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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+CD25highFoxP3+ 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+CD25highFoxP3+ 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+CD25highFoxP3+ cells seemed to be suggested, which may result in increased co-expression of CD28/CD152 on both CD4+ and CD8+ subpopulations.

IntroductionTopical glucocorticosteroids (GCSs) are commonly used in treatment of atopic dermatitis (AD).AimTo assess the patients’ compliance with the recommended instructions of the therapy.Material and methodsThe study involved 141 adult AD patients. The clinical course of AD and its treatment with GCSs during the last year were analysed.ResultsIn 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.ConclusionsThe AD patients need to be thoroughly educated by the medical staff in the topical GCSs therapy in atopic dermatitis.

IntroductionPositive 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.AimTo 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 methodsIn 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.Results59.1% 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).ConclusionsThe 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.