Moisturizing creams have beneficial effects in the treatment of dry, scaly skin, but they may induce adverse skin reactions. In a randomized double-blind study, 197 patients with atopic dermatitis were treated with one of the following: a new moisturizing cream with 20% glycerin, its cream base without glycerin as placebo, or a cream with 4% urea and 4% sodium chloride. The patients were asked to apply the cream at least once daily for 30 days. Adverse skin reactions and changes in skin dryness were assessed by the patient and a dermatologist. Adverse skin reactions such as smarting (a sharp local superficial sensation) were felt significantly less among patients using the 20% glycerin cream compared with the urea-saline cream, because 10% of the patients judged the smarting as severe or moderate when using glycerin cream, whereas 24% did so using urea-saline cream (p < 0.0006). No differences were found regarding skin reactions such as stinging, itching and dryness/irritation. The study showed equal effects on skin dryness as judged by the patients and the dermatologist. In conclusion, a glycerin containing cream appears to be a suitable alternative to urea/sodium chloride in the treatment of atopic dry skin.
Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients.Johansson, C.; Sandström, M.H.; Bartosik, Jacek; Särnhult, T.; Christiansen, J; Zargari, A.; Bäck, Ove; Wahlgren, C.F.; Faergemann, J.; Scheynius, A.; Tengvall Linder, M. Link to publication Citation for published version (APA): Johansson, C., Sandström, M. H., Bartosik, J., Särnhult, T., Christiansen, J., Zargari, A., ... Tengvall Linder, M. (2003). Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients. British Journal of Dermatology, 148(3), 479-488. DOI: 10.1046479-488. DOI: 10. /j.1365479-488. DOI: 10. -2133479-488. DOI: 10. .2003 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Clinical and Laboratory InvestigationsAtopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients SummaryBackground The yeast Malassezia is considered to be one of the factors that can contribute to atopic dermatitis (AD).Objectives To investigate the reactivity to Malassezia allergens, measured as specific serum IgE, positive skin prick test and positive atopy patch test (APT), in adult patients with AD. Methods In total, 132 adult patients with AD, 14 with seborrhoeic dermatitis (SD) and 33 healthy controls were investigated for their reactions to M. sympodialis extract and three recombinant Malassezia allergens (rMal s 1, rMal s 5 and rMal s 6).Results Sixty-seven per cent of the AD patients, but only one of the SD patients and none of the healthy controls, showed a positive reaction to at least one of the Malassezia allergens (extract and ⁄ or recombinant allergens) in at least one of the tests. The levels of M. sympodialis-specific IgE in serum correlated with the total serum IgE levels. Elevated serum levels of M. sympodialis-specific IgE were found in 55% and positive APT reactions in 41% of the AD patients with head and neck dermatitis. A relatively high proportion of patients without head and neck dermatitis and patients with low total serum IgE levels had a positive APT for M. sympodialis, despite lower proportions of individuals with M. sympodialis-specific IgE among these groups of patients.Conclusions These results support that Malassezia can play a role in eliciting and maintaining eczema in patients with AD. The addition of an APT to the test battery used in this study reveals a previously overlooked impact of Malassezia hypersensitivity in certain subgroups of AD patie...
Cultures for Malassezia yeasts were taken from both normal-looking skin and lesional skin in 124 patients with atopic dermatitis, 16 patients with seborrhoeic dermatitis and from normal skin of 31 healthy controls. Positive Malassezia growth was found in fewer patients with atopic dermatitis (56%) than in patients with seborrhoeic dermatitis (88%) or in healthy controls (84%, p<0.01). In the patients with atopic dermatitis, fewer positive cultures were found in lesional (28%) than in non-lesional skin (44%, p<0.05), while positive cultures were found in 75% of both lesional and non-lesional skin of patients with seborrhoeic dermatitis (not significant). M. sympodialis dominated in patients with atopic dermatitis (46%) and in healthy controls (69%). In patients with seborrhoeic dermatitis both M. sympodialis and M. obtusa were cultured in 43%. A Malassezia species extract mixture would increase the possibility of detecting IgE sensitization to Malassezia in patients with atopic dermatitis.
Thyroid hormones have an in uence on the connectivedermal blood ow as a consequence of increased metatissue biology of the skin and, theoretically, topically bolic rate and decreased systemic vascular resistance applied thyroid hormones or hormone analogues could have and are thus not attributable to a direct action of TH a stimulatory eVect on collagen synthesis. In this investion cells in the skin (2-5). However, it is also known gation the eVect of topical tri-iodothyroaceti c acid (Triac) that the connective tissue biology of the skin is sensitive and other thyroid hormone analogues were tested for their to alterations in thyroid hormone status (3) and the eVect in preventing betamethasone-indu ced skin atrophy in presence of intracellular receptors ( TRs) for thyroid the normal haired mouse. Triac, tri-iodoproprioni c acid hormones in human skin, in both dermal and epidermal ( Triprop) and the synthetically developed thyroid hormone parts, have been demonstrate d (6-10). analogue KB-026 and 2 diVerent Triac cream formulationsInformation concerning the mechanism of action of TH were applied along with betamethasone on shaved mouse in broblasts, especially in regulation of collagen producskin. Triac in daily doses of 1 nmol/cm2 and higher was tion, is limited. In one study by Rycker et al., thyroid able to block the betamethasone-induce d skin atrophy in hormone administration diminished collagen production mice skin. In high doses, Triprop and KB-026 also had a in cultured broblasts (9). Although a vast number of blocking eVect. Triac alone had a stimulatory eVect on studies on thyroid hormone action in organs such as liver, dermal thickness. This study indicates that thyroid hormone heart, pituitary, brain and adipose tissue have been peranalogues may be used to prevent corticosteroid-induce d formed, no studies have been undertaken to investigate skin atrophy. Keywords: animal model; skin thickness; the activity of topical TH in glucocorticoid-treated skin. normal haired mouse.Moreover, as TRs are part of a larger superfamily of nuclear receptors, which comprises the receptors for gluco-
There is a need for unified guidance on the management of ocular manifestations of atopic dermatitis and ocular manifestations associated with dupilumab in the Nordic region (Denmark, Finland, Norway and Sweden). This initiative gathered Nordic dermatologists and ophthalmologists to identify consensus in this area using a modified Delphi process. The initiative was led by a Nordic expert panel who developed a questionnaire that was circulated to a wider group. The results informed an agenda consisting of 24 statements to be voted on using a 5-point Likert scale at a meeting in Copenhagen on 24 April 2019. A facilitator moderated discussion and revised statements according to expert feedback for a second vote when required to reach consensus. Consensus was reached for 23 statements regarding the diagnosis, treatment and referral of these patients, which we hope will improve patient management in the Nordic region.
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