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    23105 results match your criteria Dermatitis Atopic

    1 OF 463

    Evaluation of the in vitro effect of Boldo and Meadowsweet plant extracts on the expression of antimicrobial peptides and inflammatory markers in canine keratinocytes.
    Res Vet Sci 2017 May 17;115:255-262. Epub 2017 May 17.
    Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA.
    Dogs with allergies are prone to skin infections and treatments/preventatives to boost innate immune-defenses are beneficial. The aim of this study was to evaluate the effects of Boldo and Meadowsweet extracts on the expression of β-defensins (cBD), cathelicidin (cCath), and pro-inflammatory cytokines in canine keratinocyte. This study had two phases. Read More

    Asthma, other atopic conditions and risk of infections in 105,519 general population never and ever smokers.
    J Intern Med 2017 May 26. Epub 2017 May 26.
    Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.
    Background: Individuals with atopic conditions may have increased susceptibility to infections outside the organs directly affected by their atopic condition.

    Objective: We tested the hypothesis that atopic conditions overall, and stratified by smoking history, are associated with increased risk of hospitalization for infections.

    Methods: We collected information on smoking history and self-reported atopic conditions from 105,519 individuals from the general population and followed them for up to 23 years for infectious disease hospitalizations and deaths. Read More

    Dupilumab: First Global Approval.
    Drugs 2017 May 25. Epub 2017 May 25.
    Springer, Mairangi Bay 0754, Private Bag 65901, Auckland, New Zealand.
    Dupilumab (Dupixent(®)) is a fully human monoclonal antibody directed against the interleukin (IL)-4 receptor α (IL-4Rα) subunit. Dupilumab inhibits the signalling of the type 2 cytokines IL-4 and IL-13 and was co-developed by Regeneron Pharmaceuticals and Sanofi as a potential therapeutic agent for the treatment of atopic or allergic diseases. In March 2017 dupilumab received its first global approval, in the USA, for use in the treatment of adult patients with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. Read More

    Can human allergy drug fexofenadine, an antagonist of histamine (H1) receptor, be used to treat dog and cat? Homology modeling, docking and molecular dynamic Simulation of three H1 receptors in complex with fexofenadine.
    J Mol Graph Model 2017 May 17;75:106-116. Epub 2017 May 17.
    Department Chemistry & Biochemistry and Department of Translational Biomedical Sciences, College of Science and Mathematics, Rowan University, Glassboro, NJ, 08028, USA. Electronic address:
    Fexofenadine, a potent antagonist to human histamine 1 (H1) receptor, is a non-sedative third generation antihistamine that is widely used to treat various human allergic conditions such as allergic rhinitis, conjunctivitis and atopic dermatitis. Encouragingly, it's been successfully used to treat canine atopic dermatitis, this supports the notion that it might have a great potential for treating other canine allergic conditions and other mammal pets such as dog. Regrettably, while there is a myriad of studies conducted on the interactions of antihistamines with human H1 receptor, the similar studies on non-human pet H1 are considerably scarce. Read More

    Associations between prevalence of adult atopic dermatitis and occupational characteristics.
    Int J Nurs Pract 2017 May 24. Epub 2017 May 24.
    Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.
    Aim: To examine the prevalence of adult atopic dermatitis according to occupational status.

    Background: While atopic dermatitis is more prevalent among children, some adults also suffer from it. The disease causes considerable difficulty in these adults' social lives at school or work, suggesting that they require high-quality health care. Read More

    Perceptions and Practices Regarding Atopic Dermatitis: A Survey.
    Pediatr Dermatol 2017 May 25. Epub 2017 May 25.
    Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.
    Parents (N = 392) completed a survey at the Minnesota State Fair in August and September 2015 addressing knowledge regarding the pathogenesis of atopic dermatitis (AD), basic skin care practices, and the perceived role of infection and food allergies in AD. Of participating parents, 82% identified food allergy or sensitivity in AD pathogenesis, whereas only 42% identified bacterial infection as an important factor in AD severity. Participants most often received education on skin health from their pediatrician (49%), followed by Internet-based sources (23%), rather than a dermatologist or pediatric dermatologist. Read More

    An Atopic Dermatitis Management Algorithm for Primary Care Providers and Assessment of Its Usefulness as a Clinical Tool.
    Pediatr Dermatol 2017 May 25. Epub 2017 May 25.
    Department of Pediatrics, University of California, San Francisco, San Francisco, California.
    Background/objectives: There is a lack of primary care provider (PCP) understanding of atopic dermatitis (AD) treatments and topical steroid use. We designed an AD management algorithm for pediatric PCPs. We hypothesized that the algorithm would improve pediatric PCPs' knowledge of AD diagnosis and management. Read More

    Particular characteristics of atopic eczema in tropical environments. The Tropical Environment Control for Chronic Eczema and Molecular Assessment (TECCEMA) cohort study.
    An Bras Dermatol 2017 Mar-Apr;92(2):177-183
    Group of Clinical and Experimental Allergy, Pediatric and Allergy Department, University of Antioquia - Medellín, Colombia.
    Background:: Atopic dermatitis is a prevalent health problem in the world. Allergic sensitization is an important risk factor, but the roles of other factors, inherent in tropic region, are unknown.

    Objective:: A cohort study was designed in a tropical city to investigate molecular and environmental risk factors for eczema, considering as particular features perennial exposure to mites, poor living conditions and others tropical characteristics. Read More

    Measuring Sleep Disturbance in Atopic Dermatitis: Patient-Reported Versus Objective Outcomes.
    Dermatitis 2017 May 23. Epub 2017 May 23.
    Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine at Northwestern University; and Northwestern Medicine Multidisciplinary Eczema Center, Chicago, IL. Department of Dermatology, Case Western Reserve University, Cleveland, OH.

    A child with kwashiorkor misdiagnosed as atopic dermatitis.
    Dermatol Online J 2017 May 15;23(5). Epub 2017 May 15.
    Hospital Infantil Padre Anchieta, Belo Horizonte, Minas Gerais, Brazil.
    Although uncommon, kwashiorkor continues to occur in developed, but mainly in developing nations. It is a type of protein-calorie malnutrition that occurs in the setting of insufficient protein intake in the presence of sufficient caloric intake. Skin and hair changes should prompt a thorough dietary history and appropriate dietary intervention. Read More

    Use of an oral phosphodiesterase-4 inhibitor (apremilast) for the treatment of chronic, severe atopic dermatitis: a case report.
    Dermatol Online J 2017 May 15;23(5). Epub 2017 May 15.
    University of Vermont College of Medicine, Burlington, Vermont.
    Atopic dermatitis (AD) is a common inflammatory dermatosis characterized by pruritus, erythema, induration, and lichenification. Current treatment options for generalized atopic dermatitis are limited and have potentially serious adverse effects, especially in patients with severe, chronic AD who frequently require systemic anti-inflammatory agents. Apremilast, an oral phosphodiesterase-4 inhibitor, was FDA approved in September 2014 for the treatment of moderate-to-severe plaque psoriasis. Read More

    The role of anti-IgE (omalizumab/Xolair) in the management of severe recalcitrant paediatric atopic eczema (ADAPT): statistical analysis plan.
    Trials 2017 May 23;18(1):231. Epub 2017 May 23.
    Imperial Clinical Trials Unit, School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, London, W12 7RH, UK.
    Background: The Atopic Dermatitis Anti-IgE Paediatric Trial (ADAPT) is a trial to determine the clinical efficacy and safety of omalizumab for children with severe atopic eczema. This article describes the detailed statistical analysis plan for the ADAPT as an update to the published protocol and is submitted prior to knowing all outcomes.

    Method And Design: The ADAPT is a randomised, double-blind, placebo-controlled trial with a primary objective to determine whether anti-IgE reduces eczema severity as assessed by the validated eczema score (objective SCORAD) after 24 weeks of treatment in children with severe eczema. Read More

    Successful treatment of lichen amyloidosis accompanied by atopic dermatitis by fractional CO2 laser.
    J Cosmet Laser Ther 2017 May 23. Epub 2017 May 23.
    a Department of Dermatology , Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine , Seoul , Korea.
    Lichen amyloidosis is a subtype of primary cutaneous amyloidosis that presents as persistent, multiple grouped hyperkeratotic papules usually located on the shins, back, forearms, or thighs. The treatment of lichen amyloidosis has been considered to be difficult, and of the various methods available, recent studies have reported the efficacy of fractional CO2 lasers. Lichen amyloidosis may be accompanied by atopic dermatitis, in which the treatment options may be more limited. Read More

    Association Between Inflammatory Skin Disease and Cardiovascular and Cerebrovascular Co-Morbidities in US Adults: Analysis of Nationwide Inpatient Sample Data.
    Am J Clin Dermatol 2017 May 22. Epub 2017 May 22.
    Department of Dermatology, Northwestern University Feinberg School of Medicine, Suite 1600, 676 N. St. Clair St., Chicago, IL, 60611, USA.
    Background: Psoriasis, atopic dermatitis or eczema (AD-E), pemphigus, bullous pemphigoid (BP), and hidradenitis are chronic inflammatory skin disorders associated with systemic immune activation, considerable symptom burden, stigma, functional disturbances, and mental health symptoms. All of these might increase cardiovascular risk.

    Objective: The objective of this study was to determine whether these inflammatory skin diseases are associated with increased cardiovascular/cerebrovascular risk and/or disease. Read More

    Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic.
    Pan Afr Med J 2017 3;26:125. Epub 2017 Mar 3.
    The Ronald Perelman Department of Dermatology, New York University School of Medicine, USA.
    Introduction: Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. Read More

    Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood.
    JAMA Pediatr 2017 May 22. Epub 2017 May 22.
    Utrecht University, Institue for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht, Germany.
    Importance: Atopic dermatitis is an inflammatory, pruritic skin disease that often occurs in early infancy with a chronic course. However, a specific description of subtypes of atopic dermatitis depending on the timing of onset and progression of the disease in childhood is lacking.

    Objective: To identify different phenotypes of atopic dermatitis using a definition based on symptoms before age 6 years and to determine whether some subtypes are more at risk for developing other allergic diseases. Read More

    TWEAK mediates inflammation in experimental atopic dermatitis and psoriasis.
    Nat Commun 2017 May 22;8:15395. Epub 2017 May 22.
    Division of Immune Regulation, La Jolla Institute for Allergy and Immunology, La Jolla, California 92037, USA.
    Atopic dermatitis (AD) and psoriasis are driven by alternate type 2 and type 17 immune responses, but some proteins might be critical to both diseases. Here we show that a deficiency of the TNF superfamily molecule TWEAK (TNFSF12) in mice results in defective maintenance of AD-specific T helper type 2 (Th2) and psoriasis-specific Th17 cells in the skin, and impaired expression of disease-characteristic chemokines and cytokines, such as CCL17 and TSLP in AD, and CCL20 and IL-19 in psoriasis. The TWEAK receptor, Fn14, is upregulated in keratinocytes and dermal fibroblasts, and TWEAK induces these cytokines and chemokines alone and in synergy with the signature T helper cytokines of either disease, IL-13 and IL-17. Read More

    [TRADITIONAL CHINESE MEDICINE IN TREATMENT OF ATOPIC DERMATITIS].
    Harefuah 2016 Oct;155(10):596-599
    Department of Dermatology, Sheba Medical Center, Tel Hashomer, Israel.
    Background: Atopic dermatitis is a common chronic inflammatory skin disease, affecting up to 15-30% of children in industrialized countries. As there is no definitive cure for atopic dermatitis, patients often seek other complementary therapeutic options, such as traditional Chinese medicine (TCM). TCM comprises numerous treatment modalities for the management of atopic dermatitis including acupuncture and herbal medicine. Read More

    [BULLOUS PEMPHIGOID RESISTANT TO CORTICOSTEROIDS].
    Harefuah 2016 Oct;155(10):593-595
    Department of Dermatology, Ha'Emek Medical Center, Afula, Israel.
    Introduction: Bullous pemphigoid is the most common autoimmune bullous disease, treated with low dosage local or systemic corticosteroids. This is a case report of a 65 years-old female patient with a month long history of a bullous disease before admission to the dermatology department with a generalized bullous rash. Clinical examination and histopathology revealed bullous pemphigoid. Read More

    Preliminary evaluation of cytosine-phosphate-guanine oligodeoxynucleotides bound to gelatine nanoparticles as immunotherapy for canine atopic dermatitis.
    Vet Rec 2017 May 19. Epub 2017 May 19.
    Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.
    Cytosine-phosphate-guanine oligodeoxynucleotides (CpG ODN) are a promising new immunotherapeutic treatment option for canine atopic dermatitis (AD). The aim of this uncontrolled pilot study was to evaluate clinical and immunological effects of gelatine nanoparticle (GNP)-bound CpG ODN (CpG GNP) on atopic dogs. Eighteen dogs with AD were treated for 8 weeks (group 1, n=8) or 18 weeks (group 2, n=10). Read More

    Staphylococcus aureus colonization is associated with increased inhaled corticosteroid requirements in patients with atopic dermatitis and asthma.
    J Allergy Clin Immunol Pract 2017 May 16. Epub 2017 May 16.
    Department of Pediatrics, National Jewish Health, Denver, Colo; Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, Colo; Department of Pediatrics, University of Colorado at Denver and Health Sciences Center, Aurora, Colo. Electronic address:

    Exposure to phenols, parabens and UV filters: Associations with loss-of-function mutations in the filaggrin gene in men from the general population.
    Environ Int 2017 May 16;105:105-111. Epub 2017 May 16.
    University Department of Growth and Reproduction, Copenhagen University Hospital Rigshospitalet, Section 5064, Blegdamsvej 9, 2100 Copenhagen, Denmark.
    Background: Filaggrin is an epidermal protein that is important for normal skin barrier functions. Up to 10% of Europeans and Asians carry filaggrin gene (FLG) loss-of function mutations that appear to facilitate trans-epidermal penetration of certain chemicals. We previously showed that mutation carriers have higher internal exposure to certain phthalates, compared to controls, and hypothesized that they could have increased trans-epidermal penetration of other chemicals. Read More

    MicroRNA in skin diseases.
    Eur J Dermatol 2017 May 19. Epub 2017 May 19.
    Department of Pathophysiology, Krasnoyarsk State Medical University, P. Zeleznyaka str. 1, 660022, Krasnoyarsk, Russian Federation.
    MicroRNAs are essential regulators of various cellular processes such as cell growth, differentiation, apoptosis, and the immune response, acting as factors for translational repression and/or degradation of target messenger RNA. Currently, microRNAs are considered as promising biomarkers and therapeutic targets for different pathological conditions. Skin may serve as a convenient model for microRNA modulation studies due to the comparatively easy access to targets cells. Read More

    Expression of keratin 1, keratin 10, desmoglein 1 and desmocollin 1 in the epidermis: possible downregulation by interleukin-4 and interleukin-13 in atopic dermatitis.
    Eur J Dermatol 2017 May 19. Epub 2017 May 19.
    Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan.
    In the pathogenesis of atopic dermatitis (AD), skin barrier dysfunction and T-helper (Th) type 2 immune reactions play important roles. Alterations in the stratum spinosum of AD have not been studied in much detail. In this study, we investigated the changes of structural proteins and adhesion molecules residing in the stratum spinosum of AD lesional skin, and whether Th2 cytokines including interleukin (IL)-4 and IL-13 alter the expression of these proteins. Read More

    Case Series Study of the Efficacy of Compounded Antibacterial, Steroid, and Moisturizer in Atopic Dermatitis.
    Pediatr Dermatol 2017 May;34(3):322-325
    Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
    Background/objectives: Previous studies have demonstrated that the use of a topical antimicrobial combined with a steroid may benefit patients with atopic dermatitis (AD), but modern guidelines discourage the use of antimicrobials in treating this condition. We sought to evaluate the degree of improvement in the severity and extent of AD lesions after using a compounded antibacterial, steroid, and moisturizer (CASM).

    Methods: This was a nonblinded retrospective review of patients with AD treated using CASM. Read More

    Mother Nature in Eczema: Maternal Factors Influencing Atopic Dermatitis.
    Pediatr Dermatol 2017 May;34(3):240-246
    Department of Medicine, Dermatology Division, University of Arizona, Tucson, Arizona.
    Atopic dermatitis (AD) is a highly prevalent chronic inflammatory skin disease. Current knowledge about the etiology of AD suggests that it is multifactorial and involves the interaction of several factors, including environmental triggers, genetics, immunologic factors, and skin barrier dysfunction. The prenatal environment has a significant influence on fetal development, including the maturation of skin barrier function. Read More

    Validation of a Parent-Reported Diagnostic Instrument in a U.S. Referral Population: The Childhood Eczema Questionnaire.
    Pediatr Dermatol 2017 May 19. Epub 2017 May 19.
    Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
    Background/objectives: There is a paucity of validated tools for diagnosing atopic dermatitis (AD) in very young children that do not rely on clinical evaluation. The Childhood Eczema Questionnaire (CEQ)-a diagnostic tool for AD in children younger than 2 years that a caretaker can complete-was recently validated in Sweden. The objective of this study was to validate the tool in a U. Read More

    Anti-allergic and Profilaggrin (ProFLG)-mRNA expression modulatory effects of sacran.
    Int J Biol Macromol 2017 May 15. Epub 2017 May 15.
    Graduate School of Advanced Science and Technology, Energy and Environment Area, Japan Advanced Institute of Science and Technology, Nomi, Japan. Electronic address:
    Atopic dermatitis (AD) is a skin disorder characterized by filaggrin (FLG) defect. We evaluated sacran's effects on dust-mite extracts (DME)-induced AD-like disease and also its effect on profilaggrin (proFLG) in a murine model of 2,4-dinitroflurobenze (DNFB)-induced contact hypersensitivity. In the murine AD-like disease model, allergic NC/Nga mice (N=60) were randomly divided into five treatment groups of 12 animals each: 0. Read More

    The Role of Hydrolyzed Formula in Allergy Prevention.
    Ann Nutr Metab 2017 19;70 Suppl 2:38-45. Epub 2017 May 19.
    Department of Pediatrics, Epidemiology and Biostatistics and Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
    Asthma, eczema, food allergy, and allergic rhinitis are some of the most common pediatric, chronic conditions in the world. Breastfeeding is the optimal way to feed all infants. For those infants who are exposed to infant formula, some studies suggest that certain partially hydrolyzed or extensively hydrolyzed formulas may decrease the risk of allergic disease compared to nonhydrolyzed formulas for children with a family history of atopic disease. Read More

    Mechanisms of Tolerance Induction.
    Ann Nutr Metab 2017 19;70 Suppl 2:7-24. Epub 2017 May 19.
    Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, NY, USA.
    Food allergy results from failure in oral tolerance that usually occurs in infancy or early childhood. Exposure to peanut and hen's egg via the inflamed and disrupted epithelial barrier in children with severe atopic dermatitis is a risk factor for the development of allergy to these foods and supports the hypothesis that epicutaneous exposure in the absence of oral feeding is an important pathway of allergic IgE sensitization in infants. In recent years, the collective evidence has pointed toward the protective effect of an early feeding with peanut and egg in children with eczema, taking advantage of the pathways underlying oral tolerance to counteract epicutaneous exposure. Read More

    Correlation Between Socioeconomic Status and Atopic Dermatitis in Korean Adults: The Korea National Health and Nutrition Examination Survey (2007-2014).
    J Eur Acad Dermatol Venereol 2017 May 18. Epub 2017 May 18.
    Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
    Introduction: Atopic dermatitis (AD) is one of the most common allergic diseases. Its prevalence has been increasing in recent decades. Social economic status is well-known risk factor of allergic diseases. Read More

    [Skin diseases associated with environmental factors].
    Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017 May 17. Epub 2017 May 17.
    Abteilung Allergologie, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Deutschland.
    Background: Multiple environmental exposures may derange the regulatory and repair mechanisms of the skin and lead to dermatological disease.

    Objectives: Provide an overview of non-allergic skin diseases associated with environmental factors.

    Materials And Methods: Review of current scientific evidence for associations of non-allergic skin diseases with environmental exposures: irritation, chemicals, infection, UV-radiation, temperature. Read More

    A CASE OF BRONCHIAL ASTHMA WITH HYPEREOSINOPHILIA WITH EFFECTIVE SAIBOKUTOU THERAPY.
    Arerugi 2017 ;66(3):231-234
    Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital.
    A 42 year old woman visited on our hospital because of cough, sputum, pruritus and erythema. She showed peripheral blood eosinophilia, high level of FENO, bronchial hyperresponsiveness. Diagnosis of bronchial asthma and atopic dermatitis was made, but she rejected therapy except for Saibokutou, a Kampo herbal medicine. Read More

    The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study.
    Vet Dermatol 2017 May 17. Epub 2017 May 17.
    Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 311 Diagnostic Medical Center, 300 West Drake, Fort Collins, CO, 80524, USA.
    Background: Oclacitinib is a selective Janus kinase inhibitor for the treatment of canine allergic pruritus and atopic dermatitis in dogs. Glucocorticoids and ciclosporin increase urinary tract infection (UTI) frequency in dogs with inflammatory skin disease.

    Objective: Prospective study to evaluate the frequency of UTI and subclinical bacteriuria in dogs with allergic dermatitis receiving oclacitinib. Read More

    Evaluation of Immune Indices and Serum Vitamin D Content in Children with Atopic Dermatitis.
    Adv Exp Med Biol 2017 May 17. Epub 2017 May 17.
    Pediatric, Nephrology and Allergology Clinic, Military Institute of Medicine, Warsaw, Poland.
    The influence of vitamin D on allergic diseases, including atopic dermatitis, is linked to the presence of vitamin D nuclear receptors in immune cells. The present study seeks to determine the possible relationship between serum vitamin D content and immune indices in children with atopic dermatitis. The study was conducted in 19 children with atopic dermatitis. Read More

    Antidepressants have Anti-inflammatory Effects that may be Relevant to Dermatology: A Systematic Review.
    Acta Derm Venereol 2017 May 17. Epub 2017 May 17.
    Department of Psychiatry, Oslo University Hospital, NO-0196 Oslo, Norway.
    There is increasing evidence of clinically relevant anti-inflammatory effects of monoaminergic antidepressants. PubMed and Ovid databases were searched systematically for the use and efficacy of antidepressants in association with 5 common inflammatory skin disorders: chronic urticaria, psoriasis, atopic dermatitis, other eczema, and alopecia areata. From January 1984 to June 2016, publications included a total of 1,252 dermatological patients in 28 trials or case reports. Read More

    Obstructive sleep apnea and dermatologic disorders.
    Clin Dermatol 2017 May - Jun;35(3):319-327. Epub 2017 Jan 21.
    Department of Medicine, University of Toronto School of Medicine, 645 Windermere Road, London, Ontario, Canada, N5X 2P1.
    Obstructive sleep apnea (OSA) is present in at least 2% of women and 4% of men, and its prevalence is increasing, because a major predisposing factor for OSA is a high body mass index. Psoriasis has the most strongly substantiated link with OSA, where the relationship may be bidirectional. Dermatologic disorders may be comorbid with OSA due to several factors: (i) the heightened proinflammatory state in OSA, which can occur independent of body mass index, and may exacerbate inflammatory dermatoses; (ii) intermittent hypoxemia may promote neovascularization and tumor growth in certain cancers, such as melanoma; (iii) obesity, present in majority of OSA patients, can be associated with a heightened proinflammatory state; (iv) upper airway obstruction due to local tumors or soft tissue swelling due to physical urticaria or angioedema; (v) acute nasal congestion in the atopic patient with allergic rhinitis; (vi) dermatologic disorders associated with other OSA risk factors (eg, acanthosis nigricans and metabolic syndrome); and (vii) a high sympathetic tone (eg, in atopic dermatitis) and resultant sleep fragmentation contributing to upper airway instability during sleep. Read More

    Dissociation and conversion symptoms in dermatology.
    Clin Dermatol 2017 May - Jun;35(3):267-272. Epub 2017 Jan 21.
    Department of Medicine, Faculty of Medicine, University of Toronto, Ontario, Canada.
    Dissociation and conversion (defined as the somatic component of dissociation) can play an important mediating role in the exacerbation of the stress-reactive dermatoses (eg, psoriasis, idiopathic urticaria, atopic dermatitis), dermatoses that are exacerbated by excessive scratching (eg, lichen simplex chronicus, prurigo nodularis) and koebnerization, and the self-induced dermatoses (dermatitis artefacta, acne excoriée, skin picking disorder, trichotillomania, onychotillomania/onychophagia). Dissociative symptoms often coexist with obsessive-compulsive symptoms in the more severe cases of the self-induced dermatoses. Dissociation can play an important role in cutaneous sensory disorder (eg, scalp dysesthesia syndrome, stomatodynia/glossodynia, vulvodynia/scrotodynia, medically unexplained anesthesia). Read More

    Posttraumatic stress disorder (PTSD) and the dermatology patient.
    Clin Dermatol 2017 May - Jun;35(3):260-266. Epub 2017 Jan 22.
    Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
    Dermatologic symptoms can be associated with posttraumatic stress disorder (PTSD) in several situations: (1) as features of some core PTSD symptoms, such as intrusion symptoms manifesting as cutaneous sensory flashbacks, as autonomic arousal manifesting as night sweats and idiopathic urticaria, and as dissociation manifesting as numbness and dermatitis artefacta; (2) the cutaneous psychosomatic effects of emotional and physical neglect and sexual abuse (eg, infantile eczema, cutaneous self-injury, and body-focused repetitive behaviors such as trichotillomania and skin picking disorder) and eating disorders, which can have dermatologic effects; (3) the direct effect of physical or sexual abuse or catastrophic life events (eg, earthquakes) on the skin; and (4) as a result of significant alterations in hypothalamic-pituitary-adrenal and sympatho-adrenal medullary axes, which can affect neuroendocrine and immune functions, and can lead to exacerbations of stress-reactive inflammatory dermatoses such as psoriasis, chronic urticaria, and atopic dermatitis. Elevated levels of inflammatory biomarkers and impaired epidermal barrier function have been reported in situations involving sustained psychologic stress and sleep deprivation. Some PTSD patients show hypothalamic-pituitary-adrenal axis hyporesponsiveness and higher circulating T lymphocytes, which can exacerbate immune-mediated dermatologic disorders. Read More

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