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Atopic dermatitis with mononuclear phagocytic activity deficiency.
W C N Forte1, M C Santos de Menezes, S M Cipolli Guerra de Oliveira
1Immunology Section of Santa Casa Medical School and Hospital. São Paulo. Brazil.
Allergologia Et Immunopathologia
|October 25, 2002
Summary
Children with atopic dermatitis and fungal infections showed improved outcomes with a new treatment plan. This approach combined prophylactic ketoconazole shampoo with systemic antifungals, enhancing their quality of life.
Area of Science:
- Dermatology
- Immunology
- Mycology
Background:
- Atopic dermatitis is a chronic inflammatory skin condition.
- Recurrent dermatophytosis poses a treatment challenge, especially in pediatric patients.
- Air allergen sensitivity is common in atopic dermatitis patients.
Observation:
- Patients presented with severe, recurrent dermatophytosis resistant to standard antifungal therapy.
- Immunologic evaluation revealed a specific defect in the mononuclear phagocyte ingestion phase.
- All patients exhibited positive reactions to common airborne allergens like Dermatophagoides species.
Findings:
- A novel treatment strategy involving prophylactic ketoconazole shampoo and systemic antifungals (without macrolides) was implemented.
- This regimen, coupled with hepatic function monitoring, effectively managed recurrent fungal infections.
- Patients experienced a significant improvement in their quality of life.
Implications:
- This study suggests an underlying immunodeficiency may contribute to severe fungal infections in some atopic dermatitis patients.
- The described treatment protocol offers a promising therapeutic option for similar complex cases.
- Further research into the interplay between atopic dermatitis, airborne allergens, and immune function is warranted.