Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy

Lever, Rosemary; Hadley, Kay; Downey, D.G.; MacKie, Rona M.

doi:10.1111/j.1365-2133.1988.tb03201.x

Cited by 231 publications

(131 citation statements)

References 13 publications

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“…Several independent studies have demonstrated that staphylococci can aggravate AD pathogenesis by many mechanisms including the activation of mast cells, T cells, keratinocytes and macrophages via multiple virulence factors such as protein A, lipoteichoic acid and toxins with superantigenic properties (24). This is supported by reports on a positive correlation of the presence of bacteria and disease severity (25) as well as by significant improvement of eczema achieved upon antibiotic treatment (26). Antibiotics emerged to be helpful in the management of acute AD inflammation.…”

Section: High Prevalence Of Microbial Infections In Allergic Diseasessupporting

confidence: 62%

Does allergy impair innate immunity? Leads and lessons from atopic dermatitis

Mrabet-Dahbi

Maurer

2010

Allergy

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To cite this article: Mrabet‐Dahbi S, Maurer M. Does allergy impair innate immunity? Leads and lessons from atopic dermatitis. Allergy 2010; 65: 1351–1356.AbstractHost defence responses against invading pathogens are well‐balanced, inflammatory processes of the innate and adaptive immune system. Impaired development or abnormal function of either system can result in failure to control pathogens and to clear infections. Infections have been claimed to modulate the onset and course of allergic diseases. This so‐called hygiene hypothesis is still an active area of research. In contrast, the effects of allergies on infections and pathogen‐directed immune responses are less well understood. Here, we have reviewed the existing evidence that allergies result in impaired innate immunity and we discuss recent observations that may explain why and how innate immunity is dysfunctional in allergic patients. With a focus on atopic dermatitis as a model of allergic disease, we speculate that one of the key features of allergic conditions, namely Th2 polarization, leads to several independent inhibitory effects on host defence and consequently to a higher risk of infections in allergic patients. A better understanding of impaired host defence and its mechanisms in allergic subjects will help to improve the management of these diseases.

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Section: High Prevalence Of Microbial Infections In Allergic Diseasessupporting

confidence: 62%

Does allergy impair innate immunity? Leads and lessons from atopic dermatitis

Mrabet-Dahbi

Maurer

2010

Allergy

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“…On the other hand, S. aureus was rare in healthy controls. Thus, S. aureus appears to be insignificant in the normal cutaneous flora in healthy controls, apart from its existence in the nose and perineum (12,13). Interestingly, not all AD patients had S. aureus in non-lesional (healthy skin), and the mean density was only half of that found in lesional skin.…”

Section: Discussionmentioning

confidence: 95%

The effect of UVB radiation on skin microbiota in patients with atopic dermatitis and healthy controls

Dotterud

Wilsgaard

Vorland

et al. 2008

International Journal of Circumpolar Health

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Objectives. To investigate Staphylococcus aureus and Staphylococcus epidermidis quantitatively in adult patients with atopic dermatitis and in healthy controls treated with UVB radiation. Study design. Twenty-three adult patients (of these, 3 were excluded) with flexural atopic dermatitis and 20 healthy controls were randomly selected at the outpatient clinic of the Dermatological Department, University Hospital, North Norway. Methods. Adult patients with atopic dermatitis (n=20) and healthy controls (n=20) were given 20 UVB treatments. Bacterial samples were collected before treatment, after 4 weeks of treatment, and finally after 2 weeks follow-up. Results. The main bacteria found were Staphylococcus aureus and Staphylococcus epidermidis. 16 of the 20 patients with atopic dermatitis had Staphylococcus aureus in lesional skin and 12 in non-lesional skin. None of the healthy controls had Staphylococcus aureus in the sample from the flexural elbow. The Staphylococcus aureus counts decreased (not significant) in lesional skin after 4 weeks of treatment and Staphylococcus aureus counts were slightly higher after 2 weeks follow up. The same figures were also seen in non-lesional skin and forehead. Conclusions. Staphylococcus aureus is widely colonised in the skin of atopic dermatitis patients, but is rare in healthy adults. UVB treatment decreases the Staphylococcus aureus count in patients with atopic dermatitis. (Int J Circumpolar Health 2008; 67(2-3):254-260)

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“…S. aureus may aggravate AD due to a secondary infection (3,84,93,94,118). However, of greater importance is probably the presence of exotoxins and other substances from S. aureus that may act as allergens or, more importantly, as superantigens (59,60,89,90,139,142,168).…”

Section: Introductionmentioning

confidence: 99%

Atopic Dermatitis and Fungi

Faergemann

2002

Clin Microbiol Rev

150

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Atopic dermatitis (AD) is a chronic, itching, inflammatory skin disease which is associated with asthma and/or hay fever and a familial occurrence of these conditions. Genetic factors are important in the development of AD, but the exact hereditary pathway is still unknown. Dry skin and the weakened barrier function in patients with AD is very important for the patient's reactions to irritants and other external trigger factors including microorganisms. The standard treatments are topical corticosteroids, topical immunomodulating agents, and emollients. If AD cannot be controlled by this type of treatment, systemic immunomodulating agents may be used. UVB, UVA, or psoralen-UVA may also be used for widespread severe lesions. However, some patients do not respond to these standard treatment, and then it is important to consider the role of microorganisms, house dust mites or food. The role of the Malassezia yeasts in AD, especially AD located to the head and neck region, is now documented in several papers. There are also several papers indicating the role of Candida as an aggravating factor in AD. Patients with AD also develop chronic dermatophyte infections more easily, and patients with AD and chronic dermatophyte infections may show improvement in their AD when treated with antifungal drugs

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Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy

Cited by 231 publications

References 13 publications

Does allergy impair innate immunity? Leads and lessons from atopic dermatitis

Does allergy impair innate immunity? Leads and lessons from atopic dermatitis

The effect of UVB radiation on skin microbiota in patients with atopic dermatitis and healthy controls

Atopic Dermatitis and Fungi

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