Secondary contact sensitivity to TMTD in patients primarily positive to TETD.
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Biomedical subjects
Publications and source records attributed to E Rudzki.
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In 481 patients with atopic dermatitis (AD), 4 major features of Hanifin and Rajka were found in 72%, and in 96% over 6 minor features were seen, which is much more than the minimum required by these authors for making a 'firm diagnosis'. The incidence of particular minor features in all patients was varying significantly, and in subgroups of patients they appeared with different frequency. For example, asthma occurred more often in AD patients with the onset of skin lesions before the 6th month of life, and food intolerance was more frequently observed in patients with very high serum IgE level. In the control groups some minor features also occur but less frequently than in AD patients. We conclude that the anterior neck folds and Dennie-Morgan infraorbital fold should be regarded as minor AD features.
In a group of 228 patients with Asthma-Prurigo syndrome in 82.5% of patients the onset of skin lesions was earlier than the onset of asthma. It was found that the early onset of atopic dermatitis suggests the greater probability of subsequent asthma. In 88.6% of patients also other allergic diseases were diagnosed, and rhinitis allergica was observed most frequently. In the investigated group of patients urticaria chronica idiopathica or physical urticarias were not observed. Among 228 patients with Asthma-Prurigo syndrome, 74.6% of patients pointed to house dust as one of the most frequent causative factors. The house dust similarly to other inhalant allergens, somewhat more frequently had influence on the course of atopic dermatitis than on the course of asthma. Contrary to this observation according to patients food allergens (milk, eggs, fish, chocolate) aggravated or induced the relapses of skin lesions much more frequently than asthma. It was shown how often patients noticed adverse reactions due to penicillin and sulphonamides.
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The frequency of basic and minor features of atopic dermatitis were compared between 86 patients with coexistent asthma, and 269 without asthma. The coexistence of asthma caused a statistically significantly more frequent presence of one of the basic features: personal or family history of atopy and five minor features. The latter included: early age of onset, recurrent conjunctivitis, tendency toward cutaneous infections, elevated serum IgE and keratosis pilaris.
In 365 children and 213 adults the characteristics of atopic dermatitis isolated by Hanifin and Rajka were analysed in relation to a family history of allergy. A positive history in both parents and/or their families was associated with higher IgE titres, earlier appearance of skin changes, more frequent occurrence of urticaria, allergic respiratory diseases, cheilitis, and, in women, nipple eczema. These changes were less frequent and the IgE titre was lower in patients with one atopic parent, and even less frequent (or lower IgE titre) in patients with no family history of atopic disease, although the latter difference was sometimes slight.
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The study was carried out in 535 children. The frequency of positive RAST for food allergens decreased with age, whereas the frequency of positive RAST for inhalant allergens increased with age. Coexistence of asthma and/or rhinitis was not related to the results of RAST with food allergens. Positive RAST and multiple sensitivity for inhalant allergens were significantly greater in children with coexistence atopic respiratory disease. Total IgE was significantly higher in children with coexistent atopic respiratory disease in all age groups. This study provides information for the critical analysis of a RAST in atopic dermatitis.