ABSTRACT
Background@#Prurigo nodularis (PN) is a chronic pruritic skin disorder with a large number of hyperkeratotic nodules. The precise mechanisms of its pathogenesis remain unknown. PN has been linked to atopic dermatitis (AD), but its association remains unclear. @*Objective@#We aimed to investigate the clinical, histological, and immunohistochemical characteristics of patients with PN and PN underlying AD (PN-AD). @*Methods@#Eight patients were recruited for PN, PN-AD, and eight normal subjects, respectively. Skin tissues were obtained from patients and healthy subjects for histological and immunohistochemical analyses. @*Results@#Histological examination showed increased epidermal thickness and dermal inflammatory cell counts in the PN-AD and PN groups compared to normal subjects. Immunohistochemical analyses revealed that the expression of interleukin (IL)-4, IL-13, IL-18, IL-31, IL-33, interferon (IFN)-γ, stromal-derived factor (SDF) 1-α and thymic stromal lymphopoietin (TSLP) was increased in the tissues of PN-AD and PN groups, in which the staining intensities of IL-4, IL-13, SDF1-α and TSLP in the PN-AD group were higher than those in the PN group, but the differences were not statistically significant. Conversely, the staining intensities of IL-18, IL-33 and IFN-γ were significantly higher in the PN group than those in the PN-AD group. @*Conclusion@#The pathogenesis of PN may differ from that of PN-AD, in which IL-18, IL-33 and IFN-γ may be associated, implying that epidermal injury is the initial cause of IL-18 and IL-33 induction, which then increases IFN-γ, resulting in the inflammatory process of PN.
ABSTRACT
Background@#Patients with atopic dermatitis (AD) are vulnerable to xerosis due to impaired skin barrier function, which makes moisturizing essential. Recently, zinc-alpha-2 glycoprotein (ZAG) has appeared to modulate the skin barrier function in AD, and has been proposed as a potential therapeutic molecule in AD. @*Objective@#This study aimed to evaluate the effects of a ZAG-containing moisturizer on restoration of the skin barrier and clinical improvement of AD. @*Methods@#In this randomized, double-blind study, 42 patients (average age, 26.5 years) with mild-to-moderate AD were enrolled. The subjects were divided into two groups, ZAG-containing moisturizer or control, in which the intervention or control were applied twice a day for 4 weeks. The primary outcome was a change in the eczema area and severity index (EASI) after 4 weeks, and the secondary outcome included the transepidermal water loss (TEWL), corneometer, visual assessment score (VAS) for pruritus and sleep disturbance, and investigator’s global assessment (IGA). @*Results@#ZAG-containing moisturizer was well-tolerated, with a significant decrease in the EASI score compared to the control group after 4 weeks of application (p＜0.05). As objective assessments of skin barrier function, TEWL also showed a significant, rapid decrease in the ZAG group compared to the control group after 2 weeks of application (p＜0.05). A significant improvement in AD symptoms was observed at 4 weeks, such as the VAS score for pruritus and sleep disturbance, and IGA. Conclusion: The moisturizer containing ZAG (By the doctor Ato repair cream , Whitecospharm, Korea) effectively restored the function of the skin barrier, which led to a relief in the signs and symptoms of AD.
ABSTRACT
Patient education is important for successful management of atopic dermatitis; however, due to limited time and resources, patient education remains insufficient. This study aimed to investigate the current state of education provided by Korean dermatologists, pediatric allergists, and allergists to patients with atopic dermatitis. A questionnaire survey consisting of items regarding educational programs for patients with atopic dermatitis was conducted via e-mail. In total, 153 participants responded to the questionnaires, and 26.8% indicated that they have had separate educational programs. The workforce involved in the educational program included nurses, residents or fellows, dieticians, pharmacists, and clinical psychologists. Most education protocols addressed the characteristics and natural course of atopic dermatitis and environmental management. Overall, 96.7% of the participants replied that an additional charge is needed for education; moreover, additional assistance from an academic society or association, in the form of medical staff, organized data, and advertisement, is required to develop and provide a well-structured educational program. A standardized education protocol will effectively provide appropriate education for patients with atopic dermatitis. Arrangement of education fees, covered by the National Health Insurance Service, will lead to the establishment of a structured educational program and participation of an additional medical workforce.
Subject(s)
Humans , Dermatitis, Atopic , Education , Electronic Mail , Fees and Charges , Korea , Medical Staff , National Health Programs , Nutritionists , Patient Education as Topic , Pharmacists , PsychologyABSTRACT
PURPOSE: Atopic dermatitis (AD) is a chronic eczematous dermatitis that has a high prevalence and diverse clinical features. Although several hypotheses about its multifactorial pathogenesis have been suggested, the cause is not yet fully understood. A better understanding of the clinical features may helpful inelucidating the pathogenesis of AD. METHODS: This retrospective study analyzed the questionnaires, medical charts, and laboratory examination results of 5,000 patients diagnosed with AD at a single tertiary hospital in Korea. RESULTS: The demographics, allergic comorbidities, family history, severity, and treatment experiences of the patients were analyzed. Most of the patients were adults, 76.3% of whom were classified as havingan extrinsic type of AD. The mean eczema area and severity index (EASI) score was found to be 13.68, and adult patients were found to have higher severity than the other age groups. The anatomical involvements were different among the age groups, with more involvements of the head and neck in adults. The patients reported seasonal changes and stress as the factors that aggravated their symptoms the most. Topical steroids and oral cyclosporine were the most used medications at our clinic, whereas 10.1% of the patients underwent allergen-specific immunotherapy. CONCLUSION: This analysis of 5,000 patients would lead to a better understanding of various subtypes and diverse clinical features of AD in Koreans. Distinct characteristics were observed among different age groups; thus, treatment strategies may need to be differentiated accordingly.
Subject(s)
Adult , Humans , Comorbidity , Cyclosporine , Demography , Dermatitis, Atopic , Eczema , Head , Immunotherapy , Korea , Neck , Prevalence , Retrospective Studies , Seasons , Steroids , Tertiary Care CentersABSTRACT
BACKGROUND: Little knowledge is available on the characteristic differences between patients with atopic dermatitis (AD) with and without atopic march after childhood. OBJECTIVE: To observe and compare the phenotypes of patients with AD in regards to atopic march tendency at a single point. METHODS: We enrolled patients with AD aged between 10 and 30 years. The patients were divided into the atopic march and non-atopic march groups on the basis of an investigator-designed survey questionnaire, and their serum-specific immunoglobulin E (IgE) levels or results of the skin prick test were compared. RESULTS: In a total of 182 patients enrolled in the study, 93 patients with atopic march and 89 patients with non-atopic march were observed. When their serum-specific IgE levels or results of the skin prick test were compared between the two groups, there was no significant difference, except for a in the atopic march group. Analysis of AD severity, family history of allergic diseases, and total IgE levels between the two groups showed no statistically significant differences. CONCLUSION: Our findings suggest that although no apparent phenotype characteristics could differentiate the presence of atopic march, the history of the patient's allergic diseases should be revalidated, and clinicians should watch out for future developments of atopic march when a patient shows a high-class sensitization rate to dust mite.
Subject(s)
Humans , Dermatitis, Atopic , Dust , Immunoglobulin E , Immunoglobulins , Mites , Phenotype , SkinABSTRACT
Cryotherapy is one of the most widely used procedures in the field of dermatology. Since the development of cryotherapy with the use of liquid nitrogen beginning in the 19(th) century, its use has gradually increased for various dermatologic conditions, including benign conditions, premalignant lesions, and malignancies. Because the therapeutic effects of cryotherapy are diverse, it must be applied specifically for each indication, requiring a thorough understanding of the basic principles and mechanisms of cryotherapy. In addition, both acute and chronic complications can develop, which may possibly leave permanent scars and tissue damage, thus, careful manipulation is required. In conclusion, cryotherapy is a frequently used treatment method but should be performed precisely by well-trained specialists.
Subject(s)
Cicatrix , Cryotherapy , Dermatology , Methods , Nitrogen , Specialization , Therapeutic UsesABSTRACT
No abstract available.
Subject(s)
Humans , Activins , Telangiectasia, Hereditary Hemorrhagic , TelangiectasisABSTRACT
No abstract available.