Atopic diathesis

If atopic dermatitis is addressed which criteria are used to diagnose atopic dermatitis or atopic diathesis ... 

With regard to subjects with atopic diathesis (xerosis and/or itching on sweating, white dermographism, wool intolerance, family history for atopy, etc.), it is advisable to perform ... 

A particularly vulnerable group comprises those who have or have had atopic dermatitis, and there is a risk that this may flare up in the office environment. Chemical products, paper and paper dust, friction, climatic factors, and stress are present, and their relative importance is hard to specify in individual cases. Patch testing is recommended in order to exclude elements of contact allergy. Immunoglobulin E, radio-allergosorbent test and prick tests help to verify an atopic diathesis. 

Atopic diathesis is indubitably a common human trait, but several factors make it difficult to obtain an absolutely accurate measurement of its true frequency (1) differences in definition of the state and of individual diseases that accompany it (2) significant influences of race, sex, and environmental factors in the production of clinical disease (3) the natural history of the individual conditions, with remissions and exacerbations, means that prevalence figures at any given time underestimate the number of patients actually at risk and (4) symptoms occurring in early life are often not recognized as atopic. However, one can estimate that at least one in five Western individuals will have experienced at least one atopic disorder by the age of twenty. The frequency of positive skin tests, with or without symptoms, indicates that about a third of the population carry the atopic predisposition (Davis, 1976 Godfrey and Griffiths, 1976). 

The possibility of hereditary factors has been raised on many occasions. Although animal experiments suggest that such factors do exist, recent research on this subject in man is scanty. All that can be gleaned from the older literature is that the existence of any such influence remains uncertain. It is nevertheless claimed that patients with an atopic predisposition or with the lupus erythematosus diathesis are more prone to drug reactions than normal people. 

It has to be distinguished between mucosal atopy (asthma, hay fever) and atopic skin diathesis (ASD) regarding the risk of developing OCD. Nowadays, there is sufficient evidence that mucosal atopy, without skin manifestations, is not associated with increased risk of ICD (Rystedt 1985 Diepgen and Fartasch 1993, Diepgen et al. 1993, Majoie et al. 1996). 

Table 7. Score of atopic skin diathesis (ASD-score) based on chi-square values without laboratory investigations (modified according to Diepgen et al. 1991, 1992) The statistical analysis is based on 428 atopic eczema (AE) patients and 628 non-eczematous controls.

Table 8. Relative risk and etiologic fi action for subjects with atopic skin diathesis (ASD) in bakers with notified occupational contact dermatitis (n = 107) The frequency of ASD in seased bakers was 61% (modified according to Tacke et al. 1995)...

Atopic skin diathesis is an important endogenous risk factor, or atopic dermatitis is activated by exposure... 

Irritants produce a wide range of clinical features. Cutaneous responses depend on the type of irritant (Table 2), the concentration at which the irritant comes into contact with the skin, the type of exposure, and the individual response. Clinical manifestations of ICD syndromes are also modified by external factors, such as environmental factors (mechanical pressure, temperature, and humidity) and predisposing characteristics of the individual (age, gender, ethnic origin, pre-existing skin disease, atopic skin diathesis and the anatomic region exposed) (Pinnagoda et al. 1989 Emtestam and OUmar 1993). 

At the beginning of the study, the test persons were examined anamnestically and clinically with the help of the atopy score (Diepgen et al. 1991). The purpose of this was to determine an existing atopic skin diathesis on the basis of this score in order to register constitutionally varying reactions to the irritation. 

Diepgen TL, Fartasch M, Hornstein OP (1991) Criteria of atopic skin diathesis. Derrnatosen 39 79... 

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