Eczema allergic manifestation

It is indicated in subjects already sensitised with serums of animal origin, existence of prior or present allergic manifestations (asthma, eczema, etc.), burns, injuries, open and compound fractures unimmunized or inadequately immunised mothers. 

Type I. Anaphylactic immediate hypersensitivity. The allergen reacts with tissue cells, such as mast cells or basophils that have been sensitized by antibody, which release vasoactive substances into the bloodstream. Anaphylaxis, which is characterized by an immediate (within 15 minutes) vasoconstriction, bronchoconstriction, shock, and in severe cases, death, is a Type I reaction, as are angioedema (vascular engorgement) and atopy. Atopy, a syndrome mediated by Type I reactions, is a genetic susceptibility to such allergic manifestations as hay fever, eczema, asthma, and urticaria (hives). 

ATOPY A SYNDROME resulting from a genetic susceptibility to allergic manifestations. Symptoms include hay fever, ECZEMA, asthma, and URTICARIA. 

Atopy refers to the allergic sensitivity that certain individuals develop towards common and mostly innocuous environmental antigens such as dust mites, plant pollens and animal proteins. The condition of atopy generally manifests itself clinically in the form of asthma, hay fever, eczema or allergic rhinitis. The development of an atopic condition has been associated with the generation of predominately Th2 biased immune response to the particular allergen, and is thus often referred to as a Th2 based disease (Romagnani, 1994). 

Allergic disorders of the eyelid include atopic dermatitis, contact dermatitis, and urticaria. Eczema is a common feature of both atopic and contact dermatitis.Table 27-5 summarizes the clinical manifestations and management of each entity. 

In the first clinical demonstration of specific probiotic strains modifying the changes related to allergic inflammation (i.e. tertiary prevention), a randomised double-blind controlled trial was carried out in Finland. A small number of infants who manifested atopic eczema while exclusively breast-feeding were weaned to probiotic supplemented Bifidobacterium lactis or Lactobacillus) extensively hydrolysed whey formulas, or to the same formula without probiotics. A significant improvement in skin condition occurred in patients given probiotic-supplemented formulas. The concentration of soluble CD4 in serum and eosinophilic protein X in urine were reduced, indicating that probiotics may counteract inflammatory responses beyond the intestinal milieu [186(Ib)]. 

In contrast, strategies aimed at secondary prevention can be based on the early manifestation of the IgE-mediated disease or even disease preceding IgE sensitisation, which usually occurs during infancy. Potential interventions include allergen avoidance measures to induce tolerance and early immunotherapy. Data have been provided that the early administration of pharmacotherapy in infants who have already developed atopic eczema can attenuate the allergic march into asthma (see Chapter 3, Early Immunological Influences). 

In Ippen s (1978) case of contact eczema, the epicutaneous test, with isoniazid as substance or as pulverized tablets (from several manufacturers), showed in all instances definite eczema reactions which exceeded the test areas and required local treatment with corticosteroids. Wang and Schmeo (1974) report the case of a patient with occupational allergy to isoniazid. Beside the allergic reaction of the immediate type (asthma bronchiale) there was a latent sensitization of the delayed reaction type (eczema reaction). This latent sensitization was manifested in a circumscribed area by the epicutaneous test. Reexposure to the allergen led to an asthmatic spasm of the bronchi and to recrudescence of the eczematous cutaneous efflorescences when it was inhaled. 

Individuals with an atopic disposition can develop atopic eczema, aUergic rhinitis, or allergic asthma. Presently, there is sufficient evidence that these different atopic manifestations are not always associated with an increased risk for OCD. Two important issues have to be distinguished ... 

The individual atopic conditions have different natural histories. Although any one may develop for the first time at any age, each tends to have a typical pattern. Individual patients may have only a single manifestation, or multiple manifestations either sequentially or concurrently. Gastrointestinal reactions to foods are most common in the first year and are often transient. Eczema also tends to develop in the first few months of life. Roughly 50% continue to have some disease activity into adult life. Childhood asthma often improves around puberty, but presentation in early adult life is also common. Allergic rhinitis may be associated with any of the previous conditions in childhood, but when occurring alone, has a peak onset between 15 and 25 years. 

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