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

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

Diffuse dermatitis and markedly elevated serum IgE concentrations were observed in three adult males who were seropositive for human immunodeficiency virus (HIV) antibody. The clinical features in common for these patients included 1) an adult onset of greater than 6 weeks' duration associated with pruritus, 2) T-helper (CD-4) cell depletion, 3) the lack of overt atopic disease, and 4) the lack of opportunistic infection (except oral thrush) and neoplasia. The mean serum IgE concentration was 5,959 (range: 4,930-6,260) IU/ml. Cutaneous involvement consisted of hyperpigmented papules with variable excoriations and lichenification. Zidovudine was administered to all 3 patients and was associated with cutaneous improvement. Serum IgE concentrations from 19 AIDS patients without cutaneous disease did not show significant elevations. These observations suggest that certain patients with HIV infection can manifest a unique hyper-IgE syndrome associated with diffuse cutaneous disease.
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PMID:Chronic diffuse dermatitis and hyper-IgE in HIV infection. 246 86

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

Forty-six of 152 consecutive adult rhinitis patients had perennial nonallergic rhinitis (PNR). Eighty-five percent of those with PNR presented with nasal congestion, whereas 15% presented with rhinorrhea. Their mean age was 40.5 years (range = 21-77), and 74% were female. Patients with perennial nonallergic rhinitis in this series were characterized by ocular pruritus or burning, 28%; frontal headache, 22%; symptoms consistent with asthma, 33%; an unremarkable nasal mucosa, 96%; the absence of nasal polyps, 100%; nasal eosinophilia (greater than or equal to 5%), 10%; nasal neutrophilia (greater than or equal to 25%), 22%; numerous nasal bacteria, 12%; sinusitis, 6%; and a geometric mean IgE of 26.4 U/mL. This experience suggests that PNR is a common problem in a general allergy practice. Nasal obstruction, usually more difficult to treat than rhinorrhea, is the dominant symptom. Unexpected findings were frequent conjunctivitis and nasal neutrophilia.
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PMID:Perennial nonallergic rhinitis: a retrospective review. 248 Jul 28

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

A total of 65 patients with food allergy which manifested primarily by disorders of the gastrointestinal tract, bronchi and skin were placed under observation. The patients were administered sodium chromoglycate (nalcrom) per os in a dose of 200 mg 4 times a day for 2-3 weeks, in part of cases up to 3 months and even up to 1-1.5 year. The skin manifestations of allergy (pruritus, urticaria, Quincke's edema, and eczematous rash), abdominal pain, diarrhea, vomiting, bronchospasm, rhinitis, and conjunctivitis disappeared. At the same time the majority of the patients demonstrated the reduction of the intensity of skin responses to the administration of different food antigens, the decrease of the antibody titer in blood serum in response to food antigens, and of the IgE content in blood. The side effects (nausea, heartburn, intensification of skin itch and abdominal pain) were noted in 4 cases.
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PMID:[Treatment of patients with food allergy using Nalcrom]. 249 73

Occupational diseases of the skin have been detected in 19.6% of 352 workers engaged in molybdenum production. These diseases are characterized by a relatively low incidence on the dermatitis transformation into eczema and a considerable length of this process, by weak skin reactions to molybdenum tests (with 20% aqueous solution of ammonium paramolybdate), by the predominance of skin itching in the clinical picture, by a secondary pyococcic infection, and by frequent combination of eczema with allergic involvement of the ENT organs. Experimental and clinical immunologic studies have revealed that mostly humoral immune mechanisms with a relatively weak involvement of the T-lymphocytes contribute to the pathogenesis of the dermatoses due to molybdenum exposure; this fact is responsible for poor clinical manifestation of the delayed type hypersensitivity reactions and at the same time a manifest IgE-dependent pattern of allergic reactions. A clear-cut correlation between the frequency of the dermatoses and molybdenum level in environmental dust was detected, as were a considerable molybdenum contamination of the skin and the fact that hot and humid microclimate are conducive to the development of dermatoses. Basing on the results of these studies, the authors have developed recommendations on the diagnosis and prevention of molybdenum-induced dermatoses.
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PMID:[Clinico-immunologic characteristics and prevention of occupational allergic dermatoses due to molybdenum exposure]. 253 14

In a group of 535 children and 103 adult patients with atopic dermatitis no differences were observed between persons with normal and raised IgE level with respect to incidence of lesions in the first or the first three months of life, the total number of the positive RAST results and the most intense reactions, that is 4 degrees, the percent of helper and suppressor T-cells, duration of remission, darkening of lower eyelids, cheilitis, involvement of the hands, the feet, the elbow flexures or knee flexures. On the other hand, in individuals with raised IgE level, especially in patients with IgE level tenfold higher or more than normal, the co-existence of alergic diseases of the respiratory system, the appearance of itching after sweating, itching after emotion, pityriasis alba, and eczema of breasts were
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PMID:[Atopic dermatitis in patients with normal and raised IgE levels]. 262 28

Radioimmunological tests were carried out in 180 children with pruritus and 167 children with pruritus and allergic respiratory diseases. Difference between these groups was statistically insignificant in case of food allergy. Results of RAST were more often positive in case of respiratory allergy in the patients with pruritus and coexisting allergic respiratory diseases than in patients with skin involvement only. Reaction was more intense and allergy polyvalence measured with RAST was higher. All differences were statistically significant (p less than 0.001 or 0.01). Mean IgE levels was higher in children of all age groups in case of pruritus coexisting with allergic respiratory diseases.
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PMID:[Radioimmunologic tests in children with pruritus and with a combination of pruritus and allergic respiratory disease]. 263 38

Clinical and biological evaluations were carried out on 84 Congolese patients with parasitologically confirmed Loa loa filariasis (without concurrent infection with other filariae) and on 98 controls without filariasis. On the patients, 72 presented with microfilaremia; another 12 with negative blood tests were seen towards the end of an episode of subconjunctival migration of the adult worm. The incidence and severity of the clinical signs depended upon the method of recruitment. The 3 most common signs were pruritus and edema (both occurring in successive acute episodes affecting mainly the hands and forearms) and subconjunctival migration of adult filariae. Papulovesicular eruptions were located mainly on the arms. Headaches and arthralgia were noted more frequently than in the controls. No relation was found between the ABO blood groups and loiasis. Eosinophilia (higher in patients with symptoms) and raised serum IgE levels were found in nearly all patients and were strongly marked in approximately 66%. A positive correlation was observed between these 2 parameters. Fluorescent antibody levels (adult filaria Dipetalonema viteae antigen) were comparatively low in patients with microfilaremia.
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PMID:Clinical and biological study of Loa loa filariasis in Congolese. 267 58


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