Atopy dermatitis

As noted earlier, routes other than inhalation must also be eonsidered. Thus exposure to a substanee whieh ean be hazardous upon ingestion, absoiption tlirough tlie skin or mueous membranes, or eontaet with skin or mueous membranes needs eontrol to a standard sueh that nearly all the population eould be exposed repeatedly without any adverse health effeet. (Note that this will not neeessarily proteet those who are atopie or with a relevant pre-existing eondition, e.g. dermatitis.)... 

Atopy A genetic predisposition to develop type I hypersensitivity reactions against common environmental antigens commonly seen in patients with allergic rhinitis, asthma, and atopic dermatitis. 

The IgE-mediated food allergy is one of the main atopie diseases. Its symptoms, espeeially among ehildren, are not disease-eharaeteristie. GI symptoms observed after an ingestion of partieular food are eommonly thought to be the result of previously diagnosed respiratory or skin disorders, thus food allergy may remain misdiagnosed if it eoexists with asthma or atopie eezema/dermatitis. 

Dotterud LK, Falk ES. 1994. Metal allergy in north Norwegian schoolchildren and its relationship with ear piercing and atopy. Contact Dermatitis 31 308-313. 

Atopic dermatitis is the most common itchy dermatosis, with well-documented alteration in the stratum comeum function. Numerous studies have revealed an increase in the basal transepidermal water loss (TEWL) in the stratum corneum of patients with this condition. Of note, this increase in TEWL was also described in the clinically unaffected skin of atopies.2 There have been direct correlations shown between the degree of inflammation and severity of barrier impairment in atopic dermatitis. Despite these findings, to date there have been no definitive reports correlating degree of barrier function with itch variability. 

Fusidic acid and mupirocin has been proven to be equal in clinical efficacy 85-87 The risk of allergic contact dermatitis to fusidic acid in patients with AD can be considered very low. In an analysis of multicenter surveillance data in Germany, fusidic acid did not cause any case of sensitization in the subgroup of atopies.29 Topical neomycin, however, is rarely indicated not only because of inefficacy and high resistance rates, but also because of frequent development of allergic contact dermatitis.88,89... 

Nassif, A. et al., Abnormal skin irritancy in atopic dermatitis and in atopy without dermatitis. Arch. Dermatol. 130, 1402-1407, 1994. 

A thorough history for burning, stinging, and itching identifies sensory irritation and possible CUS. The history should include careful questioning of all topical products applied, as well as the time of onset in relation to exposure. Personal and family history of atopy should be actively sought, as should other skin conditions such as psoriasis and rosacea. A meticulous physical examination may identify other stigmata of atopic dermatitis, psoriasis, or other skin disease. 

Seidenari, S., Skin sensitivity, interindividual factors atopy, in The Irritant Contact Dermatitis Syndrome, Van der Valk, P.G.M. and Maibach, H.I., Eds., CRC Press, Boca Raton, FL, 1996. 

Ruiz, R. G., Kemeny, D. M., and Price, J. F. 1992. Higher risk of infantile atopic dermatitis from maternal atopy than from paternal atopy. Clin Exp Allergy 22 762-766. 

Revised European Task Force on Atopic Dermatitis (ETFAD) Key for Atopy Patch Test (APT) Reading... 

Roehr, C.C., Reibel, S., Ziegert, M. et al. 2001. Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis. J Allergy Clin Immunol 107 548-553. 

McFadden, J., White, J.M.L., Basketter, D., and Kimber, I. 2008. Reduced allergy rates in atopic eczema to contact allergens used in both skin products and foods Atopy and the hapten-atopy hypothesis. Contact Dermatitis 58(3) 156-158. 

Atopy denotes a hereditary predisposition for IgE-mediated allergic reactions. Clinical pictures include allergic rhinoconjunctivitis ( hay fever ), bronchial asthma, atopic dermatitis (neurodermatitis, atopic eczema) and urticaria. Evidently, differentiation ofT-helper (TH) lymphocytes toward the TH2 phenotype is the common denominator. Therapeutic interventions are aimed at different levels to influence pathophysiological events (A). 

Atopic dermatitis is a chronic inflammatory skin disorder that affects the epidermis and is characterized by eczema and itching. Two percent of the adult population is afflicted by atopic dermatitis, often with the earliest manifestation first appearing in childhood.The peak incidence occurs during the fourth or fifth decade.There is a femily tendency as well as a predisposition to allergy and asthma. Periorbital inflammation is a common manifestation of atopy. Acute manifestations include exudative lesions, erythema, and edema. Chronic manifestations include dry scaly lesions with lichenification. 

A 35-year-old man developed a subacute dermatitis with scattered patches of erythema and scahng on the lower legs, ankles, hands, and wrists. He had no history of atopy but a prior history of allergy to a leather watch-strap. He had taken various oral vitamin and mineral formulations for several weeks. Patch-testing showed reactions to potassium dichromate at 48 and 96 hours. 

A 49-year-old man developed acute pruritic dermatitis of the hand, which settled quickly with oral glucocorticoids and antibiotics (2). Six months later he developed a similar eruption, which became more widespread, involving the trunk and limbs. He had no personal or family history of atopy, and had no known allergies or previous... 

Personal Atopy (allergies, asthma, eczema) seborrheic dermatitis Work stress Gender Lower job status and pay Increased tear-film break-up time... 

Polster Holst R, Moises HW, Yang L, et al Linkage between atopy and the IgE high-affinity receptor gene at 1 lql3 in atopic dermatitis families. Hum Genet 1998 102 236-239. (Ill)... 

Liu X, Nickel R, Beyer K, et al An IL13 coding region variant is associated with a high total serum IgE level and atopic dermatitis in the German multicenter atopy study (MAS-90). J Allergy Clin Immunol 2000 106(1 pt 1) 167-170. (Ill)... 

Rystedt I Work-related hand eczema and atopies. Contact Dermatitis 1985 12 164. (Ill) Yunginger JW Natural rubber latex allergy in Middleton E Jr, Reed CE, Ellis EF, Adkinson NF Jr, Yunginger JW, Busse WW (eds) Allergy. Principles Practice. St. Louis, Mosby, 1998. (evidence not coded)... 

---