Advertisement

Approach for Aggravating Factors in Atopic Dermatitis

  • Sakae KanekoEmail author
Chapter

Abstract

Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease characterized by pruritus and inflammation and is accompanied by cutaneous physiological dysfunction (Saeki et al. J Dermatol 36: 563–577, 2009).

A wide variety of etiological and exacerbating factors has been proposed, with the importance level of each varying among individual patients. In addition, inflammation associated with this disease will be elucidated by both allergic and nonallergic mechanisms. Etiological and exacerbating factors vary among age groups. While the dominant factors in the first half of childhood include foods, sweating, physical irritation (including scratching), environmental factors, and microbes/fungi, the dominant factors in the second half of childhood to adulthood include environmental factors, sweating, physical irritation (including scratching), microbes/fungi, contact allergens, stress, and foods (Fig. 24.1) (Katayama et al. Allergology International 63: 377–398, 2014).

The detection of both atopic dermatitis (AD) aggravating factors and countermeasures is crucial. Additionally, the method of patient instruction relating to these countermeasures is an important aspect of AD management. We conducted a questionnaire-based survey (Kaneko et al. Nishinihon J Dermatol 73, 614–618, 2011; Kaneko et al. Japanese J Dermatol 123, 2091–2097, 2013; Kaneko et al. Arerugi 63, 1250–1257, 2014) on physicians, patients, and pharmacists, on the topic of instruction given to patients with AD on an outpatient basis, and our findings are summarized below.

Keywords

Aggravating factors Management Sweat Itch-scratch cycle Stress-scratch cycle Instructions for patients 

References

  1. 1.
    Saeki H, Furue M, Furukawa F, et al. Guidelines for management of atopic dermatitis. J Dermatol. 2009;36:563–77.CrossRefPubMedGoogle Scholar
  2. 2.
    Katayama I, Kohno Y, Akiyama K, et al. Japanese guideline for atopic dermatitis 2014. Allergol Int. 2014;63:377–98.CrossRefGoogle Scholar
  3. 3.
    Kaneko S, Sumikawa Y, Dekio I, et al. Questionnaire-based study on the knack of medical personnel with regard to providing directives to outpatients with atopic dermatitis. Nishinihon J Dermatol. 2011;73:614–8. [In Japanese]CrossRefGoogle Scholar
  4. 4.
    Kaneko S, Kakamu T, Sumikawa Y, et al. Questionnaire-based study of the Doctor’s Guidance for patients with atopic dermatitis. Jpn J Dermatol. 2013;123:2091–7. [In Japanese]Google Scholar
  5. 5.
    Kaneko S, Kakamu T, Matsuo H, et al. Questionnaire-based study on the key to the guidance to the patients with atopic dermatitis by pharmacist. Arerugi. 2014;63:1250–7. [In Japanese]PubMedGoogle Scholar
  6. 6.
    Hide M, Tanaka T, Yamamura Y, et al. IgE-mediated hypersensitivity against human sweat antigen in patients with atopic dermatitis. Acta Derm Venereol. 2002;82:335–40.CrossRefPubMedGoogle Scholar
  7. 7.
    Hiragun T, Ishii K, Hiragun M, et al. Fungal protein MGL_1304 in sweat is an allergen for atopic dermatitis patients. J Allergy Clin Immunol. 2013;132:608–15.CrossRefPubMedGoogle Scholar
  8. 8.
    Eishi K, Lee JB, Bas SJ, et al. Impaired sweating function in adult atopic dermatitis: results of the quantitative sudomotor axon reflex test. Br J Dermatol. 2002;147:683–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Murota H, Izumi M, Abd El-Latif MI, et al. Artemin causes hypersensitivity to warm sensation, mimicking warmth-provoked pruritus in atopic dermatitis. J Allergy Clin Immunol. 2012;130:671–82.CrossRefPubMedGoogle Scholar
  10. 10.
    Rieg S, Steffen H, Seeber S, et al. Deficiency of dermcidin-derived antimicrobial peptides in sweat of patients with atopic dermatitis correlates with an impaired innate defense of human skin in vivo. J Immunol. 2005;174:8003–10.CrossRefPubMedGoogle Scholar
  11. 11.
    Schmid-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Physiol. 2006;19:296–302.CrossRefPubMedGoogle Scholar
  12. 12.
    Norris PG, Schofield O, Camp RD. A study of the role of house dust mite in atopic dermatitis. Br J Dermatol. 1988;118:435–40.CrossRefPubMedGoogle Scholar
  13. 13.
    Gutgesell C, Heise S, Seubert S, et al. Double-blind placebo-controlled house dust mite control measures in adult patients with atopic dermatitis. Br J Dermatol. 2001;145:70–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Oosting AJ, de Bruin-Weller MS, Terreehorst I, et al. Effect of mattress encasings on atopic dermatitis outcome measures in a double-blind, placebo-controlled study: the Dutch mite avoidance study. J Allergy Clin Immunol. 2002;110:500–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Williams H, Robertson C, Stewart A, et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol. 1999;103:125–38.CrossRefPubMedGoogle Scholar
  16. 16.
    Yokozeki H, Takayama K, Katayama I, et al. Japanese cedar pollen as an exacerbation factor in atopic dermatitis: result of atopy patch testing and histological examination. Acta Derm Venereol. 2006;86:148–51.PubMedGoogle Scholar
  17. 17.
    Kisich KO, Carspecken CW, Fieve S, et al. Defective killing of Staphylococcus aureus in atopic dermatitis is associated with reduced mobilization of human b-defensin-3. J Allergy Clin Immunol. 2008;12:62–8.CrossRefGoogle Scholar
  18. 18.
    Morita E, Hide M, Yoneya Y, et al. An assessment of the role of candida albicans antigen in atopic dermatitis. J Dermatol. 1999;26:282–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Glatz M, Buchner M, Von Bartenwerffer A, et al. Malassezia spp.-specific immunoglobulin E level is a marker for severity of atopic dermatitis in adults. Acta Derm Venereol. 2015;95:191–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Takaki H, Ishii Y. Sense of coherence, depression, and anger among adults with atopic dermatitis. Psychol Health Med. 2013;18:725–34.CrossRefPubMedGoogle Scholar
  21. 21.
    Higaki Y. Atopic dermatitis. Arerugi. 2010;59:82–90.PubMedGoogle Scholar
  22. 22.
    Amano H, Negishi I, Akiyama H, et al. Psychological stress can trigger atopic dermatitis in NC/Nga mice: an inhibitory effect of corticotropin-releasing factor. Neuropsychophamacology. 2008;33:566–73.CrossRefGoogle Scholar
  23. 23.
    Halling-overgaard AS, Kezic S, Jakasa I, et al. Skin absorption through atopic dermatitis skin: a systematic review. Br J Dermatol. 2016; doi: 10.1111/bjd.15065.
  24. 24.
    Takayama K. Japanese guideline for care of contact dermatitis; the guess and identification of the allergens. Arerugi. 2012;61:175–80.PubMedGoogle Scholar
  25. 25.
    Girsh CM, Peter AL. Comparison of dermatology and allergy guidelines for atopic dermatitis management. JAMA Dermatol. 2015;151:1009–13.CrossRefGoogle Scholar
  26. 26.
    Sumikawa Y, Ueki Y, Miyoshi A, et al. Survey of atopic dermatitis and skin barrier functions in Japanese and Chinese school students. Arerugi. 2007;56:1270–5.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Dermatology, Faculty of MedicineShimane UniversityIzumoJapan

Personalised recommendations