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PubMed1996

Elevated plasma RANTES levels in patients with atopic dermatitis.

Eosinophils and T cells are involved in the pathologic process of atopic dermatitis. To further understand the role of these cells, and the possible involvement of RANTES, in the pathogenesis of atopic dermatitis, we measured the plasma level of RANTES using the sandwich ELISA. The mean plasma level of RANTES in 11 patients with atopic dermatitis was significantly higher than that of 15 normal control subjects. RANTES levels were higher in patients with severe form of atopic dermatitis than that of patients with mild disease. These findings suggest that RANTES may play a role in the recruitment and activation of eosinophils and T cells in atopic dermatitis.

Adolescent↗
PubMed2006

[Relationship of trichloroethylene-induced medicamentosa like dermatitis to HLA-DMA and HLA-DMB].

OBJECTIVE: To investigate the susceptibility of trichloroethylene-induced medicamentosa like dermatitis by comparing the frequency of HLA-DMA and HLA-DMB in patients with trichloroethylene-induced medicamentosa like dermatitis and in normal controls. METHODS: The DNA of lymphocytes in 61 patients with trichloroethylene-induced medicamentosa like dermatitis and in 60 people as the normal control were abstracted by using touchdown PCR amplification of HLA-DMA and HLA-DMB. Then through restriction fragment length polymorphism (RFLP) and sequence base typing, the alleles and genotypes were confirmed. The frequency of HLA-DMA and HLA-DMB in the two groups was compared. RESULTS: The HLA-DMA*0101 allele frequency in patients with trichloroethylene-induced medicamentosa like dermatitis was significantly higher than in the control group (71.3% vs 55.0%, P < 0.05). The allele frequency of HLA-DMA*0103 was significantly higher in the patient group than in the control group (11.5% vs 3.3%, P < 0.05). The ratio of *0102 homozygotes of HLA-DMA*0102 in the patient group was significantly higher than in the control group (25.0% vs 8.2%, P < 0.05). The ratio of *0102 heterozygotes of HLA-DMB*0101 in the patient group was lower than in the control group (P < 0.05). CONCLUSION: The polymorphisms of DMA may be related to the susceptibility of the patients with trichloroethylene-induced medicamentosa like dermatitis.

Alleles↗
PubMed1991

Allergic contact dermatitis prevalence in patients with otitis externa.

A statistical analysis of the relationship between otitis externa and various clinical and etiological variables was carried out in 64 patients. Between 1988 and 1989, true eczema of the auditory canal was found in 43 of the 64 patients seen sequentially. 23.5% of all the patients found to have dermatitis could be regarded as having allergic contact dermatitis and the allergen identified. This incidence is less than the 40% and the 58% found in other previous studies. We did not find any specific difference in sex and age between the allergic and non-allergic groups. In the allergic group, topical drugs were the commonest sensitizing agents, followed by chemicals and resins found in the ear prosthesis. Twenty-one patients with negative patch tests were classified as seborrheic dermatitis and 11 as atopic dermatitis. The other 19 patients, who were discharged before patch testing, were diagnosed as having psoriasis (8) or chronic bacterial (6) or fungal infections (5), without true blister reaction. We think that accurately selected series must be used for these studies because of the low incidence of allergic contact dermatitis.

Adolescent↗
PubMed1991

Local cholinergic sweat stimulation in atopic dermatitis. An evaporimetric study.

In atopic dermatitis the nature of potential sweating disturbances is still obscure. Using an evaporimeter, local sweating response to a supra-threshold concentration of methacholine and baseline water loss were measured from non-eczematous back skin of 167 young males in five main groups (pure atopic dermatitis, atopic dermatitis with rhinitis/asthma, rhinitis/asthma, non-atopic dermatosis, and non-atopic healthy). Subjects with atopic dermatitis were further divided into two subgroups: dry-looking and normal-looking back skin. Compared with non-atopic healthy individuals, the sweat loss was significantly depressed (p less than 0.01) and the baseline water loss significantly increased (p less than 0.001) in the main groups with atopic dermatitis. Both these trends were most distinct in atopic dry-looking skin, whereas in normal-looking atopic skin only the sweat loss was depressed (p less than 0.05). Respiratory atopy had no effect on the sweating response. No significant correlation was found between the individual baseline water loss and the sweating response.

Adolescent↗
PubMed1991

The influence of interferon-gamma and interleukin-4 on IgE production in B lymphocytes of patients with atopic dermatitis. A possible criterion for selection of patients for interferon therapy.

The regulation of IgE production in B lymphocytes of patients with atopic dermatitis by interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) was studied. IL-4 stimulated IgE production in vitro in B-cells of healthy donors and of children with atopic dermatitis, but had only a marginal effect on the high basal level of IgE production by lymphocytes from adult patients with atopic dermatitis. The addition of IFN-gamma prevented in all cases the stimulation of IgE synthesis induced by IL-4. The production of IgG and IgM was differently influenced. These results indicate that the in vitro production of IgE by mononuclear cells from adult patients is more resistant to the regulatory effects of IL-4 and IFN-gamma than is that in B cells of children with atopic dermatitis. We propose that a previous in vitro test of the responsiveness of IgE-producing B cells to IFN-gamma may be used to select patients with atopic dermatitis for treatment with IFN-gamma.

Adolescent↗
PubMed1990

[Langerhans cells in the physiopathology of atopic dermatitis].

INTRODUCTION. Atopic dermatitis (AD), allergic rhino-conjunctivities and allergic asthma constitute the classical triad of atopic diathesis attended, in many cases, by high serum IgE levels. While the pathophysiology of IgE-mediated allergic respiratory diseases is now better understood, the pathophysiological significance of atopic phenomena in the genesis and control of AD is still far from being clear. Numerous clinical and laboratory data point to a pathophysiological relation between IgE-mediated reactions and AD, but no one yet knows by which mechanism this interaction takes place. Some recent studies suggest that Langerhans cells might well be the missing link. THE LANGERHANS CELLS. Langerhans cells (LC) are dendritic epidermal cells originating in the bone marrow and supposedly belonging to the monocyte lineage. Their circulating precursors, the mechanism of their migration into the epidermis and their relationship with other dendritic cells, such as the interdigitating follicular cells, are controverted. LC express numerous surface markers, such as class I and II HLA, CD1a, CD4 and receptors for complement and IgE Fc fragments. Under normal conditions, LC do not express IgE receptors. Ultrastructurally, LC are characterized by the presence of Birbeck granules in their cytoplasm. Among the presumed functions of LC in the skin, the best documented is the presentation of antigens to T lymphocytes in allergic contact dermatitis. LANGERHANS CELLS IN ATOPIC DERMATITIS. Quantitative studies. Modern immunohistological methods based on the reactivity of monoclonal anti-CD1a antibodies have given results that are sometimes conflicting due to differences in the quantification techniques utilized. However, morphometric enumeration of LC on cryostat sections have shown that their number is about the same in AD and in normal skin. PRESENCE OF IgE BEARING LANGERHANS CELLS IN ATOPIC DERMATITIS. The presence of IgE molecules on the LC surface has been demonstrated in subjects with AD. It must be noted that in atopic subjects IgE bearing Lc are only found in patients with high serum IgE levels. They are absent in asthma patients without eczema, irrespective of their serum IgE levels. Daily applications of corticosteroids on AD lesions result in a decrease of anti-IgE markers on LC after one week and in their complete disappearance after 2 weeks. IN ATOPIC DERMATITIS LANGERHANS CELLS EXPRESS A RECEPTOR SPECIFIC TO Fc FRAGMENTS OF IgE. The exact nature of the receptor for IgE expressed in situ in AD patients is still conjectural. Some authors have been able to demonstrate that the binding of IgE molecules by LC isolated from the skin of atopic patients is inhibited by a monoclonal antibody directed against the low affinity receptor (Fc epsilon R2) of eosinophils and macrophages. This strongly suggests that certain factors induce the expression by LC of an Fc epsilon R2 receptor. IN VITRO INDUCTION OF IgE RECEPTORS ON NORMAL LANGERHANS CELLS...

Dermatitis, Atopic↗
PubMed1985

Prognostic factors in atopic dermatitis.

A long-term follow-up study (24 years minimum) was made of 955 individuals aged 24-44 years, who had atopic dermatitis (AD) in childhood. The material was divided into two groups; patients who in 1952-56 had been hospitalized on at least one occasion at the Department of Dermatology, Karolinska Hospital, Stockholm (Group 1), and patients who in 1955-56 had been out-patients in the same department (Group 2). At the time of investigation 62% and 40% of the patients in Groups 1 and 2 respectively had ongoing dermatitis, the majority with mild skin lesions. The frequency of healing of AD and severity of persistent or recurring dermatitis were influenced by several factors. In order of relative importance, disregarding sampling errors, persistent dry/itchy skin in adult life, widespread dermatitis in childhood, associated allergic rhinitis, family history of AD, associated bronchial asthma, early age at onset, and female sex were associated with low frequency of healing and increased severity of persistent or recurring dermatitis.

Adolescent↗
PubMed1989

Epidermal Langerhans' cells in chronic eczematous dermatitis of the palms treated with PUVA and UVB.

Epidermal Langerhans' cells (LC) were studied in patients with chronic eczematous dermatitis of the palms. The monoclonal antibodies anti-Leu 6 and anti-HLA-DR were used, and the cells visualized with an immunoperoxidase technique. Increased numbers of LC were found in allergic contact dermatitis as well as in irritant contact dermatitis and hyperkeratotic dermatitis of the palms. The increased number of epidermal LC in lesional skin may facilitate presentation of exogenous or endogenous antigens to activated T-cells. One hand was treated with PUVA or UVB and the other hand served as a non-exposed control. PUVA treatment cleared the dermatitis and the LC number decreased markedly. With UVB treatment clinical improvement was achieved, and a less pronounced decrease in epidermal LC was noticed. There seems to be a crude relationship between the extent of clinical improvement and the reduction in epidermal LC numbers. The change in LC might be a primary event or secondary to a reduction of the inflammatory process.

Adult↗
PubMed1989

[The investigation of asthmatic children by multiple factor analysis. II. The influence of 17 allergic factors on atopic dermatitis and allergic rhinitis in asthmatic children].

We investigated possible influence of 17 allergy-associated factors on atopic dermatitis and allergic rhinitis using Multiple factor analysis in 150 asthmatic children. Atopic dermatitis was complicated in ninety-seven cases and allergic rhinitis in ninety-seven cases. 17 allergy-associated factors were as follows: 1) sex, 2) age, 3) onset age of asthma, 4) family history of allergy, 5) peripheral eosinophil counts, 6) IgE RIST, 7) IgE RAST score to egg white, 8) IgE RAST score to milk, 9) IgE RAST score to soybean, 10) IgG4 antibody titers to egg white, 11) IgG4 antibody titers to milk, 12) IgG4 antibody titers to soybean, 13) IgE RAST score to house dust, 14) IgE RAST score to Dermatophagoides farinae, 15) severity of asthma, 16) exercise-induced asthma, 17) atopic dermatitis or allergic rhinitis. We concluded as follows: 1) Factors which more strongly influenced both atopic dermatitis and allergic rhinitis were IgE RAST score to D.f., positive family history of allergy, IgE RIST and eosinophil counts. 2) Combination with high levels of IgG4 antibody to 3 food allergens such as egg-white, milk and soybean and IgE RAST to egg-white has a strong influence on atopic dermatitis, but high levels of IgG4 antibody to 3 food allergens except high level of IgG4 antibody to soybean have a weak influence on allergic rhinitis.

Adolescent↗
PubMedDate not supplied

[Analysis of selected constitutional and environmental factors in patients with atopic dermatitis].

In 156 children and adolescents with atopic dermatitis retrospective analysis was carried out for establishing the effect of constitutional and environmental factors on the process of development and clinical course of this disease. It was demonstrated that the type of feeding during infancy was related to the beginning of the first symptoms. The onset of atopic dermatitis was earliest and most frequent in children with a history of only brief breast-feeding (up to 2 months) or fed with cow milk formulas since birth. Breast-feeding during 2-6 months delayed the onset of atopic dermatitis by about 2 months in relation to the former group. The effect of environmental factors manifested itself also as exacerbation of skin changes after contact with house dust, animal hairs, feathers and other antigens (fish food, contact with plants). At the same time positive results were observed of point tests with these allergens. A significant effect of the constitutional factor on the development of atopic dermatitis included familial occurrence of atopic diseases (mostly atopic dermatitis). Only 12.8% of the studied children had no family history of atopy.

Adolescent↗
PubMed1988

Increased prevalence of atopic dermatitis in Kawasaki disease.

Atopic dermatitis is associated with immunoregulatory abnormalities similar to those observed in acute Kawasaki disease. We investigated whether the prevalence of atopic dermatitis is increased among children who acquire Kawasaki disease. In a case-control telephone survey 83 Kawasaki disease patients and 83 children with innocent heart murmurs were matched for age and time between clinic visit and interview. The interviewer was blinded to the hypothesis of the study. Nine (11%) Kawasaki disease patients but only one (1%) unaffected child had atopic dermatitis; the incidence of atopic dermatitis among children with Kawasaki disease was 9 times greater than that of controls (95% confidence limits, 1.6 to 49.4). Serum immunoglobulin E concentrations were significantly higher (P = 0.02, Mann-Whitney) in 44 unselected Kawasaki disease patients (median, 22; range, less than or equal to 4 to 900 IU/ml) studied 6 to 12 months after onset than in 27 children of similar age (median, less than or equal to 4; range, less than or equal to 4 to 164 IU/ml). We observed that there is a strong association between atopic dermatitis and Kawasaki disease.

Child, Preschool↗
PubMed1985

[Parasitologic studies, diagnosis and clinical aspects of cercarial dermatitis--public health significance for bathing waters in temperate zones].

Swimmer's dermatitides occurring in natural--accordingly polluted--waters are most probably of chemical nature. In clean waters, however, they are primarily caused by larvae of duck-flukes, the so called cercariae. In a natural pool near Biberach undetermined cases of swimmers' dermatitis have appeared. Hence a cercarial dermatitis was suspected and specific examinations were carried out. At the biological examination of the pool, many watersnails of the species Radix ovata have been found near the shore. Out of 180 collected snails 8 produced cercariae of different trematode species. Hence an infective cycle between duck and snail could be ascertained here. However, the special cercariae, producing dermatitis, could not be found. Having taken that into account the author was standing in the snail biotop without protective clothes for about 1 hour to provoke cercarial dermatitis. A few minutes later the corresponding clinical picture with an extremely strong itching developed. Papules were to be seen 12 h later, the symptoms lasted 2 weeks altogether. By different serological methods (Cercarienhuellenreaction) indirect immunofluorescent test with complete cercariae and cercarial sections antibodies against cercariae could be demonstrated in the serum of the author 14 days later. As a therapy only the symptomatic treatment of the itching is possible. In principle etiologic measures against cercarial dermatitides are possible by chemical snail control. But as a rule this is to be refused because of the severe ecological damages. However, in case of swimmers' dermatitis it is nonetheless indispensible to clarify eventual parasitogenic reasons because of the specific hygienic consequences.

Animals↗
PubMed1985

[Vitiligoid achromias and severe atopic dermatitis. Apropos of 4 cases].

Four patients with important and disabling atopic dermatitis persisting during adulthood have presented leucodermia in certain areas of eczema. As melanosomes and melanocytes have totally disappeared in these regions, this depigmentation corresponds thus to an achromia. Clinically, we noted macular achromia with hyperpigmented border of special topography since touching pleat regions initially present eczema lesions: anterior face of wrists and footnecks. Slight lichenification is noted in achromic regions. In spite of many analogies with vitiligo, we differentiate this achromia from vitiligo on the basis of absence of familial post-history and absence of new localisations after 5 to 6 years cause. A review of depigmentations described during atopic dermatitis does not show similar facts. Depigmentation induced by local steroid therapy does not give such clinical and ultrastructural aspects. In 3 patients, there was no local application of depigmenting agent. In one case, 8-oxyquinoleine was applied transiently. Vitiliginous achromias of pleat regions initially presenting important atopic dermatitis are probably due to multifactorial factors: possible factors are inflammation and secondary epidermal modification due to local steroid therapy and may be some excipients. Being a rare situation in atopy, we have registered it only 14 times in 860 followed atopic dermatitis. The study of series of atopic dermatitis followed on a long-term basis should allow to evaluate the frequency of such incidents and the respective role of aetiological factors with we suspect.

Adult↗
PubMed1981

Mechanisms of decreased antibody-dependent cytotoxicity mediated by monocytes and neutrophils in atopic dermatitis.

By using IgG-sensitized erythrocytes as target cells, we found the antibody-dependent cytotoxicity mediated by monocytes and neutrophils to be depressed in atopic dermatitis. This change was accompanied by a reduction of phagocytosis of target cells by the effector cells, and also by a decreased lysozyme liberation from, and hexose monophosphate shunt activation in, the effector cells during the cytotoxic reaction. However, the binding of target cells to effector cells remained normal. In individual patients, cytotoxicity and phagocytosis were equally depressed. No relation was found between cytotoxicity and lysozyme liberation in atopic dermatitis, but a relation between cytotoxicity and hexose monophosphate shunt activity was highly significant. These results suggest that the decreased cytotoxicity mediated by monocytes and neutrophils in atopic dermatitis is caused by a diminished production of oxygen radicals during the respiratory burst. This reduced respiratory burst was not due to any defect in the enzymes responsible for this process, since the superoxide production of monocytes and neutrophils stimulated with phorbol myristate acetate was found normal in atopic dermatitis. It therefore seems that although binding of target cells to effector cells was normal, the signals created by the binding process were defective in activating monocytes and neutrophils in atopic dermatitis.

Adolescent↗
PubMed1984

[Immunoblastic sarcoma associated with dermatitis herpetiformis].

Association between dermatitis herpetiformis and gluten enteropathy is well established. An increased incidence of malignant disease has been reported in patients with coeliac disease and also in dermatitis herpetiformis. Linear IgA dermatitis herpetiformis has a much lower incidence of associated enteropathy compared with patients with papillary dermatitis herpetiformis, but the risk of malignancy could be the same. We report a case of linear IgA dermatitis herpetiformis in which immunoblastic sarcoma subsequently developed.

Celiac Disease↗
PubMed1984

Hyperlinear palms in atopic dermatitis: a manifestation of ichthyosis vulgaris?

It has recently been suggested that hyperlinear palms seen in atopic dermatitis are actually a manifestation of concomitant ichthyosis vulgaris. Patients with atopic dermatitis were examined in our clinic for the presence or absence of ichthyosis vulgaris and/or hyperlinear palms. While 70 percent of the patients with atopic dermatitis and ichthyosis did have hyperlinear palms, only 29 percent of the patients with atopic dermatitis and hyperlinear palms had concomitant ichthyosis vulgaris. These findings do not support the suggestion that hyperlinear palms in atopic dermatitis are a manifestation of concomitant ichthyosis vulgaris.

Adolescent↗
PubMed1984

[Contact dermatitis from hexamidine].

Twenty patients with contact dermatitis to hexamidine, a commonly used antiseptic solution are reported. They have been collected during a 7 months period, thus suggesting that this contact allergy is not infrequent. Hydroalcoholic solution applied on epidermless skin is most frequently responsible for the contact dermatitis. Clinical features are very peculiar with papular semi-spheric and papulo-vesicular lesions being more frequently seen than classical vesicular eczema lesions. Due to this peculiar aspect, contact dermatitis to hexamidine is frequently misdiagnosed. The delay between onset and diagnosis has been sometimes longer than one year. It is four months as a mean. Pathologic aspect of these lesions is unusual too: dermal vasculitis either lymphocytic or with pycnotic polymorphonuclear is the most frequent aspect (14 out of 23 histological sections). Epidermal spongiosis is infrequent (5 cases). Contact dermatitis has usually a long standing evolution despite removal of the allergen and topical cortico-steroid treatment. Patch-test to hexamidine are frequently followed by a worsening of cutaneous lesions. One case of anaphylaxis following patch-testing has been reported. Clinical and pathological features of this contact dermatitis, suggests that humoral immune mechanisms play a key-role in its pathogenesis.

Anti-Infective Agents, Local↗
PubMed1978

Dermatitis herpetiformis--a skin manifestation of a generalized disturbance in immunity.

Detailed investigations on 42 patients with dermatitis herpetiformis (DH) are presented, emphasis being placed on the presence of other disorders having a prominent immunopathogenic basis. These patients and 42 age and sex matched controls were submitted to an extensive clinical and investigative search for the presence of disorders with an immunological basis including the atopic disorders. The findings provided further evidence supporting the association of dermatitis herpetiformis with thyroid disease and pernicious anaemia. A statistically increased incidence of Raynaud's phenomenon and atopy was found in the patients with dermatitis herpetiformis compared to the control group. In addition, of the patients with dermatitis herpetiformis, two had rheumatoid arthritis, two had ulcerative colitis, one had systemic lupus erythematosus and four had splenomegaly. The possible basis for these associations is discussed and it is suggested that dermatitis herpetiformis may be part of a wider spectrum of disease. Genetic linkage and the formation of immune complexes following exposure to a dietary antigen may both be responsible for the disorders associated with DH.

Adult↗