Atopic dermatitis

Residual Washing Detergent in Cotton Clothes: A Factor of Winter Deterioration of Dry Skin in Atopic Dermatitis

Although it is well known that the skin in patients with atopic dermatitis becomes drier in winter, the mechanisms of winter deterioration of dry skin are not fully understood. Our purpose was to determine whether residual washing detergent in cotton clothes plays a role in the winter deterioration of atopic dry skin. We studied 148 Japanese patients with atopic dermatitis who visited our dermatology clinic during winter months. They wore cotton underwear, which they had washed in cold tap water. We examined the distribution of dry skin on their trunks. We then asked them to stop washing their clothes with common anionic, additive-enriched detergents, and to use a nonionic, additive-reduced detergent for a period of two weeks. Photographs of 2 or 3 representative dry skin sites on the trunk were taken before and after the trial. By comparing the before-after trial photographs, the severity of dry skin at the end of the trial was assessed on a 5-point scale ranging from markedly improved to worsened. Of the 148 patients examined, 115 (78%) had widespread or localized dry skin on the trunk. The dryness of the skin was prominent around the shoulders. Of these 115 patients, 87 (76%) showed marked or moderate improvement of dry skin after the two-weeks of use of the nonionic, additive-reduced washing detergent. No patient showed worsening of the dry skin. These results suggest that residues of common washing detergents in cotton underclothes play an important role in the winter deterioration of dry skin in patients with atopic dermatitis who use cold tap water for washing their clothes.

The prevalence of accentuated palmoplantar markings and keratosis pilaris in atopic dermatitis, autosomal dominant ichthyosis and control dermatological patients

The prevalence of keratosis pilaris and accentuated palmoplantar marking was evaluated in 61 patients with atopic dermatitis, 35 patients with dominant ichthyosis vulgaris and 247 other dermatological cases taken as controls. Our data showed that (1) these features are of no diagnostic significance for atopic dermatitis and (2) they are significantly more frequent in patients with ichthyosis vulgaris without associated eczema than in those with atopic dermatitis. Consequently, they should be considered as part of the phenotype of ichthyosis vulgaris rather than attributed to a concomitant atopic dermatitis as suggested by some. These findings should be taken into account when evaluating atopic dermatitis or ichthyosis. To assess the frequency of scaling under winter weather conditions, 155 control subjects were also examined for evidence of visible desquamation and 25.8% showed slight but definite scaling.

Immunoglobulin E antibodies to ingested cereal flour components: studies with sera from subjects with asthma and eczema

The specificity of immunoglobulin E for different cereal grain proteins was investigated using sera from twenty paediatric patients with asthma and/or eczema. Close correlations were observed between radioallergosorbent test values for grain extracts of wheat, rye and barley, and, to a lesser extent, oats. Of the different wheat four fractions tested, the globulins and glutenins consistently bound higher levels of IgE than the gliadins and albumins. This is in contrast both with bakers' asthma (an allergy to inhaled flour where the albumins are important allergens) and with coeliac disease (in which gliadin is the most toxic fraction). Partial digestion of the flour proteins largely removed their ability to bind IgE. An analytical technique of identifying allergens after gel isoelectric focusing demonstrated that many different flour proteins were involved.

Asthma predictors in infantile atopic dermatitis

In a search for predictive factors in early childhood for later developing childhood asthma, sixty chidren who suffered in the first year of life from atopic dermatitis were examined at ages between 6-11 years. There were 40 boys and 20 girls, of whom 21 were asthmatic boys and 10 asthmatic girls. The non-asthma group was similar to the asthma group in age, sex and socio-economic background and familial-hereditary background. The psychosocial aspects of the study were not reported in this paper. The atopic dermatitis followed a different pattern in the asthmatic group than in the non-asthma group. A continuation of the atopic eczematous condition in infancy beyond two years appeared to be highly predictive for future childhood asthma. Severity of the eczema in infancy does not seem to be a strong predictor in boys and not at all in the small group of girls. Persistent eczema appeared twice as much in the asthmatic boys as in the asthmatic girls. There was no distinct difference between the asthmatic children and the non-asthmatic children in time of onset of the infantile eczema nor in the location of the atopic dermatitis.