Eczematous skin diseases Temesvári, Erzsébet
Orvosi hetilap,
2006-Oct-15, Letnik:
147, Številka:
41
Journal Article
Recenzirano
The skin, as one of the most important barriers of the human body, protects the inner homeostasis from the harmful environmental influences as well as physical, chemical and biological factors. When ...the impact of these factors exceeds the tolerance and reproducing capacity of the skin, pathological alterations will develop. If follows from this that dermatology can surely be considered to be a part of environmental medicine. Eczematous diseases are mostly pathological pictures of varied mechanisms developing as a result of environmental influences (irritants, contact allergens, microbes). Since their clinical appearance is similar, it is a serious professional challenge to diagnose them. In this article we present the clinical features, provoking factors of these skin diseases as well as therapeutical possibilities.
The purpose of this study was to determine whether cats with allergic skin disease have significant concentrations of serum Immunoglobulin E (IgE) specific for antigens derived from the house dust ...mites (HDM)
Dermatophagoides farinae (DF) and
Dermatophagoides pteronyssinus (DP). Enzyme-linked immunosorbent assays (ELISA) were developed for this purpose. Binding of serum allergen-specific IgE was detected via the use of biotinylated Fc-epsilon receptor alpha chain protein (FcɛRIα). Following optimisation of the assay, serum samples from 59 cats with allergic skin disease and 54 clinically normal cats were screened. Results were expressed as ELISA units per ml (EU/ml) compared to a standard curve. Serological findings were correlated with the clinical presentation of affected cats. Cats with symptoms of feline allergic skin disease were grouped as follows: self-induced alopecia without lesions (group 1), papulocrusting dermatitis (group 2), eosinophilic granuloma complex (group 3), papular/ulcerative dermatitis of head and neck/facial dermatitis (group 4), and a combination of symptoms (group 5). Control normal cats comprised the final group (group 6). The Kruskal–Wallis test was used for statistical analysis. There was no significant difference between groups for DF- and DP-specific IgE concentrations with a
p-value of 0.875 and 0.705, respectively. Although the FcɛRIα-based ELISA was able to detect house dust mite-specific feline IgE, the presence of this allergen-specific IgE correlates poorly with the presence of clinical manifestations of allergic skin disease. The results of this study question the clinical relevance of house dust mite-specific IgE in feline allergic skin disease.
Background: To improve health outcomes during the treatment for pruritic skin diseases, it is important to understand which factors most influence patients' concerns about oral antihistamine drugs. ...Objectives: To survey the nature of patients' concerns about oral antihistamine drugs and to examine the factors associated with them. Methods: Patients with pruritic skin diseases expressed their concerns regarding the use of oral antihistamine drugs. The independent effects of the patients' background characteristics on their concerns were examined by multiple logistic regression analysis. Results:A total of 291 outpatients were completed the study. Overall, 32% of patients were worried about using oral antihistamine drugs. The most common concern was about their adverse drug events (except drowsiness) and the effects of long-term use. Overall, being concerned about antihistamine use was found to be significantly and independently associated with a younger age, severe itching, being a homemaker, and having previous personal experience of embarrassment due to drowsiness caused by taking over-the-counter drugs. Conclusions:Several factors are associated with altered self-reported concerns about antihistamines. Our results suggest the importance of understanding the nature of patients' fears about oral antihistamine use so that sound advice can be offered to them in a timely manner.
Eczematous disorders in adolescence (definition WHO: the period between 10 and 20 years) are common and include mainly atopic dermatitis, contact eczema, and seborrheic dermatitis. They all share the ...similarity of inflammatory reactions which mainly affect the epidermis and can take a chronic course, depending on the underlying dermatosis. In the following article, the particularities of eczematous diseases in adolescents are discussed.
Only few reports about eczematous reactions overlying nevi flammei exist. All of them were observed in children. The description of an eczematous reaction within a congenital nevus flammeus on the ...left lower leg of a male adult gives reason to discuss this rare phenomenon. Eczema or inflammatory changes within a port-wine stain may mostly be a collision dermatosis with an atopic dermatitis, especially when they arise in children and are localized to the neck and face. When they are observed within a grossly visible vascular malformation, as for example in the Klippel-Trenaunay syndrome, they may have a pathogenesis similar to stasis dermatitis. In rare cases, an eczematous reaction within a nevus flammeus may be the result of genetic mosaicism and is interpreted as a variant of the so-called Meyerson phenomenon.
The authors report 4 cases of eczematous-like drug eruption after oral ingestion of synergistins, pristinamycin (3 cases) and virginiamycin (1 case). The lesions occurred after contact sensitization ...with topical virginiamycin. The clinical symptoms appeared a few hours after ingestion: a generalized maculopapular eruption, sometimes with general symptoms of anaphylactic reaction. Eczema appeared again on initial areas of contact dermatitis. There is a common allergenic group between these 2 antibiotics, which is a macrocyclic lactone. Physiopathology of this drug eruption is not clear: allergic reaction of the delayed type or anaphylactic reaction. Patients allergic to virginiamycin should be strongly cautioned against oral pristinamycin.
The most common clinical presentations of hand eczema are atopic hand dermatitis, pompholyx, and contact dermatitis (irritant contact dermatitis ICD, allergic contact dermatitis ACD). The diagnosis ...of hand dermatitis is determined by a review of the patient's medical history, a physical examination including other body sites as well as the hands, and a thorough overview of the patient's daily activities with emphasis on occupation and hobbies. Irritant contact dermatitis usually is diagnosed by the absence of a positive patch test result; however, patch testing is essential in confirming a clinical diagnosis of ACD by identifying the allergens to which the patient has been sensitized. Treatment includes topical and/or systemic corticosteroids to reduce inflammation and ceramide-containing moisturizers to repair the skin's barrier function. Topical calcineurin inhibitors may be alternatives to topical corticosteroids. The most important step in the management of hand eczema is prevention with physical protective products (e.g., gloves) or barrier protection creams.
