Odontogenic focal infection could be partly involved in the pathogenesis of atopic dermatitis as exacerbating factor

Association between bleeding periodontal pockets and eczemas: Results of the Northern Finland Birth Cohort 1966

AIM

To investigate whether the periodontal condition as measured by bleeding periodontal pockets is associated with atopic dermatitis, seborrheic dermatitis, and eczema nummulare.

MATERIALS AND METHODS

The study population (n = 1871) was obtained from the 46-year follow-up study of the Northern Finland Birth Cohort 1966 study (NFBC1966). The periodontal condition was measured by the number of sites with bleeding periodontal pockets that were ≥4 mm deep. The whole skin of the participants was clinically examined, and diagnoses of skin diseases were made according to the International Classification of Diseases. Prevalence rate ratios (PRR) and 95% confidence intervals (95% CIs) were estimated using Poisson regression models with robust error variance.

RESULTS

In this cohort, comprising 46-year-old participants of NFBC1966, the presence of 1-3 and ≥4 bleeding-deepened periodontal pockets (≥4 mm deep) were associated with seborrheic dermatitis (PRR 1.9, 95% CI: 1.3-2.8 and PRR 2.2, 95% CI: 1.4-3.3, respectively) and with eczema nummulare (PRR 1.7, 95% CI: 0.9-3.1 and PRR 1.7, 95% CI: 0.9-3.3, respectively). For non-smokers, the corresponding estimates were 1.7 for seborrheic dermatitis (95% CI: 1.1-2.6) and 1.8 (95% CI: 1.1-3.1) and 1.4 for eczema nummulare (95% CI: 0.7-2.9) and 1.2 (95% CI: 0.5-2.9), respectively. No association was found between bleeding-deepened periodontal pockets and atopic dermatitis. Further adjustments for C-reactive protein, diabetes, and inflammatory diseases did not essentially change the risk estimates among either the total population or the non-smokers.

CONCLUSION

Bleeding periodontal pockets appeared to be associated with the presence of seborrheic dermatitis and eczema nummulare.

Clinical oral profile of pediatric patients with atopic dermatitis: A cross-sectional study

OBJECTIVES

This work aims to describe oral health conditions, eating habits, and oral hygiene in pediatric and adolescent patients with atopic dermatitis and correlate them with the severity of the Scoring Atopic Dermatitis (SCORAD). Also, we aim to estimate the effect of several variables on the diagnosis of dental caries in these patients.

MATERIAL AND METHODS

A total of 92 children and adolescents with atopic dermatitis had their oral cavities examined. The effect of independent variables on the diagnosis of dental caries (outcome) was assessed using multiple binary logistic regression model.

RESULTS

Mild patients presented higher score of decayed, missing, and filled teeth in permanent dentition than moderate patients (p = 0.040). In the multivariable regression final model, the covariates using inhaled corticoid (OR = 6.4; p = 0.003), type of teething [deciduous dentition (OR = 7.9; p = 0.027) and mixed dentition (OR = 10.5; p = 0.007)], and brushing quality [poor mechanical control (OR = 10.6; p < 0.0001)] demonstrated significant direct effect on the diagnosis of dental caries.

CONCLUSIONS

Our findings suggest that the presence of dental biofilm, use of inhaled corticoid, and type of teething are related to the presence of caries in atopic dermatitis patients.

Identification of oral symptoms associated with atopic dermatitis in adolescents: Results from the Korea national representative survey 2009-2017

The relationship between oral health and atopic dermatitis (AD) remains unclear. Here we investigated the association between oral health status and AD using data from 634,299 subjects in the Korean Youth Risk Behavior Survey (KYRBS). Participants with oral symptoms were defined as those with any of following: sensitive teeth, toothache, bleeding gums or gum pain, and dry mouth. Current AD was determined by the question if participant had been diagnosed with AD from doctor within the past 12 months. We estimated the odds ratio (OR) for AD diagnosis according to the presence of oral symptoms. The OR for current AD, which is a dependent variable, was significantly increased in participants with oral symptoms, which are independent variables, in an adjusted model (OR, 1.27; 95% confidence interval [CI], 1.26–1.29; P < 0.001). In detailed analyses, all four oral symptoms were significantly associated with AD diagnosis: sensitive teeth (OR, 1.21; CI, 1.19–1.23; P < 0.001), bad breath (OR, 1.18; CI, 1.17–1.20; P < 0.001), toothache (OR, 1.18; CI, 1.16–1.20; P < 0.001), and bleeding gums (OR, 1.14; CI, 1.12–1.16; P < 0.001). In the presence of oral symptoms, the ORs for having two or more allergic diseases (AD, allergic rhinitis, and/or asthma) were higher than that of AD alone. In this study, oral symptoms appeared to be associated with AD in Korean adolescences.

Prevalence of chronic infection foci in patients with dermatoses

This paper presents the results of a retrospective epidemiological study carried out to detect chronic infection foci (CIF) in patients affected by T-cell mediated dermatoses. The values obtained for the CIF prevalence are compared with those in the general population, as well as in the control group. The latter comprised generally healthy people according to the results of in-depth medical examination. It is found that patients with psoriasis demonstrate a higher prevalence of chronic tonsillitis compared to the values both in the general population and in the control group (p = 0.001). Patients with eczema are characterized by an increased prevalence of chronic granulomatous periodontitis, but only in comparison with generally healthy individuals (p = 0.046). The results obtained for patients with atopic dermatitis, lichen planus and alopecia areata are found to be statistically significant for chronic tonsillitis, which occurs therein more frequently than in the general population and in the group of generally healthy people (p = 0.001).

Oral Aspects Identified in Atopic Dermatitis Patients: A Literature Review

Introduction:

Atopic dermatitis is a chronic inflammatory skin condition that is more prevalent in children (10-20% of the world's population) than in adults. As its etiology is multifactorial, it is important to know the most frequent oral manifestations in atopic dermatitis patients.

Methodology:

In the last decades, the correlation between atopic dermatitis and conditions and/or changes in the oral cavity has been demonstrated by several studies. The objective of this paper was to describe, through a review of the literature, the oral health conditions and/or oral aspects identified in patients with atopic dermatitis.

Search Strategy:

A descriptive literature review was carried out through a bibliographical survey based on the last 10 years, in order to answer the study questions.

Results:

As a result, we found six studies with different sample sizes, ranging from 43 to 468 patients, and the majority of them were of cross-sectional study design.

Discussion:

Two studies performed their analysis through dental exams and reported that patients with atopic dermatitis tend to have a greater frequency of carious lesions, and two studies correlated Candida with atopic dermatitis through mycological analyzes.

Conclusion:

There are a few studies in the literature that identify the oral aspects of atopic dermatitis. More investigations are needed in order to contribute to the knowledge of such oral aspects and the approach to treat these patients regarding oral health.

Role of nidi of infection in various skin diseases

Reviewed scientific publications that define the location of foci of chronic infections in dermatology. Indicated by the currently existing problematic issues and their solutions.

Could leprosy reaction episodes be exacerbated by oral infections?

INTRODUCTION: This study evaluated whether leprosy reactions could be associated with oral infection. METHODS: Leprosy patients (n = 38) with (Group I) and without (Group II) oral infections were selected. Reactions were identified from the clinical and histopathological features associated with serum C-reactive protein (CRP) and10kDa interferon-gamma-induced protein (IP-10) levels, determined before and after elimination of the foci of infection. RESULTS: Group I presented more reactions than group II did, and improvement of the reactions after dental treatment. Serum CRP and IP-10 did not differ before and after the dental treatment, but differed between the groups. CONCLUSIONS: Oral infection could be an exacerbating factor in leprosy reactions.

The recurrence of leprosy reactional episodes could be associated with oral chronic infections and expression of serum IL-1, TNF-α, IL-6, IFN-γ and IL-10

The aim of this study was to determine whether the presence of leprosy reactional episodes could be associated with chronic oral infection. Thirty-eight leprosy patients were selected and divided into 2 groups: group I - 19 leprosy patients with oral infections, and group II - 19 leprosy patients without oral infections. Ten patients without leprosy, but presenting oral infections, were assigned to the control group. Leprosy patients were classified according to Ridley and Jopling classification and reactional episodes of the erythema nodosum type or reversal reaction were identified by clinical and histopathological features associated with serum IL-1, TNF-α, IL-6, IFN-γ and IL-10 levels. These analyses were performed immediately before and 7 days after the oral infection elimination. Patients from group I presenting oral infections reported clinical improvement of the symptoms of reactional episodes after dental treatment. Serum IL-1, TNF-α, IL-6, IFN-γ and IL-10 levels did not differ significantly before and after dental treatment as determined by the Wilcoxon test (p>0.05). Comparison of the 2 groups showed statistically significant differences in IL-1 and IL-6 at baseline and in IL-1, IL-6 and IL-10 on the occasion of both collections 7 days after therapy. Serum IL-6 and IL-10 levels in group I differed significantly at baseline compared to control (Mann-Whitney test; p<0.05). These results suggest that oral infection could be involved as a maintenance factor in the pathogenesis of leprosy reactional episodes.