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In 365 children and 213 adults the characteristics of atopic dermatitis isolated by Hanifin and Rajka were analysed in relation to a family history of allergy. A positive history in both parents and/or their families was associated with higher IgE titres, earlier appearance of skin changes, more frequent occurrence of urticaria, allergic respiratory diseases, cheilitis, and, in women, nipple eczema. These changes were less frequent and the IgE titre was lower in patients with one atopic parent, and even less frequent (or lower IgE titre) in patients with no famiy history of atopic disease, although the latter difference was sometimes slight. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is exacerbated by Staphylococcus aureus, which is capable of displacing not only the physiological microbiota, but also other strains of its own species. Analyses of the molecular characteristics and relationships of S. aureus strains present in different microniches are lacking., Objectives: To determine, using multilocus sequence typing (MLST), the relationship of S. aureus isolates from the lesional and nonlesional skin and anterior nares of patients with AD, and to review the characteristics of the dominant clones., Methods: Sixty-three individuals with active AD were enrolled. Ten patients with moderate-to-severe AD (SCoring of Atopic Dermatitis score ≥ 25) colonized by S. aureus in all analysed locations were included in the MLST analysis., Results: The most prevalent sequence types were 7 (10/30 strains; 33.3%), 15 and 97 (both 5/30 strains; 16.7%) all of which were associated with the expression of adhesins and toxins promoting chronic microbial dysbiosis, skin barrier damage and inflammation. Six patients (60%) were carriers of clonal S. aureus strains at all analysed locations, three (30%) carriers in lesional and nonlesional skin, and one (10%) was a carrier in nonlesional skin and the anterior nares., Conclusions: The results imply that the identified S. aureus lineages are better adapted to dominate the microbiota in AD. Decontaminating the identified reservoirs of S. aureus (i.e. anterior nares and nonlesional skin) could reduce the severity of AD., Competing Interests: Conflicts of interest The authors state no conflict of interest related to the present work., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The term 'proactive therapy' refers to a long-term management of clinically intact skin in previously disease-affected areas. This method was initially implemented in atopic dermatitis to maintain the remission and decrease the risk of exacerbations. Proactive therapy aims to limit the need for reactive treatment and improve the patients' quality of life. A proactive approach is likely to be adopted for other relapsing and inflammatory skin conditions in the future. This scoping review aims to identify dermatological conditions to be treated with the proactive approach, evaluate the available evidence for its efficacy and safety, as well as highlight the research gaps., Competing Interests: KM and JN declare no conflict of interest. LB: invited speaker – AbbVie, Sanofi. LR: member of advisory boards – Janssen Pharmaceutical Companies, L’Oréal, Leo, Lilly, Pfizer, Sanofi, Novartis, UCB, Timber Pharma; invited speaker – Leo, AbbVie, L’Oréal, Lilly, Pierre Fabre. Registration: OSF Registration number (DOI): 10.17605/OSF.IO/WX5J7., (Copyright: © 2023 Termedia Sp. z o. o.)

Staphylococcus aureus superantigens (SAgs) have been reported to aggravate atopic dermatitis. However, comprehensive analyses of these molecules in multiple microniches are lacking. The present study involved 50 adult patients with active atopic dermatitis. S. aureus was isolated from the lesional skin, nonlesional skin, and anterior nares. Multiplex-PCR was performed to identify genes encoding (1) selX (core genome); (2) seg, selI, selM, selN, selO, selU (enterotoxin gene cluster, EGC); and (3) sea, seb, sec, sed, see, tstH (classic SAgs encoded on other mobile genetic elements). The results were correlated to clinical parameters of the study group. selx and EGC were the most prevalent in all microniches. The number of SAg-encoding genes correlated between the anterior nares and nonlesional skin, and between the nonlesional and lesional skin. On lesional skin, the total number of SAg genes correlated with disease severity (total and objective SCORAD, intensity, erythema, edema/papulation, lichenification and dryness). Linear regression revealed that AD severity was predicted only by selx and EGC. This study revealed that selX and EGC are associated with atopic dermatitis severity. Anterior nares and nonlesional skin could be reservoirs of SAg-positive S. aureus . Restoring the physiological microbiome could reduce the SAg burden and alleviate syndromes of atopic dermatitis.

Atopic dermatitis is a chronic inflammatory skin disorder characterized by eczematous lesions, itch, and a significant deterioration in the quality of life. Recently, microbiome dysbiosis has been implicated in the pathogenesis of atopic dermatitis. Changes in the fungal microbiome (also termed mycobiome) appear to be an important factor influencing the clinical picture of this entity. This review summarizes the available insights into the role of the cutaneous mycobiome in atopic dermatitis and the new research possibilities in this field. The prevalence and characteristics of key fungal species, the most important pathogenesis pathways, as well as classic and emerging therapies of fungal dysbiosis and infections complicating atopic dermatitis, are presented.

Atopic dermatitis (AD) is a common inflammatory dermatosis affecting up to 30% of children and 10% of adults worldwide. AD is primarily driven by an epidermal barrier defect which triggers immune dysregulation within the skin. According to recent research such phenomena are closely related to the microbial dysbiosis of the skin. There is growing evidence that cutaneous microbiota and bacterial biofilms negatively affect skin barrier function, contributing to the onset and exacerbation of AD. This review summarizes the latest data on the mechanisms leading to microbiome dysbiosis and biofilm formation in AD, and the influence of these phenomena on skin barrier function.

Introduction: It has been claimed that patients with systemic sclerosis (SSc) have an increased risk of developing cardiac arrhythmias and atrioventricular conduction disorders, but it is unknown whether SSc may be a cause of sinoatrial conduction abnormalities., Aim: To establish the incidence of sinoatrial conduction abnormalities in patients with SSc and verify the relationship of these disorders with various clinical descriptors of SSc., Material and Methods: Forty women with systemic sclerosis of varying duration and severity underwent 24-hour ambulatory ECG monitoring. The occurrence of type I second-degree sinoatrial block (SA-block) and calculation of sinoatrial conduction time (SACT) were evaluated to establish the incidence of sinoatrial conduction abnormalities. The measurements of SACT were obtained using spontaneous atrial premature beats. The effect of various clinical descriptors on sinoatrial conduction abnormalities was assessed., Results: The mean ± SD SACT for the 40 patients was 150 ±15 ms. Prolonged (> 150 ms) SACT was found in 20 patients. In 14 (35%) patients SA-block occurred during ambulatory ECG monitoring. The discriminant analysis identified the severity of SSc cutaneous manifestation as an independent marker for developing SA-block ( p < 0.005) and SACT prolongation ( p < 0.0002)., Conclusions: Patients with SSc are at an increased risk of developing type I second-degree sinoatrial block and prolonged sinoatrial conduction time. The occurrence of these abnormalities is related to the severity of skin involvement. Therefore, cardiological diagnosis using 24-hour ambulatory ECG in this group of patients should be focused also on this type of disorders. Prospective, controlled studies are needed to assess their prognostic role., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Termedia.)

Background: Atopic dermatitis is a chronic inflammatory dermatosis with complex pathogenesis. The skin microbiome in atopic dermatitis is dominated by Staphylococcus aureus which shows the ability to produce biofilm., Objectives: The aim of this work was to assess the influence of S. aureus biofilm on the course of atopic dermatitis., Methods: Disease severity was evaluated based on the SCORAD index in 56 adult patients with atopic dermatitis. Microtiter plate assay of the propensity to form biofilm was performed on S. aureus strains isolated from the anterior nares, lesional skin, and nonlesional skin. Microbiological results were correlated to the clinical parameters and total IgE concentration., Results: Biofilm-producing strains of S. aureus were identified in 76.3% (29/38) and 79.1% (34/43) of samples from the anterior nares and lesional skin, respectively (p > 0.05), and in 48.5% (16/33) of samples from nonlesional skin (p < 0.03). Patients colonized by biofilm-producing strains of S. aureus within the anterior nares showed statistically higher mean values of total and objective SCORAD and its components (extent, dryness), and of the largest extent of skin lesions during the flares in the last year when compared to patients colonized by non-biofilm-producing strains. Carriage of biofilm-producing S. aureus on lesional skin was associated with higher mean values of the extent of skin lesions during stable periods of the disease., Conclusions: The results of this study may suggest a relationship between the production of biofilm by S. aureus strains colonizing the anterior nares and the course of atopic dermatitis. Biofilm seems crucial for dispersal and persistent colonization of large areas of the skin by this pathogen. Destruction of S. aureus biofilm could positively affect the course of atopic dermatitis., (© 2020 S. Karger AG, Basel.)

Atopic dermatitis (AD) is secondary to genetic, immunological and microbiological disorders as well as epidermal barrier defects, which are the main targets of therapy. The disease proceeds with periodic exacerbations. Its development and course are influenced by numerous environmental and individual factors. In recent decades, in industrialized countries, there has been a threefold increase in the incidence of AD. There is also an increasing number of cases resistant to topical treatment. Effective treatment of AD should provide control of clinical symptoms, prevent exacerbations and improve the quality of life of patients. The multifactorial etiopathogenesis and various endotypes and phenotypes of AD justify the tendency to optimize and personalize the therapy. Currently, we recommend the use of dupilumab for the treatment of patients from 12 years of age with moderate and severe atopic dermatitis, who do not respond to topical treatment., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Termedia.)

Background: Skin colonization by Staphylococcus aureus (SA) correlates with increased severity of atopic dermatitis (AD). The role of nasal SA carriage and coagulase-negative staphylococci (CNSs) in AD is unclear., Objective: The aim of this study was to assess the influence of colonization of lesional/nonlesional skin and the anterior nares by SA and CNSs on AD severity in 63 adult patients., Methods: Disease severity was assessed with SCORAD index. The total immunoglobulin E (IgE) concentration was determined using the enzyme-linked immunosorbent assay method. The prevalence and abundance of staphylococci were assessed with the combination of bacterial culture and mass spectrometry., Results: The prevalence values of SA within the skin (lesional/nonlesional) and anterior nares were 79.4%/61.9% and 69.8%, respectively (vs 5.6% and 13.9%, respectively in controls, P < 0.0001). The carriage of CNSs in all niches was associated with lower mean IgE concentration (1164.66 ± 1010.36 vs 1762.99 ± 1059.15, P < 0.0213; 1166.9 ± 1006.4 vs 2152.7 ± 759.2, P < 0.0063; 1022 ± 1100 vs 1925 ± 880.8, P < 0.0044, respectively). The abundance of SA correlated with the extent of skin lesions and total IgE (ρ = 0.42, P = 0.0007; ρ = 0.488, P < 0.0001; ρ = 0.312, P < 0.2; and ρ = 0.402, P = 0.0007; ρ = 0.403, P < 0.002; ρ = 0.287, P < 0.03, respectively)., Conclusions: Atopic dermatitis severity correlates with both cutaneous and nasal colonization by SA. Staphylococcus aureus seems to promote TH2-type response, whereas CNS probably limits this process. Preventive measures within the anterior nares should be considered for AD patients.

The treatment goal in atopic dermatitis is eliminating clinical symptoms of the disease, preventing exacerbations and complications, as well as improving patients' quality of life. In cases of severe atopic dermatitis and lack of response it is recommended to introduce systemic therapy. Patients ofter require multi-specialist consultations, and occasionally hospitalization. It is not recommended to use acupuncture, acupressure, bioresonance, homeopathy, or Chinese herbs in the treatment of atopic dermatitis., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Termedia Sp. z o. o.)

Atopic dermatitis is a chronic and recurrent inflammatory dermatosis with concomitant intensive pruritus, and is diagnosed both in children and adults. Atopic dermatitis-patients are predisposed to have bacterial, viral and fungal skin infections; they also suffer from an increased risk of developing food allergies (especially, at an infantile age), allergic rhinitis, or bronchial asthma (a so-called atopic march). Currently, an increasing atopic dermatitis incidence constitutes a serious medical problem that regards not only dermatology and allergology, but also paediatrics, and family medicine. The basis for atopic dermatitis treatment and prophylaxis is restoration of epidermal barrier functions by means of tailored emollients. Atopic dermatitis therapies should effectively eliminate clinical symptoms of the disease, prevent exacerbations as well as complications, and improve patients' quality of life., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2020 Termedia Sp. z o. o.)

Background: Atopic dermatitis (AD) is a highly pruritic skin condition of unclear pathogenesis. Patients with AD are predisposed to colonization by Staphylococcus aureus due to deficiencies in the mechanical and immunological functions of the skin barrier. Recent studies indirectly show that S. aureus may aggravate disease flares in AD., Aims: The aim was to assess the relationship between S. aureus skin colonization and itch intensity in patients with AD., Materials and Methods: The SCORAD index components reflecting itch intensity (excoriations, subjective evaluation of pruritus, and sleep loss) were assessed in 33 adult patients with AD. Swabs were taken from lesional and nonlesional skin. The prevalence and abundance of S. aureus were assessed. Statistical analysis was performed to correlate the microbiological results with the clinical parameters. The control group consisted of 36 healthy volunteers., Results: Lesional and nonlesional skin showed a high frequency of S. aureus colonization when compared with controls (81.8% and 57.6% vs 5.6%, respectively, P < 0.0001). The mean concentration (points) of S. aureus was 2.01 ± 1.25, 1.06 ± 1.14, and 0.11 ± 0.46, respectively ( P < 0.0001). S. aureus abundance on lesional/nonlesional skin positively correlated with excoriations and sleep loss (rho = 0.69, P < 0.00001; rho = 0.44, P < 0.01; rho = 0.41, P < 0.02; and rho = 0.34, P < 0.05, respectively). The mean values of excoriations were higher in patients colonized by S. aureus than in patients without S. aureus carriage., Conclusion: S. aureus skin colonization may be one of the factors aggravating itch in AD. It may be hypothesized that restoring the natural composition of the skin microbiome may reduce pruritus intensity., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Indian Journal of Dermatology.)

Introduction: Positive skin prick tests (SPT) results with protein allergens are the minor Hanifin and Rajka's atopic dermatitis (AD) criterion. In adults, they mainly concern aeroallergens. The inflammation of skin often prevents SPT, but does not exclude the assessment of serous specific immunoglobulin E (sIgE) concentrations., Aim: To assess usefulness of testing AD patients to aeroallergens with SPT and sIgE concentrations, and the correlation of these results and the clinical AD course., Material and Methods: In 286 AD patients, total IgE and sIgE (14 aeroallergens) were measured. SPTs were performed with 17 aeroallergens. The AD severity was determined depending on the concurrent co-existence of asthma, allergic rhinitis, extensive skin flares and severe itching., Results: 59.1% and 66.1% of patients have had positive results of sIgE and SPT, respectively ( p > 0.05). The concentration of total IgE has positively correlated with the number of positive sIgE results (rho = 0.588, p < 0.001) and their intensity (rho = 0.592, p < 0.001). Among the patients with at least one high positive sIgE score, severe AD patients have been dominant (59.8% vs. 40.2%, p < 0.04). Among the patients with positive results without any high scores, the percentages are 21.6 and 78.4, respectively ( p < 0.001)., Conclusions: The compatibility of SPT results and IgE concentrations indicates that the two methods equally assess aeroallergy in AD patients. The assessment of sIgE concentrations is especially advisable in patients with an elevated total IgE level. The obtained results may suggest that presence of a high specific IgE level of antibodies to aeroallergens may be the factor predicting a severe clinical AD course., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2019 Termedia Sp. z o. o.)

Atopic dermatitis is a common, recurrent pruritic dermatosis with a complex pathogenesis. It has been associated with disordered patterns of immunological response and impaired epithelial barrier integrity. These features predispose the patients to robust colonization of skin lesions by Staphylococcus aureus . Virulence factors of S. aureus (e.g. superantigens, α- and δ-toxin, protein A) have been shown to exacerbate and perpetuate the course of atopic dermatitis. Novel therapeutic options with potential for restoring natural microbiome composition are being elaborated and may enter clinical practice in the future., Competing Interests: The authors declare no conflict of interest.

MicroRNAs are relatively new molecules that have been widely studied in recent years as to determine their exact function in the human body. It is suggested that microRNAs control approx. 30% of all genes, making them one of the largest groups that control the expression of proteins. Various functions of miRNAs have already been described. In skin diseases, there are more and more studies describing an altered expression of microRNAs in the skin or serum. Relatively little is known about the function of these molecules in atopic dermatitis, which prompted us to gather current reports on this subject.

Atopic dermatitis is a common term used in the medical literature, but according to The Nomenclature Review Committee Of The World Allergy Organization the name which should be used is eczema. Eczema is divided into two subtypes: atopic and non-atopic. These subtypes differ in the level of total immunoglobulin E (IgE) in serum, response to allergens in skin prick tests, and detection of specific IgE antibodies. Non-atopic eczema is characterized by a low level of total IgE, negative skin prick tests, and undetectable specific IgE antibodies. It is estimated that 10-45% cases of eczema are non-atopic ones. In recent studies, other features differentiating these two subtypes have been identified, such as female predominance in non-atopic eczema. A more severe course, damage of the epidermal barrier, predominance of Th2 (T helper cells 2) response, and a lower positive reaction to metal patch tests are the characteristics of the atopic subtype. In our opinion, new diagnostic criteria taking into account the non-atopic subtype of eczema need to be established.

Background: Vascular endothelial growth factor (VEGF) was found increased in the stratum corneum of patients with atopic dermatitis (AD). However, its potential pathogenic role(s) in AD needs further clarification., Objective: The aim of this study was to determine whether VEGF serum levels correlate with other selected cytokine levels and features of AD., Methods: VEGF and other cytokine levels were measured in 83 patients with AD and in a control group and then correlated with clinical and laboratory parameters of AD., Results: The mean serum concentrations of VEGF and tumor necrosis factor α were significantly higher in patients with AD than in the control group, whereas the mean interleukin eight serum level was lower. VEGF concentrations correlated with the severity of AD as expressed by SCORAD index and objective SCORAD., Conclusion: VEGF could be regarded as a potentially important mediator in the pathogenesis of AD, as VEGF levels correlate somewhat with AD severity., (© 2015 The International Society of Dermatology.)

Introduction: Topical glucocorticosteroids (GCSs) are commonly used in treatment of atopic dermatitis (AD)., Aim: To assess the patients' compliance with the recommended instructions of the therapy., Material and Methods: The study involved 141 adult AD patients. The clinical course of AD and its treatment with GCSs during the last year were analysed., Results: In the periods of exacerbation the lesions involved 10-50% of the skin surface area. Outpatient treatment in specialised dermatological and/or allergology clinics was given to 93% of the study subjects. Sixty-five out of 141 patients regularly attended medical control examinations. Glucocorticosteroids, mostly very potent ones (70.2%), were applied to all the subjects. 66.7% of patients obtained no information about their medications' anti-inflammatory potential. The substances were applied more frequently than twice daily by 36.4% of the patients. Seventy-two of 141 subjects applied GCSs both temporarily and in the long-term treatment, for 8.3 weeks on average. In the long-term treatment, in which very potent GCSs predominated (70.7%), no one used intermittent therapy. One hundred and thirty patients introduced their own modifications to the instructions concerning GCSs use, among which 37.7% changed the site of application, 58.5% prolonged the duration of application and 49.5% shortened it or occasionally temporarily withdrew the prescribed drug. None of the patients knew the fingertip unit method of dose assessment. Apart from steroid therapy, 56.7% of the patients carried out regular care treatment., Conclusions: The AD patients need to be thoroughly educated by the medical staff in the topical GCSs therapy in atopic dermatitis.

Background: Because vitamin D has immunomodulatory properties and immunologic mechanisms play a role in the pathogenesis of atopic dermatitis (AD), it is possible that vitamin D may influence the activity of AD., Objective: The aim of the study was to correlate vitamin D concentrations in patients who had AD with clinical, immunologic, constitutional, and environmental factors, and to determine if vitamin D supplementation affects the clinical manifestations of AD., Methods: Clinical and laboratory parameters of 95 patients with AD and 58 control subjects were measured. Severity of AD was assessed with the SCORAD index., Results: The mean serum concentration of 25(OH)D3 in patients with AD was not statistically different from control subjects. The frequency of bacterial skin infections was higher in patients with AD who had lower 25(OH)D₃ levels. No statistical associations between vitamin D levels and other multiple laboratory and clinical parameters were found. After supplementation both mean objective SCORAD and SCORAD index were significantly lower (P < .05)., Limitations: All study patients were Caucasians and only one supplemental vitamin D dose and treatment duration were assessed., Conclusion: The results from this study indicate that vitamin D supplementation may help ameliorate clinical signs of the disease and can be considered as a safe and well-tolerated form of therapy., (Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.)

The changes in lymphocyte subpopulations in atopic dermatitis (AD) concern also T-regulatory cells. We investigated the expression of various surface receptors on CD3(+)CD4(+)CD25(high)FoxP3(+) 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 CD4(+)CD25(high)FoxP3(+) as well as CD3(+)CD8(+) 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 CD4(+)CD25(high)FoxP3(+) cells seemed to be suggested, which may result in increased co-expression of CD28/CD152 on both CD4(+) and CD8(+) subpopulations.

Background: Atopic dermatitis (AD) diagnosis in children gives rise to many problems. Although the Hanifin and Rajka criteria are acknowledged and used universally in diagnosing AD, their evaluation is a major source of difficulty in pediatrician's daily practice. The simplified criteria, revised by Williams et al, seem to be more useful and represent the most common clinical manifestations of AD. The aim of the present study was to compare the efficacy of the two different criteria for diagnosing AD in children., Methods: This study involved 250 children with AD. All of the patients underwent clinical examinations and the diagnostic procedures according to the criteria of Hanifin and Rajka as well as those of Williams., Results: According to the Hanifin-Rajka criteria, AD was diagnosed in 173 children, of whom 153 were diagnosed positive by the criteria of Williams. Among the 77 children who were diagnosed without AD according to the Hanifin and Rajka criteria, 4 were detected with AD by the Williams criteria. Four children with scabies and seborrhoeic dermatitis were misdiagnosed as having AD according to the Williams criteria due to the atypical locations of their lesions and the histories of asthma or hay fever and xerosis., Conclusions: Although the criteria of Hanifin and Rajka are the gold standard for diagnosing AD, the Williams criteria are also very useful in children older than 4 years. The most useful Williams criteria for AD diagnosis in children is pruritus with history of lesions in characteristic locations and history of generally dry skin. The significant increase in the detectability of AD is found by raising the borderline age for the first skin lesion development from 2 to 5 years of age.

Atopic dermatitis (AD) is a disease with a complex pathomechanism, it is very difficult to establish the exact factors which can either trigger or exacerbate the disease. Knowledge of the mechanisms involved in AD development can be increased by, among others, applying new diagnostic tests and careful assessment of the results obtained. The aim of this study was to determine the allergic mechanisms of hypersensitivity to selected aeroallergens in patients with AD. The study comprised 109 AD patients. In all the patients the total IgE level was measured and atopy patch tests and skin prick tests were performed. We also assessed the presence of specific IgE against house dust mite, birch-tree, mixed grass pollen and cat dander. The highest incidence of positive results was found for house dust mite allergens, irrespective of the test employed. Analysing hypersensitivity to all the examined allergens we revealed the presence of allergic mechanisms in 85.3% of the patients. In 30.2% of the examined individuals we proved a type I immunological response, in 45.9% -- both types I and IV in 9.2% -- only type IV in one patient. In 14.7% of the patients the results of all the tests performed were negative. Analysing hypersensitivity to particular aeroallergens, negative test results to house dust mite were observed in 25.8% of the patients. The percentage of positive results for birch pollen, grass pollen and cat dander were 45.0, 44.1 and 53.2, respectively. Analysis of the results showed that allergic reactions to the same aeroallergens may develop via different mechanisms. We also revealed that the coexistence of various mechanisms involved in the development of hypersensitivity to a particular aeroallergen may occur in individual patients.

Unlabelled: The complex pathomechanisms underlying skin lesions in atopic dermatitis (AD) result in variations of the clinical picture and frequent diagnostic difficulties. The purpose of this study was to evaluate the usefulness of atopy patch tests (APT) for aeroallergens in the diagnosis of AD. The study involved 115 adult patients with AD and 98 healthy volunteers (the control group). APTs for cat dander allergens, birch pollen, a mixture of house dust mite species and a mixture of 5 grass pollen allergens were applied for both groups. Positive reaction to at least one test allergen was found in 53.9% patients compared to 6.2% in the control group (p<0.001). The most frequent hypersensitivity (45.2%) observed was to house dust mite allergens. Polyvalent allergy to 2-4 allergens was found in 56.5% patients. The specificity of tests exceeded 75%, whereas the sensitivity varied from 18 to 66%., Conclusions: 1. Atopy patch tests, which are characterised by considerable specificity, confirm the role of polyvalent contact hypersensitivity to aeroallergens in the development of atopic dermatitis. 2. Positive aeroallergen ATP results are observed in the majority of patients and can thus be regarded as an additional diagnostic criterion in atopic dermatitis.

The possibility of forecasting of atopic dermatitis (AD) course is limited. The aim of the study was to determine the prognostic usefulness of determination of total and specific IgE concentrations and the results of immediate skin tests in AD patients. The study included 480 adult patients with AD. Immediate skin tests with extracts of 18 aeroallergens and 10 food allergens were performed by PRICK method. Total IgE concentration and concentration of specific IgE (sIgE) against 13 aeroallergens and 12 food allergens were determined by the FAST method. For the assessment of the degree of pathologic process intensity the occurrence was determined of selected AD features according to Hanifin and Rajka exerting direct effect on the severity of the disease, urticaria, extensive cutaneous lesions and remission of the disease. The results were subjected to statistical analysis. In patients in whom total IgE concentration was significantly increased and/or hypersensitivity was found to aeroallergens, coexistence of atopic diseases of the airways, ectodermal defect, urticaria and extensive skin lesions was more frequently observed. Extensive skin lesions were also more frequent in patients with hypersensitivity to food allergens. The studies performed demonstrated that the diagnostic tests discussed are useful for prognostication of AD course. The presence of SIgE, positive results of immediate skin tests and high total IgE concentration prognosticate a more severe course of the disease.

On the basis of literature data new classification of chronic urticaria was presented, depending on pathogenetic factors and clinical picture. The most frequent causes of the disease, such as food, drugs, infectious and hormonal factors were discussed in detail. The relationship between ordinary chronic urticaria and other systemic diseases was underlined.

Background: The association of allergic diseases, drug adverse reactions and elevated total immunoglobulin E (IgE) concentration in systemic lupus erythematosus patients remains controversial. The aim of the study was to investigate the prevalence of those features in active and inactive systemic lupus erythematosus patients, and in the control group as well., Methods: Total IgE concentration was evaluated by enzyme-linked immunosorbent assay., Results and Conclusions: The results of our study revealed that concomitant allergic diseases were not more frequent in systemic lupus erythematosus patients than in the general population. Total IgE concentration was significantly higher during the active stage of the disease. Drug reactions were very frequent but not connected with IgE elevation. Our results indicate that IgE may play a role in lupus pathogenesis, especially in the active phase of the disease.

Prognostication of the course of atopic dermatitis (AD) is of special importance in prophylaxis of this disease. The aim of the study was to describe the AD minor feature sets, according to Hanifin and Rajka, on the basis of which one can predict the occurrence of extensive skin lesions, allergic rhinitis, atopic bronchial asthma, cataracts, hand and/or foot dermatitis, food intolerance, urticaria and elevated IgE serum in AD patients. Two-hundred-fifty-four patients were included in the study. Minor feature sets of prognostic value were selected using the MANOVA method in conjunction with the discriminant analysis. On the basis of the above sets, one can predict: involvement of more than 60% of body surface, occurrence of allergic rhinitis, elevated serum IgE, cataracts, atopic bronchial asthma, food intolerance and urticaria with the probability ratio of 90.8%, 82.8%, 79.9%, 78.4%, 77.3%, 77.1% and 76.1% respectively. In the examined group, no association was found between hand and/or foot dermatitis and the tendency towards skin infection.

Atopic dermatitis and bronchial asthma are genetically dependent diseases, connected with an over-synthesis of IgE antibodies, in which a chronic inflammation is characteristic for their pathogenesis. The coincidence of bronchial hyperresponsiveness and symptoms of atopic dermatitis suggests to investigate the degree of bronchial reactions in atopic dermatitis or asthma patients. The main goal of this analysis was to compare the pulmonary functional tests and the bronchial histamine induced reactiveness in 71 patients. The investigation included 27 atopic dermatitis patients, 12 asthma-prurigo patients and 32 bronchial asthma patients. All of them were tested with "Pneumoscreen" (Jaeger), in order to define: VC, FEV1, FEF50, and Raw. The bronchial reactiveness with 1% histamine solution, was tested on "Bronchoscreen" (Jaeger). In atopic dermatitis and asthma-prurigo patients, no obstructive ventilation impairment was found. The bronchial hyper-reactiveness to histamine was found in 11.1% of atopic dermatitis patients, 16.7% of asthma-prurigo patients and 78.1% of bronchial asthma patients. The coexistence of bronchial asthma and atopic dermatitis increases the degree of bronchial reactiveness.

The frequency of basic and minor features of atopic dermatitis were compared between 86 patients with coexistent asthma, and 269 without asthma. The coexistence of asthma caused a statistically significantly more frequent presence of one of the basic features: personal or family history of atopy and five minor features. The latter included: early age of onset, recurrent conjunctivitis, tendency toward cutaneous infections, elevated serum IgE and keratosis pilaris.

In 79 males aged 19-21 years with acute and chronic urticaria living under similar conditions the levels were determined of total IgE (FIST test) and specific IgE (FAST test) against the most frequent inhaled and food allergens. Statistically significant rise of the mean value of total IgE was noted in both groups of patients. In acute urticaria increased concentration of specific IgE against inhaled allergens was significantly more common.

The study involved 117 adults and 535 children with atopic dermatitis. Immunoglobulins E against D. pteronyssinus--main allergen of the home dust--were assayed with RAST technique in children and FAST technique in adult patients. It was found that the blood serum IgE levels increase with patients' age and is the highest in patients with coexisting allergic respiratory diseases (difference statistically significant). RAST precision was compared with that of "prick" skin tests in the detection of allergy to home dust mites. Desensitization of 15 patients with home mite allergen produced satisfactory effects.

Three hundred sixty five children and hundred thirty nine adults with atopic dermatitis were divided into three groups. Group A included patients with negative family history of allergy; group B--allergy history in one parent or his family; group C--allergy in both parents or their families. It was found that total IgE level was higher in patients of group C in comparison with group A. Similarly, bronchial asthma and/or rhinitis coexisted more frequently, incidence of urticaria was higher and its onset earlier in patients of group C. The results noted in patients of group B occupied middle position between those in group A and group C. Results related to the incidence of RAST positive reactions and multiple sensitivity were similar but the differences were lower. Radioimmunologic assays were performed only in part of the tested patients.

The percentages of suppressor T lymphocytes were compared in 111 patients with atopic dermatitis and 100 healthy volunteers. In the former group there was a statistically significant reduction of suppressor T cells, which was not related to IgE level. Similar decrease in T cells has been found in patients with normal IgE as well as in patients having 10-fold increase in serum IgE. Our results were compared to previously published data of other investigators.

A case of atopic dermatitis was observed in a patient in whom clinical observation and radioimmunoassays failed to demonstrate any possible role of allergic mechanisms. The lesions were caused exclusively by contact with the irritating substances and mechanical pressure, even, at times, by pressure of clothes.

The HDM vaccine Bencard of housedust mite was used for desensitization by generally used methods of 17 patients with atopic dermatitis. Very good improvement was achieved in 6 cases, medium improvement in 10, and no improvement in 1 case. The possible role of psychogenic factors in this improvement is discussed.