• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVE: The aim of this study was an evaluation of the dependence between the severity of atopic dermatitis evaluated with the Scoring Atopic Dermatitis (SCORAD) index and the occurrence of other atopic diseases and parameters. METHODS: The complete dermatological and allergological examinations were performed. The statistical evaluation of the dependence between the occurrence of bronchial asthma, rhinitis and duration of the skin lesions, and the severity of atopic dermatitis was performed. RESULTS AND CONCLUSION: Two hundred and eighty-three patients were examined: 89 men and 194 women (average [standard deviation] age, 26.2 ± 9.5 years). The significant relationship was recorded between the severity of atopic dermatitis and bronchial asthma, the occurrence of rhinitis, and the duration of the skin lesions.

• Publikační typ
• časopisecké články MeSH

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

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

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

The aim of this study was to compare long-term results of 4 weeks Dead Sea climatotherapy at the Deutsches Medizinisches Zentrum, Israel to those obtained by classical topical treatment for moderate-to-severe atopic dermatitis. Seventy-two children from the Czech Republic were divided into three groups of 24 and treated during three periods (March 2014, October 2014 and March 2015) with gradually increasing sun exposure during 28 consecutive days. Forty-four children were treated with steroid creams at the Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic. The primary outcome was the change in the SCORing Atopic Dermatitis (SCORAD) index, recorded after 1 month of treatment (immediately after DSC) and 3, 6, 9, 12, and 18 months later in Prague. The mean SCORAD improvement was 87.5 ± 13.4% after 4 weeks at the Dead Sea and 86.1 ± 11.3% after 1 month of treatment with steroid creams in the Czech Republic. All 44 patients treated in Prague participated in this 18-month follow-up study, whereas only 47 patients (65.3%) after DSC treatment. Good clinical results were maintained in both groups and mean SCORAD values were stable and low, around 5.

• Klíčová slova
• Atopic dermatitis, Dead Sea climatotherapy, SCORAD, children, follow-up,
• MeSH
• aplikace lokální MeSH
• atopická dermatitida farmakoterapie   terapie   MeSH
• dítě MeSH
• fototerapie * MeSH
• hormony kůry nadledvin aplikace a dávkování   MeSH
• klimatoterapie * metody   MeSH
• lidé MeSH
• následné studie MeSH
• předškolní dítě MeSH
• rozvrh dávkování léků MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• hormony kůry nadledvin MeSH

UNLABELLED: The objective was to evaluate the effects of a hypoallergenic (HA) formula supplemented with prebiotic galacto-oligosaccharides on the severity of atopic manifestations. A randomised clinical trial was conducted. The control group was infants, fed with hypoallergenic formula and without supplementation. The duration of the study was six months. The primary outcome of the study was a difference in the severity of atopic dermatitis measured using SCORAD (Scoring Atopic Dermatitis) criteria. Secondary outcomes were anthropometry (length, weight, and head circumference), together with the tolerance and incidence of infections. Both groups showed a decrease of average SCORAD values, but no statistically significant difference between the evaluated groups was observed. There were no statistically significant differences in anthropometry, or the tolerance or incidence of infections. Although there is no evidence, that consumption of a hypoallergenic infant formula enriched with prebiotic galacto-oligosaccharides had any effect on SCORAD, it was safe and well tolerated. TRIAL REGISTRATION: www.clinicaltrials.gov NCT 02077088.

• MeSH
• antropometrie MeSH
• atopická dermatitida patologie   prevence a kontrola   MeSH
• dvojitá slepá metoda MeSH
• ekzém metabolismus   patologie   MeSH
• feces MeSH
• kojenec MeSH
• lidé MeSH
• náhražky mateřského mléka MeSH
• oligosacharidy terapeutické užití   MeSH
• potravní doplňky MeSH
• prebiotika * MeSH
• stupeň závažnosti nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• oligosacharidy MeSH
• prebiotika * MeSH

UNLABELLED: Few studies concerning the importance of food allergy in adolescents and adult patients with atopic eczema exist. The atopy patch tests with food have mostly been studied in infants and children since food allergy plays a role especially in this age group. AIM: The evaluation of the contribution of atopy patch tests in the diagnostic work-up of food allergy (to wheat, cow milk, peanuts, soya and eggs) in the patients with atopic eczema older than 14 years of age. METHOD: 120 patients were examined in the study in the diagnostic work-up of food allergy--86 women and 34 men, the mean age 26.5 (s.d. 9.8) and the median SCORAD at the beginning of the study 32.9 (s.d. 14.0). Complete dermatological and allergological examinations in the diagnostic work-up of food allergy were performed (assessment of personal history, assessment of serum specific IgE, skin prick tests, atopy patch tests, diagnostic hypoallergenic diet, food challenge tests with egg, soy, wheat, cow milk and double-blind, placebo-controlled food challenge test with cow milk and wheat. The results of atopy patch tests were compared with the results of other diagnostic methods in the diagnosis of food allergy. RESULTS: The food allergy to cow milk and wheat was confirmed in double-blind, placebo controlled food challenge test in few patients in our study (4%). The suspicion of food allergy to egg is in 8 %, to peanuts in 13 % and to soya in 4 % of patients in our study. The assessment of atopy patch tests response seems to be of great importance. The reaction in atopy patch tests with more papules has the greatest diagnostic accuracy for predicting the result of challenge tests. At the beginning and at the end of diagnostic hypoallergenic diet the severity of atopic eczema/dermatitis syndrome was recorded in all patients enrolled in the study by evaluating SCORAD. The decrease of SCORAD was statistically important. CONCLUSION: Atopy patch tests alone cannot be used as a single test for the determination of food allergy in patients with atopic eczema/dermatitis syndrome but such a test, together with other diagnostic methods, can help to trace the food allergy.

• MeSH
• atopická dermatitida etiologie   MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• náplasťové testy * MeSH
• potravinová alergie komplikace   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The aim of the controlled double-blind trial was to demonstrate the superiority of a topical combination product over its single constituents. PATIENTS AND METHODS: A total of 278 patients with atopic dermatitis were randomized into four groups: 79 patients were treated with a topical combination of levomenol and heparin (A), 80 patients with levomenol alone (B), 78 patients with heparin alone (C) and 41 patients with the cream base with no active substances (D). The medication was applied twice daily for 8weeks. Efficacy criteria included the severity of pruritus (visual analogue scale, VAS) and the SCORing Atopic Dermatitis (SCORAD) index as well as the overall assessment of efficacy and tolerance by both physician and patient. RESULTS: The improvement of pruritus and SCORAD values in Group A was significantly higher compared with Groups B-D (ancova, P<7×10(-8) ). The improvement of pruritus in Group A approximately corresponded to the cumulative effect of the two single active substances, with mean improvements of itching of -41.3, -13.3, -21.3 and +0.6mm VAS in Groups A-D, respectively (95% CI 7.1-13.5, 2.9-9.2 and 10.4-18.3mm for the comparisons A vs. B, A vs. C and A vs. D). CONCLUSION: The combination of levomenol and heparin proved to be significantly more efficacious in the treatment of pruritus and inflamed skin than the preparations of the single components.

• MeSH
• aplikace kožní MeSH
• atopická dermatitida komplikace   farmakoterapie   MeSH
• dítě MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• fibrinolytika aplikace a dávkování   terapeutické užití   MeSH
• fixní kombinace léků MeSH
• heparin aplikace a dávkování   terapeutické užití   MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• monocyklické seskviterpeny MeSH
• předškolní dítě MeSH
• pruritus etiologie   MeSH
• seskviterpeny aplikace a dávkování   terapeutické užití   MeSH
• spokojenost pacientů MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• bisabolol MeSH Prohlížeč
• fibrinolytika MeSH
• fixní kombinace léků MeSH
• heparin MeSH
• monocyklické seskviterpeny MeSH
• seskviterpeny MeSH

INTRODUCTION: Limited real-world evidence exists about the burden of atopic dermatitis (AD) in patients receiving systemic or non-systemic therapies in clinical practices. ESSENTIAL AD was an observational study that aimed to fill this information gap. METHODS: ESSENTIAL AD enrolled (September 2021-June 2022) adult patients with physician-confirmed AD that was routinely managed with systemic and non-systemic treatment in a real-world setting from 15 countries in Eastern Europe, the Middle East, and Africa. Primary outcome variables were Eczema Area and Severity Index (EASI), SCORing Atopic Dermatitis (SCORAD), and Dermatology Life Quality Index (DLQI) assessed during one office visit. RESULTS: A total of 799 enrolled patients fulfilled selection criteria and were included in the study. Patients mean (standard deviation [SD]) age was 36.3 (14.4) years, 457 (57.2%) were female, and the majority of patients were white (647 [81.0%]). Mean (SD) time since AD diagnosis was 17.6 (15.2) years (median 16.5; interquartile range [IQR] 3.3-26.8). The mean (SD) EASI, SCORAD, and DLQI total scores were 11.3 (11.3 [median 8.1; IQR 3.6-15.8]), 37.8 (17.9 [median 35.5; IQR 24.2-49.0]), and 10.6 (7.2 [median 10.0; IQR 5.0-15.0]), respectively. Patients receiving systemic treatment had significantly higher disease burden (mean [SD] EASI 13.3 [13.0]; median [IQR] 9.6 [3.9-17.9]) versus non-systemic treatment (mean [SD] 9.3 [8.7]; median [IQR] 6.8 [3.0-13.2]; P < 0.0001). Results were similar for SCORAD (39.9 [19.6] vs 35.6 [15.7]; median [IQR] 38.6 [24.7-53.1] vs 32.6 [23.9-44.6]; P = 0.0017), and DLQI total scores (11.4 [7.4] vs 9.9 [6.9]; median [IQR] 11.0 [5.0-16.0] vs 9.0 [5.0-14.0]; P = 0.0033, respectively). CONCLUSION: Patients with AD continue to have substantial disease burden despite treatment with systemic therapy, suggesting that a need for effective disease management remains, including effective therapies that improve psychological outcomes and reduce economic burden of AD, in Eastern Europe, the Middle East, and Africa.

Patients with atopic dermatitis often suffer from debilitating symptoms that impact their everyday lives. Although several treatment options are available, many patients continue to experience symptoms of disease. The ESSENTIAL AD study assessed burden of atopic dermatitis in patients receiving systemic and/or non-systemic therapies in real-life clinical practices across 15 countries in Eastern Europe, the Middle East, and Africa. The results of the study demonstrated that adult patients with atopic dermatitis continue to have substantial disease burden regardless of treatment with systemic therapy or non-systemic therapy. The findings suggest that optimal management of atopic dermatitis needs to be reassessed in Eastern Europe, the Middle East, and Africa, especially as new, more effective treatment options become available to patients.

• Klíčová slova
• Atopic dermatitis, Disease burden, Global, Real-world, Treatment patterns,
• Publikační typ
• časopisecké články MeSH