Responses of skin temperature to different thermic stimuli in atopic eczema

Patients suffering from atopic eczema (AE) often exhibit general disturbances of vasovegetative skin functions. Thus, in 21 patients with AE we studied the response of the skin of one forearm to standardized 15-min exposure of the other forearm to a moderate cold bath (17-18 degrees C) and then, after a resting time, to a hot bath (40-41 degrees C). The results were compared with those in 23 age- and sex-matched healthy controls under the same experimental conditions. In most patients, the unilateral skin exposure to warmth left the temperature of the contralateral forearm nearly unchanged or even slightly decreased, whereas the exposure to cold induced either a slight rise in contralateral skin temperature or only a minute decrease. In contrast to the normal consensual temperature reaction of the non-exposed forearm to warmth exposure of the contralateral arm in most controls, the results in atopic patients indicate a "rigid" or even inverse ("paradoxical") response to the thermic stimuli applied. This abnormal pattern of thermoregulation may reflect an intrinsic disturbance of the peripheral and hypothalamic autonomous neural system involved in the pathogenetic conditions of AE.