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Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting up to 20% of children and 10% of adults worldwide. Current research suggests a correlation between serum vitamin D level and AD severity and that vitamin D supplementation could have a potential therapeutic effect on AD. Objectives: To conduct a systematic review and meta-analysis of studies of vitamin D supplementation for disease improvement in children and adults with AD. Methods: PubMed, EMBASE, and Cochrane were searched from 19 April to 20 April 2024. We included randomized controlled trials (RCTs) of patients with AD comparing an intervention group with a control group. The risk of bias of the selected studies was assessed using the Cochrane risk-of-bias tool for randomized trials. All analyses were conducted in R (v4.1.2; R Core Team 2021). Results: Eleven RCTs with 686 participants were included. The included trials had measured AD severity by using the SCOring Atopic Dermatitis (SCORAD) or the Eczema Area and Severity Index (EASI). Vitamin D supplementation significantly reduced AD severity compared with the control group (standardized mean difference = −0.41, 95% CI: −0.67 to −0.16, I2 = 58%, p < 0.01). Conclusions: Vitamin D supplementation reduces AD severity in children and adults. Larger-scale and longer-term studies are still needed to confirm this conclusion. This study has been registered on PROSPERO (CRD42024535014). [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin condition with increasing prevalence worldwide, significantly affecting quality of life. While dietary factors are suspected to influence the onset and severity of AD, the relationship between comprehensive dietary patterns and AD, particularly in conjunction with comorbidities such as asthma, allergic rhinitis, and food allergies, remains underexplored. This study aims to investigate the dietary patterns of adults and children with AD and their association with disease severity and the presence of comorbidities. Material and Methods: A cross-sectional study was conducted with 150 patients diagnosed with AD, recruited from the Department of Dermatology, Venereology, and Leprology (DVL). Dietary patterns were assessed using a validated food frequency questionnaire (FFQ), and AD severity was measured using the Scoring Atopic Dermatitis (SCORAD) index. The presence of comorbidities, including asthma, allergic rhinitis, and food allergies, was confirmed through patient history, clinical examination, and review of medical records. Data were analyzed using descriptive statistics, chi-square tests, t-tests, and multivariate logistic regression. Results: The study found that the mixed diet pattern had the highest adherence (mean ± SD: 7.1 ± 1.9), followed by vegetarian (5.8 ± 1.9) and non-vegetarian (5.1 ± 2.0) patterns. The mean SCORAD index was 43.8 ± 14.1, indicating moderate to severe AD. Pruritus and sleep loss scores were 5.1 ± 2.0 and 4.1 ± 1.9, respectively. The prevalence of comorbidities was 36.7% for asthma, 57.3% for allergic rhinitis, and 32.0% for food allergies. The study identified significant associations between dietary patterns and AD severity, as well as with the presence of comorbidities. Conclusions: This study highlights the potential impact of dietary patterns on AD severity and the high prevalence of comorbidities among individuals with AD. The findings suggest that a mixed dietary pattern may be commonly adhered to by AD patients and could play a role in managing the disease. The study emphasizes the need for a multidisciplinary approach in managing AD, considering both dietary interventions and the treatment of comorbid conditions. [ABSTRACT FROM AUTHOR]

The immunological pathogenesis of atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) has not been fully elucidated yet. The aim of our research was to assess the serum concentration of interleukin-5 receptor (IL-5R) in relation to the disease activity and pruritus intensity in adult patients with AD and CSU. This pilot study included 45 participants (15 patients with AD, 15 patients with CSU, and 15 healthy controls). Blood samples were taken to examine the serum levels of IL-5R using the enzyme-linked immunosorbent assay (ELISA) test. The Scoring Atopic Dermatitis (SCORAD) index, the Urticaria Activity Score (UAS7), and the Visual Analogue Scale (VAS) were used to assess the disease activity and the pruritus intensity, respectively. Obtained results revealed that the IL-5R concentration was significantly higher in patients with CSU than in patients with AD and in the controls (p = 0.038). There was a positive correlation between the IL-5R level and the SCORAD index in patients with AD (r = −0.9, p = 0.047), which was not found for the CSU activity by UAS7 and with the pruritus severity by VAS in both examined groups of patients. Our findings underscore higher serum levels of IL-5R among CSU and AD patients, which may highlight its functional role in the pathogenesis of these diseases. In contrast, IL-5R might not be fully useful in reflecting the severity of symptoms. Although our results are promising, this study should be conducted on a larger cohort of patients. [ABSTRACT FROM AUTHOR]

BackgroundAtopic dermatitis (AD) is a chronic relapsing, pruritic, inflammatory skin disease. Assessing the characteristics and risk factors of severe AD is central to healthcare workers’ understanding and subsequent education of patients for the most optimal outcomes. The clinical characteristics are known to vary depending on populations and regions. AD has been well-documented in the global North in mainly Caucasian populations, while very few studies have been conducted on African patients residing in Africa. This study assessed the clinical characteristics, severity, and sociodemographic factors of children with AD in Southern Ethiopia.MethodsA hospital-based cross-sectional study was conducted among 461 children and their caregivers in four randomly selected hospitals in Southern Ethiopia from October 2022 to September 2023. A systematic sampling technique was used to enroll study participants. Clinical profile and sociodemographic data were collected by trained data collectors. The Scoring Atopic Dermatitis (SCORAD) index tool was used. The descriptive analysis was performed to characterize study participants. Univariate and ordinary logistic regression were used to identify factors associated with the SCORAD index score. The OR with 95% was used to show the strength of association, and a p-value of

Introduction: Atopic dermatitis is a chronic, relapsing disease with a multifactoral etiology. The basic disorder of the atopic dermatitis is the disruption of the epidermal barrier. The family history of atopy is a high risk factor of the development of the disease. The clinical manifestations are heterogeneous and vary depending on patient’s age, disease duration and current disease activity according to the SCORAD scale. Objective: The aim of the review is to analyze the latest information on the characteristics, diagnosis and treatment of atopic dermatitis, including new biological medications. Methods and materials: The sources available in PubMed database have been analyzed using the keywords: „atopic dermatitis”, „epidermal barrier”, „SCORAD index”, „topical treatment”, „biological therapy”, „Janus kinase inhibitors”. Current state of knowledge: Atopic dermatitis is only treated symptomatically. The greatest therapeutic challenge is to reduce the pruritus which significantly impairs the quality of life. Topical corticosteroids may cause local side effects. The most severe cases of the disease require systemic treatment with immunosuppressants. Conclusions: The complex pathogenesis of atopic dermatitis is the object of research. Understanding the immunological mechanisms responsible for the development of the disease allows to introduce new therapeutic options. Previous studies have confirmed the effectiveness of biological medications in reducing disease activity, which is a chance to improve the quality of live of the patients suffering from atopic dermatitis.

Introduction. Atopic dermatitis (AD) is a global problem of the 21st century, as the number of people suffering from this disease is steadily increasing, and around the world, about 20% of the population with clinical manifestations of this disease seek medical help. Aim of the study. Evaluation of the clinical course of AD in children in the hot climate of Uzbekistan. Patients and methods. 215 patients with atopic dermatitis aged from 1 to 18 years were under observation. The severity of AD was determined using the SCORAD index. Results. Among 215 patients, the erythematous-squamous form was observed in 63 (29.3%), erythematous-squamous with lichenification — in 47 (21.8%), lichenoid — in 55 (25.6%), exudative — in 34 (15.8%), and pruriginous form of AD — in 16 (7.4%). Most observed patients were adolescents, and the number of boys and girls with AD in this group was similar (49.6% and 50.4%, respectively). In terms of severity, taking into account the SCORAD index, in infancy, most patients had moderate (47.4%) and mild (36.8%) clinical course; in childhood — moderate (56.1%); in adolescence — moderate (40.3%) and severe (33.8%). In infancy, the exudative form was the most prevalent (52.6%). At the age of 2 to 11 years, the erythematous-squamous and lichenoid forms were the most frequently diagnosed (43.8% and 31.6% of cases, respectively). Meanwhile, at the age of 12 to 18 years, the patients were characterized by a different distribution of forms: the erythematous-squamous form with lichenification was observed in 28.1%, the lichenoid form — in 26.6%, and the erythematous-squamous form in 20.8%. Conclusion. In the present study, we assessed the relative frequency of forms of atopic dermatitis in children of different age groups in the hot climate of Uzbekistan.

Background: Atopic dermatitis (AD) is a chronic relapsing, pruritic, inflammatory skin disease. Assessing the characteristics and risk factors of severe AD is central to healthcare workers' understanding and subsequent education of patients for the most optimal outcomes. The clinical characteristics are known to vary depending on populations and regions. AD has been well-documented in the global North in mainly Caucasian populations, while very few studies have been conducted on African patients residing in Africa. This study assessed the clinical characteristics, severity, and sociodemographic factors of children with AD in Southern Ethiopia., Methods: A hospital-based cross-sectional study was conducted among 461 children and their caregivers in four randomly selected hospitals in Southern Ethiopia from October 2022 to September 2023. A systematic sampling technique was used to enroll study participants. Clinical profile and sociodemographic data were collected by trained data collectors. The Scoring Atopic Dermatitis (SCORAD) index tool was used. The descriptive analysis was performed to characterize study participants. Univariate and ordinary logistic regression were used to identify factors associated with the SCORAD index score. The OR with 95% was used to show the strength of association, and a p- value of <0.05 was used to declare the level of significance., Result: Out of 461 AD-diagnosed children, 212 (46%) were girls and 249 (54%) were boys. In the sample of pediatric patients, 149 (32.3%) exhibited mild AD, 231 (46.2%) presented with moderate, and 99 (21.5%) showed signs and symptoms of severe AD. All patients had itching. Dryness of skin, excoriation, and erythema, followed by lichenification, were the most observed signs. In the ordinary logistic regression model, age onset of the disease [AOR 95% CI 1.95 (1.3-2.94)], sex of caregiver or family [AOR 95% CI 0.61 (0.41-0.90)], family atopy history [AOR 95% CI 0.64 (0.44-0.93)], mother education status [95% CI 2.45 (1.1-5.47)], and use of herbal medication [AOR 95% CI 0.50 (0.33-0.79)] were significantly associated with the severity of AD., Conclusion: In this study, 68% of children were found to have moderate-to-severe AD. Early onset, maternal education, familial atopy history, sex of caregiver, and use of herbal medication were independent predictors of severe AD in children. We recommend further investigation into these variables for their potential to serve as markers to assess the severity of AD and improve the care and management of children with AD in Ethiopia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kelbore, Enbiale, van Wyk and Mosam.)

Background: Behçet's disease (BD) is a chronic inflammatory systemic disease that affects multiple organs. The causes of BD are still unknown, but it is primarily characterized by autoimmune reaction in the blood vessels. Current research focuses on treatments that can reduce the non-typical inflammatory responses of BD. Nevertheless, studies on improving the inflammatory effect of BD using inflammation mechanisms are still insufficient. Therefore, we conducted the integrated treatments related to inflammation modulation and achieved alleviation of symptoms in BD mice. Methods: To understand the complex etiology of BD and compare its management, the herpes simplex virus (HSV)-induced BD mouse model was used. In order to alleviate the inflammatory response in BD mice, Taraxaci Herba (TH, herbal medicine), R7050-a TNFα inhibitor, and a mixture of TH and R7050 were injected for 2 weeks repetitively. The SCORAD index was examined to evaluate the cutaneous inflammations. In addition, histological changes and inflammatory factors were analyzed. Results: Repetitive injection of TH and/or R7050 reduced the symptoms of BD and significantly decreased IL-6, IL-1β, and TNFα in blood sera. Moreover, this treatment reduced the ulcers and the deterioration of skin. Conclusions: The results of our study showed that the down-regulation of inflammatory factors is related to the control of immune responses in BD models, suggesting that a mixed drug treatment may be more effective in improving the condition of BD.

Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder affecting a large number of people in the world. Atopic dermatitis (AD) is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It was first described in 1933 but exists since antiquity. Aim and Objectives: To determine the relationship between AD and IBS. Materials and Methods: A total of 109 patients with AD and 100 healthy controls were included in the study. They were defined for diagnosis of IBS according to ROME-III diagnostic criteria. Supporting findings, Bristol stool scale, frequency of defecation and history of AD and IBS were also evaluated. AD severity was assessed using Severity Scoring of Atopic Dermatitis index. Results: A total of 62 patients (56.9%) in the AD group and 28 patients (28%) in the control group were diagnosed with IBS (P < 0.001). Supportive findings excluding abnormal stool frequency and passage of mucus were more frequent in AD patients. There was no significant relationship between disease severity according to SCORAD index and variables in AD patients. Conclusions: This is a rather uncultivated area in the field of AD. We observed that IBS was more common in AD group. Also, supporting findings like abnormal stool form, abdominal distension, feeling of incomplete evacuation, and straining were found more frequently in AD patients. These results may indicate the association between AD and IBS. In our opinion, patients with atopic dermatitis should be questioned in terms of IBS.

Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease, which primarily affects infants and young children. Due to the side effects of commonly used drugs for its treatment, the development of safer therapeutic strategies is needed. There are many reports on the topical use of marshmallow (Althaea officinalis) for a range of skin diseases in Persian medicine. The main aim of the present investigation was evaluating the efficacy of marshmallow in children with mild‐to‐moderate atopic dermatitis. Another aim of the study was screening the anti‐allergic and anti‐inflammatory potential of phytocomponents against target proteins, including TNF‐alpha, IL6, and PDEs A, B, and D enzymes with PDB IDs: 2AZ5, 1P9M, 3I8V, 4KP6, and 1Y2K, respectively, along with their respective standard ligands using computational docking analysis. A pilot clinical trial was designed to investigate the safety and efficacy of Althaea officinalis in children with AD. The diagnosis of AD was made according to the criteria of Hanifin and Rajka. Children between 3 months and 12 years old were participated in this trial and randomly allocated into two parallel intervention and control groups. The intervention group used Althaea officinalis 1% ointment while the positive control group used Hydrocortisone 1% ointment twice a day for a week and after that, three times per week for a period of 3 weeks. The severity of AD was measured using the SCORAD score at the end of each assessment visits. A total number of 22 patients completed the study. A significant decrease of the SCORAD score was observed in both groups. At the end of the study, this score change, which indicates the improvement of the patients was significantly higher in the intervention group in comparison to the baseline (p‐value =.015) and week 1 (p‐value =.018). In the docking analysis of the study, 33 phytochemical compounds were identified, which were docked into the active site of IL6, TNF‐alpha, and human PDE4 isoenzymes. Affinity toward the selected enzymes was significantly higher in glycosylated compounds. The results of this pilot study showed that the efficacy of Althaea officinalis 1% ointment in a decrease of disease severity is more than Hydrocortisone 1% in children with AD. However, further studies are needed to confirm this finding. Moreover, the docking analysis revealed that the inhibitory activity of compounds with free hydroxyl groups such as glycosylated compounds was better than others, probably due to the hydrogen bond interaction of hydroxyl groups of the ligands with the enzymes. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the benefit of testing specific IgE antibodies against molecularly defined allergens in patients with atopic dermatitis (AD) using the multiplex method ISAC and to assess whether the sensitization profiles differ in mild, moderate and severe forms of AD. A total of 81 patients (41 men and 40 women) were included in the study, who underwent a complete dermatological and allergological examination, including the determination of the sensitization profile to molecular components by the ImmunoCAP ISAC method. The results of the examination were statistically processed. A significantly higher number of positive reactions with high levels of specific IgE (= 15 ISU - E) was demonstrated in patients with moderate to severe AD. For most molecular components, increasing relative frequencies of positive reactions from mild to severe have been reported. In patients with severe form, sensitization to the molecular components of house dust mites, animals (cats, dogs, horses), egg white, shrimp and fungi (Aspergillus, Alternaria) was significantly more common. In this regard, we recommend focusing examinations, treatment, and regimen measures. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the efficacy and safety of the exopolymers from Aureobasidium pullulans (EAP) in subjects with mild-to-moderate atopic dermatitis. Methods: A total of 68 subjects who visited Semyung Oriental Medical Center from November 16, 2015, to September 8, 2016, were included in the study. The subjects were treated orally with EAP (250 mg/day; experimental group) or placebo (control group) for 12 weeks. A series of clinical examinations, hematological assessments, blood biochemistry, urinalysis, and skin assessments were conducted at baseline and after the study period to evaluate efficacy and safety. The primary endpoint was the Severity Scoring of Atopic Dermatitis (SCORAD) index. Results: A significantly greater reduction of SCORAD index as a primary endpoint showed in the treatment group than in the placebo group (p = 0.0053) during the treatment period. The secondary endpoints of serum interferon-γ levels, skin hydration, and transepidermal water loss showed significant changes over time within the EAP group. Other secondary endpoints showed no statistically significant changes. Safety evaluations identified no abnormal changes within the experimental or placebo groups. Conclusions: These experiments indicated that it was safe to ingest this dose of EAP orally for 12 weeks and that this treatment could help to alleviate atopic dermatitis. [ABSTRACT FROM AUTHOR]

Abstract Background The efficacy of low-dose medicine (LDM) in childhood mild/moderate eczema is not known. We conducted a double-blind, two-stage, randomized, placebo-controlled clinical trial, lasting 23 months, to address this issue. Method Eighty children with chronic mild/moderate eczema were randomly allocated to Group A (placebo) or Group B (treatment group; Galium-Heel®, a low-dose multicomponent medicine based upon natural substances; Guna-Interleukin 12 and Guna-Interferon-γ administered twice a day for six non-consecutive months for each stage). LDM is characterized by the use of biological molecules, such as cytokines, neuropeptides, growth factors, hormones at very low concentrations, which correspond to physiological levels within the human body. The dosage of the cytokines used in this trial (IFN-γ and IL-12) is 10 fg/ml. The SCORAD index was evaluated by the same operator: subjects with a SCORAD index below 20 were considered to have mild eczema (61/80; mean: 10.79), whereas a SCORAD index between 20–50 indicated moderate eczema (19/80; mean: 26.84). The data of 66/80 children were analyzed in stage 1 and those of 62/66 children in stage 2. The primary outcome measure was reduction of eczema severity assessed by the SCORAD index. Secondary outcomes were disease-free interval, and treatment safety and tolerability. Results The decrease in disease severity was greater in Group B than in Group A already in stage 1 (a decrease 63.9% versus 53.2%), but the difference was not significant (p = 0.16). Moreover, subjective symptoms (itching and sleep disturbances) initially decreased and then worsened in Group A, whereas itching decreased linearly and sleep disturbances decreased significantly (p=0.049) in Group B. Conclusions Preliminary evidence suggests potential benefit, but further work is needed to validate this approach. Trial registration The trial was registered with EudraCT number 2010–018640-13 through the database of the National Clinical Trials Monitoring Centre Database (Osservatorio delle Sperimentazioni Cliniche, OsSC) of the Italian Medicines Agency.

Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder affecting a large number of people in the world. Atopic dermatitis (AD) is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It was first described in 1933 but exists since antiquity. Aim and Objectives: To determine the relationship between AD and IBS. Materials and Methods: A total of 109 patients with AD and 100 healthy controls were included in the study. They were defined for diagnosis of IBS according to ROME-III diagnostic criteria. Supporting findings, Bristol stool scale, frequency of defecation and history of AD and IBS were also evaluated. AD severity was assessed using Severity Scoring of Atopic Dermatitis index. Results: A total of 62 patients (56.9%) in the AD group and 28 patients (28%) in the control group were diagnosed with IBS (P<0.001). Supportive findings excluding abnormal stool frequency and passage of mucus were more frequent in AD patients. There was no significant relationship between disease severity according to SCORAD index and variables in AD patients. Conclusions: This is a rather uncultivated area in the field of AD. We observed that IBS was more common in AD group. Also, supporting findings like abnormal stool form, abdominal distension, feeling of incomplete evacuation, and straining were found more frequently in AD patients. These results may indicate the association between AD and IBS. In our opinion, patients with atopic dermatitis should be questioned in terms of IBS. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of atopic dermatitis (AD) remains to be determined; recently a possible change in the immune system with production of immunoglobulins is proposed. As vitamin E is a potent antioxidant, with the ability to decrease the serum levels of immunoglobulin E (IgE) in atopic patients, we aimed to evaluate the effect of oral vitamin E on treatment of AD. Materials and Methods: This randomized, double-blind, placebo-controlled trial comprised seventy participants with mild-to-moderate AD, based on the Hanifin and Rajka diagnostic criteria. The patients were randomly selected from teaching skin clinics in Isfahan, Iran. They were randomly assigned to two groups of equal number, receiving vitamin E (400 IU/day) and placebo for four 4 months. Each month, the extent, severity, and subjective symptoms including itch and sleeplessness were measured by SCORAD index. Three months after the end of intervention, the recurrence rate was assessed. Results: The improvement in all symptoms, except sleeplessness, was significantly higher in the group receiving vitamin E than in controls (-1.5 vs. 0.218 in itching, -10.85 vs. -3.54 in extent of lesion, and -11.12 vs. -3.89 in SCORAD index, respectively, P < 0.05). Three months after the end of intervention, the recurrence rate of AD was evaluated. Recurrence rate between all 42 individuals, who remained in the study, was 18.6%. Recurrence ratio of the group receiving vitamin E compared to the placebo group was 1.17, without significant differences between the two groups (P > 0.05). Conclusion: This study suggests that vitamin E can improve the symptoms and the quality of life in patients with AD. As vitamin E has no side effects with a dosage of 400 IU/day, it can be recommended for the treatment of AD.

Background: The efficacy of low-dose medicine (LDM) in childhood mild/moderate eczema is not known. We conducted a double-blind, two-stage, randomized, placebo-controlled clinical trial, lasting 23 months, to address this issue. Method: Eighty children with chronic mild/moderate eczema were randomly allocated to Group A (placebo) or Group B (treatment group; Galium-Heel®, a low-dose multicomponent medicine based upon natural substances; Guna-Interleukin 12 and Guna-Interferon-γ administered twice a day for six non-consecutive months for each stage). LDM is characterized by the use of biological molecules, such as cytokines, neuropeptides, growth factors, hormones at very low concentrations, which correspond to physiological levels within the human body. The dosage of the cytokines used in this trial (IFN-γ and IL-12) is 10 fg/ml. The SCORAD index was evaluated by the same operator: subjects with a SCORAD index below 20 were considered to have mild eczema (61/80; mean: 10.79), whereas a SCORAD index between 20-50 indicated moderate eczema (19/80; mean: 26.84). The data of 66/80 children were analyzed in stage 1 and those of 62/66 children in stage 2. The primary outcome measure was reduction of eczema severity assessed by the SCORAD index. Secondary outcomes were disease-free interval, and treatment safety and tolerability. Results: The decrease in disease severity was greater in Group B than in Group A already in stage 1 (a decrease 63.9% versus 53.2%), but the difference was not significant ( p = 0.16). Moreover, subjective symptoms (itching and sleep disturbances) initially decreased and then worsened in Group A, whereas itching decreased linearly and sleep disturbances decreased significantly ( p=0.049) in Group B. Conclusions: Preliminary evidence suggests potential benefit, but further work is needed to validate this approach. Trial registration: The trial was registered with EudraCT number 2010-018640-13 through the database of the National Clinical Trials Monitoring Centre Database (Osservatorio delle Sperimentazioni Cliniche, OsSC) of the Italian Medicines Agency. [ABSTRACT FROM AUTHOR]

The aim of this study is the evaluation of the relationship between the severity of atopic dermatitis (AD) and the occurrence of IgE-mediated food allergy, food sensitization, and sensitization to inhalant allergens. The complete dermatological and allergological examinations were performed and the severity of AD was evaluated with the SCORing Atopic Dermatitis index. The statistical evaluation of the relationship between the occurrence of IgE-mediated food allergy, food sensitization, sensitization to inhalant allergens, and the severity of AD was performed. Two hundred and eighty-three patients were examined, 89 men and 194 women, average age 26.2 (s.d. 9.5). The significant relation was recorded between the severity of AD and sensitization to tested inhalant allergens. The significant relation was also found between the severity of AD and IgE-mediated food allergy. It turns out that the higher time to reaction, the higher the severity of AD. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the relation of the severity of atopic dermatitis evaluated by SCORAD index to the occurrence of other atopic diseases and parameters. The complete dermatological and allergological examinations were perfomed. The statistical evaluation of the dependence of the occurrence of bronchial asthma, rhinitis and manifestations of the skin lesions in the last year on the severity of atopic dermatitis was performed. Two hundred and eighty-three patients were examined - 89 men and 194 women, average age 26.2 (s.d. 9.5). The significant relation of the severity of atopic dermatitis and the occurrence of bronchial asthma, rhinitis, and duration of skin lesions was recorded. [ABSTRACT FROM AUTHOR]

Background and Objectives: Atopic dermatitis is one of the most common pediatric chronic inflammatory skin diseases, and certain food allergens and nutrients are closely related to the development and severity of atopic dermatitis. While avoidance of the causative foods is considered the mainstay of treatment, unverified excessive restriction might induce unnecessary limitations in the food intake, consequently leading to nutritional deficiencies and poor growth. This study aimed to identify the characteristics and nutrient intake status in children with atopic dermatitis and to investigate the effects of individualized nutrition intervention.Methods and Study Design: We retrospectively reviewed electronic medical records of 77 pediatric patients with atopic dermatitis who received 4 months of individualized nutrition intervention combined with an elimination diet. The patient characteristics, nutrient intake status, and clinical status were examined before and after the intervention.Results: Before the intervention, 5 children had a weight for height z-score below -2.0, and 48.1% had experienced food restriction; these children showed a significantly higher SCORing of Atopic Dermatitis index than those without experiences, with the number of restricted foods before the intervention positively correlating with the disease severity. The intakes of n-6 and n-3 fatty acids, calcium, folate, and vitamin D were lower than the recommended nutrient intakes for Koreans. After the intervention, the weight for height z-score of 35 children was significantly increased and their SCORing of Atopic Dermatitis index was significantly reduced (p<0.05).Conclusions: Individualized nutrition intervention appears useful for alleviating the severity of atopic dermatitis and improving the growth status by improving the nutrient intake. [ABSTRACT FROM AUTHOR]

The aim of this study is the evaluation of the relationship between the severity of atopic dermatitis (assessed by SCORAD index) and the occurrence of food allergy and food sensitisation to cow's milk, wheat, egg, soy, peanuts, and sensitisation to mites, feather, animal dander, and dust. The complete dermatological and allergological examinations were performed and the severity of atopic dermatitis was evaluated with use of SCORAD index. The statistical evaluation of the dependence between the occurrence of food allergy, food sensitisation, sensitisation to inhalant allergens and the severity of atopic dermatitis was performed. Two hundred and eighty-three patients were examined, 89 men and 194 women, average age 26.2. The significant relation was detected between the severity of atopic dermatitis and sensitisation to all tested inhalant allergens; no significant relation was detected between the severity of atopic dermatitis and food allergy or food sensitisation to tested food allergens. The significant relation was observed between the late type allergic food reaction and the severity of atopic dermatitis. [ABSTRACT FROM AUTHOR]

The aim of this study is the evaluation, if the level of total IgE, onset of atopic dermatitis (AD) and the family history are in the significant dependence to the severity of AD. The statistical evaluation of the dependence between the severity of AD and the the level of total IgE, family history and onset of AD was performed. 296 patients were examined. The level of total IgE above 200 IU/ml is recorded in 93 % of patients suffering from severe form and the positive data about atopy in family history are recorded in 66 % of patients with severe form of AD. The significant dependence was recorded between the severity of AD and parameters such as the level of total IgE, and family history about atopy. No dependence was recorded between the severity of AD and the onset of AD. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. Clusterin is a sensitive cellular biosensor of oxidative stress and has been studied as a marker to assess inflammatory diseases. The clusterin levels in AD have not been evaluated thus far. Objective: We evaluated serum clusterin levels in children with AD and assessed the relationship between serum clusterin levels and the severity of AD. Method: The study enrolled a total 140 children, of whom 100 had AD (n = 100) and 40 were healthy (n = 40). The severity of AD was scored by using the SCORing Atopic Dermatitis (SCORAD). Total serum immunoglobulin E and specific immunoglobulin E levels against egg whites, cow's milk, peanuts, soybeans, wheat, and Dermatophagoides farinae were measured. Clusterin levels in serum were measured by enzyme-linked immunosorbent assay. Results: The mean (interquartile range) age of the children was 5.1 years (1.3-8.4 years), and 92 (69.3%) of the children were boys. The mean (standard deviation) SCORAD index was 50.4 ± 17. The mean (standard deviation) clusterin level of children with AD was higher than that in the healthy control group children (148.13 ± 4.3 pg/mL versus 144.85 ± 5.1 pg/mL; p = 0.001). Serum clusterin levels were correlated with the SCORAD index (r = 0.327, p = 0.002). Conclusions: The serum clusterin level was higher in children with AD than in the healthy control group and increased with the severity of AD. Serum clusterin may be a candidate molecule that reflects AD and its severity. [ABSTRACT FROM AUTHOR]

Aim of this study is to evaluate the dependence between the occurrence of food hypersensitivity reactions and the severity of atopic dermatitis. The detailed personal history about the food hypersensitivity reactions was recorded and the severity of atopic dermatitis was evaluated with SCORAD index. The statistical evaluation of the dependence between the occurrence of food hypersensitivity reactions and the severity of atopic dermatitis was performed. Two hundred and eighty-five patients were examined – 90 men and 195 women, average age 26.2 (s.d. = 9.5). The significant dependence between the severity of atopic dermatitis and the occurrence of food hypersensitivity reactions was confirmed; 96% of patients with severe form of atopic dermatitis suffer from food reactions. In evaluating the single foods, the significant dependence was found between the severity of atopic dermatitis and the reactions to nuts, apples, and fishes. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of atopic dermatitis (AD) remains to be determined; recently a possible change in the immune system with production of immunoglobulins is proposed. As vitamin E is a potent antioxidant, with the ability to decrease the serum levels of immunoglobulin E (IgE) in atopic patients, we aimed to evaluate the effect of oral vitamin E on treatment of AD. Materials and Methods: This randomized, double-blind, placebo-controlled trial comprised seventy participants with mild-to-moderate AD, based on the Hanifin and Rajka diagnostic criteria. The patients were randomly selected from teaching skin clinics in Isfahan, Iran. They were randomly assigned to two groups of equal number, receiving vitamin E (400 IU/day) and placebo for four 4 months. Each month, the extent, severity, and subjective symptoms including itch and sleeplessness were measured by SCORAD index. Three months after the end of intervention, the recurrence rate was assessed. Results: The improvement in all symptoms, except sleeplessness, was significantly higher in the group receiving vitamin E than in controls (-1.5 vs. 0.218 in itching, -10.85 vs. -3.54 in extent of lesion, and -11.12 vs. -3.89 in SCORAD index, respectively, P < 0.05). Three months after the end of intervention, the recurrence rate of AD was evaluated. Recurrence rate between all 42 individuals, who remained in the study, was 18.6%. Recurrence ratio of the group receiving vitamin E compared to the placebo group was 1.17, without significant differences between the two groups (P > 0.05). Conclusion: This study suggests that vitamin E can improve the symptoms and the quality of life in patients with AD. As vitamin E has no side effects with a dosage of 400 IU/day, it can be recommended for the treatment of AD. [ABSTRACT FROM AUTHOR]

Background: Vitamin D seems to influence the evolution of atopic dermatitis (AD) in children. Methods: We tested the vitamin D serum levels of 39 children with AD (AD group t0) and of 20 nonallergic healthy controls (C group). AD severity was evaluated using the AD scoring system (SCORAD index). Cytokine serum levels (IL-2, IL-4, IL-6, IFN-γ, TNF-α) and atopy biomarkers were also measured. The patients were then treated with vitamin D oral supplementation of 1,000 IU/day (25 mg/day) for 3 months. We then reevaluated the vitamin D serum levels, AD severity and cytokine serum levels in all of the treated children (AD group t1). Results: The cross-sectional analysis on patients affected by AD (AD group t0) showed that the initial levels of all the tested cytokines except for TNF-α were higher than those of the healthy control group (C group), falling outside the normal range. After 3 months of supplementation the patients had significantly increased vitamin D levels (from 22.97 ± 8.03 to 29.41 ± 10.73 ng/ml; p = 0.01). A concomitant significant reduction of both the SCORAD index (46.13 ± 15.68 at the first visit vs. 22.57 ± 15.28 at the second visit; p < 0.001) and of all the altered cytokines (IL-2, IL-4, IL-6, IFN-γ) was also found. Conclusions: This study showed vitamin D supplementation to be an effective treatment in reducing AD severity in children through normalization of the Th1 and Th2 interleukin serum pattern. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The changes in lymphocyte subpopulations in atopic dermatitis (AD) concern also T-regulatory cells. We investigated the expression of various surface receptors on CD3CD4CD25FoxP3 T-regulatory cells and the activation CD28 receptor and the inhibitory CD152 receptor on helper/inducer as well as cytotoxic/suppressor T cells. Peripheral blood lymphocytes of 15 AD patients and 20 healthy subjects were analyzed by flow cytometry using monoclonal antibodies. The concentrations of IL-6, IL-10 and TGF-β were determined in the serum and the supernatant of ConA-stimulated CD4 lymphocytes. In AD patients the percentage of CD4CD25FoxP3 as well as CD3CD8 cells increased, which positively correlated with SCORAD index ( r = 0.55, p = 0.03). The concentrations of IL-10 in the CD4 lymphocyte culture supernatants and the concentrations of TGF-β in the sera and the supernatant negatively correlated with the severity of AD ( p < 0.01, r = −0.63; p < 0.02, r = −0.64 and p < 0.03, r = −0.58, respectively), whereas the serum concentration of IL-6 correlated positively ( p < 0.003, r = 0.71). The regulatory cells expressed more CD62L and CD134 surface markers but less CD95. Reduced expression of the apoptotic CD95 receptor suggests that survival time of these cells is prolonged. Since CD62L and CD134 were upregulated, the enhanced modulatory effect of CD4CD25FoxP3 cells seemed to be suggested, which may result in increased co-expression of CD28/CD152 on both CD4 and CD8 subpopulations. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the possible influence of the diagnostic hypoallergenic diet on disease intensity and subjective parameters in patients suffering from atopic dermatitis. Methods: The diagnostic hypoallergenic diet for the period of 3 weeks was recommended to patients with atopic eczema. Severity of eczema was scored according to the SCORAD score and intensity criteria (erythema, oedema, crusting, excoriations, lichenification, dryness) and subjective parameters (pruritus, sleeplessness) were evaluated at the beginning and at the end of the diet. Results: 149 patients, including 108 women and 41 men, with the average age of 26.03 (s. d. 9.6 years), range from 14 to 63 years, completed the diet. There was a statistically significant reduction in the severity of sleeplessness and pruritus and a reduction in all of the intensity criteria except for lichenification at the end of this diet. Conclusion: The diagnostic hypoallergenic diet can improve the intensity and subjective parameters of atopic dermatitis evaluated by SCORAD index except for lichenification.We recommend to introduce the diet as a temporarymedical tool in patients suffering frommoderate or severe atopic dermatitis and as well as a diagnostic tool in the diagnosis of food allergy. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disease with increasing frequency over the last decades, especially in adults. Cytokines orchestrate atopic skin inflammation. The aim of this study was to compare serum levels of cytokines in adult patients with acute AD (AD1) with other groups of AD patients and controls and investigate the possible association between such cytokines and disease severity. We measured cytokine levels using flow cytometry in 21 adult patients with acute AD, 12 adults with chronic AD, 10 children with acute AD and 10 healthy adults. Flow cytometry analysis of cytokines revealed that interleukin 10 (IL-10), IL-6, interferon γ (IFN-γ) and IL-4 levels were significantly decreased in AD1 group compared with controls, whereas IL-2 and tumour necrosis factor (TNF) did not differ. Comparison of AD1 group with adults chronic phase group showed that IgE, eosinophil and IL-2 levels remained unaltered, whereas IL-10, IL-6, IFN-γ, IL-4 and TNF were significantly decreased. SCORAD and IgE levels were significantly increased, IL-10, IL-6 and IFN-γ were decreased and TNF, IL-2, IL-4 and eosinophil levels remained unchanged in AD1 group compared with children acute phase group. Within AD1 group correlation analysis revealed that IgE and TNF levels were significantly associated with AD severity. Coefficient of determination analysis revealed that TNF and IgE levels could explain 49.14% and 35.28% of the variance of SCORAD. These data indicate that serum IgE and TNF levels correlate with AD severity and that serum cytokines are downregulated in AD1 group. Further studies are clearly needed to elucidate cytokines' role in adults with AD [ABSTRACT FROM AUTHOR]

It is important to determine the severity of atopic dermatitis (AD) for evaluation of disease improvement after and during therapy. Scoring of the severity of AD is demanded in clinical trials. The European Task Force on Atopic Dermatitis (ETFAD) has developed the SCORAD (SCORing AD) index to create a consensus on assessment methods for AD, so that study results of different trials can be compared. However, modification of the SCORAD index has led on several occasions to wrong and incorrect use of the system. To measure the extent of AD, the rule of nines is applied on a front/back drawing of the patient’s inflammatory lesions. The extent can be graded 0–100. The intensity part of the SCORAD index consists of six items: erythema, oedema/papulation, excoriations, lichenification, oozing/crusts and dryness. Each item can be graded on a scale 0–3. The subjective items include daily pruritus and sleeplessness. Both subjective items can be graded on a 10-cm visual analogue scale. The maximum subjective score is 20. All items should be filled out in the SCORAD evaluation form. The SCORAD index formula is: A/5 + 7B/2 + C. In this formula A is defined as the extent (0–100), B is defined as the intensity (0–18) and C is defined as the subjective symptoms (0–20). The maximum SCORAD score is 103. Based on training sessions by the ETFAD, the SCORAD index was modified by excluding the subjective symptoms (objective SCORAD). The objective SCORAD consists of just the extent and intensity items, the formula being A/5 + 7B/2. The maximum objective SCORAD score is 83 (plus an additional 10 bonus points). Bonus points are given for severe disfiguring eczema (on face and hands). The three-item severity (TIS) score involves the scoring of erythema (redness), oedema and excoriations (scratches) in one representative lesion, marked as R-O-S. The TIS score corresponds well with the more detailed objective SCORAD and can be used as a prescreening system or as a quick system in studies and is excellent for epidemiological studies. [ABSTRACT FROM AUTHOR]

Allergen exposure plays an important role in atopic dermatitis (AD). Because immunological mechanisms underlying asthma and AD have great similarities, we evaluated whether features such as allergen sensitization, immune response, disease severity and duration or allergen exposure could be considered predictive for AD persistence. Seventy-one AD children (age range 14–158 months) were enrolled and followed for 3 consecutive years for AD severity using the SCORAD index (SI). At enrollment, reactivity to inhalant and food allergens using the skin prick test (SPT) and house dust mite (HDM) atopy patch test (APT), and HDM allergens in house dust were evaluated. After 3 years, 38 children outgrew their AD (AD– group), while in 33 AD persisted (AD+ group). At enrollment, AD+ children had a higher SI, higher rate of positivity to SPT and APT for mites (p = 0.001), and higher environmental exposure to HDM allergens (p = 0.035). The AD+ children developed more respiratory symptoms in comparison to AD– children (p < 0.001). None of the AD– children presented APT positivity. In our study population, positivity of SPT and APT for HDM, environmental allergen exposure levels and severity of the disease at enrollment presented a significant predictive power towards AD persistence. Subjects with positive skin reactivity to HDM should be considered at risk of AD persistence and of possible development of allergic respiratory disorders. [ABSTRACT FROM AUTHOR]