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Introduction: Atopic dermatitis (AD) is a disease frequently occurring in children. The immune response is characterized by T-helper (Th)-2-dependent inflammation. Type 1 diabetes mellitus (T1DM) is an autoimmune disease that destroys pancreatic islet beta cells. In contrast, it is mainly mediated by a Th-1-dependent response. An inverted association has been hypothesized between T1DM and AD since Th1 and Th2 responses are mutually inhibitory. Methods: Data was retrieved from a nationwide healthcare database in Taiwan. A logistic regression model was used to evaluate the association of T1DM in patients with AD within a year. A Cox proportional hazards analysis was used to evaluate the subsequent risk of developing T1DM 1 year after AD diagnosis. Results: We identified 396,461 patients with AD and 1,585,844 age- and sex-matched controls. During the first year of follow-up, after adjusting variates, the association between T1DM and AD showed no statistical differences (odds ratio: 1.40; 95% confidence interval [CI]: 0.83–2.38, p = 0.207). After excluding those T1DM cases within 1 year of AD diagnosis and those with a follow-up duration of less than 1 year, AD did not significantly increase the risk of T1DM (hazard ratio [HR]: 1.02; 95% CI, 0.83–1.25, p = 0.843). Conclusions: Our study revealed that there was no significant association between AD and T1DM in the first year after AD diagnosis, and there was no increased risk of T1DM in AD patients in the average 5-year follow-up in our study. [ABSTRACT FROM AUTHOR]

Background: There have been some reports on the coexistence of psoriasis and atopic dermatitis; however, the longitudinal relationship between these two diseases remains unclear. Objective: This study aimed to investigate the bidirectional association between psoriasis and atopic dermatitis. Methods: This cohort study recruited patients from the National Health Insurance Research Database in Taiwan. We included 8,206 patients with psoriasis and 32,824 matched controls to assess the risk of atopic dermatitis and 25,743 patients with atopic dermatitis and 102,972 matched controls to assess the risk of psoriasis. Cox regression model was used for the analyses. Results: After adjusting for potential confounders, patients with psoriasis had a higher risk of atopic dermatitis (adjusted hazard ratio [aHR] 13.01; 95% CI 10.23–16.56) than the controls. Patients with atopic dermatitis had a higher risk of psoriasis (aHR 10.37; 95% CI 6.85–15.69) than the controls. Stratified analyses revealed similar results in both sexes and all age groups. Conclusion: Our study demonstrated a bidirectional association between psoriasis and atopic dermatitis, suggesting that psoriasis and atopic dermatitis are not mutually exclusive and may share some biological mechanisms. [ABSTRACT FROM AUTHOR]

Background: Several studies have suggested that vitamin D (VD) deficiency (VDD) is associated with atopic dermatitis (AD). However, little is known about the relationship between AD and vitamin A (VA). The interaction between VA and VD on AD requires further study.Objective: We detected serum levels of VA and VD in children with AD to explore how VA deficiency (VAD) and VDD affect AD severity.Methods: We assessed the SCORing Atopic Dermatitis (SCORAD) index, total immunoglobin E levels and peripheral blood eosinophil counts. VA and VD levels were determined with high-performance liquid chromatography. Correlations among variables were investigated with Pearson's correlation analysis.Results: The VD and VA levels were significantly lower in children with AD than in normal children (p < 0.001, p = 0.0423). Both VD and VA levels were negatively correlated with SCORAD scores. The SCORAD scores were significantly higher in AD patients with both VDD and VAD (co-deficiency) than in other AD patients. Significant inverse correlations were observed between peripheral blood eosinophil counts and serum VA and VD levels.Conclusions: VA and VD co-deficiency may exacerbate AD symptoms in children, but the specific mechanism underlying this relationship requires further study. These findings may indicate the need for studies evaluating the use of VD and VA as potential treatments for AD patients. [ABSTRACT FROM AUTHOR]

Background: Atopic patients are exceptionally sensitive to airborne allergens. Sensitization to fungal allergens may be associated with respiratory allergic disease (RAD) and atopic dermatitis (AD). This study investigates the relationship between sensitization to different fungal allergens and the clinical manifestations of atopic disease. Methods: We retrospectively reviewed the medical records of atopic patients from the National Taiwan University Hospital from 2004 to 2009. A total of 133 atopic patients were found who were sensitive to at least 1 of the 3 most common fungi (Candida albicans, Aspergillus fumigatus, Penicillium chrysogenum) in Taiwan and were enrolled in the study. These patients were further divided into subgroups of isolated AD, isolated RAD and AD + RAD. The association between sensitization to fungi and allergic disease was analyzed by logistic regression analysis. Results: The sensitization rate to Candida-specific IgE was 81.2%, followed closely by Aspergillus at 69.2% and Penicillium at 63.2%. Isolated AD was the most common diagnosis. The levels of specific IgE antibodies against Aspergillus, Candida and Penicillium were highest in patients with isolated AD. Logistic regression revealed that isolated AD was highly associated with sensitization to Candida [odds ratio (OR) 10.45, 95% confidence interval (CI) 2.37-45.9]. In contrast, sensitization to Penicillium (OR 0.34, 95% CI 0.13-0.87)and Candida (OR 0.30, 95% CI 0.10-0.92) showed a negative association with isolated RAD. Conclusions: Fungal sensitization is more closely associated with AD than RAD. Our results suggest that specific sensitization to fungal allergensplays a critical role in the pathogenesis of atopic disease. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]