Dermatitis Extent Research Articles

English

BACKGROUND: Eczema of the hands and feet is one of the commonest conditions encountered in dermatologic practice affecting 1% of adults. The patch test is the only scientific proof of contact allergy, a positive reaction to a correctly prepared and applied patch test confirms the person has allergic contact sensitivity. There are not much studies done on the patterns of lower leg and foot eczema's especially from India. Hence this study tries to determine the patterns of lower leg and foot eczema and also to evaluate the common allergens by patch testing. The aim of this study is: To determine the pattern of lower leg and foot eczema. Confirm the common allergens responsible by patch testing using Indian Standard Series. METHODS: A prospective clinical study was done comprising of 50 clinically suspected cases of lower leg and foot eczema for a period of 2 years from September 2008 to September 2010. The study included 32 males and 18 females. An informed consent was obtained from all the patients and detailed history with particular emphasis on age of onset, site of initial lesion, extent of dermatitis, seasonal variation, aggravating factors and association with atopy were noted. RESULTS: Mean age of 50 patients in this study was 44.52 years with a standard deviation of 15.8 (range 7 - 70 years). The most common age group affected was 46- 60 years (40%), followed by 31-45 years (30%). 32 cases (64%) were males and 18 cases (36%) were females with a male to female ratio of 1.78: 1.0. Out of 50 cases, 23 patients (46%) showed positive patch test result to at least a single allergen. To the 26 allergens in Indian standard series tested, around 19 allergens were found to be positive. Some were having positivity to multiple allergens, giving a total of 51 positive results. Out of which 46 were relevant (90.20%) against which only 5 cases were non-relevant (9.80%) according to the history.

Splitting the scotoperiod: effects on feeding behaviour, intestinal fill and digestive transit time in broiler chickens

1. The aim of this study was to evaluate how splitting the dark period (scotoperiod) affects feeding behaviour and associated intestinal measures in broilers. 2. Ross 308 broilers were reared to 37 d in groups given either a daily 8-h continuous scotoperiod (DARK 8) or an intermittent light schedule with two equally spaced 4-h scotoperiods (DARK 4 + 4), which yielded the same total duration of darkness per 24 h. 3. Feeding behaviour was recorded weekly from 24-h video recordings of 24 groups each of 64 birds. Empty intestinal weights as well as their contents were measured weekly at 4 time points (n = 192). Digestive transit time was estimated on d 29 using a chromic oxide marker; production variables and the extent of foot pad dermatitis were also recorded. 4. In the 3 h prior to a scotoperiod, feeding activity increased in chickens from DARK 8 but not DARK 4 + 4. This increase was reflected in a higher relative content of the crop in DARK 8 at this time. 5. Immediately following the scotoperiod, feeding activity peaked and, although the chickens in DARK 4 + 4 expressed more feeding behaviour in the first 20 min after the scotoperiod, the chickens in DARK 8 had overall higher feeding activity across the day. However, DARK 4 + 4 had a higher feed intake and weight gain. The occurrence and severity of foot pad dermatitis was similar between treatments. 6. In conclusion, broilers modify their feeding behaviour according to the prevailing light schedule. Eight consecutive hours of darkness reduced growth, but did not affect overall feed conversion efficiency, and did not appear to exacerbate hunger or foot pad dermatitis to any great extent.

Levels of serum IgE, serum soluble-Fc epsilon RII, and Fc epsilon RII(+) peripheral blood lymphocytes in atopic dermatitis.

Levels of serum IgE, serum soluble-Fc epsilon RII (S-Fc epsilon RII), and Fc epsilon RII(+) peripheral blood lymphocytes (PBL) were examined in 73 patients with atopic dermatitis (AD) and 17 control subjects with no atopic disease, in order to investigate the correlation of these parameters with AD. AD patients showed increases in IgE, S-Fc epsilon RII and Fc epsilon RII(+)PBL as compared with control subjects. In AD patients, levels of serum IgE and Fc epsilon RII(+)PBL increased as the extent of dermatitis became more severe, while levels of serum S-Fc epsilon RII showed no correlation with the extent of dermatitis. In 8 of the 73 AD patients who showed an improvement in their symptoms with treatment with topical corticosteroids or antihistamine, IgE, Fc epsilon RII(+)PBL, and S-Fc epsilon RII were measured before and after treatment. Fc epsilon RII(+)PBL correlated with disease activity; IgE and S-Fc epsilon RII did not show any such correlation. Patients with elevated IgE levels (IgE greater than 5,000 U/ml) showed low levels of S-Fc epsilon RII. Severely affected cases with a history of respiratory atopy also showed decreased S-Fc epsilon RII levels. It is believed that S-Fc epsilon RII binds to IgE in serum and may neutralize or down-regulate IgE mediated allergic reactions. A low level of S-Fc epsilon RII may cause an elevation of IgE and an exacerbation of the disease.

UVA solarium versus UVB phototherapy of atopic dermatitis: a paired-comparison study

In a paired-comparison study, 21 patients suffering from atopic dermatitis were treated with fluorescent tubes radiating mainly ultraviolet A (UVA) on one half of the body and with tubes radiating mainly UVB on the other. Treatment was given three times a week for up to 8 weeks. Eight variables reflecting disease status were recorded and the sum of these comprised the total score. The total score and the overall evaluation score were better with UVA therapy (P less than 0.02 and P = 0.01, respectively). No statistically significant difference for the pruritus score was found. The reduction in extent of dermatitis, seen with both therapies, was more pronounced with UVA (P less than 0.05). Differences in the healing score were not statistically significant. Treatment with UVA resulted in healing or considerable improvement in 15 patients and 13 patients showed improvement when treated with UVB. A better result was found with UVA in 10 subjects and with UVB in two subjects. Equal results occurred with both UVA and UVB in nine of the patients although most preferred UVA treatment.

Recurrent viral infections in patients with past or present atopic dermatitis.

Histories of recurrent infections were obtained from 955 adults with past or present atopic dermatitis (AD) and from 199 controls. Patients who had previously been hospitalized in childhood because of severe AD had a significantly higher incidence of recurrent (greater than 5 episodes per year) cold sores and upper respiratory tract infections as well as a higher incidence of herpes zoster, than non-atopic controls. Patients with milder AD in childhood (never hospitalized) had lower incidence of these diseases, but as regards cold sores, the frequency of recurrent infections was still significantly higher than that of the controls. AD patients with past or present respiratory allergy had a slight but not statistically significant increased incidence of recurrent infections, as compared to AD patients without concomitant respiratory allergy. The factors predisposing to frequent infections appeared to be those related to severity of the atopic condition, i.e. ongoing AD, need for hospitalization in childhood and extent of dermatitis. The increased susceptibility to recurrent viral infections in AD patients is most probably related to dysfunctioning cell-mediated immunity.

Atopic dermatitis and IgE. Relationship between changes in IgE levels and severity of disease

At the Mayo Clinic, atopic dermatitis was evaluated in a series of 28 patients to determine whether, during the course of the disease, serum IgE levels fluctuated with changes in the severity of dermatitis. The study covered a 1- to 11/2-year follow-up period. Previously, it had been shown that, at initial examination, serum IgE levels were positively related to the extent of disease. Although notable fluctuations in serum IgE levels and in extent of dermatitis were seen in more than half of the cases, no relationship was found between the two factors during the period of study.