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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a paired-comparison study 30 patients with atopic dermatitis underwent treatment with a combination of UVA and UVB radiation (UVAB) on one side of the body and UVB on the other. Treatment was administered three times a week for a maximum of 8 weeks. Each patient was evaluated with respect to eight effect variables. Statistically significant differences in favor of UVAB were observed for all analyzed variables, namely total score (p = 0.002), pruritus score (p = 0.04), and overall evaluation score (p = 0.03). No statistically significant differences in healing rate were seen; 25 of 30 UVB-treated, and 26 of 30 UVAB-treated, body halves healed or were considerably improved. Patient preference was overwhelmingly in favor of UVAB; 23 of 24 patients who completed an evaluation form preferred this treatment. Only 1 of 24 preferred UVB.
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PMID:Combined UVA-UVB versus UVB phototherapy for atopic dermatitis: a paired-comparison study. 229 65

The atopic conditions, atopic dermatitis, asthma, and allergic rhinitis, may arise as a result of infiltrating bone marrow-derived cells into skin or respiratory mucosae. Release of inflammatory factors from these cells could account for cutaneous vascular instability and pruritus in atopic dermatitis. Erythema and itch have been induced by experimental stress interviews and by blind food challenges. In the latter, increased plasma histamine was detected and correlated with cutaneous reactions. Basophils from patients with atopic dermatitis have increased histamine release after exposure to immunologic or nonimmunologic lectin stimuli. This increased releasability may relate to inadequate cyclic AMP regulation of cell function. We have found that leukocytes of patients with atopic dermatitis have elevated phosphodiesterase activity and consequently reduced intracellular cyclic AMP. Exposure of the cells to a phosphodiesterase inhibitor caused considerable reduction in histamine release. Similarly, exposure of atopic B lymphocytes to a phosphodiesterase inhibitor greatly reduced the high spontaneous IgE synthesis in mononuclear leukocyte cultures. Elevated leukocyte phosphodiesterase activity may also serve as a marker for the atopic diathesis. We have found elevated enzyme activity in umbilical cord blood from newborns with atopic parents, suggesting that this defect may relate to a genetically determined defect. These studies have provided insight into basic abnormalities associated with atopic dermatitis and the atopic diathesis. Defects of regulatory mechanisms in immune and inflammatory cells may help explain the seemingly disparate disorders of physiologic, pharmacologic, and immunologic systems in atopy.
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PMID:Immunopharmacology of the atopic diseases. 240 83

A long-term follow-up study (24 years minimum) was made of 955 individuals aged 24-44 years, who had atopic dermatitis (AD) in childhood. The material was divided into two groups; patients who in 1952-56 had been hospitalized on at least one occasion at the Department of Dermatology, Karolinska Hospital, Stockholm (Group 1), and patients who in 1955-56 had been out-patients in the same department (Group 2). At the time of investigation 62% and 40% of the patients in Groups 1 and 2 respectively had ongoing dermatitis, the majority with mild skin lesions. The frequency of healing of AD and severity of persistent or recurring dermatitis were influenced by several factors. In order of relative importance, disregarding sampling errors, persistent dry/itchy skin in adult life, widespread dermatitis in childhood, associated allergic rhinitis, family history of AD, associated bronchial asthma, early age at onset, and female sex were associated with low frequency of healing and increased severity of persistent or recurring dermatitis.
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PMID:Prognostic factors in atopic dermatitis. 241 Oct 75

Atopic dermatitis (AD) is a familial inflammatory skin disorder, which is characterized by extreme pruritus, the typical morphology and distribution, the chronic or chronically relapsing course, and the personal or family case history of atopy (asthma, allergic rhinitis, atopic dermatitis); moreover, we find a variety of additional features, which are either less specific or relatively rare. Although this disease has been well-known since the beginning of the century, we have not clearly understood its pathogenesis so far. This article reviews the reported deviations of the immune system and the alterations of the mediators of inflammation as well as the abnormalities of cyclic nucleotide regulation. These findings are correlated to the clinical symptoms. The following topics have been dealt with in detail: association with HLA-antigens, elevation of serum IgE and generation of IgE immune complexes, numerical and functional deficiencies of T-suppressor cells, involvement of granulocytes, alterations of mediators of inflammation, and particularly, observations on the cAMP-phosphodiesterase. These extremely complex findings, which are based on the interaction between disregulation of the autonomous nervous system and alterations of the immune system, may provide a better understanding of the pathogenesis of atopic dermatitis.
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PMID:[Pathogenesis of atopic dermatitis]. 243 53

Dry-looking skin of unknown etiology develops in a majority of patients with chronic renal failure. The hydration of the stratum corneum influences the appearance of the skin and lack of water is considered to induce roughness, e.g. in atopic dermatitis. The aim of the present study was to compare the water content in uremic and healthy skin and to evaluate the possible relationship between skin hydration and pruritus in uremic patients. Thirty-one patients, 19 with pruritus, undergoing chronic hemodialysis participated. Twelve healthy age-matched subjects served as controls. The skin of the uremic patients appeared generally xerotic, whereas the controls had normal-looking skin. The water content of the stratum corneum was recorded with the Corneometer, a capacitance-measuring device, on three different sites: the neck, the chest and the lower leg. There was a significant difference in water content between locations in all groups, the water content being highest in the neck and lowest in the leg (p less than 0.01). There was a tendency that patients with pruritus had a lower water content than patients without pruritus, but there was no significant difference between uremic patients and controls. Hence, insufficient hydration does not seem to explain the difference in skin texture between uremic patients and healthy subjects.
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PMID:Stratum corneum hydration in patients undergoing maintenance hemodialysis. 246 93

Apart from increased production of immunoglobulin E antibodies and disturbed T-cell regulation, altered patterns of releasability of vasoactive mediators have been described in patients with atopic eczema. The best studied substance is histamine which is a classical inducer of pruritus in man. Elevated concentrations of histamine have been found in vivo in the skin and in the plasma of patients with atopic eczema especially during exacerbation of the disease. Similar findings have been described for other atopic diseases as extrinsic bronchial asthma. Histamine acts via characteristic receptors; symptoms as itch, wheal formation, mucus production, contraction of smooth muscle, tachycardia H2-effects include acid secretion in the stomach as well as the development of flush and itch reactions, blood pressure changes and cardiac arrhythmia. Of special interest is an inhibitory effect of histamine on lymphocyte reactions mediated via a H2-receptor. The existence of a new H3-receptor in the brain serving as autocrine feed-back inhibitor of histaminergic neurones has been established in the rat but not yet in man. In vitro an increased histamine releasability of peripheral leukocytes has been found after stimulation with a variety of different substances. The difference between patients with atopic eczema and normals is generally most pronounced after stimulation with anti-IgE. There is, however, a tendency towards an increased spontaneous histamine release compared to normals. The release reaction of histamine seems to occur more rapidly in atopics compared to normals.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Histamine and atopic eczema. 247 78

Atopic dermatitis is a pruritic, inflammatory cutaneous disorder found most frequently among patients with a personal or family history of atopic disease. A primary defect is found in bone marrow cells. The most consistent abnormality relates to the overproduction of IgE. Pharmacophysiologic abnormalities include abnormal vascular responses, abnormal sweating responses, and a reduced threshold for itch. In addition, seven of 12 patients with pure atopic dermatitis with no respiratory disease have an abnormal methacholine inhalation test. There is an abnormal response of leukocyte cyclic AMP to a variety of adenylate cyclase stimulants. Characteristic histological findings are interepidermal edema, called spongiosis, which is consistent with a composite of late-phase and delayed hypersensitivity. The brittle stratum corneum can be treated with hydration, a commonly neglected aspect of management. An overlooked complication is herpes simplex infection of the eye. Overall management includes stress control, treating allergenic trigger factors, topical steroids, systemic antibiotics, antihistamines, ultraviolet light, and hospitalization in severe cases.
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PMID:Recognizing and managing clinical problems in atopic dermatitis. 248 93

For many years, the use of antihistamines in dermatological conditions has been closely linked to the treatment of urticarias and to the symptomatic relief of pruritus. H1-receptor antagonists are the first-line drugs for urticarias. Those urticarias of type I immunological origin respond better than physical urticarias. H2-receptor antagonists may be added for refractory patients but are rarely effective alone. Conventional H1-blockers are frequently associated with somnolence and anticholinergic effects. Therefore, new antihistamines without depressive effects on the central nervous system have recently been introduced. In other pruritic conditions such as atopic dermatitis the limited effects of these drugs suggest that histamine is not the only mediator involved in pruritus. In these cases, their beneficial effects seem to be due mainly to their sedative properties; recently available nonsedative H1-blockers are less effective.
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PMID:Rational use of antihistamines in allergic dermatological conditions. 257 6

We report the results of a double-blind, placebo-controlled, cross-over study of terfenadine 120 mg twice daily for pruritus in atopic dermatitis. Twenty-eight subjects with chronic atopic dermatitis received both terfenadine 120 mg b.d. and placebo each for a period of 1 week. Response was recorded by the subjects using visual analogue scales for severity of pruritus twice daily for the last 4 days of each treatment phase. There was no benefit from terfenadine.
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PMID:Failure of terfenadine in relieving the pruritus of atopic dermatitis. 200 9

Adults with atopic dermatitis (AD), with respiratory atopy only and healthy non-atopic controls were given intradermal injections of substance P (SP), neurokinin A (NKA), neurotensin (NT), vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP) and histamine into the normal-appearing skin on the back. The weal and flare responses were evaluated after 3, 5 and 15 min and the areas calculated using an automatic image analyser. With the three different concentrations used (1, 3 and 30 pmols) a statistically significant (P less than 0.05) reduction in both the weal and flare response to SP, NKA, NT and histamine and a reduced flare to CGRP was observed only in AD patients. Among those with AD there was no uniformity of response to the individual neuropeptide and in general the more severely affected showed a lower reactivity. Dose-response relationships were evaluated for SP and NT (10-320 pmols) in AD and healthy controls. In AD dose-response curves and time-course relationships were similar to controls, but at significantly reduced levels. The itch response to the neuropeptides and histamine was not different in atopics and controls. We suggest that this hyporesponsiveness in AD is the result of natural tachyphylaxis of the target structures (mast cells and blood vessels) and possibly due to a higher availability of neuropeptides in the skin or to a primary abnormal sensitivity of the blood vessels and mast cells to these peptides.
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PMID:Skin reactivity to neuropeptides in atopic dermatitis. 261 Nov 20


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