Eczema Articles

Yeast Offers Clue To A Cure For Eczema

Main Category: Eczema / Psoriasis
Article Date: 28 Nov 2011 – 0:00 PST

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Scientists have found that a strain of yeast implicated in inflammatory skin conditions, including eczema, can be killed by certain peptides and could potentially provide a new treatment for these debilitating skin conditions. This research is published in the Society for Applied Microbiology’s journal, Letters in Applied Microbiology.

20% of children in the UK suffer from atopic eczema and whilst this usually clears up in adolescence, 7% of adults will continue to suffer throughout their lifetime. Furthermore, this type of eczema, characterized by dry, itchy, flaking skin, is increasing in prevalence. Whilst the cause of eczema remains unknown, one known trigger factor is the yeast Malassezia sympodialis.

This strain of yeast is one of the most common skin yeasts in both healthy individuals and those suffering from eczema. The skin barrier is more fragile and often broken in those suffering from such skin conditions, and this allows the yeast to cause infection which then further exacerbates the condition. Scientists at Karolinska Institute in Sweden looked for a way to kill Malassezia sympodialis without harming healthy human cells.

The researchers looked at the effect on the yeast of 21 peptides which had either; cell-penetrating or antimicrobial properties. Cell-penetrating peptides are often investigated as drug delivery vectors and are able to cross the cell membrane, although the exact mechanism for this is unknown. Antimicrobial peptides, on the other hand, are natural antibiotics and kill many different types of microbe including some bacteria, fungi and viruses.

Tina Holm and her colleagues at Stockholm University and Karolinska Institute, added these different peptides types to separate yeast colonies and assessed the toxicity of each peptide type to the yeast. They found that six of the 21 peptides they tested successfully killed the yeast without damaging the membrane of keratinocytes, human skin cells.

Tina commented “Many questions remain to be solved before these peptides can be used in humans. However, the appealing combination of being toxic to the yeast at low concentrations whilst sparing human cells makes them very promising as antifungal agents. We hope that these peptides in the future can be used to ease the symptoms of patients suffering from atopic eczema and significantly increase their quality of life.”

The next step will be to further examine the mechanism(s) used by the peptides to kill yeast cells, in order to develop a potential treatment for eczema and other skin conditions.

MLA

Treatment Variability Found In Pediatric Psoriasis Outpatient Health Care Delivery

Editor’s Choice
Main Category: Eczema / Psoriasis
Also Included In: Pediatrics / Children’s Health
Article Date: 20 Sep 2011 – 2:00 PDT

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According to a report published Online First by Archives of Dermatology, one of the JAMA/Archives journals, most outpatient for pediatric psoriasis in the U.S. who visit dermatologists and pediatricians consist of white children aged 8 years and older, however, treatment approaches seem to vary according to physician specialty and patient age.

Background information in the article states that in the U.S. approximately 2.5 % of the population is affected by psoriasis, with 1% being children from birth to 18 years. A third of all patients develop first signs and symptoms by the age of 20 years. Health professionals consider various factors, such as disease severity, presentation and distribution of lesions, patient age and the presence of concurrent conditions in determining patients’ treatment. While topical medications are generally used for mild, localized cases in pediatric patients, more complex cases are usually treated with phototherapy and systemic medication. The authors state that, “Management of psoriasis in children can be challenging owing to a paucity of data and lack of standardized guidelines specific to the pediatric population.”

Sinae A. Vogel, B.S., from the University of California at the San Francisco School of Medicine and her team carried out a retrospective, cross-sectional examination based on data from the National Ambulatory Medical Care Survey. They evaluated outpatient-visit data from dermatologists and non-dermatologists from 1979 to 2007 of children from birth 18 years with a diagnosis of psoriasis. Data was not collected between the periods of 1982-1984 and 1987-1988.

They charted the frequency of medications in the database and divided them into three categories, i.e. topical corticosteroid group, topical non-corticosteroid and systemic. The corticosteroid category was further subdivided into a relative potency value from one (super potent) to seven (very weak).

Over the 28-year study period, an estimated 3.8 million pediatric psoriasis visits occurred in total, with a median (midpoint) of 123,420 visits per year. Almost two-thirds of patients (63%) visited dermatologists for the condition while 17% of psoriasis visits were made to pediatricians and 14 % to internists. Numbers of male and female patient visits were equal, with 93% of patients being white.

47% of visiting patients were aged between 13 to 18 years, with 35% of visits being made by children aged 8 to 12 years and 18% aged between 0 to 7 years respectively.

Researchers found that the most commonly prescribed medications consisted of topical corticosteroids with equal potency levels in younger and older children. In general, both younger and older age groups were commonly administered with betamethasone, a topical coricosteroid.

According to the findings, dermatologists and internists mostly prescribed high-potency steroids, while pediatricians most commonly prescribed the topical immunosuppressant tacrolimus. According to the study, dermatologist’s top 20 most-prescribed medications did not include topical calcineurin inhibitors, a medication preventing inflammation and the top 20 most-prescribed medications in any age group did not include systemic antipsoriatic agents.

The authors write, “This study confirms that pediatric psoriasis visits are frequent and represent a substantial burden of disease in the United States, validating the social, economic, and medical impact of this disease.” They highlight the age differences in office visits for the condition as well as trends in medication usage, and are especially concerned about the frequency of strong corticosteroid use in patients younger than 8 years. They comment: “In our experience, the highest potency topical corticosteroids are not commonly needed for psoriasis in young children.”

Trends like this indicate a need for treatment guidelines that address the condition in children. The authors conclude saying:

“The current state-of-the-art care for pediatric psoriasis is based primarily on experience and expert consensus. Some clinicians may not be anticipated to change even if standardized treatment guidelines existed, as such, education of our dermatology and non-dermatology colleagues about unique clinical and treatment aspects of pediatric psoriasis, rather than guidelines alone, may decrease the treatment gap by creating more comfortable, safe, and effective use of topical and systemic regimens for children with psoriasis.”

MLA

Certain Drugs Lower Risk Of Diabetes For Patients With Rheumatoid Arthritis Or Psoriasis

Main Category: Diabetes
Also Included In: Arthritis / Rheumatology;  Eczema / Psoriasis
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In a study that included nearly 14,000 patients with rheumatoid arthritis or psoriasis, the use of certain disease-modifying antirheumatic drugs was found to lower the risk of diabetes, according to a study in the June 22/29 issue of JAMA.

Two common systemic inflammatory conditions, rheumatoid arthritis (RA) and psoriasis, predispose patients to insulin resistance and may place patients at risk for diabetes mellitus (DM). The treatment of psoriasis and RA includes disease-modifying antirheumatic drugs (DMARDs) such as tumor necrosis factor (TNF) inhibitors, which are directed against the inflammatory response, according to background information in the article. The relationship between these conditions and DM suggests that systemic immunosuppression may also reduce the risk for DM.

Daniel H. Solomon, M.D., M.P.H., of Brigham and Women’s Hospital, Boston, and colleagues examined the relationship between DMARD medications and the risk of newly diagnosed DM among participants with RA or psoriasis. The researchers conducted a retrospective cohort study among 121,280 patients with a diagnosis of either RA or psoriasis on at least 2 visits. The analyses were conducted in the context of 2 large health insurance programs, 1 in Canada and 1 in the United States, using administrative data. The average follow-up was 5.8 months and began with the first prescription for a DMARD after study eligibility was met. Drug regimens were categorized into 4 mutually exclusive groups: (1) TNF inhibitors with or without other DMARDs; (2) methotrexate without TNF inhibitors or hydroxychloroquine; (3) hydroxychloroquine without TNF inhibitors or methotrexate; or (4) other nonbiologic DMARDs without TNF inhibitors, methotrexate, or hydroxychloroquine.

The final study cohort consisted of 13,905 participants with 22,493 new treatment episodes starting 1 of the categories of DMARD regimens between January 1996 and June 2008. The researchers found 267 newly diagnosed cases of DM: 55 cases among 3,993 treatment episodes with nonbiologic DMARD users; 80 cases among 4,623 treatment episodes with TNF inhibitor users; 82 cases among 8,195 treatment episodes with methotrexate users; and 50 cases among 5,682 treatment episodes with hydroxychloroquine users. The incidence rates for DM were highest for individuals who switched to other nonbiologic DMARDs and lowest for TNF inhibitor users. “The fully adjusted models suggest a reduced relative risk of DM for TNF inhibitor and hydroxychloroquine compared with other nonbiologic DMARDs,” the authors write.

According to the authors, “The findings from this epidemiologic study should be considered hypothesis-generating. However, considering these results in light of prior findings regarding improved insulin and glucose metabolism and reduced DM risk with hydroxychloroquine and TNF inhibitors, there is evidence suggesting a possible role for DMARDs and immunosuppression in DM prevention. A randomized controlled trial testing the ability of these agents to prevent DM among participants with systemic inflammatory disorders should be considered.”

JAMA. 2011;305[24]2525-2531.

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Of course, in regard to autoimmune etiology of DMII, BUT the effect of corticosteroids, widely used in treatment until recently, was different.

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Does Exclusive Breastfeeding Prevent Eczema? It Appears Not

Editor’s Choice
Academic Journal
Main Category: Eczema / Psoriasis
Also Included In: Dermatology;  Pediatrics / Children’s Health
Article Date: 31 Aug 2011 – 0:00 PDT

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There is no clear evidence showing that exclusive breastfeeding for at least four months reduces the chances of a baby eventually developing eczema, researchers reported in the British Journal of Dermatology. The authors, from King’s College London, say that in view of their findings, the UK’s breastfeeding guidelines with regards to eczema should be reviewed.

This study was a joint collaboration between researchers from King’s College London, the University of Ulm, Germany, and the University of Nottingham, England. They gathered data on 51,119 children aged 8 to 12 years from 21 nations.

The investigators collected data on breastfeeding, when the baby was weaned, and eczema. Parents had to fill in questionnaires. The children were given a skin examination for eczema, as well as a skin prick test to determine whether they had any allergies.

Previous studies had indicated that breastfeeding might protect from eczema. WHO (World Health Organization) and the UK Department of Health recommend six months of exclusive breastfeeding to reduce eczema risk.

However, in keeping with the findings in this present study, the researchers reviewed more recent articles and found no evidence showing that exclusive breastfeeding for four months or more reduced the risk of developing eczema.

Moreover, there is growing evidence that introducing potentially allergenic food proteins, such as peanut early on in life helps improve tolerance, rather than causing allergies. The authors point out that further intervention studies are required to confirm this.

Dr. Carsten Flohr and team set out to determine whether breastfeeding protects from eczema, and if so, to what extent. They focused on children who had been exclusively breastfed for at least four months. They found that these children had the same risk of eventually developing eczema as the children who had been weaned earlier.

The study formed part of Phase II of ISAAC (The International Study of Asthma and Allergies in Childhood) – the largest epidemiological research project ever done.

Dr Carsten Flohr, who works at the Asthma, Allergy and Lung Biology Division, King’s College, said:

“Although there was a small protective effect of breastfeeding per se on severe eczema in affluent countries, we found no evidence that exclusive breastfeeding for four months or longer protects against eczema in either developed or developing nations.

We feel that the UK breastfeeding guidelines with regard to eczema should therefore be reviewed. Further studies are now required to explore how and when solids should be introduced alongside breastfeeding to aid protection against eczema and other allergic diseases.

It is widely accepted that breast milk is the most important and appropriate nutrition in early life. Especially in the context of developing countries it is also important to keep in mind that exclusive breastfeeding reduces the risk of gastrointestinal infections compared to mixed or bottle feeding. Our study does not change this notion.

Nina Goad of the British Association of Dermatologists said:

“The size of this study means that its findings are very significant, although the authors recognise that further studies are required. Following these further studies we may need to review the UK’s advice on how long mothers should breastfeed exclusively for, and at what age we should be weaning our infants, in relation to eczema prevention.

This study isn’t about the benefits of infant formula milk versus breast milk, nor is it questioning other benefits of breast feeding, but it is about whether breastfeeding exclusively for prolonged periods and weaning after six months, as opposed to after four months, has any impact on eczema risk.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

MLA

Early, Aggressive Treatment May Help Reduce Symptoms And Improve Joint Function In Psoriatic Arthritis (PsA)

Main Category: Arthritis / Rheumatology
Also Included In: Eczema / Psoriasis
Article Date: 20 Jan 2012 – 1:00 PST

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Medications or biologic agents that target T-cells, white blood cells involved in the body’s immune system, appear to offer significant benefit to patients suffering from psoriatic arthritis (PsA), a type of arthritis that affects up to 48 percent of patients with the skin disease psoriasis, according to a new review article in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). About 7.5 million Americans – roughly 2.2 percent of the population – have psoriasis, an autoimmune disease that causes red, flaky skin.

“Although these new immunosuppressive agents are expensive, they are the only agents that have demonstrated a decrease in radiologic progression of peripheral arthritis, and can be used to manage associated types of inflammation, as well as skin and nail disease,” said lead study author Michael S. Day, MD, MPhil, a resident orthopaedic surgeon with the Department of Orthopaedic Surgery at NYU Hospital for Joint Diseases.

PsA can range in intensity from mild, involving only a few joints, to severe, where more joints are affected and pain may be significant. In about 15 percent of patients with PsA, skin lesions appear before arthritic symptoms; however, patients with more severe psoriasis are not necessarily at greater risk for developing PsA, Dr. Day said.

“When patients in dermatology clinics are screened for evidence of inflammatory arthritis, many have evidence of joint inflammation that they did not report, suggesting that many of these patients are undiagnosed and untreated,” said study co-author, Dr. Susan M. Goodman, an assisting attending rheumatologist and internist at Hospital for Special Surgery.

Currently, initial treatments for PsA include nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce inflammation, pain and fever. In the near future, drugs aimed at providing more targeted therapy will allow more PsA patients to avoid progressing to end-stage arthritis and joint destruction, she added.

Similarities between PsA and rheumatoid arthritis (RA) have spurred PsA researchers to consider early, aggressive treatment, an approach that has proved to be successful in RA patients.

Surgery may also be considered for patients who have joint deformities as a result of PsA, but so far there have been few large-scale, high-quality clinical trials, Dr. Day said. “The disease typically follows a moderate course, but up to 48 percent of cases develop into destructive arthritis in which the inflammatory process leads to bone erosion and loss of joint architecture,” he said.

“Initially, it was believed that PsA had a more benign course than does RA, but this belief has been disproven,” said Dr. Goodman.

Orthopaedic surgeons play a key role on the PsA treatment team. Dr. Day added that collaboration with dermatologists, rheumatologists, internists and family physicians is essential to the successful surgical treatment of PsA.

“PsA is a systemic inflammatory disease with multi-organ system effects,” said Dr. Day. “As such it should be treated with a multi-disciplinary approach.”

“Those who do progress to joint destruction may benefit from surgery, and may provide researchers with insights and further data regarding outcomes as well as the risks of surgery in this population,” Dr. Goodman said.

MLA

Hypoallergenic Baby Formula Claims Challenged

Main Category: Pediatrics / Children’s Health
Also Included In: Nutrition / Diet;  Allergy;  Eczema / Psoriasis
Article Date: 15 Jul 2011 – 1:00 PDT

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Despite the formula being recommended in public health guidelines set out by the Australasian Society of Clinical Immunology and Allergy, the new study, published online in the Journal of Allergy and Clinical Immunology, found there was no benefit in using hypoallergenic (partially hydrolysed whey) formula to prevent allergies in high-risk infants up to seven years of age, compared to a conventional cow’s milk based formula.

The trial, which is one the largest to test the effect of hypoallergenic baby formula, involved 620 infants and assessed whether using the formula decreased the risk of allergy in later life.

Infants in the study were given either hypoallergenic, cow’s milk or soy formula after the cessation of breastfeeding. Allergy testing was undertaken at six, 12 and 24 months and children were followed up again at six or seven years of age.

Lead authors David Hill, a Senior Consultant Allergist at the Murdoch Childrens Research Institute and Adrian Lowe, a research fellow at the Murdoch Childrens Research Institute and the Centre for MEGA Epidemiology, the University of Melbourne said their findings did not support the recommendations that hypoallergenic formula should be used after breast feeding as a preventive strategy for infants at high risk of allergenic disease.

“In our study of high risk children, this ‘hypoallergenic’ formula did not show any beneficial effect, when compared with a normal cows’ milk based formula, for the prevention childhood eczema, asthma or hay fever up to seven years of age,” Dr Lowe said.

Dr Hill said: “Our findings do not support the role of hypoallergenic formula for the prevention of allergic disease. Families at high risk of allergy should continue to be encouraged to breast feed for the many known benefits associated with breastfeeding.”

Source:
Charlotte Crawford
University of Melbourne

MLA

Vitamin D Insufficiency Prevalent Among Psoriatic Arthritis Suffers

Main Category: Arthritis / Rheumatology
Also Included In: Eczema / Psoriasis;  Nutrition / Diet
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New research reports a high prevalence of vitamin D insufficiency and deficiency among patients with psoriatic arthritis. Seasonal variation in vitamin D levels was not observed in patients in southern or northern locations. The findings published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR), also show no association between disease activity and vitamin D level.

Psoriasis is a common chronic skin disorder, likely caused by an autoimmune response, and is characterized by red scaly patches on the surface of the skin. When accompanied by inflammatory arthritis the condition is known as psoriatic arthritis (PsA) – a disease gaining public attention with the recent diagnosis of professional golfer, Phil Mickelson. Studies suggest that psoriasis occurs in up to 3% of the world population and roughly one third of these patients have PsA with prevalence estimates ranging from 6% to 42%.

“Vitamin D deficiency is a widespread concern,” explains lead study author Dafna Gladman, MD, FRCPC, Director of the University of Toronto Psoriatic Arthritis Clinic in Canada. “And it is more common to see individuals living in Northern regions with a deficiency in vitamin D than in those who reside in Southern areas.” Medical evidence shows that vitamin D deficiency is more common in individuals living at higher latitudes during the winter, suggesting the deficiency is a result of reduced sun exposure. Furthermore, several studies have reported reduced levels of vitamin D in patients with autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and scleroderma.

The Canadian and Israeli teams set out to determine the prevalence of vitamin D deficiency in PsA patients, seasonal and geographical variants, and associations with disease activity by evaluating 302 patients with PsA from March to August 2009. There were 258 patients evaluated during the winter and 214 patients during the summer. This cross-sectional study was conducted at two geographically diverse locations; the arthritis clinic in Toronto, Canada was designated the northern site and medical centers in Haifa, Israel were selected for their subtropical southern location.

Vitamin D levels in the blood, known as 25-hydroxyvitman D [25 (OH) D], were used as the primary measure as this takes into account vitamin D synthesized from sunlight as well as from ingested foods. At the northern site, the 25 (OH) D level was insufficient in 56% of PsA patients in the winter and in 59% during the summer. Approximately 51% of patients at the southern location had insufficient 25 (OH) D levels in winter and 62% of patients had insufficient levels in the summer. The level of vitamin D was deficient in 3% of patients at the northern location only in winter; at the southern site vitamin D deficiency was reported in 4% of patients in the winter and in 1% during the summer.

Differences in patient vitamin D levels regarding seasonal or geographical variations were not statistically significant. Levels of vitamin D were not found to affect disease activity in PsA patients. However, Dr. Gladman added, “Additional research is needed to determine if PsA patients require a greater vitamin D intake to maintain healthy levels than that recommended for the general population.”

Full citation

Seasonal Variation in Vitamin D Levels in Psoriatic Arthritis Patients from Different Latitudes and its Association with Clinical Outcomes.” Zahi Touma, Lihi Eder, Devy Zisman, Joy Feld, Vinod Chandran, Cheryl F. Rosen, Hua Shen, Richard J. Cook and Dafna D. Gladman. Arthritis Care and Research; Published Online: July 11, 2011 (DOI: 10.1002/acr.20530).

Source:
Dawn Peters
Wiley-Blackwell

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.

As someone who has suffered with both RA and exzema since childhood i can personally atest to being in a constant state of craving sun exposure.Without it i quickly become sick again .As for vit d in tabs cant get enough of those either,eat them like candy…

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When will the medical community learn that many of the diseases of civilization can be reversed or prevent by optimum levels of vitamin D. I have lived this truth for years

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No Protection Found Against Eczema With Prolonged Breastfeeding: International Study

Main Category: Eczema / Psoriasis
Also Included In: Women’s Health / Gynecology;  Pediatrics / Children’s Health
Article Date: 24 Aug 2011 – 2:00 PDT

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The largest worldwide study on the association between breastfeeding, time of weaning and eczema in children has concluded that there is no clear evidence that exclusive breastfeeding for four months or longer protects against childhood eczema

The largest worldwide study on the association between breastfeeding, time of weaning and eczema in children has concluded that there is no clear evidence that exclusive breastfeeding for four months or longer protects against childhood eczema. The study, led by scientists at King’s College London, and published online in the British Journal of Dermatology (BJD), concludes that children who were exclusively breastfed for four months or longer were as likely to develop eczema as children who were weaned earlier.

Breastfeeding is still considered by many to be an important strategy to prevent the development of eczema and other allergic diseases, and most health ministries in Europe advocate four months of exclusive breastfeeding to aid allergy prevention. The World Health Organization (WHO), UK Department of Health, and US Department of Health and Human Services all recommend exclusive breastfeeding up to six months of age, but until now little has been known about the effect of breastfeeding on eczema in developing countries.

The researchers, based at King’s College London, The University of Nottingham and the University of Ulm, Germany, looked at data from 51,119 children aged 8 to 12, in 21 countries across Europe, Latin America, Africa and Asia. The study formed Phase Two of The International Study of Asthma and Allergies in Childhood (ISAAC)*, the largest epidemiological research project ever undertaken. Information on eczema, breastfeeding and time of weaning was gathered by parental questionnaire. Children also underwent a skin examination for eczema and skin prick testing to environmental allergens, including house dust mite.

The researchers found no evidence for a protective effect of breastfeeding and delayed weaning on eczema risk in both developed and developing countries, in keeping with other more recent studies, suggesting that the current breastfeeding guidelines with regard to eczema need to reviewed.

The authors also point out that there is mounting evidence to suggest that the early introduction of potentially allergenic food proteins, such as peanut, could increase tolerance to these foods, rather than causing allergy, although this remains to be confirmed in intervention studies.

Dr Carsten Flohr, one of the researchers based at King’s College London, said: ‘Although there was a small protective effect of breastfeeding per se on severe eczema in affluent countries, we found no evidence that exclusive breastfeeding for four months or longer protects against eczema in either developed or developing nations. We feel that the UK breastfeeding guidelines with regard to eczema should therefore be reviewed. Further studies are now required to explore how and when solids should be introduced alongside breastfeeding to aid protection against eczema and other allergic diseases.’

Dr Flohr is keen to emphasise that other benefits of breastfeeding on infant health, unrelated to eczema, are not being disputed. He explained: ‘It is widely accepted that breast milk is the most important and appropriate nutrition in early life. Especially in the context of developing countries it is also important to keep in mind that exclusive breastfeeding reduces the risk of gastrointestinal infections compared to mixed or bottle feeding. Our study does not change this notion.’

Nina Goad of the British Association of Dermatologists said: ‘The size of this study means that its findings are very significant, although the authors recognise that further studies are required. Following these further studies we may need to review the UK’s advice on how long mothers should breastfeed exclusively for, and at what age we should be weaning our infants, in relation to eczema prevention.

‘This study isn’t about the benefits of infant formula milk versus breast milk, nor is it questioning other benefits of breast feeding, but it is about whether breastfeeding exclusively for prolonged periods and weaning after six months, as opposed to after four months, has any impact on eczema risk.’

Professor Hywel Williams from the University of Nottingham added: ‘There is no doubt that breast is best in terms of prevention of infections and parental bonding, but mothers who cannot breastfeed should not feel guilty if their child develops eczema. The evidence that prolonged and exclusive breastfeeding protects against eczema is not convincing.’

List of countries and regions included in study:

China (Hong Kong), France, Germany, Greece, Iceland, Italy, Netherlands, New Zealand, Norway, Spain, UK, Albania, Brazil, China, Ecuador, Georgia, Ghana, India, Latvia, West Bank, Turkey

*About ISAAC

The International Study of Asthma and Allergies in Childhood, is a unique worldwide epidemiological research programme established in 1991 to investigate asthma, rhinitis and eczema in children due to considerable concern that these conditions were increasing in western and developing countries. ISAAC has become the largest worldwide collaborative research project ever undertaken, involving more than 100 countries and nearly two million children. Its main aim is to develop environmental measures and disease monitoring in order to form the basis for future interventions to reduce the burden of allergic diseases, especially in children in developing countries.

MLA

Nearly 1 In 4 People With Psoriasis May Have Undiagnosed Psoriatic Arthritis

Main Category: Eczema / Psoriasis
Also Included In: Arthritis / Rheumatology
Article Date: 14 Oct 2011 – 0:00 PDT

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If you have psoriasis or a family history of psoriasis and you are experiencing joint pain and swelling, you could have psoriatic arthritis, a serious disease that may lead to joint destruction and disability.

New research from the National Psoriasis Foundation reveals that nearly one in four people with psoriasis – the most common autoimmune disease in the country, affecting as many as 7.5 million Americans – may have undiagnosed psoriatic arthritis, a type of inflammatory arthritis that affects the joints and tendons. This is in addition to the up to 2 million people already diagnosed with the disease.

The Psoriasis Foundation study found that 22 percent of psoriasis-only participants had significant symptoms of psoriatic arthritis, such as joint pain, pain that moved from one joint to the other; joints that were hot to the touch; and swollen, sausagelike fingers and toes.

Other key findings revealed that people with psoriatic arthritis are not being diagnosed in a timely manner. Forty-four percent of these respondents said they experienced symptoms for a year or longer before being diagnosed. Nearly one in three reported a delay of two years or longer to receive diagnosis.

“It’s vital to diagnose and treat psoriatic arthritis early in order to prevent or slow joint damage. Yet, nearly 30 percent of psoriatic arthritis patients said it took more than two years for a diagnosis,” said Dr. Mark Lebwohl, chair of the National Psoriasis Foundation Medical Board.

In response to these findings, the Psoriasis Foundation Medical Board issued a set of recommendations for both people with psoriasis and medical professionals who treat them to evaluate for symptoms of psoriatic arthritis.

For people with psoriasis and/or a family history of the disease, the medical board recommends watching for the following symptoms, and if they experience one or more, to call their physician: Pain, swelling or stiffness in one or more joints; Joints that are red or warm to the touch; Frequent joint tenderness or stiffness; Sausagelike swelling in one or more of the fingers or toes; Pain in and around the feet and ankles; Changes to the nails, such as pitting or separation from the nail bed; Pain in the lower back, above the tailbone. “Up to 30 percent of people with psoriasis develop psoriatic arthritis,” said Dr. Elaine Husni, a rheumatologist and psoriatic arthritis expert with the Cleveland Clinic in Ohio. “These guidelines could help millions of Americans with psoriasis recognize the signs of psoriatic arthritis early, so they can seek medical attention for a diagnosis and begin treatment. If untreated, the joint damage can be disabling.”

Additionally, the findings show that psoriatic arthritis significantly impacts quality of life: 63 percent say they are unable to be as active as they once were, nearly half (47 percent) say the disease impacts their ability to work, 34 percent report difficulty getting in and out of a car and 34 percent have stiffness for more than two hours after waking.

About the study

The National Psoriasis Foundation conducted interviews with 477 people with psoriasis and psoriatic arthritis by phone (202) and online (275) from April 13 to May 4, 2011. Sixty-two percent of the respondents had moderate to severe psoriasis.

About psoriatic arthritis

Psoriatic arthritis, a type of inflammatory arthritis that affects the joints and tendons, occurs in up to 30 percent of people with psoriasis – the most common autoimmune disease in the country, affecting as many as 7.5 million Americans. People with mild psoriasis are just as likely to develop psoriatic arthritis as those with moderate to severe forms of the disease. Symptoms of psoriatic arthritis include generalized fatigue; tenderness, pain and swelling of the tendons; swollen fingers and toes; joints that are hot to the touch; and reduced range of motion.

MLA

Atopic Dermatitis: Signs and Symptoms

Atopic dermatitis (AD) looks different in infants, children, and adults. The following gives you the signs (what you see) and symptoms (what you feel) for each age group. AD can begin early. A child may be 2- or 3-months old when AD begins. When AD begins early, it often causes: A rash that appears suddenly and: makes the skin dry, scaly, and itchyforms on the scalp and face, especially on the cheeks (can appear on other areas of the body)can bubble up, then ooze and weep fluidcauses itching that may come and goRubbing against bedding, carpeting, and other things in order to scratch the itchTrouble sleeping Skin infections, common due to rubbing and scratching

Parents often worry that their baby is getting AD in the diaper area. Babies rarely get AD in their diaper area. The skin stays too moist for AD.

When talking about the thickened skin, your dermatologist may use the word lichenification. This word means thickened skin.

If a person has had AD for years, patches of skin may be thick and darker than the rest of the skin (or lighter). Thickened skin can itch all the time.  

Adults who had AD as a child and no longer have AD can have the following:

Learn more about atopic dermatitis:

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

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