Presence Of Atopic Dermatitis Research Articles

#2247 Influence of the diagnosis of atopic dermatitis in childhood on the course of kidney function in young adulthood: a single-center study

Abstract Background and Aims Several studies demonstrated non-osmotic sodium-storage, especially in the skin. Patients with chronic kidney disease often suffer from skin symptoms and furthermore an association of advanced CKD-stages with inflammatory skin diseases has been shown. Additionally, in inflammatory skin disease atopic dermatitis an increased salt content was found in the affected skin areas. Thus we hypothesized that atopic dermatitis might have a detrimental effect on kidney function later in life. Method The retrospective case-control study using the patient files of a general medical practice included a randomly selected sample with a 2:1 matching technique. Initially, data of 114 patients who underwent J1-screening exam for adolescents (age 12-14) and also a follow-up examination in adulthood (over the age of 18) between January 1980 and April 2022 have been examined. By the time of inclusion they had to be over 18 years old and did not suffer knowingly from a kidney disease. Over the course of the study, patients for whom no creatinine value was recorded during the following examinations were excluded. Serum creatinine levels and eGFR were compared between the two groups at two assessment times (J1 in adolescence and Follow-Up in young adulthood) and within each group using a one-tailed t-test. A point-biserial correlation analysis was then performed. Results Biometric characteristics, gender distribution and kidney function for J1 as the first measurement point and for follow-up in young adulthood as the second one for both atopic dermatitis and control group are shown in Table 1. The statistical analysis showed that the two groups did not differ significantly in terms of gender distribution at both the first (X²(89) = 0.4918, p = 0.483103) and the second measuring point (X²(73) = 0.45, p = 0.50), therefore a gender bias in the results is unlikely. Furthermore, it was shown by a one-tailed, unpaired t-test for serum creatinine levels ​​at time J1 did not differ from those in the control group (t = 0.60, p = 0.28). This applies too for the corresponding eGFR according to Schwartz-Bedside (t = -0.47, p = 0.32). At the time of follow-up, 16 patients, 8 per group, were excluded due to a lack of creatinine values ​​- in this study using a hypothesis test, no significant difference in the creatinine values ​​was found between the two groups (t = 0.91, p = 0.18), consequently also not in the comparison of eGFR after CKD-Epi (t = -1.28, p = 0.10). Only when comparing creatinine values ​​and eGFR over time within the individual groups, a significant difference for each group was found. In the atopic dermatitis group, the creatinine levels and the eGFR differed significantly in between J1 and the follow-up examination (creatinin: t = 4.29, p = 0.00015, eGFR: t = 1.83, p = 0.042). Likewise did the creatinine levels and the eGFR differ significantly over time in the control group (creatinine: t = 4.77, p < 0.00001 and eGFR: t = 5.72, p < 0.0001). In the point-biserial correlation analysis, no connection between the presence of atopic dermatitis and the level of the serum creatinine value could be confirmed (t = 0.6, df = 89, p = 0.55, 95% CI [-0.14, 0.27], r = 0.063). Conclusion In our study, the diagnosis of atopic dermatitis in childhood does not seem to be a determinant risk factor for a decline in kidney function in young adulthood.

Investigation of the relationship between atopic dermatitis of dogs and intestinal epithelial damage.

A significant association between atopic dermatitis and leaky gut syndrome has been demonstrated in humans. No studies have been conducted to determine whether there is an association between atopic dermatitis and intestinal damage in dogs. This study aimed to determine whether there is an association between canine atopic dermatitis and intestinal damage using selected intestinal-related biomarkers. Twenty-six dogs with atopic dermatitis and 10 healthy dogs were included. Moderate-to-severe pruritus, erythema, erosion and alopecia on different parts of the body were sought in dogs to suspect atopic dermatitis. The presence of atopic dermatitis was confirmed by an allergic skin test.Serum biomarkers including intestinal fatty acid binding protein (I-FABP), intestinal alkaline phosphatase (IAP), trefoil factor-3 (TFF-3), immunoglobulin E (IgE), interleukin-4 (IL-4) and interleukin-13 (IL-13) concentrations were measured from venous blood samples. Of the 26 dogs tested for allergens, 16 were found to be sensitive to mould mites, 10 to vernal grass, eight to house dust mites, five to wheat dust and five to grass pollen mix allergens. Significant increases in serum IAP, TFF-3, IgE, IL-4 and IL-13 concentrations were determined. It was thought that the increase in TFF-3 and IAP concentrations may be due to the presence of intestinal epithelial damage and the repair of this damage. In addition, the development of atopic dermatitis may be predisposed to the entry of allergens into the body through sites of intestinal damage.

The causal relationship between atopic dermatitis and brain cancer: A bidirectional Mendelian randomization study.

Atopic dermatitis ranks among the prevalent skin disorders. Research has indicated a potential association with brain cancer. Yet, establishing a direct causal relationship between atopic dermatitis and brain cancer continues to be challenging. We extracted single nucleotide polymorphisms (SNPs) significantly associated with atopic dermatitis (sample size=382 254) at a genome-wide level from a large Finnish Genome-Wide Association Study (GWAS) dataset (n cases=15 208, n controls=367 046). Summary data for 372 622 cases of brain cancer (n cases=606, n controls=372 016) were obtained via the IEU Open GWAS database. We employed the Inverse Variance Weighted (IVW) method as our primary analytical approach for Mendelian Randomization (MR) analysis. Additionally, heterogeneity was measured using Cochran's Q value, and horizontal pleiotropy was evaluated using MR-Egger 、Mendelian Randomization Pleiotropy RESidual Sum and Outlier and leave-one-out analyses. The risk of brain cancer increases with the presence of atopic dermatitis, as evidenced by the odds ratios (ORs) and 95% confidence intervals (CIs),(OR=1.0005; 95% CI=1.0001, 1.0009;p=0.0096). However, when conducting the analysis in reverse, no significant link was observed. The findings from our study indicate a causative link between atopic dermatitis and brain cancer, highlighting the importance of conducting broader clinical investigations into their potential association going forward.

Lifetime prevalence and associated factors of itch with skin conditions: Atopic dermatitis, psoriasis and dry skin in individuals aged over 50.

Itch, common in dermatological conditions, is often accompanied by psychological distress and reduced quality of life. However, research on the prevalence and associated factors of itch with skin conditions in general populations is limited. This cross-sectional study aimed to determine the lifetime prevalence of itch with skin conditions and identify its associated factors in middle-aged and elderly individuals. Participants from the Rotterdam Study, a population-based cohort, were interviewed to assess whether they had ever had an itchy skin condition, defining lifetime itch with skin conditions. Over 20 demographic, lifestyle, dermatological, and non-dermatological factors were collected. Multivariable logistic regression analysis explored associations between these factors and itch with skin conditions, reported as odds ratios (ORs) with 95% confidence intervals (CIs). 5,246 eligible participants (age range: 51-100, median age: 67, female: 56.0%) revealed a lifetime prevalence of 33.7% for itch with skin conditions. Female sex (OR (95% CI): 1.26 (1.11-1.43)), body mass index (1.02 (1.01-1.03)), self-reported and presence of atopic dermatitis (4.29 (3.74-4.92), and 1.97 (1.60-2.43)), self-reported and presence of psoriasis (2.31 (1.77-3.01), and 2.11 (1.55-2.87)), self-reported dry skin (1.95 (1.73-2.29)), self-reported asthma (1.40 (1.08-1.83)), renal impairment (1.45 (1.17-1.79)), and clinically relevant depressive and anxiety symptoms (1.85 (1.52-2.25), and 1.36 (1.11-1.66)) were significantly associated with it. This study reveals a substantial one-third lifetime prevalence of itch with skin conditions in individuals aged over 50. Significant associations with diverse lifestyle, demographic, dermatological and, intriguingly, non-dermatological factors including renal impairment, imply additional contributors to itch induction or persistence in individuals with skin conditions.

Retrospective Analysis of the Effect of Comorbid Atopic Dermatitis on the Treatment Response to Topical Immunotherapy in Pediatric Alopecia Areata Patients.

Alopecia areata is an organ-specific autoimmune disease. In addition, treatment options are limited in pediatric patients. Topical immunotherapy treatment may be preferred, especially in pediatric patients with severe and/or refractory alopecia areata. In this study, it was aimed to examine the effect of atopic dermatitis, which is one of the poor prognostic factors in pediatric alopecia areata, on topical immunotherapy treatment. The data of patients aged 18 years and younger who received at least 20 sessions of topical immunotherapy with the diagnosis of alopecia areata in our clinic between January 2018 and December 2020 were analyzed. A total of 139 patients were included in the study. The mean age of the patients was 10.29 years, 67 (48.20%) of the patients were female, 72 (51.80%) were male, 24 (17.26%) of the patients had mild disease, 115 of them (82.73%) had severe disease. Atopic dermatitis accompanying alopecia areata was detected in 38 of the patients. Inadequate response was obtained in 60 (43.17%) patients and adequate response was obtained in 79 (56.83%) patients with topical immunotherapy treatment. In addition, the presence of atopic dermatitis in the patient group with inadequate response to treatment was found to be statistically significantly higher than the patient group with adequate response to treatment. Topical immunotherapy treatment was found to be effective in 56.83% of pediatric alopecia areata patients included in the study. Our study showed that questioning pediatric alopecia areata patients for atopic dermatitis before topical immunotherapy treatment can predict the response to treatment.

Mental health comorbidity in youth with atopic dermatitis: A narrative review of possible mechanisms.

The presence of atopic dermatitis (AD) in youth has been linked to a variety of mental health concerns including disruptive behavior, symptoms of anxiety and depression, and diagnoses of attention deficit/hyperactivity disorder and autism spectrum disorder. However, the factors accounting for these relationships are not well understood. The current review summarizes possible mechanisms identified in previous research and highlights areas for future investigation. Among the primary mechanisms studied to date, child sleep is the only factor that has been characterized in relative detail, with findings generally supporting the mediating role of sleep problems in the relationship between AD and psychological symptoms. There is substantial evidence suggesting a negative impact of child AD on parent mental health and the impact of parent mental health on child psychological functioning, although the latter has not been assessed specifically in populations of children with AD. There is also preliminary support for other mechanisms, including pruritus and pain, atopic comorbidities, social functioning, and systemic antihistamine use, in the development of mental health concerns in pediatric AD. Furthermore, research suggests the presence of bidirectional relationships between AD and psychological functioning via inflammatory responses to stress and impaired treatment adherence. Overall, significant additional research is needed to better characterize the nature and magnitude of the relationships among these multiple mechanisms and various psychosocial outcomes. Nevertheless, the findings to date support routine screening of psychological health in patients with AD as well as screening for potential risk factors, which may also serve as targets of therapeutic intervention.

Bloody Stool in Infants: A Pediatric Allergy View

Objective: The prevalence of food allergy (FA) has gradually increased. Bloody stool is among the symptoms associated with non-immunoglobulin E (IgE) mediated FA in infants. In our study, we shared the clinical characteristics of the patients who applied to our clinic with bloody stool. Material and Methods: The data of the patients with bloody stool were reviewed. Patients’ characteristics and the time of onset of tolerance in patients with FA were recorded, retrospectively. Results: The 110 patient files were reviewed. 68% of the patients were diagnosed with FA (63 proctocolitis/12 enterocolitis), 22% with an anal fissure, and 9% with nonspecific colitis. The most common causative food was cow milk (57%), the second was the combination of egg and milk (24.2%), and the third was egg (18.2%). The presence of atopic dermatitis (AD) and eosinophil count at the time of admission did not affect tolerance development time but it was shown that skin prick test (SPT) positivity and the high level of total IgE at the time of admission delayed the development of tolerance [(p=0.02), (r=0.510, p=0.009)]. Conclusion: Bloody stool is one of the common complaints in infants. It does not always indicate a FA. The clinic is mild when the underlying disease is non-IgE mediated FA. However, accompanying IgE-type sensitivities negatively affect the prognosis. Elevated total IgE and SPT positivity at the time of diagnosis may give an impression that tolerance of baked products could be delayed in this type of allergy.

Protective Role of Vaccination against Tuberculosis and Hepatitis B in Prevention of Atopic Dermatitis: Report on Intermediate Results of Prospective Cohort Study

Background. Studies have shown that vaccination in the first hours/days after birth shifts the immune response from intrauterine Th2 towards Th1-type activation and reduces the risk of atopic conditions. However, we did not find published data from prospective studies on this topic.Objective. The aim of the study is to define the presence of negative correlation between vaccination against tuberculosis and hepatitis B in the first hours/days of life and atopic dermatitis development in infants.Methods. Continuous prospective study of children cohort born from April to June 2021 and observed in one outpatient’s clinic was carried out. Data from 307 infant’s records (F. 112/y), vaccination record cards (F. 063/y), prenatal and delivery records (F. 113/y-20, section № 3), and neonatal discharge summaries were analyzed for the decreed period. The child vaccination status (by the time of vaccination against tuberculosis and hepatitis B), presence of risk factors for allergic disease development, and presence of atopic dermatitis were evaluated.Results. Atopic dermatitis (AD) was significantly less likely to be diagnosed by the age of 1 year in infants from the group of BCG-M vaccinated at maternity hospital than in those vaccinated later or not vaccinated at all (15.2% versus 66% and 35.7%, respectively; p < 0,01). AD was less likely to develop in children with risk factors for allergic disease who were vaccinated against tuberculosis in the maternity hospital than in those vaccinated later or unvaccinated at all (18, 75 and 62.5%, respectively; p < 0.01). The ratio of children with diagnosed AD by the age of 12 months was significantly less in the group of children vaccinated against hepatitis B in the maternity hospital than in those vaccinated later or unvaccinated at all (17.6, 44.9 and 31.8%, respectively; p < 0.01). These ratios for children with risk of allergic disease development were 24%, 50% and 44.4%, respectively (p = 0.043). It has also been shown that timely vaccination with both vaccines in the early neonatal period significantly reduces the risk of AD in general infant population compared to non-vaccinated individuals or those who had only one vaccine (odds ratio [OR] 0.374; 95% confidence interval [CI] 0.253-0.552; p < 0.01). Whereas the disease development in children with allergic risk is less likely with timely vaccination (20.8% versus 53.3%; OR = 0.252; 95% CI 0.145–0.440; OR = 0.374; 95% CI 0,253–0,552; p < 0,01).Conclusion. The obtained results may indicate possible risk reduction for AD development due to timely preventive vaccination against tuberculosis and hepatitis B, especially in children with allergic risk. The study is currently ongoing.

Quality of Life in Food Allergy: Validation of the Korean Version of the Food Allergy Quality of Life Questionnaire Parent Form (K-FAQLQ-PF) and Risk Factor Analysis

This study aimed to evaluate the reliability and validity of the Korean version of the Food Allergy Quality of Life Questionnaire-Parent Form (K-FAQLQ-PF) and to identify clinical characteristics related to low quality of life (QoL) in Korean children with food allergy (FA). Parents of 0-12-year-old patients with FA were enrolled. The English version of FAQLQ-PF was translated into Korean. Construct validation was confirmed by the Food Allergy Independent Measure-Parent Form (FAIM-PF) and the Child Health Questionnaire Parent Form 28 (CHQ-PF28). Logistic regression analyses were used to evaluate associations between potential risk factors and QoL outcomes. A total of 182 patients with a median age of 5.0 years were enrolled in the study. Cronbach's α coefficient values indicating internal consistency were higher than 0.8. Intraclass correlation coefficient values for test-retest reliability were good for all age groups (r > 0.6). Total K-FAQLQ-PF scores were positively correlated with the FAIM-PF (r = 0.56, P < 0.05) and were negatively correlated with the parental impact-emotional domain in the CHQ-PF28 (r = -0.44, P < 0.05). In multivariable logistic regression analysis, low QoL was significantly associated with female sex (adjusted odds ratio [aOR], 2.07; 95% confidence interval [CI], 1.03-4.18), age ≥ 5 years (aOR, 2.84; 95% CI, 1.31-6.16), FA diagnosis before the age of 3 years (aOR, 3.96; 95% CI, 1.13-13.93), the presence of atopic dermatitis (aOR, 2.21; 95% CI, 1.07-4.57), and residence in non-metropolitan areas (aOR, 3.44; 95% CI, 1.73-6.85). According to parental perceptions, the K-FAQLQ-PF is a valid and reliable tool to assess psychosocial QoL in Korean children with FAs. Age, sex, residential area, and comorbid AD can affect the QoL of pediatric patients with FA.

Registry analysis of patients with severe allergic asthma and clinically relevant sensitization to fungal allergens treated with genetically engineered biologics

Background. Fungal sensitization (FS) often escapes the attention of clinicians when assessing the spectrum of sensitization in patients with atopic diseases. According to cohort studies is found in 310% of the general population and in 720% of asthmatics; the proportion of patients with severe bronchial asthma (SBA) with HS ranges from 35 to 75%. Fungal conidia have a 1000-fold higher exposure and are among the most important clinically relevant allergens in asthma. Exposure to fungal allergens is capable of generating a sustained T2 response with production of proinflammatory cytokines such as IL-5 and 13, which is indirectly related to the severity of airway eosinophilia. The identification of specific serum IgE is considered the benchmark diagnostic sign of FS, and the encapsulated hydrophobic carrier polymer system is considered preferable to skin prick tests. The process of reclassifying diseases with fungal lung lesions is confusing treatment strategies, leaving the FS problem underestimated. A series of publications have shown that omalizumab and other biologics targeting IL-5 or IL-5 receptor (IL5R) alpha are effective in treating SBA with FS. However, there remains an unmet need in real clinical practice for standardized approaches to genetically engineered biological therapies (BT) for different phenotypes of SBA, especially those associated with impaired microbiological homeostasis and this type of sensitization.&#x0D; Aim. Using retrospective analysis of clinical-dynamic observational data from patients on BT treatment in a real clinical setting to determine phenotypic features of severe allergic bronchial asthma with FS and to perform additional detailed analysis of a cohort of patients on anti-IgE therapy.&#x0D; Materials and methods. A retrospective observational single-center registry study was conducted between June 2017 and August 2021 at the City Reference Center for Allergology and Immunology. The baseline cohort consisted of 198 patients with severe allergic AD who were in the initial phase of BT. Inclusion criteria: age of patients over 18 years; presence of severe allergic bronchial asthma. Complex initial examination of patients included determination of FS by two methods: ImmunoCap ISAC to fungal allergic components alt a1, alt 6 (fungi of genus Alternaria) and asp f1, asp f3, asp f6 (fungi of genus Aspergillus). Specific IgE determinations on fungal panels. Sensitization to fungi was detected in 47 people during allergy examination. The following criteria were considered in evaluation of response to omalizumab: AST score less than 19 and/or difference between initial AST score and this score in dynamics less than 3 points; FEV 1 score less than 80; combination of 2 listed criteria. The minimum period of BT was 16 weeks. Nonparametric methods of descriptive statistics were used: median, interquartile range. Differences were considered significant at p0.05. Data were statistically processed using nonparametric methods in IBM SPSS Statistics V-22 program. MannWhitney U-test and KruskalWallis one-way analysis of variance were used to compare quantitative characteristics. Fisher's 2 test was used to compare qualitative characteristics.&#x0D; Results. Characteristics of the eosinophilic phenotype of SBA combined with FS: middle-aged patients, more often women, with relatively early onset of AD and high baseline eosinophil levels before prescription of biological drug therapy. Concomitant atopic dermatitis and food allergies are additional frequent features of this phenotype. Analysis of the effect of FS on achieving response to omalizumab and further consideration of switching to alternative therapy in SBA and FS patients showed the need to avoid premature revision and perform no earlier than the 10th month of therapy due to delayed response formation. Given the aggressive impact of FS on the barrier functions of the bronchial tree epithelium, it is advisable to test patients for FS at the initial diagnosis of AD. In the presence of atopic dermatitis and/or food allergy as T2 comorbidities in patients with SBA, early testing for FS and increased control of local and systemic inflammation are appropriate, which may improve long-term outcomes and reduce risks of further damage to natural barriers.&#x0D; Conclusion. Further research on various aspects of FS and its role in allergic diseases is extremely relevant in the current context.

Значення колонізації шкіри Staphylococcus aureusта дріжджовим грибом Malassezia в дітей у розвитку атопічного дерматиту

Patients with atopic dermatitis have a disrupted epidermal barrier, which is one of the prerequisites for the colonization of bacteria and fungi on the affected skin. Purpose - to investigate the presence of Staphylococcus aureus and Malassezia species skin colonization in patients with atopic dermatitis. Materials and methods. Skin swabs were taken in 83 patients with atopic dermatitis and 70 healthy children to determine Staphylococcus aureus skin colonization. The level of Malassezia colonization in the samples was determined by polymerase chain reaction. Results. The affected skin in patients with atopic dermatitis was significantly more often colonized with Staphylococcus aureus than in healthy children (OR=3.974 (1.861-8.486)). SCORAD was significantly higher in Staphylococcus aureus carriers (p&lt;0.05). In the subgroup of Staphylococcus aureus carriers, children were older and the duration of disease was longer (p&lt;0.05). Malassezia restricta and Malassezia globosa were found in 11 patients with atopic dermatitis and 10 healthy children. The prevalence of Malassezia by species depended on sex and the presence of atopic dermatitis. Conclusions. Staphylococcus aureus skin colonization is significantly more prevalent in children with atopic dermatitis than in healthy people. Malassezia species are common on the skin of both patients with atopic dermatitis and healthy people, but the ratio of species may vary depending on the presence of disease. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author. Key words: Staphylococcus aureus, Malassezia, atopic dermatitis, children.

Personal Exposure to Total VOC Is Associated With Symptoms of Atopic Dermatitis in Schoolchildren.

BackgroundThe urinary levels of volatile organic compound (VOC) metabolites provide individual exposure levels compared to data obtained by measuring these compounds in ambient air. We aimed to investigate the association between personal urinary concentrations of VOC metabolites and symptoms of atopic dermatitis in schoolchildren.MethodsNine urinary VOC metabolites were analyzed from urine samples of 149 children. Diagnosis of atopic dermatitis was determined using standardized questionnaires. Pediatricians visited the schools and rated the severity of symptoms using the SCORing Atopic Dermatitis (SCORAD) in all children.ResultsForty-five children (30.2%) had atopic dermatitis based on the International Study of Asthma and Allergies in Childhood (ISAAC) results and 35 children (23.8%) had symptoms of atopic dermatitis with positive SCORAD index values (defined as SCORAD ≥ 5). Children with benzylmercapturic acid detected in personal urines were associated with presence of atopic dermatitis and positive SCORAD index values. Children in the highest quartile of mandelic acid concentration were associated with presence of atopic dermatitis and positive SCORAD results.ConclusionPersonal exposure to VOCs, as indicated by urinary levels of VOC metabolites, was associated with presence of atopic dermatitis and the SCORAD index value.

Association Between Prenatal Exposure to Metals and Atopic Dermatitis Among Children Aged 4 Years in Taiwan

The prevalence of atopic dermatitis has substantially increased in recent decades, and atopic dermatitis could lead to allergic airway inflammation later in life. A previous study found that inorganic arsenic exposure was associated with allergic airway inflammation in children aged 8 to 14 years. However, the association between prenatal exposure to arsenic and other metals and the risk of atopic dermatitis among young children remains unknown. To assess the association between prenatal exposure to arsenic and other metals and the occurrence of atopic dermatitis in children at age 4 years. In total, 1152 pregnant women were enrolled in the original Taiwan Maternal and Infant Cohort Study (TMICS), a multicenter birth cohort study conducted at 9 hospitals in northern, central, southern, and eastern Taiwan from October 2012 to May 2015. Of those, 586 mothers and children aged 4 years participated in follow-up questionnaire interviews from August 2016 to January 2019. After excluding 216 participants with missing data, the final statistical analysis of follow-up data included 370 mother and child pairs from the central and eastern regions of Taiwan. Data were analyzed from February 2 to August 12, 2021. Arsenic, cadmium, lead, cobalt, copper, nickel, thallium, and zinc during pregnancy. The outcome was parent-reported atopic dermatitis history among children aged 4 years. The presence of atopic dermatitis was defined as a positive response to the question, "Has your child ever had atopic dermatitis diagnosed by a physician?" During the initial TMICS study period, concentrations of arsenic, cadmium, lead, cobalt, copper, nickel, thallium, and zinc were measured in maternal urine during the third trimester of pregnancy using an inductively coupled plasma mass spectrometer. Estimated total inorganic arsenic exposure was calculated using a model that included data on both total arsenic and arsenic species (arsenite, arsenate, monomethylarsonate, and dimethylarsenate) obtained from a previous TMICS cohort. Among 370 children included in the analysis, the mean (SD) age was 3.94 (0.59) years; 208 children (56.2%) were male, and 267 children (72.2%) were from the central region of Taiwan. A total of 110 children (29.7%) had atopic dermatitis at age 4 years. Maternal estimated total inorganic arsenic exposure during pregnancy was associated with increased odds of atopic dermatitis among children at age 4 years (odds ratio [OR], 2.42 [95% CI, 1.33-4.39] for every doubled increase of total inorganic arsenic) after adjusting for parental allergies, child's sex, geographic area, maternal educational level, and exposure to tobacco smoke. Every increased unit in the weighted quantile sum index of maternal metal exposure was significantly associated with atopic dermatitis (OR, 1.63; 95% CI, 1.28-2.07). Arsenic (40.1%) and cadmium (20.5%) accounted for most of the metal mixture index. This cohort study found that prenatal exposure to inorganic arsenic and coexposure to inorganic arsenic and cadmium were associated with a higher risk of atopic dermatitis in young children. These findings suggest that prevention of exposure to inorganic arsenic and cadmium during pregnancy may be helpful for the control of atopic dermatitis and other potential allergies in children.

Evolution of bronchial obstruction pattern in children of presсhool age

Introduction. The diagnosis of asthma presents objective difficulties in children aged less than 5 years. Not all children with recurrent virus-induced obstruction can further develop asthma.Aim. To assess the realization of different clinical and pathogenetic variants of bronchoobstructive syndrome in the child population.Materials and methods. Risk factors of 75 patients with bronchoobstructive syndrome in the first 5 years of life were retrospectively evaluated. 57 patients were surveyed using the “Asthma Prediction Tool” questionnaire. At the end of the follow-up period (one year), cases of bronchial asthma were evaluated.Results. A predictive contribution to the implementation of the recurrent variant of bronchoobstructive syndrome has a burdened hereditary allergic anamnesis (OR=5,4, CI 1,79-16,46, p&lt;0,05) and the presence of atopic dermatitis (OR=7,7, CI 2,73-21,95, p&gt;&lt;0,05). Symptoms of allergic rhinitis in combination with hypertrophy of the Palatine tonsils in 6,06 and 3,45 times, respectively, increase the risk of bronchial asthma (p&gt;&lt;0.05). Conclusion. As a result of research, there are significant factors in the implementation of bronchial asthma such as concomitant allergic diseases in combination with a hereditary background and hypertrophy of the palatine tonsils. The&gt;˂ 0,05) and the presence of atopic dermatitis (OR=7,7, CI 2,73-21,95, p˂ 0,05). Symptoms of allergic rhinitis in combination with hypertrophy of the Palatine tonsils in 6,06 and 3,45 times, respectively, increase the risk of bronchial asthma (p˂ 0.05).Conclusion. As a result of research, there are significant factors in the implementation of bronchial asthma such as concomitant allergic diseases in combination with a hereditary background and hypertrophy of the palatine tonsils. The “Asthma Prediction Tool” questionnaire allows you to predict the development of bronchial asthma in patients with episodic and recurrent bronchial obstruction. The article will be useful for both pediatricians and primary care professionals, as it allows to rationally influence the risks of bronchial asthma formation.

Gut microbiota development during infancy: Impact of introducing allergenic foods

The gut microbiota potentially plays an important role in the immunologic education of the host during early infancy. We sought to determine how the infant gut microbiota evolve during infancy, particularly in relation to hygiene-related environmental factors, atopic disorders, and a randomized introduction of allergenic solids. A total of 1303 exclusively breast-fed infants were enrolled in a dietary randomized controlled trial (Enquiring About Tolerance study) from 3 months of age. In this nested longitudinal study, fecal samples were collected at baseline, with additional sampling of selected cases and controls at 6 and 12 months to study the evolution of their gut microbiota, using 16S ribosomal RNA gene-targeted amplicon sequencing. In the 288 baseline samples from exclusively breast-fed infant at 3 months, the gut microbiota was highly heterogeneous, forming 3 distinct clusters: Bifidobacterium-rich, Bacteroides-rich, and Escherichia/Shigella-rich. Mode of delivery was the major discriminating factor. Increased Clostridium sensu stricto relative abundance at 3 months was associated with presence of atopic dermatitis on examination at age 3 and 12 months. From the selected cases and controls with longitudinal samples (n= 70), transition to Bacteroides-rich communities and influx of adult-specific microbes were observed during the first year of life. The introduction of allergenic solids promoted a significant increase in Shannon diversity and representation of specific microbes, such as genera belonging to Prevotellaceae and Proteobacteria (eg, Escherichia/Shigella), as compared with infants recommended to exclusively breast-feed. Specific gut microbiota characteristics of samples from 3-month-old breast-fed infants were associated with cesarean birth, and greater Clostridium sensu stricto abundance was associated with atopic dermatitis. The randomized introduction of allergenic solids from age 3 months alongside breast-feeding was associated with differential dynamics of maturation of the gut microbial communities.

Immunohistochemical Analysis of Prurigo Nodularis in 209 Patients: Clinicopathological Analysis between Atopic and Non-Atopic Patients and between Treatment Response Groups.

BackgroundPrurigo nodularis (PN) is a highly pruritic disease that significantly impairs patient quality of life. Although the mechanism that causes pruritus is not clear, one hypothesis argues that neural hyperplasia, mast cell, and Merkel cell neurite complexes may be associated with PN pathogenesis.ObjectiveThe objective of this study was to analyze whether special staining outcomes differed depending on the presence of atopic dermatitis (AD) and treatment response.MethodsA total of 209 patients diagnosed with PN was analyzed retrospectively. Patients were divided into two groups according to presence or past history of AD and by treatment response. Histopathologic features were obtained using the following stains: Giemsa, S-100, neuron-specific enolase, cytokeratin (CK)-20, CAM5.2, and CK8/CK18.ResultsA total of 126 patients (60.29%) had AD, and 68 (32.54%) showed clinical improvement. There were no statistically significant differences in the staining results between the PN groups with AD (PN c AD) and without AD (PN s AD). Additionally, there were no statistically significant differences in staining results between the improved and non-improved groups.ConclusionImplementing the special stains helped to identify PN pathogenesis. Because there were no statistically significant differences in the special stain results between the improved and non-improved groups, we conclude that mast cell proliferation, neural hyperplasia, and Merkel cell hyperplasia may not have a significant effect on treatment response.

Association of serum lipid parameters with the SCORAD index and onset of atopic dermatitis in children

The association between dyslipidemia and atopic dermatitis in children is unclear. This study investigated the association between dyslipidemia and atopic dermatitis in children by analysis of disease onset, risk factors, and disease severity. Subset I examined 7-year-old children in elementary school (n=248), and Subset II was a retrospective long-term follow-up hospital-based study (n=52725) conducted from 1986 to 2016 that used propensity score matching. In the Subset I study, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) were determined, and the SCORing Atopic Dermatitis (SCORAD) index was determined. In the Subset II study, the time of atopic dermatitis onset was determined for asymptomatic subjects whose TC levels were below or above 170mg/dL. Our Subset I study indicated that children with atopic dermatitis (n=69, 27.8%) had significantly higher levels of TC and TG, and that the SCORAD index had significant associations with high levels of TC and TG, and a low level of HDL-C. Our Subset II study (1722 with high TC and 6735 with normal TC after propensity score matching) indicated the high TC group had a greater hazard ratio (HR) for the onset of atopic dermatitis (consensus-based HR: 2.47; 95% CI: 1.23, 5.06, P=.012) during 5years. An abnormal blood lipid profile in children is associated with the presence of atopic dermatitis and the SCORAD index. The risk of atopic dermatitis onset was significantly greater with high levels of TC.

Effectiveness of secondary prevention in metalworkers with work-related skin diseases and comparison with participants of a tertiary prevention program: A prospective cohort study.

In Germany, a multistep approach has been established to prevent work-related skin diseases (WRSDs). To evaluate the effect of a secondary individual prevention program (SIP) in metalworkers with WRSD and to compare their characteristics with those of participants of a tertiary individual prevention program (TIP). In a prospective cohort study, metalworkers with WRSD of the hands participating either in the SIP (n = 114) or in the TIP (n = 83) were recruited. At baseline and at the respective follow-up 8-12 weeks after the SIP or at dismissal from the TIP (3-4 weeks later), questionnaires were completed and the severity of WRSD was assessed. Saliva samples were collected for assessment of filaggrin (FLG) mutations and an explorative genome-wide association study (GWAS). Ninety-three SIP patients (81.6%) attended the follow-up. Disease severity was significantly reduced, and knowledge and protective behavior were significantly improved compared to baseline. Significant differences between SIP and TIP patients were found regarding duration and severity of symptoms, work absenteeism, tobacco smoking, and presence of atopic dermatitis, but not regarding FLG mutations and by GWAS. The SIP was effective in metalworkers with WRSDs. Individual factors may influence the course of the disease and the need for the TIP.

Zinc has a role in pathogenesis of pityriasis alba

Background: Pityriasis alba (PA) is a common disease of children and seen in most of the developing countries. The exact pathogenesis of PA is still not well established. Some cases of PA have been associated with atopic dermatitis, while most cases have no association with it. Objectives: The objective was to evaluate the role played by zinc (Zn) in the pathogenesis of PA. Patients and Methods: Sixty patients suffering from PA were included in the study, and 30 apparently healthy individuals of matching age and sex were recruited as a control group. Serum Zn, hemoglobin, and albumin were measured in both groups. In addition, skin phototype and body mass index were recorded. The American Academy Criteria of atopic dermatitis diagnosis were applied to the participants in this study. PA patients were examined dermatologically with a recording of the site, size, and number of lesions. Results: There was no difference in the presence of atopic dermatitis between the patient and control groups (P = 0.672). PA lesions were detected in the faces of all patients. There were no statistically significant differences between patients and controls regarding serum hemoglobin concentration (P = 0.763) or serum albumin (P = 0.487). The serum level of Zn was lower in patients with PA than controls (P

Influence of silk clothing therapy in patients with atopic dermatitis.

The existence of red, inflammatory, and chronic itchy condition in the skin is commonly speculated as the presence of Atopic Dermatitis (AD) in patients. The use of silk clothing as a non-pharmacological approach in the management of AD has been noticed as an effective alternative therapy; however, the evidence based on its usage is poorly served. Hence, we aim to evaluate the effectiveness of using pure silk clothing in the therapy of AD patients. The clinical trial was performed by recruiting 30 patients with AD for up to 8 weeks of observation. They were instructed to wear pure silk clothing for the whole day without any additional medication and were investigated using the AD-related questionnaires. The findings revealed a significant decrease of AD occurrence along with a great improvement of patient’s quality of life at each time point. Our investigation demonstrated that this treatment promotes good skin appearance, comfort, and remarkable improvement in the quality of life. This promising preliminary outcome warrants a further study; hence, it can be a potential non-pharmacological treatment choice for controlling the severity of AD.