深圳地区特应性皮炎491例临床分析

特应性皮炎(AD)是一种与遗传过敏体质有关的皮肤炎症性疾病.其特征是皮肤干燥,瘙痒剧烈,反复发作,在不同年龄阶段有不同的临床表现,多见于儿童及青少年.成年后亦常伴有哮喘、过敏性鼻炎、过敏性结膜炎及血清总IgE的升高.现分析特应性皮炎患者的血清检测总IgE和特异性IgE,并分析其与疾病严重程度的相关性.     

湿疹及皮炎

20 0 0 30 60　遗传过敏性皮炎血清特异性 Ig E分析 /陈木开 (中山医大附一院皮肤科 )…∥中国皮肤性病学杂志 .- 2 0 0 0 ,14( 3) .- 151～ 152对广东地区 90例遗传过敏性皮炎 ( AD)患者血清行 Mast SIg E检测。Mast变应原检测系统是近年来发展起来的一种体外半定量检测血清特异性 Ig E方法。90例中 AD1组 53例 ,合并哮喘、过敏性鼻炎者占58.89% ,AD2 组 37例 ( 4 1.11% )为 AD患者无合并哮喘及过敏性鼻炎者。结果显示 :AD患者中 80 %伴有Ig E升高 ,发现螨类是 AD患者最常见的变应原 ,其特异性 Ig E(屋尘螨及粉尘螨 )阳性检出率…     

天津地区特应性皮炎患儿血清特异性IgE检测结果分析

目的检测天津地区特应性皮炎患儿血清特异性IgE水平并进行相关分析。方法免疫印迹法体外半定量检测患儿血清特异性IgE水平,并分析不同年龄组别的差异。结果 353例特应性皮炎患者中,阳性患者为211例,阳性率为59.77%。其中不同组别阳性率不尽相同(P<0.05)。0～3岁组最常见变应原为羊肉、牛奶、春季花粉;4～6岁组最常见变应原为霉菌、羊肉、牛奶;7～9岁组最常见变应原为霉菌、牛奶、户尘螨;10～12岁组最常见变应原为户尘螨、屋尘、霉菌。结论天津地区特应性皮炎患儿不同年龄段过敏物质不尽相同,提示与饮食结果改变和环境因素有关。     

在儿童期患异位性皮炎的成年人的接触过敏性

异位性皮炎的发病机制不明。此类患者曾被发现有某些免疫异常。经体内和实验室检查发现血清IgE的平均值常有升高和细胞免疫反应性降低,此种低反应性发生于疾病活动期和缓解期。多数作者报道异位性皮炎患者的接触过敏性发生率很低,且此种反应并不多于其它型的内源性湿疹。为确定在儿童时期有过严重的或中等的异位性皮炎患者接触过敏性发生率;鉴定最常见的接触变应原并探讨已痊愈皮炎、成年期手部湿疹、异位性家族史、伴支气管哮喘或变应性鼻炎以及IgE的水平与接触过敏性的关系;作者选了两组病人用ICDRG标准化     

云南省曲靖市524例皮肤病患者血清总IgE和变应原特异IgE的检测

目的探讨曲靖地区变态反应性皮肤病患者血清总IgE及特异性IgE,寻找本地区的变应原分类,为防病治病提供依据。方法采用免疫印迹法(immunoblotassay)对524例变态反应性皮肤病患者血清总IgE及变应原特异性IgE水平进行检测。结果80.34%血清总IgE水平增高,慢性荨麻疹、湿疹、过敏性紫癜、异位性皮炎分别为79.53%、71.72%、71.43%和90.63%,变应原特异性IgE吸入组以户尘螨/粉尘螨阳性率最高;食物组以牛羊肉为最高,其后依次是牛奶。结论通过检测患者血清总IgE特异性IgE,能够更好的预防和治疗本病,同时可以通过改变接触的环境和生活习惯来减少发病率。     

大疱性类天疱疮89例特应性特征分析

目的 分析大疱性类天疱疮(bullous pemphigoid, BP)患者中有特应性特征(包括临床表现、实验室检查和病史)患者的比例,以探讨BP与特应性之间的关系。方法 回顾性研究89例BP患者的临床表现、实验室检查及合并特应性个人史和/或家族史的特征。根据血清免疫球蛋白E(immunoglobulin E, IgE)升高及外周血嗜酸性粒细胞(blood eosinophils, EO)升高特征进行临床分层分析。组间比较视特征采用t检验、Mann-Whitney U检验、卡方检验及Fisher精确检验。结果 89例BP患者中,80例(89.89%)有特应性特征。合并特应性疾病者43例(48.31%),其中特应性皮炎18例(20.22%),过敏性鼻炎29例(32.58%),慢性荨麻疹9例(10.11%),哮喘8例(8.99%),过敏性结膜炎13例(14.61%),27例(30.34%)一级亲属中有特应性疾病史,43/53例(81.13%)血清总IgE升高,41/76例(53.95%)外周血嗜酸粒细胞升高,17/26例(65.38%)过敏原特异性IgE阳性。分层分析表明,血清IgE升高的...     

朗格罕细胞上的IgE:遗传过敏性皮炎发病的新观点

遗传过敏性皮炎(AD)的发病机理仍不清楚,一般认为此病的内因包括免疫学和病理学的异常,外因似与食物过敏和常见的环境变应原等有关。但近来对AD病人的观察已超出了这一认识。约90％的AD病人经划痕或皮内法对吸入性变应原出现一种立即型反应,同时血清特异性IgE升高。在大多数病例中,这种对吸入性变应原的立即型过敏反应与哮喘和(或)过敏性鼻炎有关。IgE和吸入性变应原在AD发病上的确切作用仍不清楚。但     

特应性皮炎患者过敏原两种检测方法的相关性

目的探讨皮肤点刺试验和血清变应原特异性IgE检测的相关性。方法同时采用皮肤点刺试验(SPT)和德国MEDIwlss敏筛过敏原检测系统检测60例特应性皮炎(AD)患者的过敏原,并对检测结果进行比较。结果皮肤点刺试验和血清变应原特异性IgE的阳性率分别为3.89%(140/3600)和7.42%(89/1200),后者明显高于前者,差异有统计学意义(P=0.000),且这两种检测方法不相关(P=0.207)。结论皮肤点刺试验和血清变应原特异性IgE检测特应性皮炎过敏原不相关,必要时可同时进行这两种方法检测,并结合病史判断病情。     

血清特异性IgE检测在过敏性皮肤病病因筛查诊断中的应用

目的观察分析血清IgE检测在过敏性皮肤病病因筛查诊断中的临床应用效果。方法对300例过敏性皮肤病患者进行酶联免疫法检测血清变应原特异性IgE,筛查相应的过敏原,并进行比较分析。结果吸入性变应原特异性IgE检测排序前4位分别是户尘螨、屋尘螨、狗毛、猫毛;食入性变应原特异性IgE检测排序前4位分别是虾、蟹、鱼、鸡蛋;本组300例,变应原特异性IgE总反应285例(95.00%),阴性反应15例(5.00%);吸、食入组均阳性210例(70.00%),单纯吸入组50例(16.67%),单纯食入组25例(8.33%)。两组均阳性率对比单一组阳性率差异有统计学意义(P 0.05)。单纯吸入组与单纯食入组比较,差异有显著性(P0.05)。结论对于过敏性皮肤病采取血清IgE监测,可以筛查相应的过敏原,为临床病因诊断及脱敏治疗提供可靠依据。     

特应性皮炎的主动免疫疗法

特应性皮炎（atopic dermatitis,AD）又称为异位性皮炎,除有特定的皮炎湿疹表现外,患者本人或其家族中可见到明显的异位性特征,即：有容易罹患哮喘,过敏性鼻炎、湿疹的家族性倾向;对异种蛋白过敏;血清中IgE升高;血液嗜酸性粒细胞增多。     

Retrospective study of specific immunotherapy - what should be done in the future

In this retrospective study, data on 241 atopic patients treated with specific cutaneous immunotherapy during the 1985-2006 period at Allergy Clinic, University Department of Dermatology and Venereology, were reviewed. The following diagnoses were recorded: atopic dermatitis, pure or in combination with allergic rhinitis or allergic bronchitis, or allergic bronchitis and asthma, allergic rhinitis, allergic conjunctivitis, urticaria, and Quincke's edema. The aim was to retrospectively analyze clinical efficacy and laboratory findings in atopic patients undergoing specific immunotherapy. Before specific immunotherapy administration, eosinophil count, immunoglobulins, skin prick test, total IgE (RIST) and specific IgE (IgE UniCAP) were determined. The following allergens were included in specific immunotherapy: Dermatophagoides pteronyssinus, house dust mite (mixed or separately), mixed and single pollens (grass, tree, weed), feather, and animal dander. The most frequent allergens in 241 atopic patients were grass pollen mixture, Dermatophagoides pteronyssinus, ragweed, tree pollen mixture, cocksfoot, birch, animal dander, and feather. Treatment efficacy was demonstrated after 3 years of continuous therapy by clinical evaluation and with the same diagnostic procedure. After several months of therapy, initial clinical improvement was noticed in atopic dermatitis patients as well as in patients with respiratory diseases that were sensitive to airborne allergens. According to literature, specific immunotherapy was used as a treatment option, which may affect the natural course of allergic diseases. It reduces development of asthma in patients with allergic rhinitis and prevents the onset of new sensitizations.     

Correlation among skin prick test, total and specific IgE UniCAP tests in atopic patients from Zagreb, Croatia

The correlation of pollen allergens, Dermatophagoides pteronyssinus and animal dender was assessed during a two-year period. Results of skin prick test, total and specific IgE UniCAP tests were compared in atopic patients (AP) with the following diagnoses: atopic dermatitis, allergic rhinitis, allergic conjunctivitis, allergic bronchitis or asthma, allergic urticaria and angioedema. The study included total and specific IgE (in vitro) tests to allergen mixtures (grass, tree, weed) or to single allergens of Dermatophagoides pteronyssinus (Der p), cat and dog fur, feather, etc. Comparison of skin prick test with total and specific IgE UniCAP immunoassay was done in 173 patients, i.e. 107 female and 66 male atopic patients aged 9-76 years. Allergies were most commonly recorded in the 25-35 age group. Total IgE ranged from 8.63 kU/l to >4000 kU/l, with specific IgE ranging from class 1 to class 5. Skin prick test showed high correlation with specific IgE for grass and weed pollen in patients with repiratory allergy (50.28%). Good correlation among all three tests was quite frequently observed. The results suggest that the study should be continued using these three tests in further cases of atopic dermatitis.     

Evaluation of RAST in atopic dermatitis

Eighty-two patients with atopic dermatitis were examined for specific IgE antibodies by RAST. A higher number of positive RAST reactions were found in patients with high serum IgE values and with coexisting asthma and/or allergic rhinitis. Positive RAST reactions against mite and house dust were found in many of these patients and even in about one-half of patients with atopic dermatitis only. The comparisons between intradermal tests and RAST were made with various allergens and the mite extract showed the best agreement between these two tests.     

The sweat of patients with atopic dermatitis contains specific IgE antibodies to inhalant allergens

We have investigated levels of total and specific against inhalant allergens in the sweat of 15 patients with atopic dermatitis, 10 patients with allergic rhinitis and high levels of specific IgE in the serum, and five patients with psoriasis without atopy as controls, by means of various commercial methods such as fluorescence immunoassay, nephetometry, chemiluminescence assay, enzyme immunoassay and the radioallergosorbent lest. Total IgE and specific IgE antibodies were detectable in the sweat of patients with atopic dermatitis as well as of patients with allergic rhinitis alone. These levels of total IgE in the sweat correlated with the severity of the skin disease (P < 0·05). By means of the Ciba Corning assay (P < 0·001), the fluorescence immunoassay (P < 0·05) and the nephelometry assay (P < 0·05), positive correlations were then established between the levels of total IgE in the serum and the sweat. Moreover, specific IgE antibodies to birch pollen and Dermatophagoides pteronyssinus were detectable in the sweat and correlated positively with these specific IgE levels in the serum (P < 0·05). Further, the specific IgE levels against these allergens in the sweat also correlated with the severity of dermatitis (P < 0·05). It is suggested that these specific IgE antibodies against certain inhalant allergens in the sweat of patients with atopic dermatitis may play a role in allergen trapping in the skin.     

Allergy promotes alopecia areata in a subset of patients

In this commentary, we focus on allergy as a facilitating factor in the pathogenesis of alopecia areata (AA). From previous studies on AA, it is well known that subsets of patients can have one or more of; seasonal relapse, comorbid atopic rhinitis, asthma and dermatitis, lesion infiltrating eosinophils and plasma cells, high levels of total IgE, specific IgE for house dust mites (HDMs), and/or disrupted skin barrier function by the evaluation of filaggrin. Allergy and AA share a similar genetic background; both contributing to an immune reaction imbalance. Furthermore, adjunctive treatment with antihistamines, or desensitization for HDM, can reduce the severity of alopecia in atopic AA patients. Therefore, allergies may contribute to the onset and relapse of AA. Identification of an allergic or atopic immune component in AA patient subsets may indicate adjunctive treatment intervention measures against allergies should be taken which may improve the success of conventional AA treatment.     

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

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.     

Atopy patch test reaction to airborne allergens in the diagnosis of atopic dermatitis

The aim of the study was to evaluate the possible use of atopy patch test in the diagnosis of atopic dermatitis and to characterize an optimal standardized system for atopy patch test in terms of allergen concentrations and time of allergen exposure. The study included 36 patients with atopic dermatitis and IgE-mediated airborne allergy. Patients presented positive results of skin prick tests and serum antigen specific IgE against house dust mite allergens and/or selected grass pollen allergens. Control groups consisted either of patients with allergic rhinitis (control group 1) or healthy volunteers with no signs or symptoms of atopy (control group 2). Allergologic diagnostic workup consisted of skin prick test, serum antigen specific IgE and total IgE evaluation, atopy patch test with selected airborne allergens of different concentrations (0.1xSPT, 1xSPT and 10xSPT), time of allergen exposure (8, 24 and 48 h), and readings of the results (8, 24, 48 and 72 h). Positive results of atopy patch test with airborne allergens were obtained in 47.2% of atopic dermatitis patients and none of control subjects. Contact reaction itself and the intensity of reaction were demonstrated to correlate with allergen concentration and time of allergen exposure on atopy patch test. The dose and time response analysis showed the optimal concentration of allergens for atopy patch test to be 10xSPT, 500000 SBE/ml, and optimal evaluation time 24 and 48 h of allergen application. There was no correlation between atopy patch test results and mean serum concentrations of total or antigen specific IgE. Atopy patch test results did not correlate with localization of skin lesions, severity and extensiveness of skin inflammation. A significantly higher contact reactivity to airborne allergens was recorded in the group of atopic dermatitis patients with polyvalent allergy in comparison with atopic dermatitis patients allergic to only one aeroallergen. It is concluded that atopy patch test is the only provocation test currently available with clinical relevance for contact IgE-mediated sensitization in atopic dermatitis patients. Using petrolatum as a vehicle, allergen concentration of 500000 SBE/ml and evaluation time of 24 and 48 h of allergen application may lead to improved atopy patch test results.     

Impaired monocyte-mediated cytotoxicity in atopic dermatitis

Summary Twenty-three adult patients with atopic dermatitis of different severity and extent all without present cutaneous infection were investigated for antibody-dependent cytotoxicity mediated by purified monocytes. Compared to a healthy control group the monocyte cytotoxicity was significantly decreased for patients with more widespread dermatitis. Eight patients with acute contact dermatitis and 13 patients with extrinsic asthma or allergic rhinitis showed normal cytotoxicity. Decreased monocyte cytotoxicity in atopic dermatitis was not related to the serum IgE level. In vitro cultivation of defective monocytes from atopics did not increase cytotoxicity, nor did normal monocytes preincubated with patient serum show abnormal function. In atopic dermatitis the total number of Fc receptor bearing monocytes was normal. However, the affinity of this receptor was lower than in normals.Serial studies are needed to establish whether reduced monocyte function is a basic pathophysiologic defect in atopic dermatitis.     

Serum IgE and Fc epsilon receptor positive lymphocytes in atopic dermatitis--relation to the background of respiratory atopy

The serum IgE level and the population of Fc epsilon R2+ lymphocytes in peripheral blood of 62 patients with atopic dermatitis (AD) were studied. IgE was increased in the majority of the patients with personal or family history of asthma and/or allergic rhinitis (combined AD). On the contrary, only 63.2% of the patients who have solely AD (pure AD) showed less elevation of IgE. There was no correlation between IgE and the severity of dermatitis in pure AD and rhinitis combined AD. However, asthma combined AD showed a significant positive correlation between IgE and the severity of dermatitis. In AD, the population of Fc epsilon R2+ lymphocytes significantly correlated with IgE, suggesting that Fc epsilon R2+ lymphocytes may play a role in the enhanced synthesis of IgE. However, the increase of Fc epsilon R2+ lymphocytes was found only in combined AD, but not in pure AD. These results suggest that elevated IgE and Fc epsilon R2+ lymphocytes reflect combined respiratory atopy rather than AD itself, although there remains the possibility that IgE may influence the formation or exacerbation of dermatitis in asthma combined AD. As far as the participation of IgE is concerned, pure AD and asthma combined AD could be different groups and should be investigated separately.     

Association factors for atopic dermatitis in nursery school children in Ishigaki islands - Kyushu University Ishigaki Atopic Dermatitis Study (KIDS)

Atopic dermatitis (AD) is a multifactorial disease that usually decreases the quality of life of affected patients. The purpose of this study was to evaluate the associated factors for atopic dermatitis, asthma, rhinitis, and food allergy by physical examination of the skin and a questionnaire in nursery school children in Ishigaki Island, Okinawa, Japan. Enrolled in this study were 460 children from 0 to 6 years of age. Physical examination of skin symptoms and blood tests were performed. Information on past history and family history of atopic dermatitis, asthma, rhinitis, and food allergy were collected by questionnaire. The prevalence of atopic dermatitis was 12.2% (56/460). The cumulative prevalence of asthma, rhinitis, and food allergy was 19.9% (91/458), 3.3% (15/457), and 5.5% (25/456), respectively. In multivariate analysis, maternal history of rhinitis, atopic dermatitis siblings, past history of asthma and food allergy, and elevation of total IgE were significantly related to atopic dermatitis. A high total IgE level was a strong risk factor specific for atopic dermatitis in this population.