1/5. Recalcitrant atopic dermatitis due to allergy to Compositae.Atopic dermatitis is often complicated by allergic contact dermatitis, although patch testing may reveal positive reactions of uncertain relevance. We report a case of a 35-year-old woman with recalcitrant atopic dermatitis, with a positive patch-test reaction to Compositae mix (CM). Initially, sensitization appeared to be of past relevance only, due to use of calendula. However, it turned out that she followed a self-devised diet consisting largely of food products of the Compositae family. On excluding these food products her skin condition improved quickly. This case report underscores the difficulty in determining the relevance of positive patch tests, and shows that thorough analysis of positive patch tests, by both patient and physician, may reveal unexpected or less common sources of contact allergens.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. eczema molluscatum in tacrolimus treated atopic dermatitis.eczema molluscatum describes the occurrence of molluscum contagiosum virus infection in a patient with underlying atopic dermatitis. Novel, safe and effective treatment options in atopic dermatitis are the topical immunomodulators tacrolimus and pimecrolimus. One major advantage over corticosteroids is that they do not induce skin atrophy. Some physicians fear that topical immunomodulators may predispose patients to skin infections. We observed a patient with atopic dermatitis who developed eczema molluscatum during treatment with tacrolimus 0.1% ointment. After withdrawal of tacrolimus, the lesions resolved spontaneously over 3 weeks.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/5. Exacerbation of atopic dermatitis in the emergency department.A 38-year-old man was admitted to the Emergency Department suffering from an exacerbation of atopic dermatitis, fever and a burning sensation in the eyes. He was first treated with systemic corticosteroids. A subsequent dermatological and ophthalmological examination established the diagnosis of Kaposi-Juliusberg disease or eczema herpeticum with bilateral herpetic keratitis. eczema herpeticum is an uncommon herpes simplex virus infection that occurs in patients with atopic dermatitis. Because it is a possible life-threatening condition, this disease must be recognized by all emergency physicians. The association with herpetic keratitis is not frequent but is a major ophthalmological problem. Treatment consists of the administration of high-dose intravenous acyclovir and acyclovir ophthalmic ointment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/5. Chronic intractable atopic eczema. Its occurrence as a physical sign of impaired parent-child relationships and psychologic developmental arrest: improvement through parent insight and education.Atopic eczema of infancy and childhood responds readily and predictably to treatment; only a small percentage remains intractable. Lack of therapeutic response in a proportion of these patients can be attributed to dysfunctional parent-child relationships that lead to physical and emotional developmental arrest. Improvement in parent-child relationships following parental insight into their conflicted feelings permits acceptance of educational recommendations from the physician; it also allows normal development to be resumed and eczema to improve. Eight illustrative cases are reported in which aggressive dermatologic measures were combined with an approach that helped parents recognize conflict and provided education that permitted more appropriate behavioral limit setting. Rapid and sustained improvement in skin, emotional development, and social adjustment resulted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/5. staphylococcal infections in patients with atopic dermatitis.Cutaneous staphylococcal infections appear to be relatively infrequent in atopic dermatitis even though patients have broken skin heavily colonized with staphylococcal organsism. We found superficial staphylococcal pustules on the skin of 22 patients with atopic dermatitis. Such lesions were more commonly found with severe exacerbations of atopic dermatitis. They appeared on unbroken skin independent of hair follicles and were associated with considerable pruritis. Such lesions were rapidly removed by excoriation and frequently were overlooked by patients and physicians. Most lesions appeared when polymorphonuclear leukocyte chemotaxis was depressed. Ineffective chemotaxis combined with high-colonization density and inadequate stratum corneum barrier during exacerbations of atopic dermatitis may lead to mild staphylococcal infections. These infections appear to have no systemic effects but possibly the considerable associated pruritis could worsen the atopic dermatitis. Occasional patients may require intermittent or continuous antibiotic therapy.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |