AAD: Genetic Defect in Skin Barrier Tied to Eczema
Mutations in fillagrin gene leads to defect in outer layer of skin, allowing irritants to penetrate
Feb 4, 2008
(HealthDay News) -- A genetic defect in the skin's protective outer later that allows microbes, allergens and other irritants to penetrate the skin likely underlies atopic dermatitis and may contribute to the development of food allergies, according to research presented this week at the American Academy of Dermatology's 66th Annual Meeting in San Antonio, Texas.
Jon M. Hanifin, M.D., of Oregon Health and Science University in Portland, Ore., discussed new data on the genetic basis of atopic dermatitis, the relationship to childhood allergies, and implications for the management of childhood eczema.
The researchers gained insights into atopic dermatitis by studying another genetic skin disease, ichthyosis vulgaris. In both conditions, mutations in the filaggrin gene, necessary for the integrity of the skin's outer barrier layer, lead to breaches in the epidermis. When food allergens pass through this defective skin barrier, very elevated levels of IgE antibodies and allergic reactions to food can result. Thus, in contrast to the common misconception that food allergies cause eczema, it is rather the broken skin barrier of eczema that leads to food allergies.
Hanifin comments on the implications of this research: "Strong evidence linking a broken skin barrier to the development of future allergies offers an important prevention opportunity. Babies with eczema need early therapy with measures directed at repair and maintenance of the skin's barrier."
http://www.modernmedicine.com
Friday, February 8, 2008
Methotrexate Effective and Safe for Children With Severe Atopic Dermatitis: Presented at AAD
By Bruce Sylvester SAN ANTONIO, TX -- February 4, 2008
Methotrexate is an effective treatment for children with severe atopic dermatitis, researchers reported here at the American Academy of Dermatology 66th Annual Meeting (AAD). "Overall, we found that the vast majority of patients improved significantly," said presenter and lead investigator Christopher Rouse, MD, Senior Resident, Department of Dermatology, St. Louis University School of Medicine, St. Louis, Missouri, United States. In their poster, Dr. Rouse and colleagues indicated that atopic dermatitis is the most common cause of severe skin disease in children. Research on systemic treatments is limited. "Case reports have documented the efficacy of methotrexate for the treatment of severe atopic dermatitis in adults, but no information is published on treatment in children with this disease," Dr. Rouse said in a presentation on February 3. The investigators retrospectively reviewed data on 30 children with severe atopic dermatitis who had been treated with methotrexate. Patients ranged in age from 2 to 16 years and all had failed topical therapy. Many had been treated with cyclosporine and were successfully crossed-over to methotrexate. All subjects received an initial dose of 0.5 mg/kg/week (maximum 15 mg). Most of the children tolerated the tablet formulation. Of those who received a liquid formulation, most received the concentrated 25 mg/cc parenteral formulation. Supplemental folic acid (1 mg) was added after the first month of treatment and was taken on non-methotrexate days. Followup in the clinic and laboratory assessments took place at baseline and monthly for 3 months, followed every 3 months thereafter if the dosing remained stable. Laboratory parameters included complete blood counts with red blood cell indices and a comprehensive metabolic panel. The investigators reported that elevations in hepatic transaminases were transient and unusual, and were found in blood obtained within 1 to 2 days after methotrexate administration, or following a presumed viral illness. No child underwent liver biopsy. Dose adjustments occurred every 2 to 3 months as needed. The investigators found that the majority of methotrexate-treated subjects achieved a partial to complete response, with no serious adverse events occurring among the subjects during an average of 12 months exposure. "Methotrexate is a useful systemic treatment option for children with severe atopic dermatitis," the authors concluded. [[Presentation title: Methotrexate for Atopic Dermatitis in Children. Abstract P608]
By Bruce Sylvester SAN ANTONIO, TX -- February 4, 2008
Methotrexate is an effective treatment for children with severe atopic dermatitis, researchers reported here at the American Academy of Dermatology 66th Annual Meeting (AAD). "Overall, we found that the vast majority of patients improved significantly," said presenter and lead investigator Christopher Rouse, MD, Senior Resident, Department of Dermatology, St. Louis University School of Medicine, St. Louis, Missouri, United States. In their poster, Dr. Rouse and colleagues indicated that atopic dermatitis is the most common cause of severe skin disease in children. Research on systemic treatments is limited. "Case reports have documented the efficacy of methotrexate for the treatment of severe atopic dermatitis in adults, but no information is published on treatment in children with this disease," Dr. Rouse said in a presentation on February 3. The investigators retrospectively reviewed data on 30 children with severe atopic dermatitis who had been treated with methotrexate. Patients ranged in age from 2 to 16 years and all had failed topical therapy. Many had been treated with cyclosporine and were successfully crossed-over to methotrexate. All subjects received an initial dose of 0.5 mg/kg/week (maximum 15 mg). Most of the children tolerated the tablet formulation. Of those who received a liquid formulation, most received the concentrated 25 mg/cc parenteral formulation. Supplemental folic acid (1 mg) was added after the first month of treatment and was taken on non-methotrexate days. Followup in the clinic and laboratory assessments took place at baseline and monthly for 3 months, followed every 3 months thereafter if the dosing remained stable. Laboratory parameters included complete blood counts with red blood cell indices and a comprehensive metabolic panel. The investigators reported that elevations in hepatic transaminases were transient and unusual, and were found in blood obtained within 1 to 2 days after methotrexate administration, or following a presumed viral illness. No child underwent liver biopsy. Dose adjustments occurred every 2 to 3 months as needed. The investigators found that the majority of methotrexate-treated subjects achieved a partial to complete response, with no serious adverse events occurring among the subjects during an average of 12 months exposure. "Methotrexate is a useful systemic treatment option for children with severe atopic dermatitis," the authors concluded. [[Presentation title: Methotrexate for Atopic Dermatitis in Children. Abstract P608]
Subscribe to:
Posts (Atom)
