816例皮肤点刺试验过敏原结果分析

目的 探讨特应性皮炎、慢性荨麻疹、慢性湿疹常见过敏原的可能致病情况.方法 用标准变应原液在前臂屈侧皮肤进行皮肤点刺试验,分别用0.1%组胺和0.9%氯化钠液作阳性和阴性对照,统计分析采用x2检验.结果 尘螨(屋尘螨+粉尘螨)的阳性率最高,达50.0%～78.6%,其次为动物毛,达7.1%～21.4%,霉菌的阳性率也较高,达7.1%～14.3%,并且这3种变应原在3种疾病间的阳性率差异均有统计学意义(P＜0.01),以特异性皮炎的阳性率最高.食物组过敏原中虾的阳性率(6.6%～14.3%)最高,但在3种疾病间的阳性率差异无统计学意义(P＞0.05);金枪鱼在慢性荨麻疹中的阳性率(9.5%)较高,鸡蛋、牛奶、芹菜在特异性皮炎中的阳性率(7.1%～14.3%)较高,这4种变应原在3种疾病间的阳性率差异均有统计学意义(P＜0.05).结论 吸入组过敏原是慢性过敏性皮肤病的常见过敏原,尘螨为首要过敏原,以特异性皮炎的阳性率为最高.     

IMMUNOGLOBULIN E IN "HEALED" ATOPIC DERMATITIS AND AFTER TREATMENT WITH CORTICOSTEROIDS AND AZATHIOPRINE

SUMMARY.— In patients with atopic dermatitis, eczema and urticaria, systemic treatment with prednisone had no effect on the serum immunoglobulin E level (IgE) but improved their clinical condition. Neither was there any effect on the IgE level after the immunosuppressive, azathioprine. The increased level of IgE found in patients with atopic dermatitis was not seen in those who had been free from symptoms for more than a year even if they had a persistent or recurring eczema of the hands or nummular eczema.     

慢性荨麻疹患者自体血清皮肤试验结果分析

目的 :探讨慢性荨麻疹患者自体血清皮肤试验的意义。方法 :对 4 0例慢性荨麻疹患者以及2 0例正常对照者、1 0例皮肤划痕症、1 0例异位性皮炎患者进行自体血清皮肤试验。结果 :4 0例慢性荨麻疹患者中 1 3例 (32 5 % )自体血清皮肤试验阳性 ,正常对照组和皮肤划痕症及异位性皮炎患者均为阴性 ,慢性荨麻疹患者的自体血清皮肤试验阳性率显著高于正常对照组及皮肤划痕症和异位性皮炎组 (P值均 <0 0 5 )。结论 :自体血清皮肤试验的测定对自身免疫性慢性荨麻疹有一定的诊断意义。     

过敏性皮肤病患者斑贴试验结果分析及临床意义

目的研究过敏性皮肤病患者斑贴试验结果及临床意义.方法对254例湿疹、56例慢性荨麻疹、28例特应性皮炎患者进行斑贴试验检测.结果三组患者中阳性率较高的致敏原有四种物质相同,分别为硫酸镍、重铬酸甲、卡巴混合物、芳香混合物;特应性皮炎组阳性率(64.29%)明显低于湿疹组(79.92%),慢性荨麻疹(76.79%)与湿疹二组阳性率之间差异无显著性.结论过敏性皮肤病患者阳性率较高的致敏原具有相同性;硫酸镍、重铬酸甲、卡巴混合物、芳香混合物具有较高的致敏性;斑贴试验主要用于检测外源性变应原,特应性皮炎的病因可能以内源性为主;接触性过敏原可以引起接触性荨麻疹;斑贴试验阳性致敏原常是引起面部湿疹、手湿疹的致病因素.     

三种慢性变应性皮肤病患者食物不耐受结果分析

目的比较慢性湿疹、异位性皮炎及慢性荨麻疹患者对14种食物的不耐受情况。方法ELISA法检测3组患者和正常对照组血清中14种食物特异性IgG抗体,并进行等级判定以区分食物不耐受的程度。结果3组患者食物不耐受发病率和严重不耐受的发病率均显著高于正常对照组,异位性皮炎患者食物严重不耐受的发病率最高,达62.5%;三组患者对鸡蛋和牛奶的发病率最高,且不耐受的程度最严重,而异位性皮炎患者对鸡蛋和牛奶严重不耐受的发病率又显著高于另外两组患者;三组患者食物严重不耐受的发病均主要分布在婴幼儿组和青少年组,但异位性皮炎患者食物不耐受的发病年龄和异位性皮炎自身的发病年龄分布一致。结论食物不耐受和异位性皮炎的关系较为密切,提示食物不耐受在异位性皮炎的发病中可能占据较为重要的地位,但其确切机制有待进一步探讨。     

Usefulness of photochemotherapy in allergic diseases of the skin

PUVA treatment was applied in 16 patients with chronic urticaria (7 with solar urticaria, 2 with cold urticaria and 7 with urticaria of unknown etiology), 26 with chronic disseminated eczema and 41 with atopic dermatitis. In all 9 patients with physical urticaria, a clear-cut improvement was observed. The results from the treatment of chronic urticaria of unknown etiology were considerably poorer (improvement in 2 out of 7 cases). In patients with chronic disseminated eczema, a full remission was present in 5 and considerable improvement in 20 cases. In group of 41 patients with atopic dermatitis, 52 cures were carried out; in 8 patients the cure was repeated 2-3 times at 1,0-0,5-year intervals. Complete recovery was achieved in 34 and significant improvement in 16 out of them. The results presented seem to indicate the effectiveness of PUVA treatment to some allergic skin diseases, the more so that the number of exposures required to obtain a considerable improvement, or even full remission, is comparatively low (3-21 occasions), which reduces the risk of complications.     

Dermatitis induced or aggravated by selected foodstuffs

The eczema of 113 patients with dermatitis other than classical urticaria or typical atopic dermatitis cleared or showed marked improvement after one to two months of dietary restriction. In their response to a questionnaire completed at least 6 months after the initiation of the diet, 61 (54%) of these patients said that diet restriction was effective in reducing the activity of or preventing recurrence of their dermatitis. Their most common symptoms were recurrent symmetrical hand eczema, anogenital eczema, pruritic papules and excoriations of the trunk as well as a "fixed" type of eczema. Forty-nine of the 113 patients were able to reproduce their symptoms at least 3 times with certain food items, most commonly eggs, milk, tomato, cheese and fish. It is likely that both the classical food allergens and foods containing or producing histamine or other vasoactive substances could be the cause of such dermatoses or act as a non-specific aggravating factor. This type of reactivity was most common among patients with a personal and/or family history of atopic diseases (asthma, hay fever and/or atopic dermatitis). Symptoms corresponding to those of contact urticaria to food items were commonly seen among the patients.     

过敏性皮肤病患者血清吸入性过敏原特异性IgE研究

为了了解吸入性过敏原在过敏性皮肤病中的作用，采用酶联免疫吸附试验检测148例荨麻疹，138例湿疹和49例异位性皮炎血清屋尘，尘螨，霉菌，豚草花粉，艾蒿花粉，树花粉等6种常见吸入性过敏原特异IgE。结果显示70．9％荨麻疹，79．0％湿疹和77．6％异位性皮炎患者血清中至少有一种吸入性过敏原特异IgE为阳性，均显著高于健康对照组13．0％的阳性率（P＜0．01），有异位性病史的异位性皮炎患者血清吸入性过敏原特异IgE的阳性率为90．3％，显著高于无异位性病史者的阳性率58．3％（P＜0．05），提示吸入性过敏原诱发的I型变态反应在荨麻疹，湿疹和异位性皮炎的发病中起了一定作用，并且有异位性病史的异位性皮炎患者比无异位性病史的患者对吸入性过敏原敏感。     

Sensitizing potential of triclosan and triclosan-based skin care products in patients with chronic eczema

Triclosan is a lypophilic chlorophenol biocide with broad-spectrum antibacterial and antifungal activity. Triclosan-based topical products have been shown to be tolerated and beneficial in atopic dermatitis. The aim of this study was to evaluate the sensitizing potential of triclosan and triclosan-based creams in patients affected by eczematous dermatitis. Two hundred and seventy-five patients affected by chronic eczema (allergic contact dermatitis, irritant contact dermatitis, atopic eczema, nummular eczema, stasis dermatitis) were patch tested with standard patch test series as well as triclosan and triclosan-based products. Standard patch test series resulted positive in 164 patients (61%), with nickel sulfate, house dust mites, fragrance mix, propolis, thimerosal, myroxylon pereira, potassium dichromate, wool alcohols, and p-phenylenediamine the most common sensitizing haptens. Only two patients developed positive reactions to triclosan (0.7%) and four (1.4%) to triclosan-based products. The present study's results confirm that triclosan is well tolerated and has a very low sensitizing potential even in high-risk patients affected by eczema.     

三种变应性皮肤病162例血清总IgE和过敏原特异性IgE检测分析

目的：通过测定特应性皮炎、慢性特发性荨麻疹、慢性湿疹三种变应性皮肤病患者血清总IgE水平，以及对广州地区这三种疾病的致敏原进行初步分析，了解血清总Ig水平及致敏原在这三种疾病中的状况。方法：采用酶联免疫方法对89例慢性特发性荨麻疹、24例特应性皮炎(AD)、49例慢性湿疹、32例正常对照进行MAST—CLA致敏原检测。结果：这三种疾病患者血清总IgE水平显著高于正常对照，三者间无显著差异，在三种疾病主要致敏原：AD分别是：螨虫83．34％、蟑螂37．5％、狗毛或猫毛58．34％；慢性特发性荨麻疹：螨虫39．32％、蟑螂12．36％、牛肉与蟹10．11％、牛奶8．99％；慢性湿疹：螨虫24．48％、屋尘14．29％、狗毛或猫毛10．2％、棉花、青霉菌、蟑螂、牛肉均为8．16％。结论：在广州地区外原性致敏原诱发的Ⅰ型变态反应可能在这三种疾病中起了重要作用。     

Increased tryptase levels in suction-blister fluid from patients with urticaria

The levels of tryptase in the suction-blister fluid from patients with chronic urticaria, urticaria pigmentosa, cholinergic urticaria, urticarial dermographism, prurigo of unknown origin, eczema, psoriasis, atopic dermatitis, and from healthy controls were studied. The blister fluid from controls contained up to 15 micrograms/l of tryptase, whereas that from patients with active urticaria contained greater than 50 micrograms/l. This study demonstrates that patients with urticaria have mast cells that readily release tryptase in both the lesional and non-lesional areas of skin.     

Correlation of nipple eczema in pregnancy with atopic dermatitis in Northern India: a study of 100 cases

BackgroundNipple eczema is a less common presentation of atopic dermatitis. No studies in the literature have correlated nipple eczema in pregnancy as a manifestation of atopic dermatitis.ObjectiveTo evaluate whether nipple eczema presenting in pregnancy is a manifestation of atopic dermatitis.MethodsThis was a prospective observational study including 100 women who presented with nipple eczema for the first time during pregnancy. The exclusion criteria were any patient with previous history of nipple eczema, those already on oral or topical treatment for atopic dermatitis or nipple eczema, and other disorders mimicking eczema. Patients were divided into two groups ‒ nipple eczema with atopic dermatitis and without atopic dermatitis. Demographic data, clinical features, total leukocyte count, differential leukocyte count, absolute eosinophil counts, and serum IgE levels were compared between the two groups to detect association between nipple eczema in pregnancy and atopic dermatitis.ResultsOut of 100 patients, 39 were diagnosed with atopic dermatitis, whereas 61 were ruled out to have any features suggestive of atopic dermatitis. There were no statistically significant differences in mean age, mean duration of symptoms, and serum IgE levels. In patients with atopic dermatitis, bilateral symptoms were noted more commonly than in patients without the disease, but this was statistically insignificant.Study limitationsLack of long term follow-up and no large studies in literature to compare results.ConclusionNipple eczema in pregnancy follows a similar pattern as in other age groups. The clinical profile of patients is similar in cases with and without atopic dermatitis.     

Atopic contact dermatitis

Contact urticaria appears either as wheal and flare reactions or as dermatitis resembling other types of contact dermatitis. A nonimmunologic form of contact urticaria is seen more frequently than the allergic form of the disease in experimental conditions. However, the immunologic form of contact urticaria is clinically more important. It is often seen in atopic persons working in the food industry or in kitchens.
We can prevent many cases of occupational anaphylactic hand eczema by choosing proper jobs for atopic persons. Especially handling food seems to produce hypersensitivity reactions in atopic more frequently than in nonatopic persons.     

Atopic dermatitis, nickel sensitivity and xerosis as risk factors for hand eczema in women

Knowledge of the relationship between a history of atopic dermatitis and nickel sensitivity as risk factors for hand eczema is limited. Our objective was to study the relative importance of atopic manifestations and nickel sensitivity as risk factors for hand eczema in women. From women referred for patch testing with a dental series. 100 consecutive nickel-positive and 95 nickel-negative patients were studied. A history of atopic manifestations and a history of 5 symptoms of hand eczema, i.e., dry erythemas, maculopapules, vesicles, erosions and hyperkeratoses were recorded. A history of atopic dermatitis was found lo increase the risk of the 5 symptoms of hand eczema and sick leave due to hand eczema highly significantly. Nickel sensitivity increased only the risk of vesicles and erosions, Xerosis increased the risk of dry erythemas and vesicles. We concluded that a history of atopic dermatitis was more important than nickel sensitivity as a risk factor for hand eczema in women.     

Psychological symptoms and quality of life of dermatology outpatients and hospitalized dermatology patients

The aim of the investigation was to compare psychological symptoms and health-related quality of life of dermatology patients and healthy controls. The sample consisted of 333 consecutively recruited patients from four dermatology outpatient clinics, 172 hospitalized dermatological patients from two university hospitals and 293 matched healthy controls. All patients and controls completed Beck's Depression Inventory, the Brief Symptom Inventory and the Dermatology Life Quality Index. Hospitalized patients were more distressed than outpatients and healthy controls and reported greater impairment of disease-related quality of life than outpatients. More hospitalized patients had suicidal thoughts and were characterized as having severe to moderate depression compared with outpatients and controls. Female patients and younger patients were generally more distressed than male patients and older patients, and patients with atopic dermatitis and psoriasis were more distressed than patients with urticaria and eczemas. Disease-related impairment of quality of life was the main predictor of psychological symptoms, when controlling for diagnosis, age, gender, disease duration and disease severity. Although older age was associated with fewer psychological symptoms, our data suggest that skin disease affects quality of life equally in young and older patients. The findings highlight the importance of recognizing disease-related psychological problems and possible psychiatric comorbidity of dermatology patients, especially among patients with atopic dermatitis and psoriasis.     

Therapeutic effects of antibacterial treatment for intractable skin diseases in Helicobacter pylori-positive Japanese patients

In order to understand the pathogenic relationship between Helicobacter pylori (H. pylori) and skin diseases, we examined the serum levels of IgG antibody against H. pylori and then performed gastroscopic examinations in Japanese patients with chronic skin diseases. These H. prylori-positive patients were treated with antibacterial eradication therapy, and therapeutic efficacy was evaluated. A total of 198 patients who were resistant to conventional therapies were randomly selected. They included 50 cases with chronic urticaria, 32 with pruritus cutaneous, 74 with atopic dermatitis, 15 with nummular dermatitis, 17 with prurigo chronica multiformis, 6 with psoriasis vulgaris, and 4 with erythroderma. Positive anti-H. pylori antibody was detected in 102 out of these 198 patients; more than half of the ones with chronic urticaria, pruritus cutaneous, nummular dermatitis, and prurigo chronica multiformis had positive antibodies. Gastroscopy was then performed in 48 cases with positive antibodies. Eradication therapy was effective in 60% of the patients with chronic urticaria, in 58% with pruritus cutaneous, in 54% with nummular dermatitis, and in 50% with prurigo chronica multiformis. In chronic skin diseases, persistent infection with H. pylori may be an eruption trigger and may cause deterioration of the disease into an in tractable and chronic form.     

A dose-response study of irritant reactions to sodium lauryl sulphate in patients with seborrhoeic dermatitis and atopic eczema.

The susceptibility of the skin of patients with seborrhoeic dermatitis to surfactant irritation was investigated and compared to that of a group of normal subjects and patients with a history of atopic eczema. Responses to six concentrations of sodium lauryl sulphate (SLS), applied to forearm skin, were assessed clinically and measured by laser Doppler flowmetry. Analysis of dose-response curves showed statistically significant increased susceptibility to SLS-induced irritation in patients with seborrhoeic dermatitis and atopic eczema compared with normal subjects. Increased susceptibility to chemical irritation may be important in the pathogenesis of seborrhoeic dermatitis.     

Impact of acute stress on itch sensation and scratching behaviour in patients with atopic dermatitis and healthy controls

Patients with atopic dermatitis (eczema) often report that stress is a major factor to worsen their itchy skin. This study investigated the effects of acute stress on itch, urge to scratch, and scratching behavior in subjects with atopic dermatitis compared to healthy controls. Stress was created in a standardized way using the Trier Social Stress Test (TSST), where subjects were asked to perform a public speaking task and mental arithmetic. In a second control visit, instead of being stressed, subjects watched a non-stressful video of landscape scenes. Both subjects with atopic dermatitis and healthy subjects reported feeling stressed after the TSST. Interestingly, atopic dermatitis subjects who were more sensitive to stress also had higher eczema severity. Before and after the TSST or landscape video, cowhage (a plant that causes itch) was applied to the arm of each subject. Patients with atopic dermatitis reported less itch from cowhage and less urge to scratch after they had been stressed by the TSST. However, despite reporting less itch, they actually scratched their limbs significantly more when they were stressed. Healthy individuals did not have any difference in itch, urge to scratch, or scratching behavior in the stressful condition compared to the control landscape video condition. This study shows that acute stress can affect itch and scratching differently in chronic itch patients compared to healthy individuals. Stress led to more scratching in those with atopic dermatitis. Over time, this response to stress could lead to increased skin damage from scratching and therefore worse eczema and itch.     

Giardia lamblia--cause of urticaria and pruritus or accidental association?

Three patients with chronic urticaria or pruritus were found to suffer from an asymptomatic intestinal infection caused by the protozoan Giardia lamblia. Treatment with metronidazole per os or tinidazole per os was successful; the pruritic symptoms in one patient improved markedly.Giardia lamblia (Giardia intestinalis) are enteroparasites and produce gastrointestinal symptoms such as acute and chronic diarrhea. Cutaneous manifestations associated with giardiasis occur extremely rarely. Urticaria and itching may be explained as an infection-associated allergy. Hitherto, the following cutaneous signs have been described: urticaria, angioedema, mouth ulcers, pruritus, atopic dermatitis, and anal eczema.We considered that the cutaneous manifestations described here, i. e., urticaria and itching, were secondary to the associated gastrointestinal infection due to Giardia lamblia cysts and trophozoite forms, as they disappeared under specific treatment with metronidazole or tinidazole.     

咪唑斯汀治疗皮炎湿疹68例临床分析

目的评价咪唑斯汀治疗皮炎湿疹的临床疗效。方法118例皮炎湿疹患者随机分为两组,咪唑斯汀组68例口服咪唑斯汀10mg,氯雷他定组50例口服氯雷他定10mg,均1次/d。结果咪唑斯汀治疗急慢性湿疹和异位性皮炎3周有效率为90.7%,氯雷他定组为60.0%,两组差异有显著性(P<0.01);咪唑斯汀与氯雷他定对接触性皮炎的1周有效率均为100%,差异无显著性(P>0.05)。结论咪唑斯汀是治疗皮炎湿疹等过敏性疾病的理想药物。