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Treatment of Atopic Dermatitis: an Update and Review of the Literature.

Pediatric Allergy and Respiratory Disease.2009;19(3):209-219.

Atopic dermatitis is a chronic, relapsing, inflammatory skin disease, with genetic and environmental backgrounds. Successful management of atopic dermatitis requires a multipronged approach. Management should compromise of a disease-adapted treatment which combines adjuvant basic therapy, symptomatic relief and, if needed, anti-inflammatory treatment and the identification and avoidance of trigger factors. Topical calcineurin inhibitors are also considered to be good alternatives for the long-term control of severe atopic dermatitis. Also, new therapies such as immunomodulatory drugs, biologics, anti-IgE therapy, and CpG oligodeoxynucleotides (ODN) are considered to be effective in treatment of atopic dermatitis.
Antibodies, Anti-Idiotypic ; Biological Agents ; Calcineurin ; Dermatitis, Atopic ; Oligodeoxyribonucleotides ; Skin Diseases

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Clinical Significance of Exhaled Nitric Oxide Concentration in Childhood Asthma.

Hyun Hee KIM

Pediatric Allergy and Respiratory Disease.2009;19(3):205-208.

No abstract available
Asthma ; Nitric Oxide

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Risk Factors Associated with Development of Atopic Dermatitis.

Yeong Ho RHA ; Sun Hee CHOI

Pediatric Allergy and Respiratory Disease.2009;19(2):91-94.

No abstract available.
Dermatitis, Atopic ; Risk Factors

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A Case ofEscherichia Coli Empyema Preceded by Gastroenteritis.

Dong Kyu KIM ; Seung Yeon NAM ; Chong Guk LEE ; Dong Wook KIM ; Jin Soo MOON ; Yeon Su KIM ; Tae Gil HUR

Pediatric Allergy and Respiratory Disease.2007;17(1):74-79.

Pleural empyema is characterized by presence of pus or microorganism in the pleural fluid. Most cases of empyema in children are caused by bacterial pneumonia, and the most common pathogen is Staphylococcus areus or Streptococcus pneumoniae. But other uncommon causes of empyema include esophageal rupture, mediastinal disease, tumors, sepsis, thoracic trauma, and surgery can be produced by various pathogens. We experienced a case of Escherichia coli empyema followed by gastroenteritis in 9-year-old boy.
Child ; Empyema* ; Empyema, Pleural ; Escherichia coli ; Gastroenteritis* ; Humans ; Male ; Mediastinal Diseases ; Pneumonia, Bacterial ; Rupture ; Sepsis ; Staphylococcus ; Streptococcus pneumoniae ; Suppuration

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Two Cases of Pulmonary Problems as Initial Clinical Manifestations of Systemic Lupus Erythematosus.

Ik Jae IM ; Eun Hee CHUNG ; Na Hye MYONG ; In Sun LEE

Pediatric Allergy and Respiratory Disease.2007;17(1):68-73.

Systemic lupus erythematosus (SLE) is a chronic and multisystemic disease. Pleuropulmonary disease in SLE has various clinical manifestations, such as immunologic pneumonia, infectious pneumonia, interstitial lung disease, pulmonary hypertension, pulmonary hemorrhage, pleuritis and pleural effusion. It can manifest as an initial clinical finding of SLE. We experienced two cases; one case of pulmonary hemorrhage and one case of atypical pneumonia as an initial clinical manifestation of SLE.
Hemorrhage ; Hypertension, Pulmonary ; Lung Diseases ; Lung Diseases, Interstitial ; Lupus Erythematosus, Systemic* ; Pleural Effusion ; Pleurisy ; Pneumonia

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A Case of Congenital Tuberculosis in a 3-months Old Infant.

Young Mee NAM ; Hyuk CHO ; Tae Won SONG ; Kyung Won KIM ; Eun Soo KIM ; Myung Hyun SOHN ; Kyu Earn KIM ; Choon Sik YOON

Pediatric Allergy and Respiratory Disease.2007;17(1):63-67.

Congenital tuberculosis is a rare disease in which an unborn child inside the uterus or right after delivery is infected with tubercle bacillus, due to the mother suffering primary tuberculosis right before pregnancy or during pregnancy. As a newborn who was naturally delivered with a gestational age of 38 weeks, and 3.02 kg in birth weight, he entered an other hospital with a fever, which he contracted one month after birth, but the fever continued for 10 days, thus he was transferred to this hospital. Chest radiography, indicated infiltration of both lungs, thus he was treated with suspected pneumonia and sepsis. And then, his symptoms became favorable, and he left hospital. However, since chest radiography one month later, his condition had not improved, thus he was hospitalized again. In a computerized chest tomography scan, infiltration of the lungs and tuberculosis were suspected due to a mysterious region of shadow. A tubercle bacillus test was conducted, and the tuberculin test was negative. However, acid- fast bacilli smear, acid-fast bacilli culture test, and polymerase chain reaction test, which were carried out the gastric aspiration were positive. The patient was administered antitubercular agents under the diagnosis of congenital tuberculosis, and he is currently under observation as an outpatient, without complications. The authors experienced a case of congenital tuberculosis, which was discovered due to fever, generated 4 weeks after birth, and to abnormal views in chest radiography, which continued more than 2 months. We report this.
Antitubercular Agents ; Bacillus ; Birth Weight ; Child ; Diagnosis ; Fever ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Lung ; Mothers ; Outpatients ; Parturition ; Pneumonia ; Polymerase Chain Reaction ; Pregnancy ; Radiography ; Rare Diseases ; Sepsis ; Thorax ; Tuberculin Test ; Tuberculosis* ; Uterus

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Effects of Early and Low-Dose Ribavirin Therapy on Respiratory Syncytial Virus Bronchiolitis in Previously Healthy Infants.

Ji Yeon KOH ; Dong Wook KIM ; Hyun Suk LEE ; Byung Eui KIM ; Chang Keun KIM ; Myoung Jae CHEY ; Sang Woo KIM ; Bo Moon SHIN ; Sung Jun KIM

Pediatric Allergy and Respiratory Disease.2007;17(1):56-62.

PURPOSE: we performed this study to determine whether early and low dose ribavirin therapy for respiratory syncytial virus (RSV) bronchiolitis in previously healthy infants may reduce the duration of hospital stay. METHODS: Thirty-four Previously healthy infants with RSV bronchiolitis were enrolled in this study. Early in the course of illness, less than 5 days, aerosol ribavirin was administered at a low, single-dose (3 g/150 mL/day) and then we assessed the duration of hospital stays for 16 infants treated with ribavirin (ribavirin group) and 18 infants who received conservative treatment (control group). RESULTS: The baseline characteristics of each group were not significantly different with respect to gestational age, birth weight, age, sex, weight, and height. On admission, there were no significant differences between the two groups in the respiratory rate and body temperature. Duration of hospitalization was significantly shorter in the ribavirin group (4.4+/-0.3 days) as compared to the control group (5.5+/-0.3 days) (P=0.02). CONCLUSION: Early and low-dose ribavirin therapy for RSV bronchiolitis in previously healthy infants may decrease duration of hospital stay.
Birth Weight ; Body Temperature ; Bronchiolitis* ; Gestational Age ; Hospitalization ; Humans ; Infant* ; Length of Stay ; Respiratory Rate ; Respiratory Syncytial Viruses* ; Ribavirin*

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Clinical Assessment of Rhinitis with Respiratory Pressure Meter.

Ki Hye SUNG ; Yong Mean PARK

Pediatric Allergy and Respiratory Disease.2007;17(1):48-55.

PURPOSE: Nasal stuffness is one of most common symptom in children who suffer from rhinitis although there is still debates at to the best measurable device. The aim of the study was to evaluate the sniff nasal inspiratory pressure (SNIP) with respiratory pressure meter and compare this with the clinical status of patients. METHODS: We enrolled 57 rhinitis patients who visited our hospital during June 2005 to July 2006. They were treated with intranasal steroid spray (mometasone furoate) for first 2 weeks. To evaluate the outcome of treatment, we used symptom score (SS) and measured the SNIP with respiratory pressure meter (Micro RPM, Micro Medical, Rochester, UK) and also measured peak nasal inspiratory flow (PNIF) with peak nasal inspiratory flow meter (Youlten peak flow meter, Clement Clarke Int., London, UK) before and after the therapy. Skin prick test was performed to all patient to classify the atopic (AR) and non-atopic rhinitis (NAR). RESULTS: Among 57 identified patients (median age, 7 years 9 months), 40 AR and 17 NAR were studied. Most patient showed clinically improvement with 2 weeks intranasal steroid therapy (0 wk SS=4.9, 2 wk SS=1.7 in AR; 0 wk SS=4.5, 2 wk SS=1.5 in NAR, P< 0.01). The SNIP of AR group was increased after intranasal therapy (0 wk SNIP=58.5 cm H2O, 2 wk SNIP=76.2 cmH2O; P<0.01). There was also significant improvement in terms of SNIP in NAR group (0 wk SNIP=51.7 cmH2O, 2 wk SNIP=62.9 cmH2O, P<0.01). However, we could not find any correlation between SS and SNIP. Although there was the improvement of symptoms scores, there was no significant difference of peak flow between before and after treatment (71.9-->77.6 L/min, P>0.05). And there was no correlation between SNIP and PNIF measurement. CONCLUSION: The respiratory pressure meter is a useful device to evaluate the therapeutic effectiveness and clinical improvement in pediatric rhinitis patients.
Child ; Humans ; Nasal Obstruction ; Rhinitis* ; Skin

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Chronic Urticaria in Childhood: Etiology and Outcome.

Sung Yun CHOI ; Hwa Young PARK ; Young Min AHN

Pediatric Allergy and Respiratory Disease.2007;17(1):38-47.

PURPOSE: The aim of this study was to evaluate the etiology and outcome of chronic urticaria (CU) in childhood. METHODS: We reviewed retrospectively the clinical manifestations and laboratory findings of the thirty-nine patients with urticaria and/or angioedema for more than 6 weeks. We also invested the clinical parameters affecting the remission. Positive autologous serum skin test (ASST) results were compared with CU remission. RESULTS: Male occupied about 56.4% of patients (n=22). Age at first outpatient clinic visit was from 12 month to 13 years 9 month. Duration of symptoms before visit were from 6 weeks to 6 months. Among the etiologic causes, 35.9% (n=14) of patients had physical urticaria, concretely, 17.9% (n=7) of patients had cold urticaria, 12.8% (n=5) of patients had symptomatic dermographism, 5.1% (n=2) of patients had cholinergic urticaria. Sinusitis was associated with CU in 5.1% (n=2) of patients. Unknown causes were 59.9% (n=23) of patients, and among them, 34.8% (n=8) of patients had positive ASST. Disease remission was observed in 56.4% (n=22), but non-remission was observed in 43.6% (n=17). Remission of CU was not associated with age, gender, etiology, and ASST. The remission rate of ASST negative group was higher than the ASST positive group, but it was not significant statistically. CONCLUSION: Etiologies of CU were variable and physical urticaria should be evaluated first. Unknown etiology were 59.9% and of them, correlation positive ASST with disease remission rate should be evaluated later with further study.
Ambulatory Care Facilities ; Angioedema ; Humans ; Male ; Retrospective Studies ; Sinusitis ; Skin Tests ; Urticaria*

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The Effects on Treatment of Atopic Dermatitis with Oral Lactobacillus casei Supplements in Korean Children.

Do Youn KONG ; Hyeon Jong YANG ; Bok Yang PYUN

Pediatric Allergy and Respiratory Disease.2007;17(1):27-37.

PURPOSE: Recent studies suggest that oral probiotic administration might be useful in the management of atopic dermatitis. Probiotics are known to promote the maturation of gut- associated lymphoid tissue (GALT) and control inflammatory responses. The purpose of this study was to evaluate clinical and anti-inflammatory effects on children's atopic dermatitis with Lactobacillus casei (L. casei), a kind of probiotic, supplementations. METHODS: Forty four patients with atopic dermatitis who visited the Pediatric Allergy Clinic in Soonchunhyang University Hospital from December 2004 to April 2005 were enrolled. We evaluated the SCORAD scores. Then, fresh stools were collected and cultured to count colony numbers of L. casei, and blood were samples were taken to measure IFN-gamma, total IgE, specific IgE (house dust mites, milk, egg white, dog hair, soy bean), peripheral blood eosinophil percent, and ECP. We divided patients by two groups randomly. L. casei containing yoghurt was ingested by one group but not by the other group for 16 weeks. After that period, SCORAD scores, stool cultures and blood samples were reevaluated. RESULTS: Most patients who received L. casei experienced improvement of atopic dermatitis, but changes in SCORAD scores were not so significant compared with the other group. Just forty patients had their blood tested again (L. casei group was 21), and there were no statistical significances. There were also no significant changes of specific IgE, eosinophil percent, ECP, total IgE, and IFN-gamma levels, before and after. The colony counts of L. casei in stool which were cultured after investigation, were relatively high in the group with L. casei supplements. (P=0.03) Conclusion: The administration of L. casei in children with atopic dermatitis might be helpful to improve the colony counts of L. casei in intestines, and these increased L. casei are expected to act as a down-regulator of allergic inflammation, but more investigations should be conducted to reveal the precise mechanisms and possible complications.
Animals ; Child* ; Dermatitis, Atopic* ; Dogs ; Dust ; Egg White ; Eosinophils ; Hair ; Hematologic Tests ; Humans ; Hypersensitivity ; Immunoglobulin E ; Inflammation ; Intestines ; Lactobacillus casei* ; Lactobacillus* ; Lymphoid Tissue ; Milk ; Mites ; Probiotics ; Yogurt

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