Which aeroallergens are associated with eczema severity?

Atopic Dermatitis: Conventional and Integrative Medicine

Although Western medicine and ideas about atopic dermatitis (AD) have become popular in many Asian countries, local beliefs about the disease and its treatment often prevail. The multi- racial background of these countries as well as the influence of the diverse religions (such as Taoism and Ramadan) in these regions often lead to diverse belief systems about the causes of AD (such as the Chi concept, also known as the balance of yin and yang) and the types of treatment (e.g. herbal remedies, topical versus concoctions, and decoctions). In addition, many of the cultural practices are preserved among the Southeast Asian minorities residing in the United Kingdom and North America. Eastern treatments typically take a holistic approach to AD and emphasize the psychosomatic component of the disorder. This overview provides a summary of the difference between conventional, complementary, alternative, and integrative medicine in terms of epidemiology, aetiology, therapy, and prognosis in children with AD. There are a number of similarities in genetic and environmental factors in epidemiology and aetiology; however, differences exist in terms of the concept of management. Complementary and alternative medicine, traditional Chinese medicine, and integrative medicine usage are not only prevalent among the Asian population but are also becoming more popular and accepted in Western societies.

Cat Allergy as a Source Intensification of Atopic Dermatitis in Adult Patients

Atopic dermatitis (AD) is characterized by exacerbations and remissions of eczematous skin, underlain by impaired skin barrier and aberrant Th2-type and Th-22 cytokine production. A number of allergens, in particular contact with fur animals, may aggravate the disease. This study seeks to define the influence of having a regular contact with a pet cat at home on the severity of symptoms and signs of AD. We addressed the issue using the SCORing Atopic Dermatitis (SCORAD) and visual analog (VAS) scores to assess the intensity of pruritus and by measuring the blood content of specific IgE and IL-4, IL-13, and IL-22 cytokines. The study group consisted of 47 adult patients suffering from AD since childhood, 18 of whom declared having regular contact with a cat and the remaining 29 who denied it. There also was a control group consisted of 16 healthy volunteers with no AD signs. The SCORAD and VAS scores were significantly higher in patients in contact with a cat than in those without it (median SCORAD 61.0 vs. 50.4 and VAS 9.0 vs. 4.0 points, respectively). The sIgE of a majority of patients (94.4%) in contact with a cat was in Class V-VI, compared with just a few patients (3.4%) with no such contact, having sIgE in the same classes (p < 0.001). Significant correlations were revealed between SCORAD and VAS scores and the class level of serum sIgE value. In addition, IL-22 was a single elevated cytokine, only in the patients in contact with a cat, and it correlated with pruritus severity. The results of the study underline the need to beware of the cat fur allergen, and they stress forethought and caution in acquiring and keeping a pet cat by patients suffering from AD.

Atopic dermatitis is a serious health problem in Poland. Epidemiology studies based on the ECAP study

Introduction

Global epidemiological studies have revealed considerable geographical differences in prevalence of atopic dermatitis (AD).

Aim

To present the epidemiology of AD, risk factors and co-occurrence of allergic diseases in the Polish population.

Material and methods

The present paper is a part of the Epidemiology of Allergic Disorders in Poland study. We studied 22 703 participants by ECRHS/ISAAC questionnaire; 18 617 (53.8% female, 24.2% 6–7 y.o., 25.4% 13–14 y.o., 50.4% 20–44 y.o.) completed questionnaires were accepted. Four thousand seven hundred and eighty-three participants (25.7%) have undergone a medical examination.

Results

Atopic dermatitis was diagnosed in 3.91% (6–7 y.o. 5.34%, 13–14 y.o. 4.3%, adults 3.02%), more often in females (OR = 1.52; 95% CI: 0.56–0.77), in the cities (OR = 2.23; 95% CI: 1.61–3.09), in mothers (OR = 2.07; 95% CI: 1.72–2.48) and fathers (OR = 2.00; 95% CI: 1.61–2.49) with atopy, higher education (OR = 1.61; 95% CI: 1.11–2.32) and economic status (OR = 1.35; 95% CI: 1.04–1.74). The highest prevalence was found in Katowice (4.89%) and lowest in rural areas (1.9%). Coexisting AD and allergic rhinitis (AR) was found in 26.17%, AR and asthma in 9.09% and AD, AR and asthma in 14.6%. Atopic dermatitis was diagnosed by allergologists in 6.5% (6–7 y.o. 8.7%, 13–14 y.o. 9.0%, adults 3.6%). Most diagnoses were made in Poznan (16.76%) and smallest in rural area (3.67%). 78.8% of subjects were diagnosed with AD for the first time although they had earlier experienced its symptoms.

Conclusions

Atopic dermatitis prevalence in Poland is below the mean rate for Europe, but the risk factor profile is similar to other countries. Atopic dermatitis is more frequent in well-educated females with atopic parents and high socioeconomic status and who live in a city.

Skin prick testing in atopic eczema: atopic to what and at what age?

BACKGROUND

Atopic eczema is a common and distressing disease. This study aimed to review the age-dependent pattern of atopic sensitization to food and aeroallergens in patients with eczema by skin prick testing.

METHODS

The results of skin prick test (SPT), serum IgE, bronchial challenge test, and family history of atopy in eczema patients seen at a pediatric dermatology clinic were reviewed.

RESULTS

SPT results were available in 816 eczema patients. In these patients, 90% had atopic sensitization to at least one aeroallergen, 69% to at least one food allergen, and 94% to at least one allergen by SPT. Together with a family history of atopy in parents or siblings and a personal history of airway atopies, 97% and 99.8% of the patients were atopic, respectively. Bronchial hyper-reactivity (BHR) was demonstrated in 44% of 339 patients. Aeroallergen was more prevalent than food allergen sensitization among children older than 10 years. The mites (D. pteronysissnus, D. farinae and Blomia Tropicalis) were the most prevalent allergens regardless of age and BHR, but D. pteronysissnus and D. farinae sensitization were more prevalent among BHR-positive patients. Beef is the least sensitized food protein in all ages.

CONCLUSIONS

The majority of patients with eczema are atopic to aeroallergens. The mites (D. pteronysissnus, D. farinae and Blomia Tropicalis) are the most prevalent allergens regardless of age and BHR.

Atopy in children with eczema

OBJECTIVE

To explore the prevalence of common food and aeroallergens sensitization in early childhood skin diseases. and to compare the pattern of common food and aeroallergens sensitization before and after 6 months among infants with atopic dermatitis (AD).

METHODS

All skin prick tests (SPTs) performed on children pound18 months of age managed at the pediatric dermatology clinic of an university-affiliated teaching hospital over a 16-month period were examined.

RESULTS

There was generally no difference in the pattern of sensitization to common food and aeroallergens between AD patients and non-AD young children with miscellaneous dermatological or gastrointestinal conditions. Dust mites were the only common aeroallergens in these patients; whereas egg and peanuts were the common sensitizing food allergens. Cat and dog fur as aeroallergens, soy bean, orange and beef as food allergens were relatively uncommon among the studied subjects. In AD, infants pound 6 months were generally naive to aeroallergens but became sensitized to the D. Pteronyssinus in the next 12 months of age. 80% of these infants were not sensitized to cow's milk and none sensitized to soybean.

CONCLUSION

Atopic sensitization to common allergens was common in early childhood with or without AD. Majority of young infants were not sensitized to milk, and develop eczema before they show atopy to the milk or soy allergens.

Patterns of food and aeroallergen sensitization in childhood eczema

AIM

To compare the patterns of Type 1 sensitization of common food and aeroallergens among infants and older patients with atopic dermatitis (AD).

METHODS

All skin prick tests (SPTs) performed over a 6-month period were examined, and patients with urticaria were used for comparison.

RESULTS

Dust mite was the most common aeroallergen and dog dander the least common. Egg white was the most common food allergen and beef the least common. Dust mite and peanut sensitization was more prevalent in AD than in urticaria. Dust mite sensitization was more prevalent in older children than infants with AD. Cow's milk sensitization only occurred in one-tenth of these patients. Prevalence of sensitization to common aeroallergens, but not food allergens, was generally higher in children beyond 5 years of age.

CONCLUSION

Milk sensitization is far less prevalent than egg white, and the prevalence does not change beyond infancy. There is no significant change in prevalence in many of the common food allergens beyond infancy. Many infants with AD develop eczema before they show atopy to the common food and aeroallergens. The SPT information is useful in reassuring parents of the unlikelihood of severe Type 1 immediate IgE reaction to some of the common food and aeroallergens, so that empirical and multiple food avoidance/restriction can be avoided.