Patients confirmed as having contact allergy show a subsequent improvement in eczema severity and an improvement in quality of life.

No abstract

Although physician-assessed good or excellent responses of 38.5% are lower than frequently reported for other skin sites and adverse effects may be more frequent, patient satisfaction with treatment was generally high. Patients with PWS on the lower limb merit a trial of PDL treatment.

It has been suggested that the liver traps and deletes activated and potentially harmful T cells, especially of the CD8 ؉ subset, providing mechanisms to limit systemic immune responses. It is unknown whether this also applies to CD4 ؉ T cells. In this study, we show that activated stages of CD4 ؉ T cells were trapped in the liver on intraportal injection. Intravital microscopy showed an immediate adhesion of activated CD4 ؉ T cells within periportal sinusoids after intraportal injection. Furthermore, we detected high frequencies of interferon gamma (IFN-␥)-(Th1) and interleukin 4 (IL-4)-(Th2) synthesizing effector cells in the liver. Transfer experiments were performed to identify those phenotypes showing specific retention in the liver. Our data show that effector stages and activated cells in general are more efficiently recruited into the liver than resting CD4 ؉ T cells, similar to what has previously been shown for CD45RB low memory cells. In addition, we observed a certain preference for Th1-polarized cells to be trapped by the liver. However, the actual cytokine-producing cells did not specifically enrich among the total population. In conclusion, these data indicate that the liver acts as a filter for activated and memory/effector cells. Cells trapped in the liver might subsequently undergo modulatory influences exerted by the postulated specific microenvironment of the liver. (HEPATOLOGY 2002;35:568-578.)

We conclude that delayed-type hypersensitivity to NRL is a problem for a proportion of patients with eczema, particularly on their hands, and that patch testing with ammonia-preserved NRL can be recommended to identify these patients. Patients with a positive patch test should be investigated for contact urticaria to NRL.