High abundances of neurotrophin 3 in atopic dermatitis mast cell

Background  

Little is known about the prevalence of latent tuberculosis infections (LTBI) in health care workers (HCW) in low-incidence countries especially in hospitals for pulmonary diseases. With Interferon-gamma release assays (IGRA), a new method for diagnosis of LTBI is available which is more specific than the tuberculin skin test (TST).     

The epidemiology of atopic dermatitis

Atopic dermatitis is the most common chronic inflammatory skin disease and is a major cause of morbidity and suffering. This review examines its differing prevalence worldwide, its aetiology, and genetics.     

Borage oil in the treatment of atopic dermatitis

Nutritional supplementation with omega-6 essential fatty acids (ω-6 EFAs) is of potential interest in the treatment of atopic dermatitis. EFAs play a vital role in skin structure and physiology. EFA deficiency replicates the symptoms of atopic dermatitis, and patients with atopic dermatitis have been reported to have imbalances in EFA levels. Although direct proof is lacking, it has been hypothesized that patients with atopic dermatitis have impaired activity of the delta-6 desaturase enzyme, affecting metabolism of linoleic acid to gamma-linolenic acid (GLA). However, to date, studies of EFA supplementation in atopic dermatitis, most commonly using evening primrose oil, have produced conflicting results. Borage oil is of interest because it contains two to three times more GLA than evening primrose oil. This review identified 12 clinical trials of oral or topical borage oil for treatment of atopic dermatitis and one preventive trial. All studies were controlled and most were randomized and double-blind, but many were small and had other methodological limitations. The results of studies of borage oil for the treatment of atopic dermatitis were highly variable, with the effect reported to be significant in five studies, insignificant in five studies, and mixed in two studies. Borage oil given to at-risk neonates did not prevent development of atopic dermatitis. However, the majority of studies showed at least a small degree of efficacy or were not able to exclude the possibility that the oil produces a small benefit. Overall, the data suggest that nutritional supplementation with borage oil is unlikely to have a major clinical effect but may be useful in some individual patients with less severe atopic dermatitis who are seeking an alternative treatment. Which patients are likely to respond cannot yet be identified. Borage oil is well tolerated in the short term but no long-term tolerability data are available.     

Influence of childhood atopic dermatitis on future worklife

OBJECTIVES: The purpose of this study was to perform a population-based follow-up of people with childhood atopic dermatitis with respect to the possible influence on their worklife. METHODS: Medical records of the school health care services in Stockholm, Sweden, were reviewed for people born between 1960 and 1969. Altogether 600 persons with signs of atopic dermatitis ("cases") and 600 matched controls without eczema ("controls") were identified. Of these people, 405 cases and 378 controls answered a postal questionnaire focusing on choice of job, occupational exposure, past and present skin disease, and change of job due to eczema. RESULTS: The proportions of cases and controls in jobs with a high risk of hand eczema were similar, as was the exposure to water, detergents, chemicals, and hand washing. The self-reported cumulative prevalence of hand eczema was 42% for the cases and 13% for the controls (P<0.001). The 1-year prevalence was 24% for the cases and 9% for the controls (P<0.001). Among the cases, 9% reported a change of job due to eczema compared with 2% of the controls (P<0.001). The corresponding proportions of sick leave were 10% and 2% (P<0.001). CONCLUSIONS: In conclusion, a history of atopic dermatitis in childhood does not seem to influence the choice of job nor hazardous occupational skin exposure. It does, however, mean an increased risk for job changes, sick leave, and medical consultations, mainly due to the increased risk of hand eczema.     

Tacrolimus ointment for the management of atopic dermatitis

The management of atopic dermatitis is set for a major shift with the introduction of the first new topical treatment for the condition in 40 years--the non-steroidal topical immunomodulator tacrolimus (Protopic). Backed by strong clinical data, tacrolimus ointment is a valuable addition to topical steroids in the management of moderate-to-severe atopic dermatitis.     

Prevalence of atopic dermatitis in school children of Baranya county

INTRODUCTION: The prevalence of atopic dermatitis (AD) in children has significantly increased worldwide in the past decades. Although it is well known that the number of AD patients has also been growing in Hungary no prevalence studies on a given population have been performed so far. METHODS: The present research investigated the prevalence of AD in school children by means of questionnaires. The data of 1454 (771 girls, 683 boys) children aged 6-14 years in a big city (Pécs, Hungary) and three small settlements (Bóly, Magyarbóly, Villány; Hungary) were analyzed. RESULTS: Applying the standard point values of the Schultz-Larsen questionnaire the prevalence of AD accounted for 15.1%; it was higher in the big city (16.5%) and lower in the small settlements (13.7%). In girls the prevalence of AD (15.9%) was greater than in boys (14%); this difference was more remarkable in the big city (18.2% vs. 14.8%). The first symptoms of AD appeared before the age of two in 58.8% and it was significantly higher in the big city (63.5%) as in the small settlements (52.6%). Among the 221 AD patients there were 38 patients (17.1%) with asthma and 93 (42.1%) with allergic rhinitis. The AD family (parents, brothers and sisters, great parents) proved to be positive in 72.8%. CONCLUSIONS: The results indicate the high prevalence rate of AD in school children in Baranya County, Hungary reaching or nearly approaching the significantly high values registered in the welfare countries.     

Epicutaneous test with inhalers in the study of atopic dermatitis

In some 80% of patients with atopic dermatitis, the presence of specific IgE is found when facing food or environmental allergens. It has also been demonstrated in a sub-group of patients with atopic dermatitis that the dermatitis lesions are exacerbated following the ingestion or inhalation of allergens, and that they improve with reduction of exposure to allergens. Although the prick method and the determination of specific IgE in serum are highly sensitive techniques, epicutaneous tests, applying the allergen directly to the skin, might be the ideal diagnostic method since they reproduce the characteristic inflammatory response of the disease on the affected organ itself, the skin. However, there is great variability in the results obtained through epicutaneous tests with aeroallergens, basically due to methodological differences, which are reviewed in this paper. Finally, we present the results of carrying out epicutaneous tests with inhalant allergens on our patients with atopic dermatitis and controls, where some 27% of positive patches were obtained, basically with acari, and in those patients with more severe dermatitis, without there being complete concordance with the prick technique. For this reason, the epicutaneous test appears to be a method of allergological diagnosis that might be useful and complementary to the routine techniques of the prick method and the determination of specific IgE in serum, but it is in need of suitable standardization.     

Relationship between breast milk feeding and atopic dermatitis in children

OBJECTIVE: To determine whether or not the breast milk feeding has a role in the prevalence of atopic dermatitis among children. METHODS: The target population of the study was all children participating in health check-up program for 3-year-old children in 60 municipalities locating 10 selected prefectures during designated 2 months between October and December 1997. Using a questionnaire, information on nutrition in infants (breast milk only, bottled milk only, or mixed), parity, mothers' age at birth, and a history of atopic dermatitis was obtained. Besides, data on potential confounding factors were obtained. RESULTS: Questionnaires from 3856 children (81.6% of those who were to participate in the programs, and 96.4% of children who participated them) were analyzed. After the adjustment for all potential confounding factors using unconditional logistic models, the risk of atopic dermatitis was slightly higher among children with breast milk (odds ratio [OR] = 1.16 with 95% confidence interval [CI] 0.96-1.40). Mothers' age at birth (OR for those who were more than 30 years or older in comparison with those who were younger than 30 years = 1.15; 95% CI, 0.96-1.37) and those with second or later parity orders (OR = 1.14, 95% CI; 0.95-1.35) showed odds ratios that were higher than unity without statistical significance. CONCLUSION: Breast milk elevates the risk of atopic dermatitis slightly without statistical significance; the risk may be, however, higher in children in second or later parity orders.     

Relationship between breast milk and atopic dermatitis in children]

OBJECTIVE: To determine whether or not dioxins and furans in breast milk have a role in the prevalence of atopic dermatitis among children. METHODS: The target population of the study was all children participating in health check-up program for 3-year-old children in Tochigi Prefecture in September and October 1997. Using a questionnaire, information on nutrition in infants (breast milk only, bottled milk only, or mixed), parity, mothers' age at birth, and a history of atopic dermatitis was obtained. Besides, data on potential confounding factors were obtained. RESULTS: Questionnaires from 2,968 children (85.3% of those who were to participate in the programs, and 90.2% of children who participated them) were analyzed. The risk of atopic dermatitis was higher among children with breast milk (odds ratio [OR] = 1.37 with 95% confidence interval [CI] 1.02-1.83) and those with mixed nutrition (OR = 1.21, 95% CI: 0.94-1.57) in comparison with children with only bottled milk. Mothers' age at birth (OR for those who were more than 30 years or older in comparison with those who were younger than 30 years = 1.27; 95% CI, 1.01-1.62) and those with second or later parity orders (OR = 1.32, 95% CI; 1.04-1.67) were also risk factors of the dermatitis after the adjustment for some potential confounding factors. CONCLUSION: Breast milk elevates the risk of atopic dermatitis slightly; the risk is, however, higher in children in second or later parity orders. If the PCDDs and PCDFs in breast milk cause the dermatitis, this would contradict the assumed metabolism of these chemicals in human bodies.     

海口市学龄前儿童特应性皮炎流行病学调查

目的 调查海口市学龄前儿童特应性皮炎(atopic dermatitis,AD)流行病学特征及患病危险因素.方法 2020年10-11月采用问卷与体检相结合的方式调查海口市3～6岁学龄前儿童AD的流行病学特征,并采用logistic回归分析确定患病危险因素.结果 海口市学龄前儿童AD总患病率为4.79％,其中男性为5....     

IgE介导食物过敏和婴幼儿特应性皮炎的相关性研究

目的 探讨婴幼儿IgE介导的食物过敏和特应性皮炎(AD)的相关性.方法 选取2014年1月至2016年12月在济宁市第一人民医院皮肤科和儿科变态反应门诊确诊为AD的婴幼儿80例,年龄3个月至3岁.详细询问病史并填写食物过敏调查问卷,再行血清食物特异性IgE(sIgE)检测.除极高水平sIgE外,sIgE阳性患儿需要口服食物激发试验(OFCs),采用二元Logistic回归分析食物sIgE阳性分级对诊断食物过敏的影响.结果 26(32.50%)例AD患儿有食物过敏史或可疑食物过敏史.食物sIgE阳性38例,占总数的47.50%.不同程度的AD患儿在一种食物sIgE阳性和两种及以上食物sIgE阳性比较差异有统计学意义(χ2=12.88,P<0.05).其中极高水平sIgE(6级)5例.结合过敏史、sIgE阳性和OFCs,确诊食物过敏18例(鸡蛋12例、牛奶5例、鱼1例),总阳性率为22.50%.食物sIgE阳性分级越高,IgE介导的食物过敏发生率越高(Waldχ2=13.24,P<0.05,OR=2.81).结论 婴幼儿AD与IgE介导的食物过敏存在密切关联性.个人史和家族过敏史为诊断提供线索,sIgE分级为诊断提供有价值的参考,确诊需要OFCs.牛奶和鸡蛋是婴幼儿最常见的过敏原.     

Epidemiologic, clinic and allergologic profile of atopic dermatitis in south Tunisia

BACKGROUND: Atopic dermatitis (AD) is the collection of the cutaneous inflammatory manifestations which are chronic or repetitive associated with the other atopic diseases. The prevalence of the AD varies from one country to another. AIM: The aims of this work in to study the allergolicol, clinical and epidemiological profile of the AD in the south of Tunisia. METHODS: our study is prospective about 100 cases reported in a period of 18 months. The diagnostic was carried on the criteria of Hanifin and Radjka. For every patient we studied the biographical data and the clinical manifestations of AD. Allergoloigical explorations (pricks-tests) were carried out. RESULTS: the overage of the patients was 104 months with extremes of 5 moths and 43 years. 65 % of our patients were men. At the beginning the average was 61 months with extremes of 2 months and 37 years. 55 patients had antecedents of family allergy and 34 had antecedents of personal allergy. The former preceded the AD in 28 cases. We didn't note any significant relation between the existence of familial allergy and the severity of the AD. In the statement, the principal factor was the contact with the house dust (33 cases), the duration of maternal breastfeeding (overage 13.7 months) didn't influence neither the SCORAD, nor the beginning age of the AD. The date of beginning of food diversity (overage 6.16 months) didn't significantly influence the severity of the illness. The clinical aspect was a sharp eczema in 71% of the cases according. To the SCORAD score. The AD was judged to be weak in 5 cases, moderate in 68 cases and severe in 27 cases. The number of rise per year varied from one rise (75 cases), to more then 6 rises per year (6 cases). The evolution was chronic in 6 cases. The pricks test showed to be positive for the accariens in the group of aeroallergen in 9 cases among the 35 cases tested, and positive for the whole egg in the group of trophallergen in 5 cases among the 13 cases tested.     

Percutaneous absorption of biotin in healthy subjects and in atopic dermatitis patients.

The study was designed to test the ability of sequential applications of biotin-containing ointment to increase serum biotin levels. Twenty atopic dermatitis patients (mean age, 20.5 yr) and 11 healthy subjects (mean age, 25.5 yr) volunteered to participate in this study. The diagnosis of atopic dermatitis was established dermatologically. Seven grams per day of ointment containing 0.3% biotin and 1-4 g per day of steroid ointment were both applied sequentially. The healthy subjects applied only biotin ointment. The biotin concentration was determined microbiologically. Before biotin treatment, the average serum biotin level was significantly lower in atopic dermatitis patients than in healthy subjects. The percutaneous application of biotin-containing ointment caused a significant increase in the serum biotin concentration in both healthy subjects (from 41.5 +/- 10.0 to 50.2 +/- 9.2 nmol/L) and in atopic dermatitis patients (from 27.9 +/- 17.4 to 50.7 +/- 21.6 nmol/L), especially in patients whose initial level was low, and also could be effective in regulating the atopic allergic response involving eosinophils. In conclusion, biotin appears to be readily absorbed through both normal and dermatitis-affected human skin.     

他克莫司治疗特应性皮炎的效果及对患者免疫功能的影响

目的探讨他克莫司治疗特应性皮炎的临床效果及对患者免疫功能的影响。方法选取辽宁省某医院2016年12月-2019年3月收治的120例特应性皮炎患者为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组患者给予盐酸左西替利嗪口服液治疗,观察组患者在对照组基础上给予0.03%他克莫司软膏治疗,比较2组患者临床疗效、不良反应发生情况,治疗前后T淋巴细胞亚群中CD4+、CD8+,自然杀伤(NK)细胞水平及CD4+/CD8+水平。结果治疗前,2组患者血清CD4+,CD8+,NK细胞水平及CD4+/CD8+水平比较,差异无统计学意义(P>0.05);治疗后,2组患者血清CD4+,CD4+/CD8+水平均高于治疗前,NK细胞水平低于治疗前,且观察组患者CD4+细胞水平及CD4+/CD8+水平均高于对照组,NK细胞水平低于对照组,差异均有统计学意义(P<0.05)。观察组患者治疗总有效率为96.67%(58/60),高于对照组的83.33%(50/60),差异有统计学意义(P<0.05)。2组患者治疗期间均无明显不良反应发生,差异无统计学意义(P>0.05)。结论他克莫司治疗特应性皮炎效果较好,可有效改善患者免疫功能,安全性较好,值得推广。