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PubMed2006

927T>C polymorphism of the cysteinyl-leukotriene type-1 receptor (CYSLTR1) gene in children with asthma and atopic dermatitis.

Asthma and atopic dermatitis share several common features and Cysteinyl-leukotrienes are mediators that participate in the pathogenesis of both diseases. Recently, a new polymorphism (927T>C) has been identified in cysteinyl-leukotriene type-1 receptor (CYSLTR1) gene. This gene is found on the X chromosome. The aim of this study was to analyze this SNP in a population of children with asthma and atopic dermatitis. In this study, 166 individuals, 79 adult controls (CTR) and 87 children with asthma (AA) were included. Forty-one patients with asthma presented atopic dermatitis (AA-AD). Adults were chosen as controls to confirm lack of development of asthma and allergy during childhood. Standardized history, physical examination, skin prick tests, and lung function measurements were performed in all patients. The 927T>C CYSLTR1 SNP was analyzed by direct sequencing after PCR amplification. In males (53 individuals), the C allele was significantly more common among AA-AD patients (47%) than in CTR (8%) (Fisher's p < 0.005; Monte Carlo p < 0.008; OR:9.78; 95%CI: 1.73-55.30). When comparing AA-AD vs. AA-NAD (patients with asthma but not atopic dermatitis), significant differences were observed, (47% vs. 15%, Fisher's p = 0.014; Monte Carlo p = 0.022; OR: 4.97; 95%CI: 1.29-19.13). No differences in allele distribution were observed between these disease sub-groups in females. The 927T>C is a silent SNP; however, it could affect transcription or translation or may be linked to an unidentified, functional polymorphism and thus may pre-dispose male children to asthma and atopic dermatitis in our population. Further studies are needed to confirm these findings.

Adolescent↗
PubMed1998

The effect of the addition of oil preparation with increased content of n-3 fatty acids on serum lipid profile and clinical condition of cats with miliary dermatitis.

The aim of this study was to determine the influence of an oil preparation with increased n-3 fatty acids content on the serum lipid profile and clinical condition of cats with miliary dermatitis. The studies were performed on 22 cats of various breeds and both sexes, aged between 3 and 7 years, that had been fed a balanced diet, based on beef meat for the previous 6 months. The animals were divided into four groups: I, five clinically healthy cats; II, five clinically healthy cats, receiving 1 ml of oil preparation with food for 6 weeks; III, seven nonpruritic cats with miliary dermatitis, without treatment; and group IV, five nonpruritic cats with miliary dermatitis, receiving 1 ml of oil preparation per day with food for 6 weeks. Every 2 weeks all cats were clinically examined. Determination of the serum lipid profile and composition of the oil preparation was performed using gas chromatography. The concentration of total cholesterol (CHL), high-density lipoprotein (HDL) fraction and triacylglycerols (TG) were determined spectrophotometrically. In three sick animals, the dermatological signs disappeared completely. In cats with miliary dermatitis, who did not receive the oil preparation, the ratio of cholesterol and HDL to triacylglycerols was reversed compared with healthy cats and sick animals which had received the oil preparation. The addition of the oil preparation lowered the content of saturated fatty acids in serum, in particular palmitic acid, and increased the content of unsaturated acids, linolenic, eicosapentaenoic (EPA, n-3) and docosahexaenoic acid (DHA, n-3). Simultaneously, a nonsignificant rise in arachidonic acid (AA, n-6) and a decrease in dihomo-gamma-linolenic acid (DGLA, n-6) were found. These observations indicate that cats with miliary dermatitis require an increased amount of n-3 fatty acids in the diet. This was proved not only by the observed changes in the serum lipid profile but also by the clinical improvement.

Animals↗
PubMed2004

Efficacy of the non-antibiotic paste Protexin Hoof-Care for topical treatment of digital dermatitis in dairy cows.

In this study, the efficacy of the non-antibiotic paste Protexin Hoof-Care containing metallic salts and organic acids, was tested for local treatment of 26 acute digital dermatitis lesions. The control group (26 cases) was treated with local application of oxytetracycline spray. These 52 affected limbs with digital dermatitis were diagnosed in 47 dairy cows from eight different farms with slatted floors. The therapeutic effect was evaluated using a scoring system for weightbearing at stance, lameness at walk and pain of the digital dermatitis lesions. The pre-treatment and control examination scores were documented on days 0, 4, 10 and 28. Both treatment regimens were effective, no statistical differences regarding the examined parameters was found between the group treated with the non-antibiotic Protexin Hoof-Care paste and the group treated with oxytetracycline spray. Twenty-seven digital dermatitis lesions required only one treatment with one of these products. A second topical treatment was carried out on day 4 in 13 lesions of the study group and in 12 lesions of the control group. The data of this pilot study indicate that the non-antibiotic paste Protexin Hoof-Care could be a valuable alternative to topical antibiotic treatment for digital dermatitis in dairy cattle.

Administration, Topical↗
PubMedDate not supplied

Adherence of Malassezia furfur to human stratum corneum cells in vitro: a study of healthy individuals and patients with seborrhoeic dermatitis.

The role of Malassezia furfur adherence to human stratum corneum cells in vitro was studied. The adherence assay was performed with one strain of M. furfur and stratum corneum cells from 30 healthy individuals and from 28 patients with seborrhoeic dermatitis. Stratum corneum cells from patients with seborrhoeic dermatitis contained significantly lower numbers of adherent M. furfur cells than cells from healthy individuals. No correlation was found with sex or age. The adherence assay was also performed with stratum corneum cells from one healthy individual and M. furfur strains from 15 patients with seborrhoeic dermatitis and 13 healthy controls. Malassezia furfur strains from patients with seborrhoeic dermatitis showed the same in vitro capacity for adherence to stratum corneum cells as strains from healthy individuals. This in vitro study does not indicate that M. furfur adherence to human stratum corneum cells is of importance in the pathogenesis of seborrhoeic dermatitis.

Adolescent↗
PubMed2006

Allergic contact dermatitis to basic red 46 occurring in an HIV-positive patient.

A 41-year-old HIV-positive man presented with a 2-month history of a generalized pruritic rash, which had started on his feet. Patch testing made a diagnosis of allergic contact dermatitis to the textile dye basic red 46, likely to have been present in his dark-blue-coloured socks. Complete resolution of his symptoms occurred with avoidance of these socks. The patient had developed allergic contact dermatitis with a low CD4 T lymphocyte count of 361 cells/microl (normal range 410-1545 cells/microl). This raised the question of the level of CD4 count necessary for an individual to develop allergic contact dermatitis to an allergen, given its role in delayed hypersensitivity. It was concluded that a low CD4 count as a result of HIV infection does not decrease the ability of an individual to develop allergic contact dermatitis. Whereas the effector role in delayed type 4 hypersensitivity reactions is mediated by CD4 T lymphocytes, in allergic contact dermatitis it appears that CD4 T lymphocytes have the suppressor role, with CD8 T lymphocytes having the effector role.

Administration, Topical↗
PubMed1997

Contact dermatitis and in-feed exposure to antibiotics among pig feed handlers.

This study aimed to determine the prevalence of contact dermatitis among pig feed handlers, explore the association with exposure to in-feed antibiotics, and determine farmers' awareness of product safety information. One representative from each piggery in Queensland's Wide Bay Burnett Region was interviewed by telephone. Just over 21% of respondents had experienced dermatitis symptoms within the previous two years; 14.8% within the previous 12 months: and 6.7% had current symptoms. Use of at least one in-feed antibiotic was reported by 83.7%. The only antibiotic to show an association with the occurrence of dermatitis was tylosin. Precautionary behaviours were more common among those with dermatitis. Only 18% of respondents were aware of material safety data sheets. The relatively high prevalence of contact dermatitis, high use of antibiotics, low level of precautionary behaviours and poor awareness of material safety data sheets indicates a need for farmer education.

Adult↗
PubMed2006

Treatment of atopic dermatitis with the xenon chloride excimer laser.

BACKGROUND: Narrow-band ultraviolet B phototherapy is an effictive and safe treatment for atopic dermatitis. We have previously found that the 308 nm xenon chloride excimer laser was more effective than the narrow-band ultraviolet B light for the treatment of psoriasis, suggesting that ultraviolet B laser might offer advantages over narrow-band ultraviolet B. OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy of the 308 nm excimer laser in atopic dermatitis. PATIENTS AND METHODS: Fifteen patients with atopic dermatitis (less than 20% body area involvement) were treated with a xenon chloride excimer laser (XTRAC laser, Photomedex Inc.) twice weekly. The severity of the atopic dermatitis was assessed via (i) a clinical score characterizing the intensity of erythema, infiltration, lichenification and excoriation; (ii) the quality of life, determined by means of a questionnaire; and (iii) a visual linear analogue scale, with which the patients scored the severity of their pruritus. RESULTS: After 1 month of laser therapy, the clinical scores were significantly lower than the initial values. Similar decreases were observed for the quality of life and pruritus scores. No serious or unpleasant side-effects were observed. CONCLUSION: These results suggest that the xenon chloride excimer laser is an effective and well-tolerated treatment for localized atopic dermatitis.

Adolescent↗
PubMed2007

Efficacy and safety of long-term treatment with cyclosporin A for atopic dermatitis.

BACKGROUND: Cyclosporin A (CsA) is being increasingly used in the treatment of severe refractory atopic dermatitis. Clinical efficacy and safety of short-term cyclosporin A treatment in atopic dermatitis patients has been proven, however, data on long-term treatment are limited. OBJECTIVE: The aim of this study was to investigate the efficacy, safety and the effect of discontinuation of cyclosporin A treatment in atopic dermatitis patients, with a particular focus on patients treated with cyclosporin A for more than 6 months. METHODS: We performed a retrospective study of clinical and adverse effects of cyclosporin A treatment in 73 atopic dermatitis patients, with an average duration of cyclosporin A treatment of 1.3 years. RESULTS: We included 73 patients (31 women and 42 men, with a mean age of 33.8 years) with severe atopic dermatitis refractory to conventional therapy that was treated with cyclosporin A. Treatment was successful in 56/73 patients. Increases in serum creatinine levels > 30% compared to baseline were reported in 7/73 patients. Arterial hypertension appeared in 11/73 patients during treatment. After discontinuation of treatment, 40/73 patients experienced a relapse and 33/73 patients experienced clinical remission for at least 3 months. No correlation between treatment duration and nephrotoxicity or hypertension was found. Strikingly, 6/73 patients experienced a rebound phenomenon. CONCLUSIONS: We conclude that CsA is an effective and safe treatment for patients with severe AD refractory to conventional treatment, provided that the recommended guidelines for its administration are strictly observed. However, in contrast to previous reports, we found that 8% (6/73) of patients experienced a rebound phenomenon after discontinuation of treatment.

Adult↗
PubMedDate not supplied

Malassezia furfur in infantile seborrheic dermatitis.

Malassezia furfur is important in the pathogenesis of a number of dermatologic diseases including seborrheic dermatitis in adults. It has also recently been suggested that M. furfur might be the etiologic agent in infantile seborrheic dermatitis (ISD). We studied the presence of M. furfur in 21 children with the clinical diagnosis of infantile seborrheic dermatitis. Laboratory analyses showed aberrant patterns of essential fatty acids (EFA) in serum characterized by elevated levels of 18:1w9 and 20:2w6. Samples for M. furfur were taken from the foreheads and chests of children with infantile seborrheic dermatitis at the time of diagnosis, directly after treatment to complete healing, and after 1 year with no signs of infantile seborrheic dermatitis. All the patients were treated topically with borage oil containing 25% gammalinolenic acid (GLA). No reduced growth of M. furfur was seen on contact plates prepared with borage oil. The growth of M. furfur seems not to be related to the clinical symptoms in ISD.

Administration, Topical↗
PubMedDate not supplied

An epidemiologic study of perianal dermatitis among children in Egypt.

Perianal dermatitis is a common problem occurring among infants and children. Streptococci, particularly beta-hemolytic group A organisms, play a major role in its causation. An epidemiologic association between perianal dermatitis caused by group A beta-hemolytic streptococci in some patients and pharyngeal colonization with the same organisms seems to exist. A similar relation is also true for other organisms, including non-group A beta-hemolytic streptococci and Staphylococcus aureus. This was the main conclusion of a hospital-based study performed on 150 children with perianal dermatitis. All patients were subjected to a questionnaire, clinical examination, two perianal swabs, and two throat swabs. The bacteriologic examination of the perianal swabs revealed the presence of beta-hemolytic streptococci in 35.3% of the cases, half of which were of the group A beta-hemolytic strain (17.3%) and half of which were non-group A (18%). Throat swabs revealed the presence of beta-hemolytic streptococci in 44% of cases, half of which were found to belong to group A (21.3%) and half to non-group A (22.7%). Among patients with perianal dermatitis caused by group A beta-hemolytic streptococci, 53.8% had associated pharyngeal colonization by the same organism. S. aureus was isolated from the perianal skin in five patients (3.4%); in four of whom the same organism also grew in cultures from throat swabs. A relatively good association between pharyngeal colonization by beta-hemolytic streptococci and Staphylococci and the presence of perianal dermatitis caused by the same organisms was demonstrated using the Kappa test of agreement (K = 0.4).

Anal Canal↗
PubMed1981

Atopy and hand dermatitis in hospital wet work.

The relation of different atopic symptoms to the occurrence of hand dermatitis in employees who perform wet work in hospitals was studied. Atopy was defined as previous or present atopic dermatitis (AD), allergic rhinitis/conjunctivitis or asthma (AMS). In this population the prevalence of atopy was 32% and the frequency of past or present hand dermatitis 44%. Hand dermatitis had occurred in about 65% of persons with atopic symptoms and in 75% of those who had unusually dry, pruritic skin and of those with atopic relatives. Of the other workers only 33% had had skin problems. The presence of atopic symptoms significantly favoured the development of hand dermatitis in these occupations (p less than 0.001).

Adult↗
PubMed1990

Multiple parameter assessment of vulvar irritant contact dermatitis.

Transepidermal water loss (TEWL), capacitance, pH, blood flow and color reflectance were evaluated for quantifying the irritant response of vulvar and forearm skin to 3% sodium lauryl sulfate in 9 healthy premenopausal women. TEWL, capacitance, pH, blood flow, and all parameters of color reflectance changed significantly in forearm irritant dermatitis. In vulvar irritant dermatitis, however, significant changes were observed only for blood flow and the color reflectance parameters a* and b*. Using the combination of TEWL, capacitance and blood flow, forearm irritant dermatitis was detected with a sensitivity of 84% and a specificity of 100%. In this study, the best combination of parameters to detect vulvar irritant dermatitis was pH, blood flow, a* and b*, which had a sensitivity of 78% and a specificity of 75%. It is concluded that available bioengineering techniques are less suitable to quantify irritant dermatitis in the vulva than in the forearm.

Adult↗
PubMed1992

Prognosis of occupational chromate dermatitis.

To elucidate further the natural history and prognosis of occupational chromate dermatitis, 120 affected patients, diagnosed between 1980 and 1989, were reviewed. The incidence of chromate dermatitis in Western Australia appeared to remain unchanged over the decade. 65% of patients were construction workers with cement-induced chromate dermatitis. Workers at greatest risk of sensitization were those mixing bagged cement at the work site. The median age at onset of symptoms was 34 years, with 48% having been exposed to chromate for 5 years or less. Only 37% presented to the dermatologist within 12 months of developing symptoms. 76% of patients had ongoing dermatitis at the time of review. Although 48% of the study population had completely changed their occupation to avoid chromate exposure, symptoms persisted in 69%. A delayed diagnosis of chromate sensitivity was noted to be a predictor of chronicity. In view of the potential chronicity of chromate dermatitis and its associated social and occupational impairment, we recommend the addition of ferrous sulphate while mixing bagged cement at the work site. This simple technique targets the workers at greatest risk of becoming sensitized.

Adolescent↗
PubMed1994

Skin irritant reactivity following experimental cumulative irritant contact dermatitis.

Despite the frequency of irritant contact dermatitis, very little is known about the duration of barrier function impairment following cumulative irritant contact dermatitis. We studied post-irritation irritant reactivity by assessing the response to SLS irritation in previously irritated sites. Cumulative irritant contact dermatitis was induced on the forearms of 15 volunteers aged 18 to 50 years by repeated occluded application of 0.5% SLS 1 h per day over 3 weeks. 3, 6 and 9 weeks later, previously irritated and unirritated control sites were challenged with 2% SLS under occlusion for 23 h. Irritation was assessed by visual scoring, transepidermal water loss (TEWL) as an indicator of epidermal barrier function, and capacitance as a parameter of epidermal water content. While no difference in irritant reactivity between pre-irritated and unirritated sites was observed 3 weeks following irritant contact dermatitis, there was a significant hyporeactivity of previously irritated skin as expressed by clinical scores, TEWL and capacitance at 6 and 9 weeks. Our results indicate that epidermal barrier function remains altered even 9 weeks after cumulative irritant contact dermatitis. With regard to patch testing, post-irritation hyporeactivity might be a cause of false-negative tests on previously irritated sites.

Adolescent↗
PubMed1995

Occupational hand dermatitis in hospital environments.

Health care personnel form the 5th category at major occupational risk of skin disease in Italy. The aim of this study was to assess the prevalence and clinical relevance of contact dermatitis in a group of 1301 employees of the Perugia Monteluce Hospital (658 females and 643 males; mean age 39.8 years) who answered a self-administered questionnaire elaborated by the authors. The subjects with anamnestic hand dermatitis and/or atopic mucosal reactions were clinically examined and submitted to skin tests (patch and/or prick tests). Contact dermatitis of the hands and/or forearms occurred in 21.2% and was significantly more frequent (p < 0.001) in women, subjects under 31 years of age, workers in internistic and surgical fields, cleaners and nurses. In the majority of cases (94.9%), the lesions were irritant in origin and mainly related to disinfectants (especially, chlorhexidine gluconate and glutaraldehyde) and gloves (latex proteins and starch glove powder, rather than accelerators and additives of rubber). Finally, atopy seemed to favour the onset of hand dermatitis. The importance of these results for preventive measures of contact dermatitis in hospital employees is discussed.

Adult↗
PubMed1997

Shoe dermatitis.

Chronic foot dermatitis can be disabling and footwear allergy is not always excluded as a cause, partly because patch testing to shoes and their components can be daunting. Once the diagnosis of shoe allergy is made, the difficult problem of finding suitable footwear remains. There is a lack of literature regarding the follow-up of these patients. We analysed the data on 55 patients with allergic contact dermatitis from their shoes and followed them up to see whether knowledge of the allergen had enabled them to find suitable footwear and to improve their dermatitis. The files of 55 patients with shoe allergy were analysed and 48 were followed up. Rubber was the commonest allergen, followed by chromate, p-tertiary-butylphenol-formaldehyde resin and colophony. All parts of the feet were affected, except the interdigital areas. The majority of patients suffered from hyperhidrosis. 43% were atopics, who had a super-added shoe allergy. The mean duration of the foot dermatitis before patch testing was 4 years 8 months. Follow-up of 48 cases showed that 87.5% had either improved or resolved completely. Most of our patients were successful in finding suitable footwear and many differing strategies were used. All patients with foot dermatitis which does not respond to treatment should be patch tested to exclude shoe allergy.

Adhesives↗
PubMed1997

The significance of previous allergic contact dermatitis for elicitation of delayed hypersensitivity to nickel.

Several factors, such as amount of allergen, vehicle, anatomic site, immunologic status and previous eczema, may influence delayed hypersensitivity reactions. In an extended model, we have studied the significance of previous allergic contact dermatitis for elicitation of delayed hypersensitivity to nickel in 25 nickel-allergic females. On 3 occasions, 8, 4 and 1 months before the final challenge patch testing, an experimental allergic contact dermatitis from nickel was induced on the lower back. At the challenge patch testing, 4 identical dilution series of nickel were tested on 4 areas on the lower back 3 with previous but healed dermatitis and 1 control area. The tests were read in a blind way. A significantly higher test reactivity was found at the areas with a previous allergic contact dermatitis, the shorter the time interval between the previous provocation and the challenge, the stronger the reaction. These results may be of importance for the understanding of factors contributing to chronicity of allergic contact dermatitis.

Adult↗
PubMed1999

Gold--a controversial sensitizer. European Environmental and Contact Dermatitis Research Group.

Until recently, gold allergy was considered to be extremely rare. Gold has been used and worshipped for thousands of years without any obvious complaints of skin problems, either in those participating in mining and other ways of prospecting, or in those wearing jewellery. When studies on contact allergy to gold sodium thiosulfate were published at the beginning of the 1990s, the allergic nature of the reported positive patch test reactions to gold was questioned. The major argument for such questioning was the lack of demonstrable clinical relevance in most positive reactors. A major reason for the questioning may have been confusion in differentiating between contact allergy and allergic contact dermatitis. To arrive at a diagnosis of allergic contact dermatitis, 3 steps have, in principle, to be fulfilled: (i) establishment of contact allergy; (ii) demonstration of present exposure; (iii) assessment of clinical relevance, i.e., causing or aggravating a contact dermatitis. In this paper, these steps are discussed with regard to gold. With our present knowledge of contact allergy-allergic contact dermatitis, we do not recommend including gold sodium thiosulfate in the standard series. It should be applied for scientific purposes and when allergic contact dermatitis from gold is suspected.

Dermatitis, Allergic Contact↗