Torsten Schäfer

Association between severity of atopic eczema and degree of sensitization to aeroallergens in schoolchildren

BACKGROUND A subgroup of patients with atopic eczema exhibits aggravation through contact with aeroallergens. Little is known from population-based studies, however, about the association between the severity of eczematous skin disease and the degree of aeroallergen sensitization. OBJECTIVE We sought to investigate the relationship between IgE-mediated allergic sensitization to aeroallergens and severity of atopic eczema in schoolchildren. METHODS A nested case-control analysis on atopic eczema was performed on the basis of a cross-sectional study of 2201 East German schoolchildren aged 5 to 14 years. Atopic eczema and its severity was identified by dermatologic examination. Total and allergen-specific IgE antibodies to grass and birch pollen, Cladosporium herbarum, Dermatophagoides pteronyssinus, and cat epithelium in serum were determined, and additional information was obtained by means of standardized questionnaire. RESULTS The overall prevalence of actual atopic eczema was 2.5%. Thirty-seven percent of the children were sensitized to at least one allergen. Children with atopic eczema were significantly more often sensitized than those without skin disease (75.0% vs 36.3%; odds ratio, 5.27; 95% confidence interval, 2.54-11.15). This was observed for each single allergen. The prevalence of atopic eczema increased significantly with increasing RAST class (chi(2) trend test for each allergen, P <.0001). Also, the prevalence of sensitization increased with the severity of the disease (chi(2) trend test for each allergen, P <.0001). This association was pronounced for house dust mite and cat allergen. Multiple linear regression analyses showed significant associations between the severity score of atopic eczema and concentrations of allergen-specific IgE to dust mite (P =.032) and cat (P =.014) allergens after adjustment for sex, age, location, and parental predisposition. CONCLUSIONS The degree of sensitization is directly associated with the severity of atopic eczema. We speculate that early epicutaneous sensitization to aeroallergens may be enhanced by damage of the skin barrier function. The specific IgE response seems to contribute to the severity of the disease in a dose-dependent fashion.

Alternative medicine in allergies - prevalence, patterns of use, and costs.

Background:  There is evidence that the use of alternative medicine (AM) for allergies has increased. However, little is known from population‐based studies about what determines its use. The objective of this study was to evaluate the patterns of use of AM for allergies.

Silver-Coated Textiles Reduce Staphylococcus aureus Colonization in Patients with Atopic Eczema

Background: In atopic eczema (AE), skin colonization with Staphylococcus aureus is known to play a major triggering and possibly pathophysiological role. Methods: In this open-labeled controlled side-to-side comparative trial, affected sites (flexures of both elbows) in 15 patients diagnosed as having generalized or localized AE were evaluated regarding S. aureus colonization and clinical severity of AE over a 2-week period. Flexures of the elbows were covered with silver-coated textiles on one arm and cotton on the other for 7 days followed by a 7-day control period. Results: A highly significant decrease in S. aureus colonization could be seen on the site covered by the silver-coated textile already 2 days after initiation lasting until the end of the treatment. Seven days after cessation, S. aureus density remained significantly lower compared to baseline. In addition, significantly lower numbers of S. aureus were observed on the silver-coated textile site in comparison to cotton at the end of treatment as well as at the time point of control. Clinical improvement correlated with the reduction of S. aureus colonization. Conclusion: A superior improvement achieved by silver-coated compared to cotton textiles paralleled a potent anti-S.-aureus effect.

Epidemiology of psoriasis. Review and the German perspective.

According to population-based European studies, 2–3% of the population are affected by psoriasis. However, commonly accepted and validated diagnostic criteria are lacking. Psoriasis patients, compared to those with other dermatological disorders, are among those who suffer the highest impact on their quality of life, and this affection is comparable to other common diseases. Several lifestyle factors including alcohol and smoking have been associated with psoriasis. There is also evidence for associations with other diseases including cancer. Treatment of psoriasis engenders considerable costs, which should always be taken into account together with the relevant clinical outcome parameters. Prevention of psoriasis is crucial, as in the case of other common chronic diseases where causative treatments are lacking, but has barely been studied.

Association of CARD15 polymorphisms with atopy-related traits in a population-based cohort of Caucasian adults.

Background Influences of microbial pathogens are crucial for the maturation of the immune system. Caspase‐recruitment domain containing protein 15 (CARD15) is a cytosolic receptor involved in bacterial recognition by antigen‐presenting cells. CARD15 polymorphisms have been associated with Crohns disease. Recently, associations with atopic phenotypes have been reported in children.

Atopic eczema in children: another harmful sequel of divorce.

Background:  Different lifestyle factors seem to be associated with the risk for atopic diseases and some studies suggest that stress increases the risk of allergic sensitization, asthma and atopic eczema. Only few studies have investigated the association of early stressful life events and atopic eczema (AE) in children.

Worm infestation and the negative association with eczema (atopic/nonatopic) and allergic sensitization

Background:  Worm infestations may play a role in preventing allergies. There is a lack of epidemiological information from Western countries on the association between worm infestation and eczema.

Swimming pool attendance and hay fever rates later in life.

Background:  Exposure to chlorination by‐products through swimming pool attendance showed adverse health effects on children. The aim of our study was to assess whether pool attendance in childhood would be related to higher rates of allergic diseases in adulthood, with special regard to hay fever.

Association study of mast cell chymase polymorphisms with atopy

Background:  Atopic disorders are the result of complex interactions between genetic and environmental factors. Associations analyses between the promoter polymorphism rs1800875 in the mast cell chymase gene (CMA1) and atopy‐related phenotypes have yielded inconsistent results.

Prospective association between food sensitization and food allergy: results of the LISA birth cohort study.

Background Food allergy is common, especially in childhood, where 6–8% of children are affected. Identification of early and efficient markers for later development of food allergy is very important.