Diseases atopic dermatitis

In the pathogenesis of many chronic inflammatory diseases (e.g., rheumatoid arthritis, glomerulonephritis, colitis ulcerosa, Morbus Crohn, atopic dermatitis, psoriasis) autoimmune processes play an important role, too. Although first of all nonsteroidal antiinflammatory agents or glucocorticoids should be applied, immunosuppressive agents may also be indicated. 

For the topical treatment of some chronic inflammatory skin diseases (like atopic dermatitis) immunosuppressive macrolides (like TRL and pimecrolimus) that permeate the inflamed epidermis are of benefit for patients. Severe side effects comparable to those after systemic application of TRL in transplanted patients (see above) have not been observed so far. For the treatment of psoriasis vulgaris these drugs are less effective. The CD2 antagonist alefacept may be a suitable alternative to allergic reactions. 

PIH can be observed after endogenous or exogenous inflammatory conditions. Essentially any disease with cutaneous inflammation can potentially result in PIH in individuals capable of producing melanin. Several skin disorders such as acne, atopic dermatitis, allergic contact dermatitis, incontinenti pigmenti, lichen planus, lupus erythematosus, and morphea have PIH as a predominant feature. Exogenous stimuli,both... 

Connective tissue disease Substance abuse Stevens-Johnson syndrome Immunocompromised Atopic dermatitis Gonococcal infection Vitamin A deficiency... 

Eczema does not occur in the absence ofT cells. Here we provide an overview on the regulatory impact which T cells have on the establishment and maintenance of atopic dermatitis. Particularly, we outline the role of different T-helper cell subsets (i.e.Th-l,Th-2,T-regulatory andTh-17 cells) and their distinct influence on the cutaneous inflammatory reaction at different stages of the disease. Eczema is characterized by epidermal inflammation and thus T-cell/ker-atinocyte interactions are of particular relevance in this condition. Alterations in innate and adaptive immunity involving cells result in susceptibility to skin infections and in hyperreactivity reactions to environmental stimuli which in turn determine the course and severity of atopic dermatitis. Copyright 2008 S. Karger AG, Basel... 

Role of Adaptive Immune Responses in Atopic Dermatitis Involving IgE Responses In about 80% of adult patients with atopic dermatitis, the disease is associated with increased serum IgE levels, sensitization against aeroallergens... 

T Cells May Contribute to the Defects in Innate Immune Response in Atopic Dermatitis Most patients with atopic dermatitis are colonized with S. aureus and experience exacerbation of their skin disease after infection with this organism [2]. In patients with S. aureus infection, treatment with anti-staphylococcal substances can result in the reduction of skin disease. Binding of S. aureus to the epidermis is enhanced by atopic skin inflammation. This is supported by clinical studies demonstrating that treatment with topical corticosteroids or tacrolimus reduces S. aureus counts in atopic dermatitis. 

In addition, some patients with atopic dermatitis produce specific IgE antibodies directed against staphylococcal superantigens, which correlate with skin disease severity. Superantigens have been shown to penetrate into the dermis and higher doses have been shown to induce cutaneous inflammation when applied onto the skin. Low doses which do not induce visible clinical inflammation are still able to amplify aeroal-lergen-induced patch test responses [14]. 

Th-17 cells appear to be involved in protection against bacterial pathogens. In addition, Th-17 cells may also be crucial in the pathogenesis of various chronic inflammatory diseases that were formerly categorized as Th-1-mediated disorders. Whereas IL-17 may play an important role in the pathogenesis of psoriasis and contact hypersensitivity, its role in atopic dermatitis is still unclear [36]. In skin biopsy specimens recovered from acute and chronic skin lesions from patients with atopic dermatitis, IL-17 was preferentially associated with acute lesions [37]. 

Dust has been recognised as a trigger for asthma for many years and the allergens are present in the faeces of the house dust mite, of genus Dermatophagoides. They are members of the order Arachnida (close relatives of ticks and spiders). They live off human skin that has been shed and hence are present in bedding and carpets. Since they are not visible to the naked eye and are difficnlt to control, they can be overlooked as the canse of this distressing disease. They may also be a cause of perennial rhinitis and atopic dermatitis. 

Pimecrolimus (58 Elidel ) Ascomycin Macrolactum antibiotic Semi-synthetic NP Microbial Inflammatory skin diseases and atopic dermatitis Blocks T-cell activation 505-517... 

Dermatologic diseases Pemphigus bullous dermatitis herpetiformis severe erythema multiforme (Stevens-Johnson syndrome) mycosis fungoides severe psoriasis angioedema or urticaria exfoliative, severe seborrheic, contact, or atopic dermatitis. 

Both topical and systemic PUVA are useful in some patients with vitiligo, although repigmentation is rarely complete. Other skin diseases for which PUVA may be helpful include atopic dermatitis, dyshidrotic eczema, and polymorphous light eruption. 

Unlabeled Uses Treatment of alopecia areata, aplastic anemia, atopic dermatitis, Behpet s disease, biliary cirrhosis, prevention of corneal transplant rejection... 

Skin diseases Atopic dermatitis, dermatoses, lichen simplex chronicus (localized neurodermatitis), mycosis fungoides, pemphigus, seborrheic dermatitis, xerosis... 

Because of the effectiveness of systemic tacrolimus in some dermatologic diseases, a topical preparation is now available. Tacrolimus ointment is currently used in the therapy of atopic dermatitis and psoriasis. 

IL-5 is usually not present in high levels in humans. However, in a number of disease states where the number of eosinophils is elevated, high levels of IL-5 and its mRNA can be found in the circulation, tissue and bone marrow. These conditions include the diseases of the respiratory tract, hematopoietic system, gut and skin. Some other examples include food and drug allergies, atopic dermatitis, aspirin sensitivity and allergic or nonallergic respiratory diseases. 

Atopic dermatitis (AD) is a chronic, relapsing, pruritic, and inflammatory skin disease that frequently predates the development of allergic rhinitis and asthma [38],... 

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