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Skin disease and its therapy affect health-related quality of life (HRQoL). The aim of this study was to measure the burden caused by dermatological therapy in 3,846 patients from 13 European countries. Adult outpatients completed questionnaires, including the Dermatology Life Quality Index (DLQI), which has a therapy impact question. Therapy issues were reported by a majority of patients with atopic dermatitis (63.4%), psoriasis (60.7%), prurigo (54.4%), hidradenitis suppurativa (54.3%) and blistering conditions (53%). The largest reduction in HRQoL attributable to therapy, as a percentage of total DLQI, adjusted for confounders, was seen in blistering conditions (10.7%), allergic/ drug reactions (10.2%), psoriasis (9.9%), vasculitis/ immunological ulcers (8.8%), atopic dermatitis (8.7%), and venous leg ulcers (8.5%). In skin cancer, although it had less impact on HRQoL, the reduction due to therapy was 6.8%. Treatment for skin disease contributes considerably to reducing HRQoL: the burden of dermatological treatment should be considered when planning therapy and designing new dermatological therapies. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD), a common childhood skin disorder, can limit a child's learning and physical activities. South Korean mothers, as primary caregivers, experience anxiety and helplessness when caring for their ill children. The aim of this study was to develop a hybrid AD education programme (consisting of a face-to-face session followed by 8 online sessions) and evaluate its effects on anxiety, caregiving efficacy and caregiving behaviour among mothers of children with AD. Twenty mothers of patients with AD treated in a South Korean hospital received one on-site session and 8 weekly online modules. After the intervention, mothers' mean ± standard deviation anxiety reduced (from 50.3 ± 14.2 to 31.7 ± 6.3 points, t = 5.75, p < 0.001). Their caregiving efficacy and caregiving behaviour improved significantly, from 18.3 ± 3.5 to 29.4 ± 3.2 points (t = -9.64, p < 0.001) and from 47.7 ± 7.7 to 78.8 ± 4.9 points (t = -14.4, p < 0.001), respectively. The effects of the hybrid education programme for this population were significant. Healthcare providers should consider examining the programme nationwide, including in rural areas, while investigating its long-term effects. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic, itchy, inflammatory skin disorder that may worsen due to stress and anxiety. Tachykinins have been suggested to be involved in the inflammation in AD, as well as pruritus. Aprepitant is a NK-1 receptor antagonist. This open randomized trial evaluated the effect of aprepitant added to topical treatment in adult patients with moderate-severe AD. The treatment group (n = 19) received 80 mg/day aprepitant for 7 days as a supplement to standardized topical treatment with a moderately strong steroid and a moisturizer. The control group (n = 20) received topical treatment alone. Patients were monitored for the extent of the disease (using SCORing of Atopic Dermatitis; SCORAD), pruritus, and scratching movements. In both the aprepitant-treated and the control groups there was a decrease in SCORAD, pruritus and scratching movements. However, there was no significant additional improvement in any of these parameters in the aprepitant-treated group compared with the control group. [ABSTRACT FROM AUTHOR]

A cross-sectional study was performed to assess symptoms of suicidality, depression and anxiety in adult patients with atopic dermatitis. The study describes the relationships between these psychiatric symptoms and skin-specific factors, such as atopic dermatitis severity and skin satisfaction. A sample of 181 German patients with atopic dermatitis was compared with a control group of 64 persons with healthy skin with a similar age and sex distribution. Standardized questionnaires were used to assess suicidality (Pöldinger's Scale), depression and anxiety (Hospital Anxiety and Depression Scale; HADS), quality of life (Dermatology Life Quality Index; DLQI), atopic dermatitis severity (Patient-Oriented Scoring Atopic Dermatitis; PO-SCORAD) and skin satisfaction (Skin Satisfaction Questionnaire; SSQ). The prevalence of suicidal ideation among patients with atopic dermatitis was high (21.3%); 3.9% scored above the cut-off that might be an indicator for acute suicidality. Depression symptoms, high severity of atopic dermatitis, lower age, and little touching within the family were identified as significant factors to predict suicidality in atopic dermatitis. Psychiatric screening in dermatological treatment of atopic dermatitis is discussed. [ABSTRACT FROM AUTHOR]

Interleukin-19 (IL-19), a pro-inflammatory cytokine known to stimulate the production of T helper type 2 (Th2) cytokines, is induced by IL-17A and highly expressed in the lesional skin of psoriasis and atopic dermatitis (AD). This aim of this study was to investigate whether IL-19 is involved in cutaneous T-cell lymphoma (CTCL) and AD. IL-19 levels were significantly higher in the sera of patients with AD and those with advanced-stage CTCL than in normal controls, correlating significantly with clinical disease markers. IL-19 mRNA levels in lesional skin of both diseases were significantly elevated. Immunohistochemical staining revealed that IL-19 was expressed in the epidermis of AD skin and CTCL skin. In vitro, IL-17A and IL-4 increased IL-19 mRNA expression in human keratinocytes. Thus, IL-19 was increased in the sera and skin of AD and CTCL. These results suggest that IL-19 is important for bridging Th17 to Th2 in these diseases. [ABSTRACT FROM AUTHOR]

Adult atopic dermatitis (AD) is associated with overweight, obesity and cardiovascular diseases (CVD) in Americans, similarly to psoriasis, but no increased risk of CVD has been shown in European patients with AD. This study investigated the prevalence and risk of gallstones in adults with AD and in those with psoriasis as a proxy for obesity using nationwide data for all Danish citizens ≥ 30 years of age. Outcome was a diagnosis of gallstones. Odds ratios (ORs) were calculated by logistic regression (cross-sectional study) and hazard ratios (HRs) were estimated by Cox regression (cohort study). The study comprised 6,742 patients with AD, 53,810 patients with psoriasis, and 3,534,164 general population subjects. The prevalence of gallstones was 3.8%, 3.5% and 5.0% in the general population, AD and psoriasis patients, respectively. Adjusted ORs were 0.81 (0.71-0.92) for AD and 1.18 (1.14-1.23) for psoriasis. During follow-up, adjusted HRs were 0.72 (0.56-0.90) for AD and 1.10 (1.02-1.18) for psoriasis. The findings highlight important differences in obesity and lifestyle factors among patients with AD and those with psoriasis. [ABSTRACT FROM AUTHOR]

Cyclosporine A is an immunosuppressive agent that suppresses pruritus and is currently used in the treatment of patients with severe atopic dermatitis. The aim of this study was to elucidate the antipruritic mechanism of cyclosporine A using a mouse model of atopic dermatitis. Intraperitoneal injection of cyclosporine A (5 mg/kg) significantly reduced epidermal nerve density, number of scratching bouts, dermatitis scores, and transepidermal water loss, as well as decreasing the numbers of inflammatory cells in the dermis and decreasing epidermal thickness. Intraperitoneal injection of cyclosporine A dose-dependently inhibited increased itch-related receptor gene expression, such as interleukin-31 receptor A and neurokinin-1 receptor, in the dorsal root ganglion of atopic dermatitis model mice. Thus, the antipruritic efficacy of cyclosporine A may involve reduced epidermal nerve density and expression levels of itch-related receptor genes in the dorsal root ganglion, as well as improvement in acanthosis and reduction in cutaneous inflammatory cell number. [ABSTRACT FROM AUTHOR]

Inflammatory cytokines can impair the skin barrier, but the question as to whether barrier alterations affect keratinocyte immune responses remains unanswered. The aim of this study was to investigate whether immune-mediated skin inflammation differs between severe atopic dermatitis patients with or without filaggrin mutation. The levels of filaggrin, inflammatory T helper 2 polarizing cytokines (thymic stromal lymphopoietin (TSLP) and interleukin 33 (IL-33)) and chemokine (C-C motif) ligand 27 (CCL27), histological severity markers, T-cell and dendritic cell counts in biopsies from lesional skin of severe atopic dermatitis patients with and without filaggrin mutation and healthy skin were quantified by immunohistochemistry. The results were confirmed by quantitative PCR analyses. No significant differences were found between the 2 patient groups. Expression of atopic dermatitis-specific cytokines showed significant correlation with histological severity. These findings suggest that the immune-mediated skin inflammation (represented by keratinocyte-derived factors, T-cell and dendritic cell counts) is similar in the 2 patient groups with severe atopic dermatitis, and that immune activation is connected to the severity of the disease rather than to the origin of barrier alterations. [ABSTRACT FROM AUTHOR]

Safety data with respect to kidney function during long-term treatment with cyclosporine A (CsA) in patients with atopic dermatitis is limited. Data on serum creatinine levels before, during and after CsA treatment were collected in a retrospective cohort of adult patients with atopic dermatitis. The median duration of treatment of 150 patients was 280 days (interquartile range 203-528 days). There was a significant, but not clinically relevant, increase in serum creatinine compared with the baseline level after 3 weeks of treatment with CsA and stabilization during the maintenance phase at the group level. Twenty-two (14.7%) patients had a greater than 30% increase in serum creatinine (cut-off point for clinically relevant change) compared with baseline. These patients were significantly older than the patients without a 30% increase (mean ± standard deviation age 41.4 ± 15.6 vs. 33.8 ± 11.7 years (p = 0.01)). During follow-up, all patients had a less than 30% increase in serum creatinine levels compared with baseline levels. At the group level serum creatinine levels during follow-up were not significantly different from baseline. [ABSTRACT FROM AUTHOR]

The article presents a study which determines the effectiveness of empowering heliotherapy (EHT) in improving the health-related quality of life (HRQoL) of patients with psoriasis and atopic dermatitis (AD). Information regarding the dermatology life quality index (DLQI) of patients, the analysis of data through generalizing estimating equation models, and the use of systemic and topical medication, are mentioned.

Psoriasis is a chronic skin disease mediated by Th17 and/ or Th1 cells. Tim-3 is a cell surface molecule preferen-tially expressed on Th17 and Th1 cells. The interaction of Tim-3 with Tim-3 ligand inhibits cytokine production. To assess whether T cells in psoriasis have functional abnormalities, expression of cell surface Tim-3 on blood T cells producing interleukin-17 (Th17/Tc17 cells) or interferon-&ggr; (Thl/Tcl cells) was examined by flow cyto-metry. Psoriasis patients had higher numbers of Th17 and Tc17 cells, as well as Th1 and Tel cells, than healthy donors. However, Th17, Th1 and Tel cells in psoriasis did not efficiently express Tim-3 upon activation, com-pared with those from atopic dermatitis and healthy do-nors. Tim-3- cells showed more potent cytokine produc-tion than Tim-3 cells. Impaired Tim-3 expression allows Th17, Th1 and Tel cells to escape from Tim-3-mediated negative regulatory systems and may contribute to the pathogenesis of psoriasis. [ABSTRACT FROM AUTHOR]

We describe here 4 patients with Sezary syndrome mas-querading as adult-onset atopic dermatitis. The patients presented with a clinical picture compatible with wide-spread atopic dermatitis and did not fulfil the criteria for Sezary syndrome (lack of lymphoadenopathy and blood involvement, skin histology without presence of atypi-cal cells). In our patients, overt Sezary syndrome deve-loped after immunosuppressive treatment (including cyclosporine). These cases support the validity of the concept of pre-Sezary syndrome, which is a long-lasting, pre-malignant condition, and which may develop to true malignancy in a state of immunosuppression. [ABSTRACT FROM AUTHOR]

Differences in itch characteristics between different in-flammatory dermatoses are not well described. The aim of this study was to assess differences in itch characteris-tics between patients with psoriasis and atopic dermati-tis using a previously validated web-based questionnaire that was made available through the National Psoriasis Foundation and National Eczema Association for Science and Education websites. Participants rated frequency and intensity of itch, associated symptoms, itch descrip-tors, and effect of scratching. A total of 524 subjects with atopic dermatitis and 195 subjects with psoriasis comple-ted the survey. Atopic dermatitis responders experienced more frequent and more intense itch. Associated sweating and heat sensation were also more common in atopic der-matitis. Scratching was considered pleasurable in both atopic dermatitis and psoriasis; pleasurability correlated weakly with itch intensity in atopic dermatitis. Psoriasis respondents reported higher embarrassment associated with itch. Itch sensation is experienced differently among patients with atopic dermatitis and psoriasis. Future therapeutic interventions may be developed to target these differences. [ABSTRACT FROM AUTHOR]

To study the prevalence of atopic dermatitis, allergic rhinitis, and asthma in Taiwan, we analysed the claims data of a nationally representative cohort of 997,729 enrolees from the National Health Insurance register from 2000 to 2007. Overall, 66,446 patients were diagnosed with atopic dermatitis, and 49.8% of them had concomitant allergic rhinitis and/or asthma. The overall 8-year prevalences of atopic dermatitis, allergic rhinitis, and asthma were 6.7%, 26.3% and 11.9%, respectively. Children and adolescents had significantly higher prevalences of these atopic diseases. The prevalence of atopic dermatitis in females was lower than that in males before the age of 8 years, but became higher after that. Patients with atopic dermatitis were more likely to have allergic rhinitis and asthma. Those having both atopic dermatitis and allergic rhinitis possessed an even higher risk for asthma (odds ratio 9.04). The numbers of visits for atopic dermatitis were highest in late spring to mid-summer. These data suggest that atopic diseases are common in Taiwan. [ABSTRACT FROM AUTHOR]

In order to explore the mechanisms of inflammatory skin disorders, we established two methods of expanding skin-derived lymphocytes, one using high levels of interleukin (IL)-2 and IL-4 (method A) and the other using low levels of cytokines and anti-CD3/CD28 microbeads (method B). Both methods provide advantages for functional studies. With either of these two, we could obtain more than 107 cells/ from a 3 mm skin biopsy in 21 days from 23 out of 26 biopsies of various skin diseases. The relevance of these cells was confirmed by shifted T-cell receptor β chain variable region (TCR-Vβ) repertoire and antigen-dependent proliferation in antigen-driven skin disorders. The propagation of skin-resident lymphocytes, seen especially in method A, seems to be mediated by a functional defect of regulatory T cells residing in skin sequentially expanding under the conditions of our methods. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) has been sub-classified into extrinsic and intrinsic types according to the presence or not of allergen-specific IgE antibodies. Although total serum IgE levels are frequently elevated in AD, their potential to predict allergen-specific IgE (asIgE) has rarely been studied. We investigated 103 children with AD and suspected allergen-specific sensitization. A thorough clinical examination, a structured medical history and total serum IgE and asIgE measurements were performed. Fifty-three male and 50 female patients, median age 35 months (range 3 months to 17 years), were recruited. Sixty-three percent of patients were aslgE positive, while 37% did not reveal such IgE antibodies; median total serum IgE levels were 224.0 kU/I (14-12,013 kU/I) and 25.2 kU/I (0-4352 kU/I), respectively. Associations of asIgE status with atopic co-morbidity and total serum IgE levels were statistically significant. At a cut-off total serum IgE level of 106 kU/I (sensitivity 68.7%; specificity 92.3%), positive and negative predicted values (93.6% and 64.3%, respectively) were determined. Clinical decision points predictive of positive asIgE results were identified in 90%, 95% and 99% of patients, respectively. Total serum IgE values were significantly associated with the aslgE status of investigated patients. However, these preliminary data warrant further large-scale investigations before total serum IgE levels can be regarded as a clinically useful parameter between patients with extrinsic atopic dermatitis and intrinsic atopic dermatitis. [ABSTRACT FROM AUTHOR]

Food and beverages may contain high amounts of histamine and thus may cause symptoms after ingestion. The aim of this study was to investigate the role of ingested histamine in atopic dermatitis. Patients with atopic dermatitis had to maintain a histamine-free diet for one week. Consecutively, double-blind, placebo-controlled provocations were performed with histamine-hydrochloride and placebo. The clinical outcome was assessed by determination of the SCORAD. Before and 30 min after each provocation blood was collected for measurement of plasma histamine levels and diamine oxidase activity. Thirty-six patients with atopic dermatitis completed the diet. Twelve of 36 showed a significant improvement of the SCORAD after one week of the diet. After provocation tests 11 of 36 showed aggravation of eczema. Plasma histamine was significantly higher in patients with atopic dermatitis compared with controls (p <0.001), whereas diamine oxidase activity was similar in both groups. Our data indicate that ingestion of moderate or high amounts of histamine-hydrochloride may aggravate eczema in a subgroup of patients with atopic dermatitis. Plasma histamine and diamine oxidase activity were not associated with the clinical response to histamine. [ABSTRACT FROM AUTHOR]

The article investigates the susceptibility of atopic dermatitis patients to contact dermatitis. AD patients become sensitized to contact allergens. Chromate, thiuram mix, nickel sulphate, perfume mix, neomycin and wool alcohols are common allergens in atopic eczema patients. All in all, medicament allergy does not seem to be much higher in atopic patients and may simply reflect more common or intensive use rather than any increased predisposition to contact eczema.

The article examines the occurrence of chronic hand eczema in atopic dermatitis patients. Due to multifactorial causes of hand eczema, careful clinical and allergological examination is important for classification of the individual case. Hand eczema is a multifactorial disease and can be considered as endogenous and exogenous in origin.

Atopic dermatitis (AD) is a chronic inflammatory skin disease which develops on a complex genetic background, the so-called atopic diathesis. AD is in most, but not all, patients characterized by the presence of elevated total serum IgE levels. However, a subgroup of atopic patients exhibits normal IgE levels and mechanisms contributing to the so-called ‘intrinsic’ or ‘non-allergic’ form have been the matter of intensive research work in the last years. These forms have been particularly studied in the context of AD, which has also led to a new nomenclature. Moreover, we now have increasing evidence for the putative role of autoimmune phenomena in the complex pathophysiology of AD. Mainly adult patients exhibit specific IgE directed against self proteins of epidermal origin. Therefore, AD may be considered as a continuous disease in which, however, depending on the age, different mutually not exclusive pathomechanisms may be of relevance. [ABSTRACT FROM AUTHOR]

Physical activity promotes health and prevents disease. When patients with atopic dermatitis (AD) undertake exercise, the itch often gets worse due to sweating, and this may reduce their engagement in physical exercise. The aim of this study was to determine the level of physical exercise in patients with AD compared with a control group from a normal population. Our hypothesis was that patients with AD have a lower level of physical exercise due to their skin disease. A total of 110 patients with AD and 196 subjects from a normal population, age range 20-34 years, answered a questionnaire. Eleven patients with AD underwent an in-depth interview. The patients with AD had the same level of physical exercise and attitude to physical exercise as the normal population. Therefore, our hypothesis could not be confirmed. In conclusion, the skin symptoms of AD do not appear to be an obstacle to moderate physical exercise. [ABSTRACT FROM AUTHOR]

The article focuses on a study of the patients with atopic dermatitis. It discusses several psychological aspects of the disease including attachment with the partner and satisfaction in the partnership. It is mentioned that the sociodemographic data and atopic dermatitis characteristics were studied to collect the data. According to the results, skin specific quality of life was affected more by the attachment than partnership satisfaction.

The article discusses a study regarding functional regulation of Interleukin 31 production by genetic polymorphism conducted in patients with Extrinsic Atopic dermatitis. It informs that 105 patients with Atopic dermatitis were recruited for the study. It mentions that Interleukin-31 was measured by using enzyme linked immunosorbent assay (ELISA). It informs that the main limitation of the study was small number of patient in this study.

Atopic eczema is a chronic disease with a severe impact on quality of life, and compliance is important for the course of the disease. During the last decade educational programmes have been increasingly popular, but only few randomized controlled trials evaluating the effect of educational programmes and eczema schools exist. These studies, however, indicate a high participant satisfaction and a positive influence on compliance. [ABSTRACT FROM AUTHOR]

The article presents the findings of a medical research study conducted on the causes of Atopic Dermatitis, a common itch-inducing skin disease in both humans and animals. Topics include the role played by Interleukin (IL-31) cytokine in causing the itch, the methods used, and results of the medical study.

The article focuses on the Eczema Cohorte Longitudinale Adultes study which aims to assess the burden of atopic dermatitis (AD) using the Atopy Burden Score – Adult (ABS-A) and compares the results with those obtained with three different quality of life scales. Other information about AD, which profoundly alters quality of life in adults, as well as few studies concerning patient burden in AD is presented.

The article presents a case study of a 23-year-old male patient who was admitted in the hospital for pursuing the treatment of atopic dermatitis and was diagnosed with the scalp condition called cutis verticis gyrata (CVG). Details regarding his scalp condition are presented. Detailed discussions with regard to the treatment proceedings for CVG are also presented.

Atopic dermatitis has many similarities with allergic contact dermatitis. Previous studies have revealed delayed-type allergic reactions indicating specific cell-mediated immune reactions in subgroups of patients. It has recently been recognized that purified house dust mite major allergens, Der p1 and Der p2 from Dermatophagoides pteronyssinus, exhibit a proteolytic enzyme activity similar to papain and maybe serine proteases (e.g. trypsin), respectively. This opens the possibility that house dust mites apart from an allergic epitope could elicit irritant reactions in atopic skin. We examined cutaneous reactivity to the purified proteins of house dust mite antigens, Der p1 and Der p2, in 36 consecutive patients with atopic dermatitis. We also patch-tested with trypsin and papain, in order to see if these proteolytic enzymes could induce irritant reactions. Twelve patients had type 1 allergy to Der p1 and two of these had type IV reactivity to D. pteronyssinus extract. Positive reactions were observed in another four patients, but they had also irritant reactions to papain and trypsin, indicating that the enzymatic activity may have elicited the reactions. The cutaneous reactivity was not linked to total serum IgE, but the patients with specific allergic patch tests had type I reactions to D. pteronyssinus extract. Our observations indicate that allergic patch tests towards Der p1 and p2 are rare and that irritant reactions from D. pteronyssinus proteolytic activity may be a more common phenomenon when patch-testing atopic dermatitis patients with house dust mite antigen extract. [ABSTRACT FROM AUTHOR]

The article discusses a study regarding the use of tape-stripping to develop serial measurements of heat shock protein 27kDa (HSP27) content of stratum corneum (SC) in patients with atopic dermatitis (AD). The study obtained SC samples by single-stripping using a skin tape. Results showed the presence of correlations between the severity scores of the AD lesions and the HSP27 in SC content.

The article presents a study of six patients with atopic dermatitis (AD) treated with extracorporeal photopheresis (ECP). Treatment with ECP was tolerated in all patients without any objective or serological clinical adverse reactions. Subjective adverse reactions, primarily in the form of gastrointestinal symptoms, were cited after the oral formulation of 8-methoxypsoralen was given.

The article presents studies on the association of interleukin (IL)-31 gene haplotype with non-atopic eczema. Functional studies revealed that peripheral blood mononuclear cells from homozygous individuals for haplotype A released more IL-31 after stimulation with CD28 or CD3 antibodies. Haplotype A carrier status was then found to correlate with an increased risk of non-atopic dermatitis.

The article presents case studies of patients with atopic dermatitis (AD) who developed labial melanotic macules after topical application of tacrolimus. The clinical case of a 16-year-old Caucasian boy with long-standing AD with numerous eczematous lesions and a 25-year-old Caucasian woman manifesting persistent cheilitis are tackled. Histology revealed an augmented melanin production by basal melanocytes. The article discusses labial melanotic macule induced by tacrolimus application.