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A 54-year old man with atypical dermatitis herpetiformis Duhring lasting about three years is reported. The lesions were located exclusively in the pubic area, groins, inner thighs and perianal regions. Routine histopathology and the direct as well as the indirect immunofluorescence supported the diagnosis. Application of a gluten-free diet and dapsone alleviated the symptoms.
Atopic dermatitis (AD) is a multifactorial disease that usually decreases the quality of life of affected patients. We monitored the incidence of AD and serum total IgE levels annually among nursery school children in Ishigaki Island, Okinawa, Japan, from 2001 to 2004. A total of 1731 children were enrolled. The prevalence of AD ranged from 3.7 to 11% in each year, with no significant difference between boys and girls. 869 children were examined at least twice. 71.6% (53/74) of AD patients regressed spontaneously, whereas 5.5% (44/795) of non-AD individuals developed AD during the 3-year follow-up. Increases in total IgE levels were greater and more rapid in children with long-term AD than in those who had spontaneously regressed, had newly-developed AD or did not have AD. The regression rate of AD was > 70% while new-onset AD occurred at a rate of 3.67%/person year in nursery school children of Ishigaki Island.
Five females with nickel contact allergy and longstanding hand dermatitis were treated with oral methoxsalen and a series of whole-body UVA irradiations with a cumulative UVA dose of 30 to 58 J/cm2. Lymphocyte stimulation to nickel sulphate was determined prior to PUVA therapy, and monitored during the treatment and at 1 year after treatment. In 4 patients the cutaneous threshold to nickel sulphate patch testing was determined immediately post-PUVA and at 1 year. In all cases, the dermatosis cleared during the PUVA treatment. In 2 patients the immediate post-PUVA skin nickel reactivity was low compared with the 1-year follow-up value, while in 2 patients a progressive diminution of the skin reactivity was noticed. One patient was in clinical remission and had negative skin test at 1-year follow-up. In spite of diminished cutaneous sensitivity and/or clinical remission, the sensitivity of blood lymphocytes to nickel was approximately the same or increased, as determined by the lymphocyte transformation test. Thus no evidence was found to indicate that systemic, nickel-specific suppressive immune regulative mechanisms would have been activated by the treatment.
Perfumes in soaps cause nondescript patterns of contact dermatitis. Patch testing with balsam of Peru and a fragrance mixture can confirm a sensitivity to a perfume. The use of additive-free soaps determines its clinical relevance.
For the purpose of investigating how IgE is correlated in the genesis of Atopic dermatitis (abbreviated as AD) micronizing method of RIST (necessary serum 10 microliter) was utilized. Serum IgE obtained from 369 cases AD, age ranged from 1 month old to 52 years old were studied. In 78 cases, IgE of the objects' parents were also studied as well. Serum IgE of the healthy control, age ranging from 3 days old to 49 years old, were studied and made comparison with those of the objects. Analysis was made in accordance with the factors like age, complication, disease type and prognosis. RAST (house dust, mite, egg, milk) and SKIN TEST (Scratch test) were carried out in order to observe the correlation between serum IgE and Specific IgE or to see the possible induction of eczematous lesion by specific IgE. The following were obtained as conclusion. Serum IgE of AD will show high level in significant manner in comparison with the healthy control from the time of infantile period. Low IgE group will show high rate of improvement after 3 years period of time. High IgE of parents will more or less affect serum IgE of their child or children. Correlation between serum IgE and the severity of AD is not noted in the infantile period but significant in the adult period. In the Scratch test immediate type of reaction could not induce eczematous lesion of AD. Induction of eczematoid reaction in AD was noted with high incidence following the Scratch test of Candida antigen. From the above it is assumed that in AD, although serum IgE level is high, induction of eczematous lesion could not be made by skin invasion of specific IgE antigen to the skin, pruritus by immediate type of reaction following release of chemical mediator will bring the tearing off the skin by scratch and invasion to the epidermis of inflammation inducing materials like human dander, sweat, bacteria or mycological agents eczematous lesion will start to take place.
In the years 1980-1981 we treated 112 cases of scabies with 20% sulphur ointment, or 1% lindane. In 18% irritative contact dermatitis occurred after the treatment.
Numerous issues concerning occupational dermatitis are covered, including age and gender of workers it affects, its anatomic location, and length of time a single eruption lasts. Extensive tables show the results of patch testing in various populations.
One reason why so little is known about the epidemiology of atopic dermatitis (AD) is lack of suitable diagnostic criteria. A simple list of diagnostic criteria for AD for use in epidemiological studies has recently been developed by a U.K. working party. These have performed well in hospital validation studies of subjects with skin diseases. This study sought to validate the newly proposed criteria for AD in a population setting by conducting a cross-sectional survey of 695 schoolchildren aged 3-11 years in three randomly selected primary schools in West Lambeth, London. As a point prevalence measure, the U.K. criteria had a sensitivity of 70%, a specificity of 93%, and a positive predictive value of 47% when compared with a dermatologist's examination findings. Subsequent analysis suggested that most children classified as false positives had suffered from AD in the last year, but were inactive at the time of examination. When adjusted for these cases, the sensitivity and specificity increased to 80 and 97%, respectively, corresponding to positive and negative predictive values of 80 and 97%, respectively. The U.K. diagnostic criteria for AD appear to work well as a 1-year period prevalence measure in London schoolchildren. Further validation in adults and other countries are needed.
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In a double-blind, randomized trial of 257 patients with chronic hand dermatitis, the validity, reproducibility, and responsiveness of the Dermatology Life Quality Index and the Work Productivity and Activity Impairment questionnaire were established, and the sample size required to detect meaningful differences between treatment groups was estimated.
Two cats with chronic eosinophilic skin disease were investigated. The clinical investigation of the skin disease in one cat was limited and inflammatory bowel disease was diagnosed post mortem. A history of weight loss and a palpably thickened bowel in the second cat suggested concurrent gastrointestinal disease. Diagnosis of inflammatory bowel disease was confirmed on biopsy. Treatment with azathioprine and methylprednisolone acetate resolved the signs of gastrointestinal disease, the pruritus and 95% of the skin lesions. The concurrence of eosinophilic papulocrustous dermatitis and eosinophilic bowel disease raises the possibility of their being linked bv a common aetiology or pathophysiology.
A patient had a chronic hand eczema, presumably as a manifestation of atopy. Treatment resistance appeared due to handling certain foods that produced burning and stinging in the chronically eczematous skin and not in otherwise normal skin. Selected tests for delayed hypersensitivity and for immediate hyper sensitivity on intact skin of the back produced negative results, but on chronically inflamed skin of the arm and back, application of the pertinent foods produced a wheal and flare response. On intact skin, scratch tests with the foods produced positive results. Intradermal tests with commercial antigens were negative. Avoidance of these foods, as contactants, led to resolution of the dermatitis. Reappraisal of the role of immediate-type hypersensitivity in chronic hand eczema is important.
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