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At least 19 recordsLinked to original sources
PubMed1999

Association between mast cell chymase genotype and atopic eczema: comparison between patients with atopic eczema alone and those with atopic eczema and atopic respiratory disease.

BACKGROUND: It has remained unclear whether genetic background of patients with atopic eczema (AE) alone is identical to that of patients with both AE and atopic respiratory disease. OBJECTIVE: We aimed to assess whether there is a genetic difference between these two groups of AE patients. METHOD: We determined the genotype with regard to an allelic polymorphism in the gene for mast cell chymase (MCC; a serine protease secreted from mast cells) in 169 AE patients. RESULTS: MCC genotype was significantly associated with pure AE patients who did not have a predisposition to atopic respiratory disease and whose serum IgE concentration was < 500 IU/mL. The distribution of MCC genotypes also differed significantly between the latter patients and those AE patients with bronchial asthma and a serum IgE concentration of > 2000 IU/mL. CONCLUSION: These results suggest that pure AE is associated with genetic variants of MCC, and that the genetic basis of pure AE differs from that of AE associated with atopic asthma.

Adolescent↗
PubMed1988

An epidemiological comparison between hand eczema and non-hand eczema.

Thirty four per cent of 2110 patients with eczema attending a contact dermatitis clinic presented with hand eczema. An epidemiological comparison was made of patients with hand eczema and non-hand eczema (defined as eczema on parts of the body other than the hands). Occupational eczema was significantly more common in the hand eczema than the non-hand eczema group (P = 0.0011). The prevalence of atopy was the same in both groups (13%). The prevalence of irritant contact dermatitis was higher in the hand eczema group (32%) than the non-hand eczema group (13%) (P less than 0.0001). The rate of allergic contact dermatitis was lower in the hand eczema group (23%) than the non-hand eczema group (39%) (P less than 0.0001). The rate of positive patch test reactions was lower in the hand eczema group (41%) than the non-hand eczema group (56%) (P less than 0.0001). Nickel sulphate (8%), cobalt chloride (3%), potassium dichromate (3%), and fragrance mix (4%) were common allergens encountered in hand eczema group. None of these allergens was specifically more prevalent in the hand eczema than the non-hand eczema group. However, the prevalence of allergy to nickel, colophony, epoxy resin and medicaments was significantly higher in the non-hand eczema group.

Adolescent↗
PubMed2001

Lack of association between atopic eczema and the genetic variants of interleukin-4 and the interleukin-4 receptor alpha chain gene: heterogeneity of genetic backgrounds on immunoglobulin E production in atopic eczema patients.

BACKGROUND: The genetic background of atopic eczema might be heterogeneous and there is a possibility that immunoglobulin (Ig)E responsiveness in patients with atopic eczema is controlled separately from the development of atopic eczema. Although both interleukin (IL)-4 and the IL-4 receptor alpha chain have an important role for IgE production and are therefore possible candidate genes for atopy, it has not been clarified whether these genes play any roles in atopic eczema patients who have normal IgE productivity. OBJECTIVE: We aimed to assess whether the polymorphisms of the IL-4 gene and the IL-4 receptor alpha chain gene play any roles in atopic eczema patients, particularly in patients who have normal IgE productivity. METHOD: We determined the genotype with regard to polymorphisms in the genes for IL-4 and the IL-4 receptor alpha chain (- 589C/T of IL-4; Ile50Val, Ala375Glu and Arg551Gln of IL-4 receptor alpha chain) in patients with atopic eczema using the fluorogenic 5' nuclease assay. RESULTS: IL-4 and the IL-4 receptor alpha chain genotypes were not significantly associated with either total patients with atopic eczema or atopic eczema patients who had normal IgE productivity. The distribution of genotypes of IL-4-589C/T differed by the serum IgE levels in patients with atopic eczema. CONCLUSION: These results suggest that the polymorphisms in the IL-4 gene and the IL-4 receptor alpha chain gene play no role in the development of atopic eczema in patients who have normal IgE productivity.

Adolescent↗
PubMed2006

Is the question 'Have you had childhood eczema?' useful for assessing childhood atopic eczema in adult population surveys?

Atopic eczema (AE) is a major risk factor for hand eczema. In Scandinavian population-based studies, the occurrence of AE in childhood has often been assessed by the question 'Have you had childhood eczema?' In the present study, this question was validated. A questionnaire was sent to 600 cases with AE and 600 controls without eczema or allergic disease, identified in school medical records from the 1960s. The response rate was 70.5%, and the mean age of the respondents was 36.7 years. The specificity of the question was 70.7% and the sensitivity 89.9%. The sensitivity was higher and the specificity lower in a subgroup with current hand eczema compared with a group without hand eczema. The results showed that the question overestimated the prevalence of AE in childhood by a factor of 1.6. When used for risk assessment, the question provided a better estimate of the risk of current hand eczema as compared with the lifetime risk of hand eczema. In conclusion, the validated question overestimated prevalence of childhood AE and may overestimate AE as a risk factor for hand eczema in adult population surveys.

Adolescent↗
PubMed2004

The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients' perspective.

OBJECTIVE: To develop a simple, valid, repeatable, and readily understandable patient-oriented assessment measure for monitoring disease activity in children and adults with atopic eczema. DESIGN: Qualitative semistructured patient interviews identified a list of symptoms of atopic eczema. These symptoms were quantitatively analyzed in a larger patient population to identify which symptoms were important to patients and amenable to monitoring as part of a scoring system. SETTING: The outpatient Department of Dermatology at the Queen's Medical Centre, University Hospital, Nottingham, England, and 5 local general practices. PATIENTS: Four hundred thirty-five patients with atopic eczema. RESULTS: Seven symptoms were incorporated into the final patient-oriented eczema measure using a simple 5-point scale of frequency of occurrence during the previous week, with a maximum total score of 28. Validity testing against the Dermatology Life Quality Index, Children's Dermatology Life Quality Index, and patients' global severity assessments showed good correlation (r = 0.78, r = 0.73, and r = 0.81, respectively; P<.001). Internal consistency was high (Cronbach alpha = 0.88), and test-retest reliability was good, with 95% of scores falling within 2.6 points on repeat testing (mean score difference, 0.04; SD, 1.32). Individual variables in the measure demonstrated sensitivity to change during a 4-week in-clinic period and an 18-week randomized controlled clinical trial. CONCLUSION: The patient-oriented eczema measure is a practical self-assessed measurement tool for monitoring aspects of atopic eczema that are important to patients in routine clinical practice or in the clinical trial setting.

Adolescent↗
PubMed2004

Overview of studies of treatments for hand eczema-the EDEN hand eczema survey.

BACKGROUND: Hand eczema is a major cause of morbidity and lost earnings. Many interventions ranging from topical steroids to oral ciclosporin are used, but their evidence base and the best methods to assess their efficacy are uncertain. OBJECTIVES: As part of a long-term project to improve standards of design and reporting in hand eczema trials, we sought to describe the prevalent study designs and comment on the quality of reporting of such studies. METHODS AND DATA SOURCES: Electronic databases (Cochrane, Medline, Embase, Pascal, Jicst-Eplus, Amed) were searched from January 1977 to April 2003 using all possible variants of the terms hand and eczema/dermatitis. In addition, four general medical and 17 specialist dermatology journals were hand-searched by pairs of researchers for all possible therapeutic studies. STUDY SELECTION: Studies were eligible for inclusion if they dealt with hand eczema as diagnosed by a physician irrespective of the aetiology, and if they described the results of a study of a therapeutic intervention in humans. Single case reports and reviews were excluded, but case series and nonrandomized studies were considered alongside randomized studies. Data selection For each study, two researchers independently assessed the type of study, outcome measures, enrolment criteria, randomization, masking of interventions and how losses to follow-up were dealt with. MAIN OUTCOME MEASURES: Proportion of studies according to type of intervention and study type. Proportion of randomized controlled trials (RCTs) that adequately reported eligibility criteria, randomization generation and concealment, masking and intention-to-treat analysis. RESULTS: A total of 90 studies reported in 87 papers dealt with 11 different classes of interventions. Around 80% of the studies dealt with just four interventions: ultraviolet light, topical steroids, radiation and systemic immunosuppressives. Of the 90 studies, 44 were case series, 15 were nonrandomized controlled trials, and the remaining 31 were RCTs. Of the 31 RCTs, 16 were parallel (one with cross-over design) and 15 self-controlled. Only 11 of the RCTs adequately reported eligibility criteria. The randomization method was described in 10, and there was adequate concealment of allocation in eight. Masking the treatment allocation from both the study assessors and patients was done in 11 RCTs, and intention-to-treat analysis was reported in four. Only 13 RCTs were 4 months or longer in duration. No study reported a rationale for the sample size, and in only one study had the outcome variable been validated. CONCLUSIONS: Most 'trials' in hand eczema are not RCTs. Internally controlled (left/right) studies were common. Based on the poor overall quality of reporting, most RCTs of hand eczema trials are not adequate to guide clinical practice. Future trials of hand eczema should be randomized, using a parallel group or self-controlled design. Research is needed to develop validated and clinically relevant outcome measures. Most of the remaining issues relating to poor quality of existing evidence can be relatively easily dealt with by following the CONSORT guidelines.

Eczema↗
PubMed2007

Paediatric eczema and psychosocial morbidity: how does eczema interact with parents' illness beliefs?

BACKGROUND: Thus far there has been relatively little work on children's illness representations regarding eczema and how these relate to parental conceptualizations of their child's psychosocial health. This is important because the challenge of raising a child with a serious illness can affect many facets of a parent's everyday life and the behaviour of parents can be closely related to the health of the child. METHODS: Two hundred and thirty-two children with eczema, asthma, eczema and asthma, and healthy controls between 7 and 12 years of age and their parents were recruited. Children were administered the Children's Illness Perception Questionnaire. Questionnaires completed by the parents were The Personality Inventory for Children and The Parental Stress Inventory. RESULTS: Parents of children with eczema did not judge their children to have poorer psychosocial health than controls, but parents of children with eczema could not be distinguished between in terms of whether their child was significantly affected by their eczema or not. CONCLUSIONS: This work could have important implications for the quality of life of the child and for the parent-child relationship and these implications are considered.

Case-Control Studies↗
PubMed1999

The Dyshidrotic Eczema Area and Severity Index - A score developed for the assessment of dyshidrotic eczema.

BACKGROUND: Dyshidrotic eczema of the palms and soles is a common condition, which can be rather resistant to treatment. Therapy studies and their comparability are of clinical importance. OBJECTIVE: As standardized assessment methods for the severity of this particular form of eczema are lacking, we developed a severity index for dyshidrotic eczema. METHODS: The Dyshidrotic Eczema Area and Severity Index (DASI) is based on the severity grade of single items - number of vesicles per square centimetre (V), erythema (E), desquamation (S) and itch (I) - and the extension of the affected area (A) and is calculated with defined score points (p) as: DASI = (pv + pE = pS + pI) x pA. RESULTS: In two treatment studies on dyshidrotic hand eczema, the DASI was found to be a simple and useful tool to assess the severity of dyshidrotic eczema and the effect of therapy. CONCLUSION: The DASI needs to be further validated in larger cohorts.

Eczema, Dyshidrotic↗
PubMed1991

[IgE.IgG4 antibody in eczema in infants between 5-7 months of age. I. Relationship to the degree of eczema involvement].

Assessments have been made of serum IgE and IgA value, specific IgE and IgG4 antibody titers to foods, house dust, mite and percent peripheral++ eosinophil count in 191 infants with and without eczema between 5-7 months of age. Eczema patients were divided into 4 groups according to the degree of eczema involvement and laboratory data were compared between these and not eczematous group. The results were as follows; 1) IgE antibody titers were higher as the degree of eczema involvement increased. 2) RAST positive rates to foods increased with the degree of eczema involvement. Positive rate was highest to egg white followed by milk, soybean, wheat and rice. 3) Only 9 cases were RAST-positive to rice or wheat and all of them had IgE antibodies to other allergens tested. 4) A value of 10 IU/ml, which is the lowest measurable value of IgE in infants was considered to be a little too high to speculate allergy to some foods. 5) Specific IgG4 antibodies were positive only to milk. 6) All the 18 cases with positive milk-specific IgG4 antibody were all negative in milk-specific IgE antibody, and conversely all the 14 cases with positive milk-specific IgE antibody were negative in milk-specific IgG4 antibody. From these results, it was concluded that food allergy is related to the degree of eczema involvement in infants between 5-7 months of age.

Age Factors↗
PubMed2003

Atopic eczema. What has caused the epidemic in industrialised countries and can early intervention modify the natural history of atopic eczema?

Atopic eczema (AE) has a lifetime prevalence of between 15 and 20% in industrialized countries, but a very low prevalence in rural Africa. The 'atopic eczema epidemic' has developed in industrialized countries within the last four decades. The disease has a strong genetic influence, so environmental factors must be responsible for the dramatic increase in disease prevalence. It is therefore fair to consider what interventions may change its prevalence. In this article, several factors are considered: the increased number of doctors in industrialized countries, the development of drugs like topical steroids and emollients, the 'demanding parents' and 'old mother' syndromes, introduction of vaccination programmes, allergen exposure, breastfeeding and the possible beneficial effects of probiotics. In 90% of children with AE, onset is before the age of 5. Its course runs over years. Approximately two out of three outgrow the disease between 7 and 12 years of age. Although its cause is unknown, type I allergic reactions are common and allergen avoidance has been attempted in many studies as a preventive measure in atopic dermatitis. However, results are rather disappointing. The use of probiotics, i.e. daily intake of Lactobacillus, has proven effective in preventing, or at least delaying, the development of atopic eczema. So has breastfeeding, although some studies cannot confirm its beneficial effect. Therapeutic interventions using antihistamines, desensitisation and control of skin inflammation using topical steroids have not proven successful in shortening the course of atopic eczema, although controlled studies are lacking. The use of emollients has, however, a documented effect in up to one of three children with mild atopic eczema. It will be interesting to observe if the new topical immuno-modulators, tacrolimus and pimecrolimus, may be able to shorten the natural course of the disease.

Journal Article↗
PubMed1993

[Air pollution, eczema and asthma in Sør-Varanger. Is the high consumption of corticosteroid ointments caused by increased tendency for eczema?].

Many investigations suggest that a high degree of air-borne pollution increases the prevalence of diseases like asthma and eczema. Sør-Varanger Municipality in Finnmark County in the north of Norway receives much air-borne pollution from domestic industry and from the metallurgic industry on the Kola peninsula in North-Western Russia. We have investigated indirect parameters of morbidity caused by asthma and eczema by analyzing data on drug consumption and hospital admissions. In Sør-Varanger there is high consumption of corticosteroids for dermatological use. Consumption of anti-asthmatic drugs and number of admissions to hospital for asthma and eczema were no higher than expected. We suspect that air-borne pollution, particularly the heavy metal nickel, increases the prevalence and perhaps worsens the degree of eczema in Sør-Varanger.

Adolescent↗
PubMed1986

Seborrhoeic eczema--a disease entity or a clinical variant of atopic eczema?

One hundred and thirty-eight children seen at the Dermatology Clinic between 1969 and 1972 were reviewed. The study comprised two groups--a study group of 76 children diagnosed as having seborrhoeic eczema, and a group of 62 children seen over the same time period at the same clinic and diagnosed as having atopic eczema. The children were examined and a family history obtained with particular reference to past or present history of atopic diseases. Serum IgE, blood eosinophil count, pulmonary function tests and skin prick testing to various allergens were measured in the two groups. In the seborrhoeic group, 19% had eczema, 20% had abnormal pulmonary function clinically; 25% had a raised eosinophil count, 44% a raised IgE level, 89% positive skin prick testing, and 52% a peak flow less than 80% of predicted value. These results indicate a closer than expected association between infantile seborrhoeic eczema and atopic disease.

Asthma↗
PubMed2005

The hand eczema severity index (HECSI): a scoring system for clinical assessment of hand eczema. A study of inter- and intraobserver reliability.

BACKGROUND: There is a need for a standardized clinical grading system for a more objective and accurate assessment of the severity of hand eczema (HE). OBJECTIVES: To develop and validate a scoring system called the hand eczema severity index (HECSI) designed for clinical assessment of HE. METHODS: Twelve dermatologists (observers) assessed 15 HE patients twice, with an interval of 30 min. The study was performed blinded for the observers, and only the hands and wrists of the patients were visible to the observers. Agreement between the observers was determined by using the intraclass correlation coefficient (ICC), which is the correlation between (single) ratings of the same patient. RESULTS: ICC for total HECSI score was 0.79 at the first assessment and 0.84 at the second assessment. ICC for intraobserver agreement was 0.90. CONCLUSIONS: Overall excellent agreement existed for both inter- and intraobserver reliability and the scoring system is suggested for use in future clinical studies on HE. Because HECSI is an entirely objective assessment of clinical signs, in addition, inclusion of patient-rated symptoms should be considered.

Adolescent↗
PubMed1994

An epidemiological study of hand eczema. IV. Degree and pattern of eczema in affected hairdressers, with and without atopic symptoms, compared with a control group of affected teachers.

The aim of this study was to show degree and pattern of hand eczema in affected hairdressers (n = 69), compared with a control group of teachers (n = 19). Both groups consisted of employees having eczema, confirmed by the visit of a doctor at the working place. The mean age for the affected hairdressers was 27 years (range: 17-63) and for the teachers 43 years (range: 27-57). The mean duration of employment was 96 months for the hairdressers (range: 2-552) and 182 months for the teachers (range: 25-336). The localization of eczematous lesions, presence of efflorescenses and extent of skin affection were recorded by constructing scores for these variables. The mean number of localizations was significantly higher in hairdressers than in teachers; this was caused by greater affection of fingers in hairdressers compared to teachers. Seventy-five percent of the hairdressers and 79% of the teachers had only modest or very moderate erythema. Fourteen percent and 5%, respectively, had vesicular dermatitis. The right upper limb was most affected in both hairdressers and teachers. Three subgroups of hairdressers were considered: hairdressers with atopic dermatitis, those with only atopic mucosal symptoms and those without atopic symptoms. No significant differences were found between these groups, except a significant higher finger involvement in atopics compared to non-atopics.

Adolescent↗
PubMed2002

International Study of Asthma and Allergies in Childhood (ISAAC): validation of the written questionnaire (eczema component) and prevalence of atopic eczema among Brazilian children.

Although Hanifin and Rajka's criteria have been used for the diagnosis of atopic eczema (AE), there is no instrument destined for epidemiological studies on AE that actually uses them. Written questionnaires (WQ) have generally been used, but when translated into another language they must be validated. The Intemational Study of Asthma and Allergies in Childhood (ISAAC) WQ was previously validated in a comprehensive study, but its validation in Brazil had not been done. Our objective was to validate the eczema component of the self-applicable ISAAC's WQ following its translation into Portuguese. The group of 10 pediatricians and 10 pediatric allergologists graded the questions from 0 to 2 and established the maximum score for each question. The WQ was answered by parents or guardians of children with atopic dermatitis (AE), aged 6-7 years (n = 23) and of non-AE control children of the same age (n = 46) as well as by AE (n = 24) and non-AE (n = 48) adolescents, aged 13-14 years. In order to evaluate the reproducibility of the ISAAC WQ, half of these individuals answered the same questionnaire after 2 to 4 weeks. The maximum possible global scores were 13 for the children aged 6-7 years and 11 for the adolescents, and the cutoff level for both groups was 3. In both age periods the WQ was reproducible (Kappa and McNemar tests) in a significant way (6-7 years, Kw = 0.79; 13-14 years, Kw = 0.73). The prevalence of AE, using the validated WQ, was then studied. The WQ was applied to the parents of 3,005 children aged 6-7 years and to 3008 children aged 13-14 years. Response rates were 72% and 94% for the 6-7-year-old children and the 13-14-year-old children, respectively. There was a slight predominance of male children in the studied population. In the group of the 6-7-year-old children, the cumulative prevalence of AE was 13.2% for boys and for girls; in the group of the 13-14-year-old children, it was 12.5% and 15.4%, respectively. AE severity was similar for both age groups. Using the criteria of global cutoff score, in the group of the 6-7-year-old children, the prevalence of AE was 12.6% for boys and 13.8 for girls; in the group of the 13-14-year-old children, it was 11.7% and 12.4%, respectively. There were no significant differences between them. In conclusion, the AE component of the ISAAC WQ proved to be reproducible, adequate, and able to discriminate between AE and control children. A significant concordance was observed between the criteria utilized in this study (ISAAC x global cutoff score).

Adolescent↗
PubMed1975

The angry back syndrome: eczema creates eczema.

False positive patch test reactions are common when the skin of the back is hper-reactive. Such reactions can obscure or invalidate observations of multiple specific sensitivity and of cross-sensitivity to contactants. The pathogenesis of the hyper-reactive skin ('angry back') is discussed and a mechanism postulated for the notion that eczema at certain sites can provoke an eczematous tendency at other sites.

Back↗
PubMed1983

[Oral provocation of a hydroxyquinoline eczema. Hematogenic contact eczema from hydroxyquinoline].

We inform about an eczema reaction from inside after perception of Reasec Plus. This hydroxyquinolin substance caused a generalized dermatitis at a patient who is contact sensibilized against Vioform. The sensitivity index found out among our patients is very little (0,85%). The probability for the appearance of an internally or externally induced contact dermatitis after perception of Hydroxyquinolin is rather poor.

Administration, Oral↗