Recurrent viral infections in patients with past or present atopic dermatitis

Abstract

Histories of recurrent infections were obtained from 955 adults with past or present atopic dermatitis (AD) and from 199 controls. Patients who had previously been hospitalized in childhood because of severe AD had a significantly higher incidence of recurrent (greater than 5 episodes per year) cold sores and upper respiratory tract infections as well as a higher incidence of herpes zoster, than non-atopic controls. Patients with milder AD in childhood (never hospitalized) had lower incidence of these diseases, but as regards cold sores, the frequency of recurrent infections was still significantly higher than that of the controls. AD patients with past or present respiratory allergy had a slight but not statistically significant increased incidence of recurrent infections, as compared to AD patients without concomitant respiratory allergy. The factors predisposing to frequent infections appeared to be those related to severity of the atopic condition, i.e. ongoing AD, need for hospitalization in childhood and extent of dermatitis. The increased susceptibility to recurrent viral infections in AD patients is most probably related to dysfunctioning cell-mediated immunity.

Safety and Efficacy of 1 Year of Tacrolimus Ointment Monotherapy in Adults With Atopic Dermatitis

“…More than 5 episodes of cold sores per year were noted in approximately 8% of adult patients who had been hospitalized at least once during their childhood for atopic dermatitis compared with less than 1% in a control population. 21 Relative to these data, the incidence of herpes simplex in the present study was consistent with that expected for this patient population and duration of observation. Eczema herpeticum is a complication of atopic dermatitis arising from herpes simplex infection that resembles varicella.…”

Clinical Management of Atopic Eczema with Pimecrolimus Cream 1% (Elidel®) in Paediatric Patients

“…As a result of skin-barrier dysfunction and impairment of cell-mediated immunity, patients with atopic eczema have an increased risk of skin infections, including fungal, viral, and bacterial infections [34, 35]. In particular, atopic eczema lesions are colonized by Staphylococcus aureus , and staphylococcal and/or streptococcal infections are suspected of having a role in the worsening of disease [35, 36].…”

Avaliação da eficácia e segurança do tacrolimo pomada 0,03% no tratamento da dermatite atópica em pacientes pediátricos

“…[13][14][15] Teoricamente, um agente imunomodulador tópico como o tacrolimo pode aumentar o risco de infecções cutâneas, devido a sua ação na resposta imune local, o que não foi evidenciado neste estudo ou em outros publicados na literatura. 15,16 Provável explicação é que o controle da doença, promovido pelo tacrolimo, resulta em recuperação da barreira cutânea com redução do risco de infecção local.…”

“…Neste estudo com tacrolimo não se encontrou aumento da incidência de infecção respiratória. [13][14][15] Pournaras et al avaliaram 11 pacientes com DA, tratados com tacrolimo pomada 0,1%, considerando parâ-metros de eficácia o escore lesional (índice SCORAD), a perda transepidérmica de água (TEWL) e a densidade de colonização das lesões por Staphylococcus aureus. Durante o tratamento, SCORAD e TEWL mostraram redução significativa no terceiro dia de tratamento, enquanto a redução na colonização pelo S. aureus mostrou-se significativa no sétimo dia.…”