eruptions of pompholyx, even in areas with no direct contact with the metal. The possible alimentary origin of dyshidrotic eczema should be considered when deciding on therapy. We have collected the clinical data for 24 patients with dyshidrotic eczema caused by nickel, to evaluate the benefit of a low-nickel diet versus treatment with oral disodium cromoglycate, comparing both objective and subjective symptoms. A low-nickel diet does not improve these patients but those treated with DSCG reacted better, from both objective and subjective point of view, than either the controls or the patients treated by diet. We next did intestinal permeability tests before therapy and after 15 days of treatment. We found that nickel uptake diminishes simultaneously with the reduction of absorption through the smaller aqueous "pores". This phenomenon was greatest after DSCG. We suggest that DSCG can help selected cases of pompholyx.     

普鲁卡因对豚鼠接触性湿疹模型的影响

目的：探讨普鲁卡因对豚鼠接触性湿疹模型的影响。方法：采用０．１％二硝基氯苯涂擦豚鼠耳部,激发接触性皮炎,每周１次,共４周,建立接触性湿疹模型,然后胜利腔注射普产因,每天１次共１４天,测人肿胀度、表皮朗格汉斯细胞数、真皮浸润细胞数。结果：普瞳因组明显地抑制豚亚急性／慢性湿疹。结论：普鲁卡因对湿疹具有治疗作用,其机制可能与朗格汉斯细胞减少有关。     

Therapy-resistant unilateral chronic blepharokeratoconjunctivitis as the main finding in autoaggression syndrome. Clinicohistopathological findings

Summary Autoaggressive syndromes as causes of diseases underlying chronic blepharitis and keratoconjunctivitis that are refractory to treatment are often difficult to recognize. Patients: Three female patients (age 21, 25, 41 years) and one male patient (age 42 years) had suffered from a right-(4 × ) or left-(1 × ) handed treatment-refractory blepharokeratoconjunctivitis for 1, 2 ,11 and 30 months prior to admission. In each case more than 5 ophthalmologists and 2–6 eye hospitals had been consulted, and extraocular surgery had been performed 1–4 times. Results: Patients presented with a visual acuity of 0.3 p (1 × ), 0.1 (1 × ), FC (1 × ), HM (1 × ). In three patients contact eczema of the facial skin and lids and a corneal pannus were observed; in two patients we saw purulent pseudomembranous and in two patients chronic cicatrizing keratoconjunctivitis. Conjunctival smears grew P. aeruginosa, and S. aureus; impression cytology showed infiltration with neutrophils and epithelial keratinization; histopathology indicated chronic inflammatory, partly purulent subepithelial and stromal conjunctival infiltrate with hyper- and parakeratosis fibrous strands and epithelial cell loss; the lower lids showed parakeratosis, focal necrosis, intercellular edema and a lymphohistiocytic round-cell infiltrate. Furthermore, multiple allergies to antibiotics and preservatives (4 × ), lacerations of the arms and legs (2 × ) and an irritative-toxic dermatitis (1 × ) were substantiated. In the patients who agreed to a psychiatric consultation, somatized-agitated longing for care combined with a dependent and infantile personality (1 × ) and reactive depression (2 × ) were verified. Conclusions: In patients suffering from treatment-refractory unilateral chronic blepharokeratoconjunctivitis correlated with the hand, one must take into consideration the fact that other factors may be involved: possible exacerbation prior to examinations; multiple inpatient diagnostic and surgical procedures in different locations; histopathological mixed inflammatory patterns; and psychiatric syndromes.      

丁丙氢化可的松霜膏治疗皮炎湿疹类皮肤病的疗效

目的:评价丁丙氢化可的松霜膏治疗皮炎湿疹类皮肤病的疗效和安全性。方法:采用随机对照开放试验,试验组188例,用丁丙氢化可的松霜膏涂于患处,tid,对照组120例用丁酸氢化可的松(尤卓尔)霜涂于患处,tid,疗程3～25d。结果:试验组的临床有效率、痊愈率及不良反应率分别为93.6％,77.7％和7.4％,对照组分别为92.5％,75.0％和8.4％,2组疗效和安全性结果经统计学处理均无显著性差异(P>0.05)。结论:丁丙氢化可的松霜膏治疗皮炎湿疹类皮肤病具有较好临床疗效。     

Randomised controlled trial of advice on an egg exclusion diet in young children with atopic eczema and sensitivity to eggs

Background: The role of exclusion diets in the management of atopic eczema in young children is uncertain. This randomised controlled trial evaluates the effect of excluding egg from the diet in young children with atopic eczema and sensitivity to eggs. Fifty-five such children were randomised either to a 4-week regimen, in which mothers were given general advice on care of eczema and additional specific advice from a dietician about an egg exclusion diet (diet group), or to a control group in which general advice only was given. Both groups continued conventional topical treatment. Disease activity was assessed by estimates of the surface area affected by eczema and by an arbitrary severity score. Possible egg sensitivity was identified by RAST before randomisation and after the trial by double-blind placebo-controlled egg challenge. Results: The mean reduction in surface area affected by eczema was significantly greater (p = 0.02) in the group receiving dietary advice (from 19.6% to 10.9% area affected) than in the control group (from 21.9% to 18.9%). A significant improvement also occurred in severity score (p=0.04): from 33.9 to 24.0 units for the diet group compared with a decrease from 36.7 to 33.5 in the control group. The study suggests that advice on the dietary exclusion of eggs is useful as part of the overall management of young children with atopic eczema and sensitivity to eggs.     

Socioeconomic status and prevalence of allergic rhinitis and atopic eczema symptoms in young adolescents

Environmental factors are known to influence the development of allergic rhinitis and atopic eczema in genetically susceptible individuals. Socioeconomic status (SES) may be an important indicator of risk for these conditions. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase 1 written questionnaire was used to determine the prevalence and severity of allergic rhinoconjunctivitis and atopic eczema symptoms in 4947 pupils aged 13-14 years attending 30 schools in socioeconomically diverse areas of Cape Town. Home addresses were used to stratify participants into five SES bands. Relationships between symptom prevalence and severity, and SES, recent urbanization and upward socioeconomic mobility were examined. Logistic regression was used to generate odds ratios (OR) and 95% confidence intervals (CI) in order to assess overall trends by SES. The prevalences of self-reported allergic rhinitis symptoms and recurrent itchy rash in the past year were 33.2% and 11.9% respectively. Girls had a significantly higher prevalence of all symptoms than boys. The prevalence of allergic rhinitis symptoms increased from lowest to highest SES (overall OR for rhinitis symptoms in past year = 1.16, 95% CI 1.11-1.21). There was no significant trend in reported eczema symptoms by SES other than for the question, 'Have you ever had eczema' (OR = 0.88, 95% CI 0.83-0.93). Longer period of urbanization was weakly associated only with recurrent itchy skin rash (OR = 1.05, 95% CI 1.01-1.09). 'Socially mobile' pupils, i.e. those resident in the lowest SES areas but attending highest SES schools showed significantly higher prevalences of eczema and some rhinitis symptoms than pupils attending lowest SES schools. These findings may reflect differences in reporting related to language, culture and access to medical care rather than real differences in prevalence.     

中药湿敷与合理护理治疗急性湿疹

[目的]观察中药湿敷治疗急性湿疹的疗效。[方法]采用自制中药湿敷配合护理治疗56例急性湿疹。[结果]经1个疗程以上治疗后治愈31例,显效20例,好转5例,总有效率100%。[结论]中药湿敷是治疗急性湿疹的有效方法之一,合理护理使治疗更显疗效。