Asteatotic dermatitis (AsD) is a common skin disease characterized by dry skin, itching, erythema, peeling and other skin lesions. It results from the damage in cutaneous barrier related to age, seasonal climate and bathing habits, and presents dysfunction of sebaceous, sweat glands and the increase of transepidermal water loss. The pathogenesis of AsD is not clear. Previous studies mainly focused on the relationship between skin barrier damage and bathing habits, age or gender. Recently, more studies focus on its relationship with other systematic diseases and drugs. This paper reviews etiology and pathogenesis of AsD to provide new ideas for the diagnosis and treatment of AsD.
Dermatitis, Atopic ; etiology ; pathology ; Humans

Adult ; Asthma ; diagnosis ; pathology ; Dermatitis, Atopic ; diagnosis ; pathology ; Enteritis ; diagnosis ; pathology ; Eosinophilia ; diagnosis ; pathology ; Gastritis ; diagnosis ; pathology ; Humans ; Male

Atopic eczema is a commonly encountered chronic skin condition in primary care. In this article, we share a holistic, structured approach, which is grounded on the chronic and atopic nature of the condition - planned reviews, patient empowerment, a written action plan for chronic and fare management, and trigger avoidance. Common pitfalls in management are insufficient emphases on scheduled reviews and patient empowerment, as well as neglect in the care of the loss of the epidermal barrier during acute flares.
Chronic Disease ; Dermatitis, Atopic ; diagnosis ; physiopathology ; therapy ; Dermatology ; methods ; Education, Medical, Continuing ; Humans ; Inflammation ; Primary Health Care ; methods ; Skin ; pathology

Atopic dermatitis (AD) is among the most common skin disorders in humans. Although a variety of regimens are available for the treatment of AD, preventive approaches are limited. Recent studies have demonstrated that certain naturally-occurring herbal medicines are effective in preventing the development of AD via divergent mechanisms, such as inhibiting cytokine and chemokine expression, IgE production, inflammatory cell infiltration, histamine release, and/or enhancement of epidermal permeability barrier function. Yet, they exhibit few adverse effects. Since herbal medicines are widely available, inexpensive and generally safe, they could represent an ideal approach for preventing the development of AD, in both highly developed and developing countries.
Animals ; Chemokines ; metabolism ; Dermatitis, Atopic ; prevention & control ; Disease Models, Animal ; Herbal Medicine ; Humans ; Immunoglobulin E ; metabolism ; Inflammation ; pathology

OBJECTIVES: Ozone is widely applied to treat allergic skin diseases such as eczema, atopic dermatitis, and contact dermatitis. However, the specific mechanism remains unclear. This study aims to investigate the effects of ozonated oil on treating 2,4-dinitrochlorobenzene (DNCB)-induced allergic contact dermatitis (ACD) and the underling mechanisms. METHODS: Besides the blank control (Ctrl) group, all other mice were treated with DNCB to establish an ACD-like mouse model and were randomized into following groups: a model group, a basal oil group, an ozonated oil group, a FcεRI-overexpressed plasmid (FcεRI-OE) group, and a FcεRI empty plasmid (FcεRI-NC) group. The basal oil group and the ozonated oil group were treated with basal oil and ozonated oil, respectively. The FcεRI-OE group and the FcεRI-NC group were intradermally injected 25 µg FcεRI overexpression plasmid and 25 µg FcεRI empty plasmid when treating with ozonated oil, respectively. We recorded skin lesions daily and used reflectance confocal microscope (RCM) to evaluate thickness and inflammatory changes of skin lesions. Hematoxylin-eosin (HE) staining, real-time PCR, RNA-sequencing (RNA-seq), and immunohistochemistry were performed to detct and analyze the skin lesions. RESULTS: Ozonated oil significantly alleviated DNCB-induced ACD-like dermatitis and reduced the expressions of IFN-γ, IL-17A, IL-1β, TNF-α, and other related inflammatory factors (all P<0.05). RNA-seq analysis revealed that ozonated oil significantly inhibited the activation of the DNCB-induced FcεRI/Syk signaling pathway, confirmed by real-time PCR and immunohistochemistry (all P<0.05). Compared with the ozonated oil group and the FcεRI-NC group, the mRNA expression levels of IFN-γ, IL-17A, IL-1β, IL-6, TNF-α, and other inflammatory genes in the FcεRI-OE group were significantly increased (all P<0.05), and the mRNA and protein expression levels of FcεRI and Syk were significantly elevated in the FcεRI-OE group as well (all P<0.05). CONCLUSIONS Ozonated oil significantly improves ACD-like dermatitis and alleviated DNCB-induced ACD-like dermatitis via inhibiting the FcεRI/Syk signaling pathway.
Animals ; Mice ; Dinitrochlorobenzene/metabolism* ; Skin/metabolism* ; Cytokines/metabolism* ; Interleukin-17/metabolism* ; Tumor Necrosis Factor-alpha/metabolism* ; Dermatitis, Allergic Contact/pathology* ; Dermatitis, Atopic/chemically induced* ; Signal Transduction ; RNA, Messenger/metabolism* ; Mice, Inbred BALB C

The purpose of this study was to evaluate the effects of a topical spray containing 0.0584% hydrocortisone aceponate (HCA) on canine atopic dermatitis (CAD) and to evaluate the skin barrier function during the treatment of CAD. Twenty-one dogs that fulfilled the diagnostic criteria for CAD were included in this study. The HCA spray was applied once a day to the lesions of all dogs for 7 or 14 days. Clinical assessment was performed before (day 0) and after treatment (day 14), and clinical responses were correlated with changes in skin barrier function. CAD severity significantly decreased after 14 days of HCA treatment based on the lesion scores (p < 0.0001), which were determined using the CAD extent and severity index (CADESI-03) and pruritus scores (p < 0.0001) calculated using a pruritus visual analog scale. Transepidermal water loss, a biomarker of skin barrier function, was significantly reduced compared to baseline (day 0) measurements (p = 0.0011). HCA spray was shown to be effective for significantly improving the condition of dogs suffering from CAD. This treatment also significantly improved cutaneous hydration and skin barrier function in the animals.
Administration, Topical ; Animals ; Anti-Inflammatory Agents/administration & dosage/*therapeutic use ; Dermatitis, Atopic/drug therapy/pathology/*veterinary ; Dog Diseases/*drug therapy/pathology ; Dogs ; Female ; Hydrocortisone/administration & dosage/*analogs & derivatives/therapeutic use ; Male

Proteases in the skin are essential to epidermal permeability barrier homeostasis. In addition to their direct proteolytic effects, certain proteases signal to cells by activating protease-activated receptors (PARs), the G-protein-coupled receptors. The expression of functional PAR-2 on human skin and its role in inflammation, pruritus, and skin barrier homeostasis have been demonstrated. Atopic dermatitis (AD) is a multifactorial inflammatory skin disease characterized by genetic barrier defects and allergic inflammation, which is sustained by gene-environmental interactions. Recent studies have revealed aberrant expression and activation of serine proteases and PAR-2 in the lesional skin of AD patients. The imbalance between proteases and protease inhibitors associated with genetic defects in the protease/protease inhibitor encoding genes, increase in skin surface pH, and exposure to proteolytically active allergens contribute to this aberrant protease/PAR-2 signaling in AD. The increased protease activity in AD leads to abnormal desquamation, degradation of lipid-processing enzymes and antimicrobial peptides, and activation of primary cytokines, thereby leading to permeability barrier dysfunction, inflammation, and defects in the antimicrobial barrier. Moreover, up-regulated proteases stimulate PAR-2 in lesional skin of AD and lead to the production of cytokines and chemokines involved in inflammation and immune responses, itching sensation, and sustained epidermal barrier perturbation with easier allergen penetration. In addition, PAR-2 is an important sensor for exogenous danger molecules, such as exogenous proteases from various allergens, and plays an important role in AD pathogenesis. Together, these findings suggest that protease activity or PAR-2 may be a future target for therapeutic intervention for the treatment of AD.
Anti-Infective Agents/pharmacology ; Dermatitis, Atopic/*enzymology ; Endopeptidases/metabolism ; Homeostasis ; Humans ; Hydrogen-Ion Concentration ; Inflammation ; Models, Biological ; Models, Genetic ; Peptide Hydrolases/*metabolism ; Receptor, PAR-2/*metabolism ; Serine Proteases/metabolism ; Signal Transduction ; Skin/enzymology/pathology ; Treatment Outcome

Quantification of quality of life (QOL) related to disease severity is important in patients with atopic dermatitis (AD), because the assessment provides additional information to the traditional objective clinical scoring systems. To document the impact of AD on QOL for both children and adults as well as to quantify the relationship with disease severity, QOL assessments were performed over a 6-month period on 415 patients with AD. A questionnaire derived from the Infants' Dermatitis Quality of Life Index (IDQOL), the Children's Dermatology Life Quality Index (CDLQI) and the Dermatology Life Quality Index (DLQI) was used to determine the QOL for 71 infants, 197 children and 147 adults, respectively. To measure AD severity, both the Rajka & Langeland scoring system and the Scoring of Atopic Dermatitis (SCORAD) index were used. The mean scores were as follows: 7.7 +/- 5.5 for IDQOL, 6.6 +/- 6.3 for CDLQI, and 10.7 +/- 7.9 for DLQI. In conclusion, these QOL scores are correlated with AD severity scores as estimated by the Rajka & Langeland severity score and the SCORAD. The outcome of the QOL instruments in this study demonstrates that atopic dermatitis of both children and adults affects their QOL.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Dermatitis, Atopic/pathology/*psychology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; *Quality of Life ; Questionnaires ; *Severity of Illness Index ; Young Adult

Quantification of quality of life (QOL) related to disease severity is important in patients with atopic dermatitis (AD), because the assessment provides additional information to the traditional objective clinical scoring systems. To document the impact of AD on QOL for both children and adults as well as to quantify the relationship with disease severity, QOL assessments were performed over a 6-month period on 415 patients with AD. A questionnaire derived from the Infants' Dermatitis Quality of Life Index (IDQOL), the Children's Dermatology Life Quality Index (CDLQI) and the Dermatology Life Quality Index (DLQI) was used to determine the QOL for 71 infants, 197 children and 147 adults, respectively. To measure AD severity, both the Rajka & Langeland scoring system and the Scoring of Atopic Dermatitis (SCORAD) index were used. The mean scores were as follows: 7.7 +/- 5.5 for IDQOL, 6.6 +/- 6.3 for CDLQI, and 10.7 +/- 7.9 for DLQI. In conclusion, these QOL scores are correlated with AD severity scores as estimated by the Rajka & Langeland severity score and the SCORAD. The outcome of the QOL instruments in this study demonstrates that atopic dermatitis of both children and adults affects their QOL.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Dermatitis, Atopic/pathology/*psychology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; *Quality of Life ; Questionnaires ; *Severity of Illness Index ; Young Adult

PURPOSE: The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. METHODS: Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. RESULTS: Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. CONCLUSION: These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.
Adult ; Asian Continental Ancestry Group ; Breast Feeding/*statistics & numerical data ; Dermatitis, Atopic/pathology ; *Employment ; Female ; Humans ; Infant ; Infant, Newborn ; Internet ; Logistic Models ; Male ; Mothers/psychology ; Odds Ratio ; Republic of Korea ; Social Support ; Surveys and Questionnaires ; Workplace