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Recent investigations on the relationship between fungal skin diseases and atopic dermatitis
E Svejgaard1, J Faergeman, G Jemec
1Departments of Dermatology, Rigshospital, University Hospital of Copenhagen, Gentofte, Denmark.
Abstract:
Atopic dermatitis may be associated with chronic dermatophyte infections and Pityrosporum related disorders. Recent epidemiologic studies in school children and young recruits have confirmed that atopic individuals have an increased susceptibility to Trichophyton rubrum infections of the feet and an increased risk for persistent infections. In contrast, an investigation on skin reactivity in dermatophyte infected atopic patients indicated that a group of these patients is fully able to eliminate the fungi concomitant with the development of a delayed type skin reactivity. Facial erythema and scaling, often including neck and shoulders, is present in many young adults with atopic dermatitis. Preliminary data from a Danish-Swedish investigation have shown that atopic dermatitis patients with head-neck-shoulder dermatitis compared to a group without this disorder and normal individuals more often demonstrate positive prick test, RAST and specific histamine release using extract of Pityrosporum ovale. These findings indicate that the presence of Pityrosporum ovale in the skin may cause an allergic reaction leading to dermatitis.
Insights
Individuals with atopic dermatitis show increased susceptibility to fungal infections like Trichophyton rubrum. Pityrosporum ovale may trigger allergic reactions, causing dermatitis in some atopic patients.
Area of Science:
- Dermatology
- Immunology
- Microbiology
Background:
- Atopic dermatitis (AD) is frequently linked to chronic fungal infections, including dermatophytes and Pityrosporum species.
- Epidemiologic studies show atopic individuals are more susceptible to Trichophyton rubrum infections, particularly on the feet.
- Some atopic patients can clear fungal infections, developing delayed-type skin reactivity.
Purpose of the Study:
- To investigate the association between atopic dermatitis, specifically head-neck-shoulder dermatitis, and allergic reactions to Pityrosporum ovale.
- To explore the role of Pityrosporum ovale in triggering dermatitis in atopic individuals.
Main Methods:
- Epidemiologic studies in school children and young recruits.
- Skin reactivity investigations in dermatophyte-infected atopic patients.
- Prick tests, RAST (radioallergosorbent test), and specific histamine release assays using Pityrosporum ovale extract in atopic dermatitis patients with and without head-neck-shoulder dermatitis, compared to controls.
Main Results:
- Atopic individuals exhibit heightened susceptibility and risk for persistent Trichophyton rubrum infections.
- A subset of atopic patients successfully eliminates dermatophytes, concurrently developing delayed-type skin reactivity.
- Atopic dermatitis patients with head-neck-shoulder dermatitis showed significantly higher positive results in prick tests, RAST, and histamine release assays for Pityrosporum ovale compared to controls.
Conclusions:
- Atopic dermatitis is associated with increased susceptibility to chronic dermatophyte infections.
- Pityrosporum ovale may act as an allergen, inducing allergic reactions and contributing to dermatitis in susceptible atopic individuals.
- The findings suggest a potential role for Pityrosporum ovale in the pathogenesis of atopic dermatitis, particularly in cases involving the head, neck, and shoulders.