Eczema Group Research Articles

Parvovirus B19 and in situ immune response in eczema and psoriasis skin lesions of patients from the Brazilian Amazon region

Parvovirus B19 (PVB19) is a virus found in the skin that causes asymptomatic infections and can exist in the host for long periods to time. The virus induces a local inflammatory response and is associated with the development of arthritis and other autoimmunes diseases. Parvovirus B19 DNA was investigated by PCR in the skin of 20 patients with psoriasis and 20 patients with eczema. Additionally, immunohistochemistry was used to characterize the expression of cytokines in these lesions. The sociodemographic variables were similar in the two groups studied. Psoriasis vulgaris was the most common clinical type in men (50%) and women (80%) (p = 0.0106). Comorbidities were observed in most patients with psoriasis (75%), with an OR of 14 (p = 0.0068). Another important finding was the high prevalence (50%) of psychiatric disorders in patients with psoriasis (OR = 16, p = 0.0218). Only two patients (10%) with psoriasis were positive for PVB19. Comparison of cytokine expression showed the same cytokine profile in the two groups (p > 0.05). However, expression of TNF-α tended to be higher in psoriasis patients. There was no significant positivity for PVB19 in the two groups studied. Immunohistochemistry showed higher expression of TNF-α in psoriasis lesions compared to the eczema group.

Factors for differentiation affecting of neonatal regulatory T cells

Objective To investigate the possible factors for differentiation affecting of neonatal regulatory T cells (Treg). Methods Umbilical cord blood was collected from 200 newborns.Treg number was detected by DNA demethylation in the Foxp3 of Treg-cell-specific demethylatedregion (TSDR) based on high resolution melting analysis (HRMA), concentrations of 7, 8 -dihydroxy -9, 10-epoxy -benzo (a) pyrene(BPDE-DNA) adducts and interleukin-4(IL-4)in the supernatants of cord blood by enzyme-linked immunosorbent assay(ELISA), and follow-up questionnaires were carried out till 1.0-1.5 years, for recurrent wheezing or stubborn eczema in infants and related information on parental history of atopic diseases. Results (1) In wheezing group [(0.48±0.05)%]and eczema group[(0.76±0.05)%], the number of Tregs was significantly lower compared with that of the asymptomatic group [(1.14±0.08) %](t=2.62, 2.83, all P<0.05); the number of Treg in parental history of atopic group was significantly lower than that of the non-atopic group (P<0.05); but the Treg numbers in the non-atopic group was still lower than that of the asymptomatic group (P<0.05). (2)The concentrations of BPDE-DNA adducts in the wheezing group [(236.30±6.59) ng/L]and the eczema group [(173.40±7.38) ng/L]were higher than those of the asymptomatic group [(111.01±3.36) ng/L](t=10.35, 6.53, all P<0.05), while BPDE-DNA adduct concentrations in the atopic group with parental history of wheezing or eczema in infants were lower than those of the non-atopic group(P<0.05). (3) The concentrations of IL-4 in the wheezing or eczema group in the supernatants of cord blood was higher than the asymptomatic group (P<0.05). Conclusions Neonatal genetic factors and BPDE-DNA adducts could affect Treg differentiation, which are probably the reasons for the formation of allergic diseases. Key words: Regulatory T cells; Atopic; Polycyclic aromatic hydrocarbon; DNA adducts; Cell differentiation

Psychiatric disorders and symptoms severity in preschool children with atopic eczema

BackgroundTo compare with a control group the frequency of psychiatric disorders and severity of psychiatric symptoms in preschool children with atopic eczema. MethodsThe study included children between the ages of 3–5 who were diagnosed to have atopic eczema. The parents of the children with atopic eczema were interviewed in person and were asked to fill in “The Early Childhood Inventory-4” form. This form assesses the psychiatric disorders and symptoms severity in children between the ages of 3–5. ResultsThe atopic eczema group included 80 patients (38 male, 42 female) with a mean age of 48.4±15.7 months and the control group included 74 patients (41 male, 33 female) with a mean age of 49.9±15.19 months. It was established that 68.8% of the group with atopic eczema received at least one psychiatric diagnosis. Between the psychiatric disorders, ADHD (Odds ratio: 2.57, 95% CI: 1.049–6.298, p=0.035), enuresis and encopresis (Odds ratio: 2.39, 95% CI: 1.121–5.097, p=0.022) and attachment disorder (Odds ratio: 2.03, 95% CI: 1.046–3.953, p=0.035) were found to be significantly higher when compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores calculated by using ECI-4, ADHD severity (p=0.043), conduct disorder severity (p=0.001), anxiety disorders severity (p<0.001), eating disorders severity (p=0.011) and tic disorder severity (p=0.01) were found to be higher in the atopic eczema group. ConclusionPsychiatric illnesses are frequent in preschool children with atopic eczema.

Improvement of inflammatory dermatoses severity and quality of life in patients treated with a betamethasone valerate plaster (LIBERE study)

Background: A ready to use betamethasone valerate 0.1% (BMV) dressing was effective and well-tolerated by patients receiving chronic plaque psoriasis treatment. Objective: Collect data related to BMV dressing used in the context of market authorization. Methods: An observational, prospective study, including 258 patients with a maximum 4-weeks-treatment of inflammatory dermatosis with BMV 2.25 mg plaster was performed. The prescription pattern was described and the disease severity assessed using a Physician Global Assessment (PGA). Patient satisfaction as well as their quality of life (DLQI) were evaluated. Clinical evaluation was performed before and after the treatment. Results: The DLQI scores improved from 10.0 ± 5.4 to 3.5 ± 3.5 points (p < 0.0001) and PGA decreased from 12.5 ± 3.1 to 4.2 ± 3.0 points (p < 0.0001). The highest DLQI and PGA improvement was reported for the eczema group. Subjects reported the test dressing was better than prior therapies with 93.5% very satisfied and 90.4% satisfied. Conclusions: The BMV dressing is well-tolerated and effective in the treatment of inflammatory dermatoses, improving both the objective signs of the disease as well as patients’ quality of life.

Is Patch Testing with Food Additives Useful in Children with Atopic Eczema?

Atopy patch testing is a useful way to determine delayed-type hypersensitivity reactions to foods and aeroallergens. Although food additives have been accused of worsening atopic eczema symptoms, according to recent studies the role of food additives in atopic eczema remains unclear. The purpose of our study was to investigate food additive hypersensitivity in a group of children with atopic eczema by using standardized atopy patch testing and to determine the role of food additive hypersensitivity in atopic eczema. Thirty-four children with atopic eczema and 33 healthy children were enrolled in the study. Children who consumed foods containing additives and did not use either antihistamines or local or systemic corticosteroids for at least 7 days prior to admission were enrolled in the study. All children were subjected to atopy patch testing and after 48 and 72 hours their skin reactions were evaluated by using the guidelines. Positive atopy patch test results were significantly higher in the atopic eczema group. Forty-one percent of the atopic eczema group (n = 14) and 15.2% (n = 5) of the control group had positive atopy patch test results with food additives (p = 0.036) (estimated relative risk 1.68, case odds 0.7, control odds 0.17). Carmine hypersensitivity and the consumption of foods containing carmine, such as gumdrops, salami, and sausage, were significantly higher in the children with atopic eczema. This is the first study investigating hypersensitivity to food additives in children with atopic eczema. Our results indicate that carmine may play a role in atopic eczema.

Nipple eczema, an indicative manifestation of atopic dermatitis? A clinical, histological, and immunohistochemical study.

Nipple eczema exhibits as a minor manifestation of atopic dermatitis (AD) or occurs as a single skin symptom on the nipple. To characterize the relationship between nipple eczema and AD, a clinical evaluation and an immunohistochemical study were performed. All cases of nipple eczema were confirmed histopathologically. We divided the patients with nipple eczema into 2 groups, namely, those with AD and those without AD, and compared several clinical features. Upon histological examination, the degree of inflammation was subjectively graded as mild, moderate, or severe by 2 separate investigators. Immunohistochemical stainings were performed by using antiinterleukin (IL)-4, anti-IL-13, anti-CD4, and anti-CD8 antibodies, and the results were scored semiquantitatively. In 43 cases evaluated, 12 were nipple eczema with AD. The clinical analysis and histological examination showed no significant differences between the groups. There were consistent findings of IL-4 expressions throughout the epidermis and IL-13 expression mainly in the perivascular area of the dermis. Although CD4 and CD8 were expressed in the cells in the dermis, CD8 expression was detected in the serocrusts of the epidermis. Expression levels of IL-4, IL-13, CD4, and CD8 exhibited no significant differences between the nipple eczema group with AD and the nipple eczema group without AD. Although nipple eczema may accompany AD, we found no definite differences in the degree or pattern of inflammation and cytokine expression level regardless of whether AD was present or not. Serocrust formation seemed to be mainly a collection of CD8-positive cells.

Prevalence of late cutaneous reactivity to metabisulfites in patients with and without chronic eczema in Argentina

Methods Twenty two participants, 14 males and 8 females (mean age 31 years old), without eczema (Group 1) and 20 patients, 3 males and 17 females (mean age 35 years old), with chronic eczema (Group 2), living in Rosario, Argentina, were patch tested (PT) with sodium metabisulfite (MBS – CAS: 7681-57-4) 1% in petrolatum and with Brazilian Contact Standard Series (FDA Allergenic, Brazil). For the test, Finn Chambers (SmartPractice, USA) with 8mm (standard series) and 12mm (MBS) of diameter were used and the patch testing was performed according to the International Contact Dermatitis Research Group criteria (2 days of occlusion, readings on D2 and D4, using a score from + to +++). Chisquared test was used to examine whether there was a significantly statistical difference between positive reactions frequencies observed in two groups. The significance level for group differences was set at p< 0.05. The software used for this analysis was the GraphPad Prism version 6.

Analysis of the relations between allergen specific LgG antibody and allergic dermatosis of 14 kinds foods.

To use food-specific IgG antibody detection to explore its application in the allergy dermatoses. 181 patients were included from January 2014 to September 2014. Fourteen food-specific IgG antibodies were detected by ELISA. The positive rates of IgG antibody of the patient group and the healthy group were significantly different. The positive rates of IgG antibody of egg, milk, shrimp and crab took a large proportion in three groups of patients with three kinds of allergy dermatoses of urticaria, eczema and allergic dermatitis, the proportion of which was respectively 70.2%, 77.8% and 71.7%. There was mild and moderate intolerance of food in the allergic dermatitis group while there was no distribution difference of food intolerance in urticaria group and eczema group. Among urticaria and allergic dermatitis patients with positive antibody, the positive rate of children was significantly higher than that of adults while there was no significant difference between children and adults among eczema patients with positive antibody. Allergy dermatoses are closely related to food-specific IgG antibody and the allergy dermatoses patients have a high incidence rate of food intolerance; detecting IgG antibody in patients is of great significance for the diagnosis and treatment of allergy dermatoses.

Time-of-Flight Mass Spectrometry in Screening Serum-Specific Protein in Patients With Scrotal Paget’s Disease

The weak cationic chip (WCX2) and the surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) were used to test the serum differential proteins in 20 healthy persons, 20 patients with chronic scrotal eczema, and 30 patients with scrotal Paget's disease and test the specificity and sensitivity of screening scrotal Paget's disease with differential proteins. We found that the differences between the 5 protein peaks of the normal group and the scrotal Paget's disease group in the range of 2000 to 30 000 Da were statistically significant (P < .01) and the difference of 3 protein peaks between the scrotal eczema group and the scrotal Paget's disease group in the range of 2000 to 30 000 Da was statistically significant (P < .05). SELDI-TOS-MS technique has certain application value in the early diagnosis of the scrotal Paget's disease and screening for the specific tumor markers.

Allergic diseases of the skin and drug allergies – 2013. Longitudinal analysis of fecal microbiota of infants followed-up for eczema till 2 years of age

Methods Children with eczema at 2 years old (n=26) and their matched (for gender, mode of delivery and feeding in first 6 months) healthy controls (n=26) were selected from the placebo group of a cohort of at-risk infants participating in an randomized double-blind placebo controlled trial on the protective effects of supplemental probiotics (first 6 months) on eczema and allergies. Children with eczema were subclassified into atopic eczema (n=12) and non-atopic eczema (n=14). Molecular evaluation of fecal microbiota were conducted using Fluorescence In Situ Hybridization-Flow Cytometry (FISH-FC) for fecal samples collected at 3 days, 1, 3, and 12 months. Probes were selected to target Eubacterium rectale-Clostridium coccoides group (Erec482), Clostridium leptum subgroup (Clep866 and the corresponding competitor probes), Bacteroides-Prevotella group (Bac303), Bifidobacterium genus (Bif164), Atopobium group (Ato291), LactobacilliEnterococci group (Lab158), Enterobacteriaceae family (Enter1432) and Clostridium perfringens (Cperf191). Linear mixed model was used to evaluate the longitudinal differences (i.e. 4 time points) of bacterial targets while adjusting for gender, mode of delivery, feeding up to 6 months, and allergic rhinitis and wheezing within the eczema group at 2 years of age. Results Longitudinal analyses over four time points showed that higher relative abundance of Enterobacteriaceae [coefficient (B): 1.104, 95% confidence interval (CI):0.175-2.033, adj p=0.022] in children with eczema by 2 years of age. Similar observations were made when eczema group was subanalyzed into non-atopic and atopic eczema, where higher relative abundance of Enterobacteriaceae [B:1.357, 95%CI; 0.382-2.332, adj p=0.008] and [B:1.165, 95%CI; 0.221-2.109, adj p=0.019] were observed respectively as compared to healthy controls. Relative abundance of Clostridium perfringens were also higher when subanalyzed for non-atopic [B:0.572, 95%CI; 0.0009-1.144, adj p=0.050] and atopic eczema [B:0.000451, 95%CI: 0.0001-0.0007, adj p=0.012] compared to healthy controls.

Prevalence of various skin disorders in school going children of Kashmir valley of North India: A cross-sectional study

Background: Reports from different parts of the world have revealed wide variation in the prevalence of various skin disorders. Variations exist with respect to age, sex, dwelling and socio-economic status. Prevalence studies of skin disorders in children and adolescents are meager. Aim: The aim of the present study was to determine the prevalence of various skin disorders in school going children of Kashmir valley of North India. Materials and Methods: This cross-sectional study was designed to find the prevalence of skin disorders in the age group of 6-19 years. Kashmir valley of North India was stratified into North, Central and South Kashmir and among them one district was selected. Educational institutions were stratified as per levels of education, i.e. primary, middle, secondary, higher secondary and college. Each strata was sub-grouped sex-wise. From each educational institution, 10% of students were selected through the systematic random sampling. A specially designed questionnaire was framed and information regarding any of dermatological ailments was noted. A total of 5000 students were examined and prevalence of all types of skin disorders was noted. Results: Eczemas formed the largest group followed by acne vulgaris. In the eczema group, pityriasis alba was most frequent type followed by hand eczema, irritant and allergic contact dermatitis taken together. Individually, acne vulgaris was the most prevalent skin disorder in the study group. Conclusion: The study found that skin disorders were more common in males than females, in urban than in rural dwellers, in students from government schools than private schools and in students belonging to the low socioeconomic group.

Job choice and the influence of prior asthma and hay fever

ObjectivesTo investigate whether prior symptoms of allergic disease influence first job undertaken on leaving school.MethodsThe study included 5020 members of the 1958 British birth cohort who provided a job history...

Specific profiles of house dust mite sensitization in children with asthma and in children with eczema

Sensitization to house dust mites (HDM) is highly prevalent among the young atopic population in Singapore. Previously published data suggest that individuals with skin allergies show preferred sensitization to Dermatophagoides pteronyssinus while individuals with pure respiratory allergies show preferred sensitization to Blomia tropicalis. The aim of our study was to compare the sensitization profiles between children with asthma and those with eczema to D. pteronyssinus and B. tropicalis and their specific allergens. A total of 60 children, 30 with asthma and 30 with eczema were recruited. IgE levels specific for a panel of HDM allergens from the two mite species were measured using enzyme-linked immunosorbent assay. The asthma group showed highest sensitization to Blo t5 while the eczema group showed highest sensitization to Der p5. Comparison between the two disease groups showed that the eczema group had significantly higher IgE levels for Der p (p = 0.042) and its allergens Der p1 (p = 0.019) and Der p5 (p = 0.001). Generally, the eczema group was more sensitized to the panel of allergens compared to the asthma group. Individuals with asthma and those with eczema showed different sensitization profiles to HDM. These findings highlighted possible mechanisms for different manifestation of allergy.

Quality of life in pediatric patients with atopic dermatitis

To measure the impact of atopic dermatitis (AD) on the quality of life of pediatric patients and their families, establishing correlations with scores of disease severity. This was an observational study of the correlations between clinical indicators of severity and two questionnaires on quality of life: IDQOL and DFI. The study also included scoring of eczema severity EASI. Forty-two children with AD, fulfilling established diagnostic criteria, and 44 children with other dermatologic diseases were investigated for the effect of eczema on quality of life. Pearson's correlation was used for the correlation analysis and the comparison between the groups was carried out using the Mann-Whitney test. Data analysis demonstrated significant differences between the scores for the two groups. The mean score in the eczema group was 9.2 (range 1-19) for IDQOL and 8.5 (range 0-17) for DFI. The highest scoring questions for IDQOL referred to itching and scratching, mood changes and problems caused by treatment. For the FDI, the highest impact domains were treatment-related expenditure and sleep disturbance affecting family members. AD has a negative impact on the quality of life of pediatric patients and their families. Data obtained in studies of quality of life in AD should be used to guide clinical practice in order to identify individual treatment strategies and should lead to the adoption of measures to reduce the impact of the disease on patients and their families.

Relationship of patch test positivity in a general versus an eczema population

Using previously generated data from multicenter studies European Environmental and Contact Dermatitis Research Group (EECDRG) and North American Contact Dermatitis Group (NACDG), we compare patch test positivity of random sample and eczema populations, attempting to ascertain how one might extrapolate frequency from an eczema group to a general population. We included population-based mathematical estimates for patch test reaction in the general population using the Multinational MONItoring of trends and determinants in Cardiovascular disease MONICA and Clinical Epidemiology and Drug-Utilization Research (CE-DUR) systems. Data analysis provides a ratio of eczema population:random sample population for each allergen and an overall ratio of all allergens 5:1 for actual data and 6:1 for population-based estimates (according to the MONICA and CE-DUR systems). If the positivity rate were the same in each population, the ratio would approximate 1. The individual allergen ratios ranged from formaldehyde at 11.6 to parabens at 1.0, with respect to the NACDG. Some differences may be explained by exposure (neomycin) being greater in patients than in random population. Materials of ubiquitous exposure - i.e. fragrance mix and nickel - had ratios closer to 1. Taken together, data obtained in eczema patients may be viewed as part of a complex biology and may eventually be of use in aiding validation of predictive dermatotoxilogic assays and in public health assessments.

Quality of life instrument for Turkish people with skin diseases

To develop a new, short, self-administrated subjective quality of life (QOL) instrument for Turkish people with skin diseases. The 11-item questionnaire of QOL instrument was developed from 200 consecutive dermatological patients' replies. The reliability and validity of the instrument was tested on data gathered from 278 patients with skin diseases attending a dermatology outpatient department and 49 normal subjects. Construct validity was assessed by an exploratory factor analyses and comparisons between patients rated severe and not severe, as well as between normal and patient groups. Reliability was assessed from the internal consistency of the scales and the correlations were made between scores from a 7-10-day retest by using intraclass correlation coefficient. Factor analyses found six separate dimensions of QOL involving skin disease: social life, emotional life, daily activity, symptoms, cognitive life and sexual life. In addition, 81.3% of common variance was explained by the above factors, all of which correlated with the scale scores of the instrument. The instrument scales were internally consistent (Cronbach's alpha= 0.77-0.84) and scale scores were reproducible after 7-10 days (ICC = 0.63-0.88). Significantly, correlations between scale scores and physician's assessment of the severity of the skin disease were found. Significant differences between diagnostic groups were observed with higher scores for patients with psoriasis, urticaria and acne than those with eczema in the emotional life domain (P < 0.05). In the sexual life domain, however, the eczema group had higher scores than patients with psoriasis, urticaria or acne (P < 0.01). The instrument provides valid and reliable assessments of QOL in Turkish patients with skin disease.

The Pattern of Skin Diseases in Hail Region, Saudi Arabia

The Pattern of Skin Diseases in Hail Region, Saudi Arabia

Psychological disturbance in atopic eczema: the extent of the problem in school-aged children.

Although psychological factors are widely considered to be important in atopic eczema, there have been few controlled studies to assess the extent of disturbance in affected children and the problems experienced by their parents. This study was designed to find out the degree of psychological difficulty experienced by children with atopic eczema, whether their mothers show higher levels of mental distress than a comparison group, and whether the families of children with atopic eczema have less social support than the comparison group. We investigated 30 school-aged children with atopic eczema for psychological problems using the Rutter parent scale and compared them with 30 children with relatively minor skin lesions such as viral warts. Mental distress in mothers was assessed using the General Health Questionnaire. The Family Support Scale was used to get a measure of the social support experienced by the families. We found twice the rate of psychological disturbance in children in the eczema group compared with the control group. This difference was statistically significant for children with moderately severe eczema and severe eczema, but not for children with very mild eczema. Levels of mental distress were no greater in mothers of children with eczema than in parents of the control group and there was no difference in the degree of social support experienced by their families. These findings indicate that school-aged children with moderate and severe atopic eczema are at high risk of developing psychological difficulties, which may have implications for their academic and social development.

The Pattern of Skin Diseases in Asir Region, Saudi Arabia: A 12-Month Prospective Study in A Referral Hospital

The literature on the pattern of skin diseases in Saudi Arabia is scanty. We have attempted to analyze the pattern of skin diseases seen in the dermatology unit of Asir Central Hospital, Abha, Southern Saudi Arabia, during a 12-month period from March 1992 to March 1993. All new patients who were seen for dematological complaints in the skin clinics, emergency room or in the wards were studied prospectively. A total of 1285 dermatoses were diagnosed in 1223 patients during the 12-month study period. Out of the top 12 groups diseases, eczema/dermatitis (25.68%) came first, followed by viral infections. Among the eczema group, atopic eczema accounted for 53.64% and was most frequently observed in children (110/177 or 62.14%) compared to adults. The main causes of superficial mycoses were dermatophytosis and candidiasis. Psoriasis was the most common papulosquamous disorder. Scabies was seen in expatriate Egyptians and Asiatics only. Primary pyogenic infections of the skin were uncommon. The pattern of skin diseases in Saudi Arabia shows a predominance of eczema. Viral infections and dermatophytosis are the most common infective dermatoses, while pyogenic infections are relatively uncommon.

Ｔｅｒｆｅｎａｄｉｎｅ（トリルダン錠）の湿疹・皮膚炎群，じん麻疹群に対する使用経験

湿疹·皮膚炎群45例, 蕁麻疹15例に対してterfenadine(トリルダン®錠)を使用し, 特にそう痒に対する効果について検討した。対象症例は湿疹·皮膚炎群45例(慢性湿疹23例, アトピー性皮膚炎10例, その他の湿疹·皮膚炎12例)と蕁麻疹群15例(急性蕁麻疹5例, 慢性蕁麻疹10例)計60例である。全般改善度が中等度以上の改善率は湿疹·皮膚炎群60.0%, 蕁麻疹群で80.0%であった。そう痒に限ってみた中等度以上の改善率は湿疹·皮膚炎群が51.1%, 蕁麻疹群は66.7%であった。副作用は1例(1.7%)にごく軽度の眠気が認められた。有用以上の有用度は湿疹·皮膚炎群が60.0%, 蕁麻疹群が80.0%であった。以上の結果よりterfenadineは湿疹·皮膚炎, 蕁麻疹といったそう痒性皮膚疾患に対して優れた止痒効果を有し, かつ従来の抗ヒスタミン剤, 抗アレルギー剤に比し眠気, 倦怠感の副作用が少なく, 有用性の高い薬剤であると考えられた。