Immediate and delayed hypersensitivity reactions can play a role in the pathogenesis of atopic dermatitis (AD). We tested 71 patients (median age 5 years) with AD for hypersensitivity to grass and birch pollen, Dermatophagoides pteronyssinus, and Dermatophagoides farinae using atopy patch test (APT), skin prick test (SPT), and specific IgE measurement. The sensitivity (SE) and specificity (SP) of the tests were calculated on the basis of personal history of AD exacerbation, clinical AD score (SCORAD) changes, and the number of days with need for topical anti-inflammatory treatment (AITD) in relation to exposure to the allergens being tested. APT was positive in 45 patients, mostly to D. farinae (n=37). SPT and/or specific IgE were positive in 42 subjects, in most cases to grass and birch pollen (n=29). SE of APT reached 33%-56% for history, 33% for SCORAD, and 0%-60% for AITD; SP of APT was comparable for all three assessment standards (history, SCORAD, and AITD) (48%-67%). SE of SPT/specific IgE was higher for history (26%-63%) than for the other two standards of assessment (0%-67%); SP of SPT/specific IgE was also highest for history (69%-91%), and lower for SCORAD (59%-87%) and AITD (65%-80%). AD is often associated with hypersensitivity; its influence on AD, however, is clinically significant only in a minor group of patients. While personal history and SCORAD changes present themselves as possible standards in the evaluation of clinically relevant hypersensitivity in AD patients, the anti-inflammatory treatment days (AITD) appears to be unsuitable for this purpose.

• Publikační typ
• časopisecké články MeSH

BACKGROUND: A few reports demonstrate the comorbidity of food allergy and allergic march in adult patients. AIMS AND OBJECTIVES: To evaluate, if there is some relation in atopic dermatitis patients at the age 14 years and older who suffer from food allergy to common food allergens to other allergic diseases and parameters as bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. MATERIALS AND METHODS: Complete dermatological and allergological examination was performed; these parameters were examined: food allergy (to wheat flour, cow milk, egg, peanuts and soy), the occurrence of bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. The statistical evaluation of the relations among individual parameters monitored was performed. RESULTS: Food allergy was altogether confirmed in 65 patients (29%) and these patients suffer significantly more often from bronchial asthma and allergic rhinitis. Persistent atopic dermatitis lesions and positive data in family history about atopy are recorded significantly more often in patients with confirmed food allergy to examined foods as well. On the other hand, the onset of atopic dermatitis under 5 year of age is not recorded significantly more often in patients suffering from allergy to examined foods. CONCLUSION: Atopic dermatitis patients suffering from food allergy suffer significantly more often from allergic rhinitis, bronchial asthma, persistent eczematous lesions and have positive data about atopy in their family history.

• Klíčová slova
• Bronchial asthma, allergic rhinitis, atopic dermatitis, family history, food allergy, onset of atopic dermatitis, persistent eczematous lesions,
• Publikační typ
• časopisecké články MeSH

• Publikační typ
• časopisecké články MeSH

AIM: To evaluate with SCORAD system the contribution of the diagnostic hypoallergenic diet on the severity of atopic dermatitis and especially on the the intensity criteria and subjective parametersin patients over 14 years of age. MATERIALS AND METHODS: The diagnostichypoallergenic diet was recommended for the period of 3 weeks. Severity of eczema was scored in agreement with SCORAD score, and especially the intensity criteria (erythema, edema, crusting, excoriations, lichenifications, dryness) and subjective parameters (pruritus, sleeplessness) were evaluated at the beginning and at the end of this diet. RESULTS: One hundred and forty-eight patients suffering from atopic dermatitis were included in the study: 107 women and 41 men with the average age of 26.03 (s.d. 9.6 years), min. 14 max. 63 years. In the end of 3 weeks diagnostic hypoallergenic diet there was a statistically significant reduction in severity of sleepless and pruritus and in all of the intensity criteria except of lichenification. CONCLUSION: The diagnostic hypoallergenic diet can improve the intensity criteria and subjective parameters of atopic dermatitis evaluated in SCORAD, but not the lichenification. We recommend to introduce this diet before a challenge tests and as a temporary medical arrangement in patients suffering from moderate or severe form of atopic dermatitis.

• Klíčová slova
• Atopic dermatitis, SCORAD, crusting, diagnostic hypoallergenic diet, dryness, edema, erythema, excoriations, lichenifications, pruritus, sleeplessness,
• Publikační typ
• časopisecké články MeSH

AIM: To evaluate the effect of a diagnostic hypoallergenic diet on the severity of atopic dermatitis in patients over 14 years of age. MATERIALS AND METHODS: The diagnostic hypoallergenic diet was recommended to patients suffering from atopic dermatitis for a period of 3 weeks. The severity of atopic dermatitis was evaluated at the beginning and at the end of this diet (SCORAD I, SCORAD II) and the difference in the SCORAD over this period was statistically evaluated. RESULTS: One hundred and forty-nine patients suffering from atopic dermatitis were included in the study: 108 women and 41 men. The average age of the subjects was 26.03 (SD: 9.6 years), with the ages ranging from a minimum of 14 years to a maximum of 63 years. The mean SCORAD at the beginning of the study (SCORAD I) was 32.9 points (SD: 14.1) and the mean SCORAD at the end of the diet (SCORAD II) was 25.2 points (SD: 9.99). The difference between SCORAD I and SCORAD II was evaluated with the Wilcoxon signed-rank test. The average decrease of SCORAD was 7.7 points, which was statistically significant (P=.00000). CONCLUSION: Introduction of the diagnostic hypoallergenic diet may serve as a temporary medical solution" in patients suffering from moderate or severe forms of atopic dermatitis. It is recommended that this diet be used in the diagnostic workup of food allergy.

• Klíčová slova
• Atopic dermatitis, SCORAD system, diagnostic hypoallergenic diet,
• Publikační typ
• časopisecké články MeSH