Reduced histamine reaction in atopic dermatitis

Uehara, M.

doi:10.1001/archderm.118.4.244

Cited by 14 publications

(3 citation statements)

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“…172 Studies have shown that AD patients had reduced itch sensations with intracutaneously injected or iontophoretically applied histamine when compared with healthy subjects. 173,174 Therefore, it is no surprise that oral nonsedating antihistamines are not very effective against itch in AD. An evidence-based review of multiple randomized, placebo-controlled trials reported little objective evidence for an antipruritic effect of antihistamines in AD.…”

Section: Systemic Antipruritic Agentsmentioning

confidence: 99%

Management of Itch in Atopic Dermatitis

Hong¹,

Buddenkotte²,

Berger³

et al. 2011

Seminars in Cutaneous Medicine and Surgery

130

105

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Atopic dermatitis is a common, pruritic, inflammatory skin disorder. Chronic, localized, or even generalized pruritus is the diagnostic hallmark of atopic dermatitis, and its management remains a challenge for physicians. The threshold for itch and alloknesis is markedly reduced in these patients, and infections can promote exacerbation and thereby increase the itch. Modern management consists of anti-inflammatory, occasionally antiseptic, as well as antipruritic therapies to address the epidermal barrier as well as immunomodulation or infection. Mild forms of atopic dermatitis may be controlled with topical therapies, but moderate-to-severe forms often require a combination of systemic treatments consisting of antipruritic and immunosuppressive drugs, phototherapy, and topical compounds. In addition, patient education and a therapeutic regimen to help the patient cope with the itch and eczema are important adjuvant strategies for optimized long-term management. This review highlights various topical, systemic, and complementary and alternative therapies, as well as provide a therapeutic ladder for optimized long-term control of itch in atopic dermatitis.

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Section: Systemic Antipruritic Agentsmentioning

confidence: 99%

Management of Itch in Atopic Dermatitis

Hong¹,

Buddenkotte²,

Berger³

et al. 2011

Seminars in Cutaneous Medicine and Surgery

130

105

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“…Equally, the increased reactivity to alpha-adrenoceptor stimulation, inferred from in vitro studies (Szentivanyi et al, 1980), does not appear to have an in vivo counterpart in the cutaneous vessels of patients with atopic eczema. Decreased flare responses to intracutaneous histamine in atopic eczema have been previously reported (Eyster, Roth & Kierland, 1952;Michaelsson, 1970) and this phenomenon may be secondary to eczematous inflammation (Uehara, 1982).…”

Section: Discussionmentioning

confidence: 58%

Actions of locally administered adrenoceptor agonists on histamine-induced cutaneous responses in atopic eczema

Archer

Paul²,

Morley³

et al. 1984

Clin Exp Dermatol

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Summary An in vivo method for the assessment of adrenergic reactivity has been employed to examine alpha‐adrenergic and beta‐adrenergic responses in atopic eczema. In a randomised, double‐blind study, intradermal administration of noradrenaline (predominantly an alpha‐1‐adrenoceptor agonist) or salbutamol (predominantly a beta‐2‐adrenoceptor agonist) significantly inhibited the histamine wheal response (P <0.001) in atopic and control subjects. However, the responses to alpha‐adrenergic or beta‐adrenergic effects were similar in both groups, a finding which does not support the concept that atopy is due to impaired beta‐adrenergic reactivity accompanied by enhanced alpha‐adrenergic reactivity. The ability of patients with atopic eczema to respond normally to the anti‐inflammatory effect of a beta‐2‐adrenoceptor agonist is of therapeutic interest.

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“…The quantity of intercellular edema and mononuclear cell infiltrates varies according to the activity of the process at time of biopsy. Early lesions of pruriginous papules in atopic dermatitis often show an eczematous change at the hair follicle (49). Thus, it should be emphasized that skin manifestations of atopic dermatitis histologically resemble those of acute or chronic allergic contact dermatitis.…”

Section: Immunological Abnormalitiesmentioning

confidence: 99%