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diagnostic criteria for atopic dermatitis

N de la Torre Rubio, S Medina Montalvo, A Gómez Zubiaur, I Polo Rodríguez, A B Piteiro Bermejo, L Trasobares Marugán
OBJECTIVE: To determine if the introduction of some referral criteria in the dermatology emergency department has changed the number of patients referred from the emergency department, as well as the type of diseases, and the profile of the patient who uses this service. MATERIAL AND METHODS: A cross-sectional study was conducted on all consecutive patients attended in the emergency department of the Hospital Príncipe de Asturias during a 31-day period from March 2015 to May 2015 and in the same period in 2016...
December 21, 2018: Semergen
Sayantani Sindher, Andrew J Long, Natasha Purington, Madeleine Chollet, Sara Slatkin, Sandra Andorf, Dana Tupa, Divya Kumar, Margaret A Woch, Katherine L O'Laughlin, Amal Assaad, Jacqueline Pongracic, Jonathan M Spergel, Jonathan Tam, Stephen Tilles, Julie Wang, Stephen J Galli, Kari C Nadeau, R Sharon Chinthrajah
Background: Double-blind placebo-controlled food challenges (DBPCFCs) remain the gold standard for the diagnosis of food allergy; however, challenges require significant time and resources and place the patient at an increased risk for severe allergic adverse events. There have been continued efforts to identify alternative diagnostic methods to replace or minimize the need for oral food challenges (OFCs) in the diagnosis of food allergy. Methods: Data was extracted for all IRB-approved, Stanford-initiated clinical protocols involving standardized screening OFCs to a cumulative dose of 500 mg protein to any of 11 food allergens in participants with elevated skin prick test (SPT) and/or specific IgE (sIgE) values to the challenged food across 7 sites...
2018: Frontiers in Immunology
Jonathan I Silverberg, Joel M Gelfand, David J Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H Grayson, Peck Y Ong, Zelma Chiesa Fuxench, Eric L Simpson
BACKGROUND: The impact of atopic dermatitis (AD) on health related quality of life and health utility in the United States adult population is not well-established. OBJECTIVES: To determine the health utilities and quality of life adjusted years (QALYs) lost in adults with vs. without AD among the US population. METHODS: A cross-sectional, population-based study of 3,495 adults was performed. AD was determined using modified UK Diagnostic Criteria for AD...
December 8, 2018: Journal of Allergy and Clinical Immunology in Practice
Gamze Türkoğlu, Rukiye Berkem, Ayşe Esra Karakoç
Antinuclear antibodies (ANA) are the autoantibodies that are produced against nuclear antigens in the cell nucleus and/or cytoplasm, and are one of the important diagnostic criteria in systemic autoimmune rheumatic diseases (SARD). Until today, several methods have been developed for detecting ANA's. However, indirect immunofluorescence (IIF) technique, that is also known as one of the oldest methods, is still the most commonly used one. Typically, anti-dense fine speckled 70/Lens epithelium derived growth factor p75 (anti-DFS70/LEDGF p75) autoantibody can be detected via IIF method where in HEp-2 (human larynx carcinoma) cells are used...
October 2018: Mikrobiyoloji Bülteni
Susan Nedorost
Purpose: Generalized dermatitis (defined as histological spongiotic dermatitis affecting more than three anatomical areas of the skin surface) has many potential causes that mimic atopic dermatitis and contact dermatitis. If a treatable cause is missed, the patient may be treated with chronic immunosuppressive therapy that carries more risk than specific treatment for a disease mimicking dermatitis. Checklists have been shown to improve patient safety, primarily in procedural contexts...
2018: Clinical, Cosmetic and Investigational Dermatology
Christoffer Dharma, Diana L Lefebvre, Maxwell M Tran, Zihang Lu, Wendy Y W Lou, Padmaja Subbarao, Allan B Becker, Piush J Mandhane, Stuart E Turvey, Theo J Moraes, Meghan B Azad, Malcolm R Sears
BACKGROUND: Persisting atopic dermatitis (AD) is known to be associated with more serious allergic diseases at later ages; however, making an accurate diagnosis during infancy is challenging. We assessed the diagnostic performance of questionnaire-based AD measures with criteria-based in-person clinical assessments at age 1 year and evaluated the ability of these diagnostic methods to predict asthma, allergic rhinitis and food allergies at age 5 years. METHODS: Data relate to 3014 children participating in the Canadian Healthy Infant Longitudinal Development (CHILD) Study who were directly observed in a clinical assessment by an experienced healthcare professional using the UK Working Party criteria...
November 2018: Paediatric and Perinatal Epidemiology
Sunna Thorsteinsdottir, Jakob Stokholm, Jacob P Thyssen, Sarah Nørgaard, Jonathan Thorsen, Bo L Chawes, Klaus Bønnelykke, Johannes Waage, Hans Bisgaard
Importance: Knowledge about factors associated with persistence of atopic dermatitis (AD) during childhood is sparse. Objective: To explore heritable, environmental, and clinical factors associated with persistent AD based on 13 years' follow-up of an at-risk birth cohort. Design, Setting, and Participants: In the Copenhagen Prospective Study on Asthma in Childhood 2000 (COPSAC2000) clinical birth cohort study, 411 children born to mothers with asthma were followed up until the age of 13 years at a clinical research unit in Copenhagen, Denmark, from August 1998 to June 2015...
November 14, 2018: JAMA Dermatology
Nikolaos A Kitsioulis, Nikolaos G Papadopoulos, Sophia Kostoudi, Emmanouil Manousakis, Nikolaos Douladiris, Paraskevi Xepapadaki
Background: Atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) represent two of the most common chronic inflammatory pruritic skin diseases. Any relationship between atopic skin disorders and CSU is controversial, mostly due to the paucity of relevant epidemiologic and pathogenetic data. Objective: To evaluate whether a history of AD in early childhood represents a risk factor for the subsequent occurrence of CSU in a pediatric population. Methods: Retrospective data of new cases of patients who visited the outpatient allergy unit of a tertiary pediatric hospital in Athens, Greece, between June 2014 and August 2016, were analyzed...
November 1, 2018: Allergy and Asthma Proceedings:
Miriam Santer, Kate Rumsby, Matthew J Ridd, Nick A Francis, Beth Stuart, Maria Chorozoglou, Amanda Roberts, Lyn Liddiard, Claire Nollett, Julie Hooper, Martina Prude, Wendy Wood, Emma Thomas-Jones, Taeko Becque, Kim S Thomas, Hywel C Williams, Paul Little
BACKGROUND: Childhood eczema is very common. Treatment often includes emollient bath additives, despite there being little evidence of their effectiveness. OBJECTIVES: To determine the clinical effectiveness and cost-effectiveness of emollient bath additives in the management of childhood eczema. DESIGN: Pragmatic, randomised, open-label, multicentre superiority trial with two parallel groups. SETTING: Ninety-six general practices in Wales, the west of England and southern England...
October 2018: Health Technology Assessment: HTA
Catalina Rincón-Pérez, Désirée Larenas-Linnemann, Marco Antonio Figueroa-Morales, Jorge Luna-Pech, Linda García-Hidalgo, Alejandra Macías-Weinmann, Javier Gómez-Vera, José Fernando Barba-Gómez, Juan José Matta-Campos, Esther Guevara-Sangines, Fermín Jurado-Santacruz, Adriana López Tello-Santillán, José Antonio Ortega-Martell, Nancy Pulido-Díaz, Liliana Guadalupe Serrano-Jaén, Mirna Toledo-Bahena, Guadalupe Villanueva-Quintero, José Luis Mayorga-Butrón
BACKGROUND: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. OBJECTIVE: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care. METHODS: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context...
2018: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
Sandeep Kapur, Wade Watson, Stuart Carr
Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life of affected individuals as well as their families. Although the pathogenesis of the disorder is not completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient's history and clinical manifestations...
2018: Allergy, Asthma, and Clinical Immunology
Jonathan I Silverberg, Joel M Gelfand, David J Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H Grayson, Eric L Simpson, Peck Y Ong, Zelma C Chiesa Fuxench
BACKGROUND: The patient burden and quality of life (QOL) impact of atopic dermatitis (AD) in the United States population is not well established. OBJECTIVE: To elucidate the patient burden of AD in the US population. METHODS: A cross-sectional, population-based study of 602 adults was performed. Atopic dermatitis was determined using modified UK Diagnostic Criteria for AD. Its severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (PO-SCORAD), PO-SCORAD-itch, and sleep...
September 2018: Annals of Allergy, Asthma & Immunology
Jonathan I Silverberg, Joel M Gelfand, David J Margolis, Luz Fonacier, Mark Boguniewicz, Lawrence B Schwartz, Eric Simpson, Mitchell H Grayson, Peck Y Ong, Zelma C Chiesa Fuxench
BACKGROUND: Patient-Oriented Eczema Measure (POEM) is the preferred patient-reported outcome (PRO) for assessing symptoms of atopic dermatitis (AD). Dermatology Life Quality Index (DLQI) is commonly used to assess the burden of skin disease. Previous severity strata were developed for POEM and DLQI in clinical cohorts, which may be biased toward more severe disease. Severity strata were not previously examined in population-based cohorts. Patient-Oriented Scoring AD (PO-SCORAD) is another commonly used PRO for assessing AD symptoms; however, severity strata are not established...
October 2018: Annals of Allergy, Asthma & Immunology
Belinda Sheary
BACKGROUND: Concerns about topical steroid withdrawal (TSW) are leading some patients to cease long-term topical corticosteroid (TCS) therapy. Diagnostic criteria for this condition do not exist. OBJECTIVE: The aim of this study was to examine the demographics and outcomes in adult patients who believe they are experiencing TSW following discontinuation of chronic TCS overuse. METHODS: This was a retrospective cohort study of patients in an Australian general practice presenting with this clinical scenario between January 2015 and February 2018...
July 2018: Dermatitis
Harrison H Lee, Kevin R Patel, Vivek Singam, Supriya Rastogi, Jonathan I Silverberg
BACKGROUND: Previous studies found conflicting results about whether atopic dermatitis (AD) begins in adulthood. OBJECTIVE: To determine rates, predictors and phenotypical differences of adult-onset AD. METHODS: A systematic review was performed of all published observational studies in MEDLINE, EMBASE, GREAT, LILACS, Cochrane Library, and Scopus that analyzed the age of AD onset beyond 10 years of age. Two reviewers performed study title/abstract review and data abstraction...
June 1, 2018: Journal of the American Academy of Dermatology
Miriam Santer, Matthew J Ridd, Nick A Francis, Beth Stuart, Kate Rumsby, Maria Chorozoglou, Taeko Becque, Amanda Roberts, Lyn Liddiard, Claire Nollett, Julie Hooper, Martina Prude, Wendy Wood, Kim S Thomas, Emma Thomas-Jones, Hywel C Williams, Paul Little
OBJECTIVES: To determine the clinical effectiveness and cost effectiveness of including emollient bath additives in the management of eczema in children. DESIGN: Pragmatic randomised open label superiority trial with two parallel groups. SETTING: 96 general practices in Wales and western and southern England. PARTICIPANTS: 483 children aged 1 to 11 years, fulfilling UK diagnostic criteria for atopic dermatitis. Children with very mild eczema and children who bathed less than once weekly were excluded...
May 3, 2018: BMJ: British Medical Journal
Grace C Brummer, Lawrence T Wang, Richard D Sontheimer
Aging individuals can develop generalized, exquisitely-pruritic, eczematous eruptions of uncertain etiology that can be therapeutically-refractory and life-altering. Limited information exists in the literature to guide clinicians in the diagnosis and management of such patients. It is suggested that in approximately 40% of such patients a known cause for their chronic pruritic eruptions cannot be identified. In this report we will refer to this subgroup of patients as having idiopathic chronic eczematous eruption of aging (CEEA)...
February 15, 2018: Dermatology Online Journal
Z Ali, C Suppli Ulrik, T Agner, S F Thomsen
Obesity has been associated with atopic dermatitis (AD); however, the results have been conflicting. Our aim was to provide an update on current knowledge from observational studies addressing the possible association between obesity and AD. Systematic literature review was performed by identifying studies addressing a possible link between AD and overweight/obesity from PubMed, EMBASE and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines...
February 14, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Z Reguiaï
Atopic dermatitis (DA) is a chronic inflammatory skin disease. Its incidence and prevalence is increasing, especially in industrialized countries. The prevalence of AD in adults is estimated at 1-3 % of the general population and can present as adult-onset AD, or as infantile/childhood AD that persists, or recurs in adulthood. There are no specific diagnostic criteria for adult AD. Diagnosis may be also complicated by the fact that the clinical manifestations sometimes differ from pediatric AD. Moreover, many recent studies have identified adult AD as a systemic disease...
December 2017: Annales de Dermatologie et de Vénéréologie
K A Engebretsen, J Bandier, S Kezic, C Riethmüller, N H H Heegaard, B C Carlsen, A Linneberg, J D Johansen, J P Thyssen
BACKGROUND: Atopic dermatitis (AD) is characterized by skin barrier dysfunction. Notably, a high number of nano-scale protrusions on the surface of corneocytes, which can be expressed by the Dermal Texture Index (DTI), were recently associated with paediatric AD, loss-of-function mutations in filaggrin gene (FLG) and reduced levels of natural moisturizing factors (NMF). No study has so far examined the association between these parameters and monomeric filaggrin levels in adults. OBJECTIVE: To determine DTI, monomeric filaggrin and NMF in healthy controls and a group of patients with controlled dermatitis...
May 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
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