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PubMed1976

Decreased adrenergic responses in lymphocytes and granulocytes in atopic eczema.

The physiologic and cyclic adenosine monophosphate (cAMP) response to beta adrenergic stimulation in lymphocytes and granulocytes was examined in atopic eczema. These cells were isolated by Ficoll-Hypaque gradient from 10 patients with atopic eczema, and their responses were compared to 10 normal subjects. In eczema, basal concentrations of cAMP were normal in both lymphocytes and granulocytes. Lymphocyte cAMP response in eczema was decreased both to epinephrine (10-5 M) and to isoproterenol (10-5 M) but normal to prostaglandin E1 (PGE1). It was also noted that the glycogenolysis response to isoproterenol was significantly less at 10-5 M in eczema, but the fall in glycogen was normal with PGE (10-5 M and 10-7 M). The inhibition of lysosomal enzyme release from granulocytes after zymosan stimulation was significantly less (p less than 0.01) in eczema with all concentrations of isoproterenol tested. There was also a decrease in cyclic AMP response to isoproterenol in the polymorphonuclear leukocytes. PGE1 inhibited lysosomal enzyme release and stimulated cAMP normally. In eczema, both lymphocytes and polymorphonuclear leukocytes have a decreased beta adrenergic response.

Adolescent↗
PubMed1999

Prevalence of self-reported hand eczema and skin symptoms associated with dental materials among Swedish dentists.

In the present study we investigated the prevalence of self-reported hand eczema as well as subjective associations between skin symptoms and composite/bonding or other dental materials among Swedish dentists. A questionnaire on skin symptoms, atopy, occupational experience, and other background factors was sent to a random sample (n=3,500) of all dentists licensed since 1965. This group corresponds to about half of the country's occupationally active dentists. The response rate was 88%. The questionnaire had previously been validated against clinical dermatological examination of subjects reporting hand eczema. The prevalence of dry and rough skin on the hands was high (45%). Hand eczema during the previous 12 months was reported by 13.5%. Dry skin and hand eczema were more common among dentists than in two age-matched general population samples investigated using identical questions. The difference versus the general population was most pronounced (about two-fold) among male dentists. A history of childhood eczema was the most important predictor for adult hand eczema, with a prevalence ratio of 2.4 compared to dentists without childhood eczema. Seven % reported skin symptoms when working with acrylic resins, and 15% had experienced rapid itching related to protective gloves.

Acrylic Resins↗
PubMed2006

Steroid fears in children with eczema.

BACKGROUND: Topical glucocorticoids (GCs) are the mainstay of treatment for eczema, but GC phobia and fears are very common among the parents of paediatric patients. AIM: To survey the nature and extent of "fears" of GC use, and to evaluate if disease severity is associated with such fears. METHODS: Patients with eczema managed in the paediatric dermatology outpatient clinic of a university hospital were recruited in this survey. Disease severity and various aspects of belief and practices of GC use were assessed with the Nottingham Eczema Severity Score and a questionnaire. RESULTS: GC "fears" were present in two fifths of informants with non-eczematous skin disease and mild eczema, but three fifths in moderate-to-severe disease. Requests for steroid-sparing medications (such as tacrolimus or pimecrolimus) had been made in nearly 50% of cases with moderate-to-severe eczema, and many parents would wait until eczema had worsened or apply GC only as a last resort to avoid potential side effects. "Fears" were predominantly interpersonal and rarely iatrogenic in nature. Skin problems (in particular skin thinning) and adverse effects on growth were the side effects of GC of most concern. However, fewer than half of the informants had discussed their concerns with doctors. CONCLUSION: Our results suggest the importance of understanding the nature and extent to which GC fears, regardless of eczema severity, are prevalent so that sound advice can be offered in a timely manner to parents and patients.

Administration, Topical↗
PubMed2005

Is the risk of lung cancer reduced among eczema patients?

Persons with a history of eczema have been shown to have a reduced risk of lung cancer, but the evidence has been inconclusive because of the small size of previous studies and their limited ability to control for confounding by smoking. The objective of this study was to determine the role of eczema in relation to lung cancer while overcoming the limitations of previous investigations. Study subjects included 2,854 cases and 3,116 population and hospital controls recruited during 1998-2001 from 16 areas in the Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and the United Kingdom. Odds ratios were calculated for self-reported history of eczema via multivariate logistic regression modeling. The odds ratio for a history of eczema was 0.61 (95% confidence interval: 0.48, 0.76) after control for age, sex, study center, and cumulative tobacco smoking. There was no heterogeneity in the results by sex or age at onset of eczema. Subjects reporting use of medication for eczema had a lower odds ratio than subjects not reporting such use. This study provides further evidence for an inverse association between history of eczema and lung cancer risk, which is unlikely to be due to chance, bias, or confounding.

Adult↗
PubMed1987

Prevalence of hand eczema in an industrial city.

The occurrence of hand eczema in an industrial city was studied. Questionnaires were sent to 20,000 individuals aged 20-65 years, randomly selected from the population register of the city. After two reminders, a response rate of 83% was obtained. Analysis of the drop-outs did not indicate that the presence of hand eczema was an important selection factor for response to the questionnaire. Those subjects considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination to verify the diagnosis and for further investigation. Seventy-one per cent accepted the invitation. Analysis of drop-outs showed that willingness to attend the dermatological examination was to some extent dependent on the severity of the hand eczema. It was found that almost 11% considered themselves to have had hand eczema at some time during the previous 12-month period; approximately two thirds were women. Five point four per cent had had hand eczema at a particular point in time (prevalence) and 2% had had continuous problems with hand eczema during the previous year.

Adult↗
PubMed2004

Immunohistochemical study of serotonin in lesions of chronic eczema.

BACKGROUND: Inflammatory mediators participate in the pathogenesis and pathophysiology of skin disease (e.g. eczema). Although some investigators have suggested that serotonin may participate in the eczematous process, there has been little substantial evidence. Our objective was to study further the participation of serotonin in the pathogenesis of chronic eczema. METHODS: Immunohistochemical techniques were used to study the expression of serotonin in the lesions of patients with chronic eczema. RESULTS: There was a significantly stronger expression of serotonin in the prickle cells, sweat gland cells, sebaceous gland cells, and hair roots of the lesions in patients with chronic eczema. There was no positive expression of serotonin in normal skin. CONCLUSIONS: Serotonin is probably important in the pathogenesis of chronic eczema. We demonstrated alterations in the expression of serotonin in chronic eczema lesions, which may in turn provide new insight into the pathogenesis of chronic eczema. Serotonin, along with cytokines, T lymphocytes, B lymphocytes, and macrophages, participates in the immune response and influences the inflammatory process by means of keratinocytes.

Adolescent↗
PubMed2005

Determining the rate of varicella vaccine rash in children with moderate-severe eczema.

OBJECTIVES: To determine the rate and severity of vesicular reactions following varicella vaccine in children with moderate-severe eczema. Secondary endpoints included the rates and severity of local reactions and eczema severity change within 42 days of vaccination. METHODS: Prospective open intervention pilot study of varicella vaccine in children aged 12 months to 13 years with moderate-severe eczema. Children were given varicella vaccine alone and followed for 42 days after vaccination. RESULTS: Fifty children, aged 12 months to 10.5 years were recruited, with complete follow-up for 48. A vesicular rash with a single lesion occurred in one child (2.1% (95% CI: 0, 11.1%)), 10 days following vaccination. Local reactions, including erythema, swelling and tenderness, were reported in eight children (16.7%). A flare-up of moderate-severe generalized eczema was reported in one child (2.1%) during the first week following varicella vaccine. CONCLUSIONS: Vesicular rash and local reactions following varicella vaccination were no more common or severe in children with moderate-severe eczema than that reported in the published literature in children without eczema. Eczema in the 42 days following vaccination did not appear to increase in severity.

Chickenpox Vaccine↗
PubMed1975

Nickel allergy and hand eczema.

A clinical study was performed in 66 female patients with hand eczema and contact allergy to nickel. They were drawn from a basic material of 165 patients with nickel allergy in which hand eczema occurred in 86 cases (52%). The hand eczema started at an average age of 32 years and it had been preceded by a metal hypersensitivity for an average of 6 years. The eczema was found to be chronic with a mean duration up to the time of examination of 8 years. It was associated with secondary eruptions in half of the cases. The hand eczema showed a low degree of relevance with regard to dependance of occupation or vacation, as well as to exacerbation of the dermatitis after a direct contact with nickel-coated objects. The clinical examination disclosed in 77% a pompholyx, i.e. a symmetric vesicular eruption mainly located on the palms and volar aspects of fingers, and sides of fingers. The eczema often showed a periodic activity, with about 15 annual eruptions in the pompholyx cases. It is concluded that simple external contact with the metal can hardly explain the most common clinical pattern of the hand eczema in nickel allergy.

Adolescent↗
PubMed1985

Atopy, occupation and domestic work as risk factors for hand eczema in hospital workers.

By means of a multivariate regression analysis, we have studied the importance of atopy, "wet" and "dry" occupations, and domestic work as risk factors for hand eczema. Hand eczema was identified by questionnaire. The studied cohort consisted of 2452 newly employed hospital workers with a median follow-up time of 20 months. Of the total cohort studied, 86% were female. The total occurrence of hand eczema in the 4 occupational groups studied were: nursing staff 41%, kitchen workers/cleaners 37%, office workers 25% and caretakers/craftsmen 17%. Atopic dermatitis increased the odds of developing hand eczema by 3 times in wet as well as in dry work. Subjects with atopic dermatitis developed a more severe hand eczema than subjects with atopic mucosal symptoms and non-atopics. Wet hospital work increased the odds by a factor of 2 compared to dry office work. 2 anamnestically available parameters of domestic work, namely "nursing of children younger than 4 years" and "absence of dish-washing machine" were found to significantly increase the risk of developing hand eczema. Wet work in combination with unfavourable domestic factors increased the odds by a factor of 4. The caretakers/craftsmen group, which was dominated by men, showed the lowest figure for hand eczema.

Adult↗
PubMed1999

Unclassified endogenous eczema.

Patients with intractable eczema are often referred for patch testing to exclude contact dermatitis. If this is excluded, then a diagnosis of endogenous eczema is made. At our clinic, we find a sizeable proportion of these patients do not fit any of the known patterns of endogenous eczema. These patients are given the diagnosis of unclassified endogenous eczema and make up 8% of the patients seen at our Occupational and Contact Dermatitis Clinic. There is little information available on this group of patients, with no mention of this problem in the recent dermatological literature. Since March 1996, we have further investigated these patients, to develop some understanding of this category. 12 of 34 patients reviewed over this period had an elevated IgE level above 100 IU/ ml. Thus, despite no past history or family history of eczema, asthma or hayfever, at least 1/3 of these patients are probably suffering from atypical, late onset atopic dermatitis. Patients were later contacted by telephone (average 2 years) to assess the natural history of this condition. In 20 of the 31 patients contacted, their eczema had either improved or resolved. We think that this important category of eczema needs to be recognized and further investigated.

Adolescent↗
PubMed2007

Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

Autoeczematization is characterized by the sudden dissemination of a previously localised form of eczema. While widely described, most cases reported have followed chronic, localized stasis dermatitis. In this study, we describe the clinical scenario of occupational contact dermatitis (OCD) triggering endogenous-like eczema in atopic individuals, who often have not had eczema since childhood, if at all. These cases appear similar to previously described cases of autoeczematization. To show this clinical scenario, a series of 6 patients is presented from the Occupational Dermatology Clinic in Melbourne, Australia. These workers initially developed OCD, usually affecting the hands, which then precipitated a flare of more generalized eczema. This appeared clinically consistent with atopic eczema (AE), and often became recurrent, and sometimes persistent. OCD can precipitate a flare of more generalized eczema, in a pattern consistent with AE, which may then persist. The clinical scenario is similar to that described for autoeczematization. It is possible that the pathophysiology, when clarified, will prove to be similar. Workers' compensation issues may become complicated for these patients, as the relationship between their generalized eczema and their occupational exposures may not be readily apparent. As a result, the work relatedness of their condition may not be recognized.

Adolescent↗
PubMed1995

Contact allergy in relation to hand eczema and atopic diseases in north Norwegian schoolchildren.

Patch testing was carried out in 424 schoolchildren (223M, 201F), aged 7-12 years, in northern Norway. In 99 (23.3%) of these children, one or more allergic patch test reactions were demonstrated; 30 children reacted to two and 6 to three or more substances; 53 irritant reactions were recorded in 33 (7.8%) of those tested. From a total of 144 positive tests, the most common allergen was nickel (14.9%), followed by cobalt (5.7%), kathon CG (5.2%), lanolin (1.7%) and neomycin (1.4%). Both allergic and irritant reactions were found twice as frequently in girls as in boys. Positive patch tests were significantly more frequent in atopic (28.8%) than in non-atopic (17.9%) children, being most pronounced in atopic girls (37.4%). Hand eczema was reported to have occurred or to be present in 6.5% of cases. Twenty-nine of 36 children reporting hand eczema participated in the clinical examination. Altogether 15 (3.5%) children had hand eczema at the time of the clinical examination but 12 of these children had no previous history of hand eczema. In 14 of these 15 subjects, the eczema was localized to the back of the hands, with 13 having atopic dermatitis. In 4 of these 15 children, an allergic patch test reaction was found; however, in only 2 of these 4 was the test considered to be clinically relevant for the diagnosis allergic hand eczema. In conclusion, irritant hand eczema may occur in early childhood and is most prevalent in children with atopic dermatitis.

Allergens↗
PubMed1982

Risk factors in childhood eczema.

The cumulative rate of childhood eczema during the first three years was studied in a birth cohort of 1265 New Zealand infants. A parental history of eczema was the strongest predictor of rates of childhood eczema but parental asthma was also related to childhood eczema. Children exposed to an early diverse solid-food diet also had increased risks of eczema, but there was no evidence to suggest that breast-feeding practices had any effect on rates of eczema. Analysis of the data suggested that the apparent association between exclusive breast-feeding and reduced rates of eczema reported in previous studies may be because exclusively breast-fed infants were not exposed to early solid feeding rather than to any beneficial effect of breast milk itself.

Animals↗
PubMed1994

Psoriasis and eczema are not mutually exclusive diseases.

BACKGROUND: Some reports have suggested that psoriasis and eczema are seldom found together. Knowledge of disease co-occurrence could lead to improved understanding of shared or opposing pathological mechanisms. OBJECTIVE: We sought to determine whether psoriasis and eczema could exist simultaneously and consecutively in the same individuals. METHODS: Skin examination data relating to 9,263 British children born during March 3rd to 9th, 1958 (the National Child Development Survey), were analysed for the co-occurrence of eczema and psoriasis. RESULTS: Of 354 children with visible eczema at the ages of 11 or 16 years, 5 (1.4%) were also noted to have visible psoriasis, compared to 89 (1.0%) of 8,909 children who did not have visible eczema at 11 or 16 years. The relative risk of psoriasis in a case of eczema was 1.41, 95% confidence intervals from 0.58 to 3.46. CONCLUSION: Contrary to some hospital-based studies which have suggested that the two diseases are seldom found together, this study of a large and representative population suggests that eczema and psoriasis may co-occur concurrently and consecutively in the same individual.

Adolescent↗
PubMed2006

Prevalence and morphology of hand eczema in patients with atopic dermatitis.

BACKGROUND: Patients with hand eczema frequently have a history of atopic dermatitis or atopy. No specific morphologic pattern of hand eczema helps distinguish atopic hand eczema from other etiologies. There are few studies of hand eczema prevalence and morphology in a well-defined population of patients with atopic dermatitis. METHODS: We evaluated 777 consecutive patients with atopic dermatitis (diagnosed by standard criteria) for hand involvement. An additional 100 patients had further evaluations, including evaluation of the historical and morphologic characteristics of their hand eczema. RESULTS: The prevalence of hand involvement in patients with active atopic dermatitis was 58.9% (458 of 777 patients). Nail dystrophy was present in 16% (124 of 777) of patients. There was a significant trend toward an increasing prevalence of hand involvement with increasing age. Hand eczema tended to involve primarily the dorsal hand surfaces and the volar wrist. CONCLUSIONS: The hands are frequently involved in patients with active atopic dermatitis and present unique physical, social, and therapeutic challenges for patients. During the evaluation of patients presenting with hand eczema, the involvement of dorsal hand surfaces and the volar wrist may suggest atopic dermatitis as a contributing etiologic factor.

Adolescent↗
PubMed1996

Comparison of cyclosporine and topical betamethasone-17,21-dipropionate in the treatment of severe chronic hand eczema.

Topical corticosteroids are the standard treatment for hand eczema. However, in chronic forms of the disease they are often ineffective or lose their efficacy due to tachyphylaxis. In a previous open study cyclosporine showed efficacy in chronic hand eczema. The aim of this study was to compare oral cyclosporine at 3 mg/kg/day with topical 0.05% beta-methasone-17,21-dipropionate (BDP) cream in the treatment of chronic hand eczema. In a randomized, double-blind study 41 patients with chronic hand eczema resistant to conventional treatment were assigned to either cyclosporine or BDP for 6 weeks. Both cyclosporine and BDP improved the eczema. The total disease activity score decreased to 57% of baseline in the cyclosporine group (mean change -6, SD 4.3; p < 0.001) and to 58% of baseline in the BDP group (mean change -5.7, SD 4; p < 0.001) at the end of treatment. However, between the groups there was no significant difference. Adverse events occurred in 68% of the patients during cyclosporine and in 56% during BDP treatment. With cyclosporine no case of hypertension or increase in serum creatinine above normal levels was recorded. In two patients the serum creatinine levels increased to values 30% above their own baseline values. Relapses occurred to the same extent in both groups. Cyclosporine at 3 mg/kg/day is as effective as topical BDP in the treatment of chronic hand eczema. Low-dose cyclosporine could be useful as an alternative treatment for severe chronic hand eczema in patients unresponsive to conventional treatment.

Administration, Oral↗
PubMedDate not supplied

Non-pruritic eczemas as presenting manifestation of leprosy.

Three patients who presented with eczemas as manifestation of leprosy are described. One of them having lepromatous leprosy had extensive areas of acquired ichthyosis. He developed asteatotic eczema on the legs. The pathophysiologic mechanisms for the development of ichthyosis and asteatotic eczema in this patient are briefly discussed. The second patient, with tuberculoid leprosy, presented with allergic contact eczema due to neomycin which he had applied over the plaque for scaling and crusting. The third patient, also with tuberculoid leprosy, presented with features of nummular eczema. Dryness of the skin that resulted from leprosy had led to the development of nummular eczema in this case. One peculiarity noted in all these eczemas was that they were non-pruritic.

Adult↗
PubMed1989

Epidemiology of different types of hand eczema in an industrial city.

Different types of hand eczema in an industrial city were studied. Questionnaires were sent to 20,000 individuals aged 20-65 years, randomly selected from the population register of the city. Those subjects (1,385) considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination. It was found that hand eczema occurred twice as often among females as among males. The most common diagnosis was irritant dermatitis. Atopic hand eczema and allergic contact dermatitis had a lower but approximately equal prevalence. Onset of hand eczema at young ages was common, in particular among women. Hand eczema was shown often to be a long-lasting disease with a relapsing course. Atopic hand eczema seemed to be most unfavourable, with a long duration, high continuity of symptoms and extensive involvement.

Adult↗