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Atopic Diathesis  [cached]
Dhara Sandipan,Kanwar Amrinder J
Indian Journal of Dermatology , 1996,
Atopic dermatitis in infants and children in India  [cached]
Dhar Sandipan,Banerjee Raghubir
Indian Journal of Dermatology, Venereology and Leprology , 2010,
Abstract: Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease characterized by pruritus and inflammation and accompanied by cutaneous physiological dysfunction, with a majority of the patients having a personal or family history of "atopic diathesis." The term "atopic diathesis" refers to the presence of allergic rhinitis, bronchial asthma or AD. The universal occurrence of AD is no longer debated. However, published material about its natural history, etiopathogenesis, epidemiology, clinical patterns and management leave a lot to be known in the Indian scenario. In the present write-up, we will try to explore the wealth of knowledge about the disease available in our country and try to unfurl the complex interplay of different factors that are implicated for the development of this condition. The diagnosis of AD is based on a constellation of signs and symptoms. There is no laboratory "gold standard" for the diagnosis of AD. In a majority of the cases, the diagnosis is quite easy. Topical corticosteroids form the mainstay of topical treatment and, along with emollient, are able to control the condition in more than 80% of the cases. However, as use of long-term topical corticosteroid has the potential to produce local and systemic adverse effects, topical tacrolimus has come up as a useful molecule for the long-term control of the disease.
Prognostic Value Of Immunoglobulin E In A Atopic Dermatitis  [cached]
Chottopadhyay S P
Indian Journal of Dermatology , 2004,
Abstract: Atopic dermatitis (AD) constituted about 6% of total dermatological cases and 0.14% of all new cases (165877) attending the outpatient of a hospital. Serum IgE was estimated in 115 patients with AD. It was observed that IgE level was raised in 84%, normal in 12% and below normal in 4% of cases. In the present study the family history of atopic diathesis was found in 66% of the cases. IgE level fell in 14 of 16 patients during follow up who remained free from active disease for six months or more.
Skin Barrier Function and Its Importance at the Start of the Atopic March  [PDF]
Mary Beth Hogan,Kathy Peele,Nevin W. Wilson
Journal of Allergy , 2012, DOI: 10.1155/2012/901940
Abstract: Atopic dermatitis can be due to a variety of causes from nonatopic triggers to food allergy. Control of egress of water and protection from ingress of irritants and allergens are key components of cutaneous barrier function. Current research suggests that a degraded barrier function of the skin allows the immune system inappropriate access to environmental allergens. Epidermal aeroallergen exposure may allow sensitization to allergen possibly initiating the atopic march. Further research into connections between epidermal barrier function and possible allergen sensitization will be important to undertake. Future clinical trials focused on skin barrier protection may be of value as a possible intervention in prevention of the initiation of the atopic march. 1. Introduction The atopic march refers to the natural progression of atopic diseases from atopic dermatitis in infancy to atopic asthma in school age children. Recent research has uncovered exciting data concerning the initiation of the atopic march. A previously little valued component of the epidermis, the strateum corneum, has become an area of scientific attention in the study of the allergic diathesis. This focus on epidermal barrier function potentially provides a heightened understanding of both atopic dermatitis and the initiation of the atopic march. Improving barrier function with reduced water loss and minimized ingress of allergens might become an important tool to controlling the onset of the atopic march. 2. Epidemiology and Definition of Atopic Dermatitis Atopic dermatitis is one of the most significant and common skin diseases of childhood. Studies from Japan suggest that the prevalence for atopic dermatitis in childhood may be as high as 11–25% [1, 2]. There is a 15.8% prevalence of atopic dermatitis in 3–5-year-old children in New Zealand [3]. A US-population-based study revealed that the prevalence of atopic dermatitis amongst 5–9-year olds was 17.2% [4, 5]. Atopic dermatitis is an inflammatory cutaneous disease characterized by erythema, pruritus, altered barrier function, and immune dysfunction resulting in IgE sensitization. Dysfunction of antimicrobial peptides such as defensins, psoriasins, and cathelicidins is associated with the development of atopic dermatitis [6–8]. Functional alteration of these peptides has been associated with eczema herpeticum. A perturbation in the function of these peptides can result in cutaneous infection with Staphylococcus aureus. Infectious sequelae frequently result in atopic dermatitis exacerbations. These and other developments in atopic
Atopic Dermatitis  [PDF]
Turkderm , 2011,
Abstract: Atopic dermatitis is one of the important public health problems of the industrialized communities, and the prevalence of the disease has been increasing in our developing country. In this paper, etiopathogenesis, clinical characteristics and current therapeutic approaches of atopic dermatitis is reviewed under highlights of recently published guidelines and the literature. (Turk-derm 2011; 45: 168-73)
A Topic Diathesis In Hereditary Ichthyosis Patients Attending A Tertiary Health Care Center In Saudi Arabia
Al-Akloby Omar M Al-Amro
Indian Journal of Dermatology , 2004,
Abstract: The occurrence of atopic diathesis in hereditary ichthyosis (HI) has not been documented in Saudi patients. The atopic manifestations in histopathologically confirmed HI patients attending the dermatology clinic of king Fahad Hospital of the University at Al-Khobar city, Saudi Arabia is discussed in this study. From the dermatology OPD logbook, all Saudi patients with confirmed HI seen between January 1990 to December 1995 were included in the study. The findings regarding atopic manifestations were extracted into data collection forms and analyzed. During the 5 year study period, 10,455 new cases were seen in our dermatology OPD. Of these, 61 had hereditary icthyosis, with 37 males and 24 females with a male to female ratio of 1.5:1. Thus, the frequency of HI among Saudi hospital attendees was 6 per 1000 new cases. The type of HI was ichthyosis vulgaris in 25 (41%) patients, X-linked recessive ichthyosis in 11 (18%), lamellar ichthyosis in 4(7%), bullous ichthyosiform erythroderma in 2 (3%) and nonbullous ichthyosiform erythroderma was seen in 19 (31%). Generalized pruritus was present in 49 (80%) cases, atopic dermatitis in , elevated serum IgE level was noted in 27 and bronchial asthma in 3 cases. Dandruff was reported in 24 cases, keratosis pilaris in15, recurrent skin infection in 7. Combination of hereditary ichthyosis, generalized pruritus and high serum IGE level was reported in 27 (44.3%) patient.
Improvement of quality of life in patients with concomitant allergic asthma and atopic dermatitis: one year follow-up of omalizumab therapy
P Velling, D Skowasch, S Pabst, E Jansen, I Tuleta, C Grohé
European Journal of Medical Research , 2011, DOI: 10.1186/2047-783x-16-9-407
Abstract: A total of 22 patients with severe allergic asthma were treated with omalizumab for 12 months. 13 patients with allergic asthma without concomitant atopic dermatitis (IgE 212 ± 224 IU/ml) and 9 patients with concomitant allergic asthma and atopic dermatitis (IgE 3,528 ± 2,723 IU/ml) were included. Asthma-related quality of life (AQLQ), atopic dermatitis related quality of life (DLQI), and asthma-related treatment were compared between both groups at baseline and after initiating omalizumab treatment.DLQI was significantly in favor of omalizumab after 2 months in the atopic dermatitis/asthma group (P = 0.01); AQLQ was improved after 6 months in the asthma group (P = 0.01), while no change was seen in AQLQ in the atopic dermatitis/asthma group (P = 0.12). Omalizumab controlled oral corticosteroid use more effective (P < 0.01) in patients with asthma and atopic dermatitis (in 9/9 cases) compared to patients with asthma alone (9/13). Baseline IgE as well as other factors do not predict response to omalizumab.Omalizumab is effective in improving atopic dermatitis-related quality of life scores and modulates oral corticosteroid use in patients with concomitant asthma and atopic dermatitis in a positive fashion.Atopic dermatitis is a chronic cutaneous inflammatory disease in childhood that often persists into adulthood [2]. It is characterized by pruritic skin lesions and frequently associated with allergic asthma disease, and atopic diathesis, or both. The syndrome of atopy may include allergic rhino conjunctivitis, allergic asthma, and atopic dermatitis; most cases of moderate to severe atopic dermatitis do not respond adequate to any single therapeutic modality and many management strategies based on systemic or local corticosteroids are limited by their systemic toxicities. Currently, we do not have effective pharmacological monotherapies with acceptable safety profiles to control the symptoms of this disease in the long run.Omalizumab is an anti-immunoglobulin E (IgE)
Addendum to "Superconnections and Parallel Transport"  [PDF]
Florin Dumitrescu
Mathematics , 2010,
Abstract: In this addendum to our article "Superconnections and Parallel Transport" we give an alternate construction to the parallel transport of a superconnection contained in Corollary 4.4 of \cite{D1}, which has the advantage that is independent on the various ways a superconnection splits as a connection plus a bundle endomorphism valued form.
Atopic dermatitis: tacrolimus vs. topical corticosteroid use
Y Langa, E Van der Merwe
South African Family Practice , 2011,
Abstract: Atopic dermatitis (AD), the dermatological manifestation of the atopic diathesis, has a variety of clinical presentations. It is a chronic and relapsing inflammatory disorder, requiring a multifaceted treatment approach. Topical corticosteroids are the backbone of therapy. However, concerns over adverse drug reactions associated with their long-term application limit their use. Tacrolimus, on the other hand, has been shown to be effective in stabilising the symptoms of AD in the long-term setting, without the side-effects that hamper the use of topical corticosteroids. Long-term safety data up to ten years are available in the literature. Despite this, the US Food and Drug Administration (FDA) black box warning of possible malignancies has resulted in much debate among experts. The main focus of this article is to compare the safety and efficacy of topical corticosteroids to calcineurin inhibitors, particularly tacrolimus. Furthermore, the aim is to evaluate the place of tacrolimus in AD therapy. A brief overview of the condition and other treatment modalities will also be discussed.
Atopic dermatitis  [cached]
Watson Wade,Kapur Sandeep
Allergy, Asthma & Clinical Immunology , 2011, DOI: 10.1186/1710-1492-7-s1-s4
Abstract: Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life of affected individuals as well as their families. Although the pathogenesis of the disorder is not completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune abnormalities. There are no specific diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient’s history and clinical manifestations. Successful management of the disorder requires a multifaceted approach that involves education, optimal skin care practices, anti-inflammatory treatment with topical corticosteroids and/or topical calcineurin inhibitors (TCIs), the use of first-generation antihistamines to help manage sleep disturbances, and the treatment of skin infections. Systemic corticosteroids may also be used, but are generally reserved for the acute treatment of severe flare-ups. Topical corticosteroids are the first-line pharmacologic treatments for AD, and evidence suggests that these agents may also be beneficial for the prophylaxis of disease flare-ups. Although the prognosis for patients with AD is generally favourable, those patients with severe, widespread disease and concomitant atopic conditions, such as asthma and allergic rhinitis, are likely to experience poorer outcomes.
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