Handbook of atopic eczema: with 113 tables
Clinical aspects of atopic eczema: Atopy: condition, disease or syndrome?.- History.- Epidemiology.- The burden of atopic eczema.- Clinical symptoms.- Atopic eczema in infants.- Stigmata of the atopic constitution.- Minimal forms.- Diagnosis.- Differential diagnosis.- Scoring systems.- Co-existing r...
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Berlin [u.a.]
Springer
2006
|
| Ausgabe: | 2. ed. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Zusammenfassung: | Clinical aspects of atopic eczema: Atopy: condition, disease or syndrome?.- History.- Epidemiology.- The burden of atopic eczema.- Clinical symptoms.- Atopic eczema in infants.- Stigmata of the atopic constitution.- Minimal forms.- Diagnosis.- Differential diagnosis.- Scoring systems.- Co-existing respiratory atopic diseases.- Complications and diseases associated with atopic eczema.- Diseases rarely associated with atopic eczema.- Natural history of atopic eczema.- Dry skin.- Occupational aspects with emphasis on atopic hand eczema.- Allergic contact dermatitis and atopic eczema.- Immunodeficiency syndromes and atopic eczema.- Atopic eczema as a psychosomatic disease.- Atopic diseases in families.- Histopathological and ultrastructural aspects.- Clinical manifestation of the itch sensation.- Clinical aspects of atopic eczema: Synopsis Pathophysiology of Atopic Eczema: Clinical genetics.-Molecular genetics of atopy.- Methods to study gene loci for atopic eczema.- IgE and regulation of IgE synthesis.- Langerhans cells in the pathophysiology.- Inflammatory dendritic epidermal cells (IDEC).- Intrinsic versus extrinsic atopic eczema.- IgG subclasses.- Mast cells in the skin.- Role of eosinophils.- T-lymphocytes.- Keratinocytes.- Inflammatory mediators and chemokines.- Cytokines.- Vascular reactivity.- Neuropeptides.- Pathophysiology of itch.- Epidermal lipids.- The phenomenon or irritable skin.- Role of aeroallergens.- Role of food allergy.- Microbial products and atopic eczema.- Environmental pollution and atopy.- Animal models.- Autoimmunity.- Pathophysiology of atopic eczema: Synopsis Management of patients with atopic eczema: Primary prevention of atopy.- Role of allergy testing.- Probiotic foods in the prevention.- Measuring disturbed barrier function.- Vehicles of topical treatment: Composition, principles of application and action.- Topical glucocorticosteroids.- Antimicrobial agents.- Antihistamines.- Clima-therapy.- Skin care and aesthetic medicine.- Dietary management.- Ultraviolet radiation therapy.- Psychotherapeutic approaches.- Phosphodiesterase inhibitors.- Therapy.- Systemic and topical immunomodulatory treatment.- Patient education programs.- Unconventional treatments.- Health economics.- Sense and nonsense of unconventional methods.- Management of patients with atopic eczema: Synopsi |
| Beschreibung: | Literaturangaben |
| Beschreibung: | XXII, 613 S. Ill., graph. Darst. |
| ISBN: | 3540231331 |
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| 245 | 1 | 0 | |a Handbook of atopic eczema |b with 113 tables |c J. Ring ... (ed.) |
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| 500 | |a Literaturangaben | ||
| 520 | |a Clinical aspects of atopic eczema: Atopy: condition, disease or syndrome?.- History.- Epidemiology.- The burden of atopic eczema.- Clinical symptoms.- Atopic eczema in infants.- Stigmata of the atopic constitution.- Minimal forms.- Diagnosis.- Differential diagnosis.- Scoring systems.- Co-existing respiratory atopic diseases.- Complications and diseases associated with atopic eczema.- Diseases rarely associated with atopic eczema.- Natural history of atopic eczema.- Dry skin.- Occupational aspects with emphasis on atopic hand eczema.- Allergic contact dermatitis and atopic eczema.- Immunodeficiency syndromes and atopic eczema.- Atopic eczema as a psychosomatic disease.- Atopic diseases in families.- Histopathological and ultrastructural aspects.- Clinical manifestation of the itch sensation.- Clinical aspects of atopic eczema: Synopsis | ||
| 520 | |a Pathophysiology of Atopic Eczema: Clinical genetics.-Molecular genetics of atopy.- Methods to study gene loci for atopic eczema.- IgE and regulation of IgE synthesis.- Langerhans cells in the pathophysiology.- Inflammatory dendritic epidermal cells (IDEC).- Intrinsic versus extrinsic atopic eczema.- IgG subclasses.- Mast cells in the skin.- Role of eosinophils.- T-lymphocytes.- Keratinocytes.- Inflammatory mediators and chemokines.- Cytokines.- Vascular reactivity.- Neuropeptides.- Pathophysiology of itch.- Epidermal lipids.- The phenomenon or irritable skin.- Role of aeroallergens.- Role of food allergy.- Microbial products and atopic eczema.- Environmental pollution and atopy.- Animal models.- Autoimmunity.- Pathophysiology of atopic eczema: Synopsis | ||
| 520 | |a Management of patients with atopic eczema: Primary prevention of atopy.- Role of allergy testing.- Probiotic foods in the prevention.- Measuring disturbed barrier function.- Vehicles of topical treatment: Composition, principles of application and action.- Topical glucocorticosteroids.- Antimicrobial agents.- Antihistamines.- Clima-therapy.- Skin care and aesthetic medicine.- Dietary management.- Ultraviolet radiation therapy.- Psychotherapeutic approaches.- Phosphodiesterase inhibitors.- Therapy.- Systemic and topical immunomodulatory treatment.- Patient education programs.- Unconventional treatments.- Health economics.- Sense and nonsense of unconventional methods.- Management of patients with atopic eczema: Synopsi | ||
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Datensatz im Suchindex
| _version_ | 1804135287254679552 |
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| adam_text | J. RING, B. PRZYBILLA, T. RUZICKA (EDS.) HANDBOOK OF ATOPIC EAEMA SECOND
EDITION WITH 187 FIGURES IN 236 PARTS AND 113 TABLES 4Y SPRINGER
CONTENTS I CLINICAL ASPECTS OF ATOPIC ECZEMA 1 ATOPY: CONDITION,
DISEASE, OR SYNDROME? J. RING 3 1.1 HISTORY 3 1.2 CLINICAL SYMPTOMS 4
1.3 ETIOPATHOPHYSIOLOGICAL ASPECTS 5 1.4 DEFINITION OF ATOPY 7 1.5
CONCLUSION 7 REFERENCES 7 2 THE HISTORY OF ATOPIC ECZEMA/DERMATITIS A.
TAIEB, D. WALLACH, G. TILLES 10 2.1 INTRODUCTION 10 2.2 PRECURSORS OF
ATOPIC ECZEMA 10 2.3 TOWARD A MODERN DEFINITION 14 2.4 HISTORICAL
LANDMARKS IN THE MODERN HISTORY OF ATOPIC ECZEMA 16 2.5 THE HISTORY OF
ATOPIC ECZEMA TREATMENTS .... 18 2.6 WHAT HISTORY TELLS US TODAY 18
REFERENCES 19 3 EPIDEMIOLOGY OF ATOPIC ECZEMA T. SCHAFER 21 3.1
DEFINITIONS 21 3.2 DIAGNOSTIC CRITERIA 21 3.3 ASSESSMENT IN
EPIDEMIOLOGICAL STUDIES 22 3.4 MEASURES OF FREQUENCY 22 3.5 TRENDS AND
FREQUENCY OF ATOPIC ECZEMA 23 3.6 ATOPIC ECZEMA IN EAST AND WEST GERMANY
.... 23 3.7 INTRINSIC AND EXTRINSIC ATOPIC ECZEMA 24 3.8 RISK FACTORS
AND CHARACTERISTICS 24 3.9 PROGNOSTIC FACTORS 27 REFERENCES 27 4 THE
BURDEN OF ATOPIC ECZEMA A.Y. FINLAY 31 4.1 INTRODUCTION 31 4.2 NATURE OF
THE BURDEN 31 4.3 MEASUREMENT OF BURDEN 32 4.4 STRATEGIES FOR IMPROVING
BURDEN 35 4.5 DECLARATION OF INTEREST 35 REFERENCES 35 5 CLINICAL
SYMPTOMS OF ATOPIC ECZEMA M. DELEURAN, A. BRAAE OLESEN, K. THESTRUP-
PEDERSEN 37 5.1 INTRODUCTION 37 5.2 EVOLUTION OF ATOPIC ECZEMA 38 5.3
COURSE OF ATOPIC ECZEMA 39 5.4 SOME TYPICAL CLINICAL FEATURES 40 5.5
ATOPIC ECZEMA IN THE ADULT PATIENT 42 5.6 THE PROGNOSIS OF ATOPIC ECZEMA
43 5.7 ATOPIC ECZEMA AND DIFFERENTIAL DIAGNOSES ... 43 5.8 CONCLUSION 43
REFERENCES 44 6 ATOPIC ECZEMA IN INFANTS A. TAIEB, F. BORALEVI 45 6.1
INTRODUCTION 45 6.2 INFANTILE ECZEMA: WHAT IT IS AND WHAT IT IS NOT 45
6.3 HISTORICAL BACKGROUND: HALL S THESIS (1905) ..46 6.4 REVIEW OF
CURRENT DIAGNOSTIC CRITERIA 48 6.5 TIME COURSE OF CLINICAL ASPECTS IN
INFANCY .. 49 6.6 DIFFERENTIAL DIAGNOSIS 50 6.7 COMPLICATIONS 53 6.8
MANAGEMENT 54 6.9 PROGNOSIS OF INFANTILE ECZEMA 59 6.10 CONCLUSIONS 59
REFERENCES 59 7 STIGMATA OF THE ATOPIC CONSTITUTION B. PRZYBILLA, C.
BAUER 61 7.1 FEATURES OF ATOPY 61 7.2 CONSTITUTIONAL STIGMATA OF ATOPY
63 7.3 CONSTITUTIONAL STIGMATA AS MARKERS OF ATOPY 70 REFERENCES 72 VIII
CONTENTS 8 MINIMAL VARIANTS OF ATOPIC ECZEMA B. WUTHRICH 74 8.1
LOCALIZED MINIMAL VARIANTS OF ATOPIC ECZEMA 74 8.2 JUVENILE PLANTAR
DERMATOSIS 77 8.3 JUVENILE PAPULAR DERMATOSIS: THE PAPULAR FORM OF
ATOPIC ECZEMA 78 8.4 PATCHY PITYRIASIFORM LICHENOID ECZEMA: THE
FOLLICULAR FORM OF ATOPIC ECZEMA 79 8.5 COMMENTS 81 REFERENCES 82 9
DIAGNOSIS OF ATOPIC ECZEMA S. WEIDINGER, J. RING 84 9.1 INTRODUCTION 84
9.2 MORPHOLOGY OF SKIN LESIONS 84 9.3 MORPHOLOGICAL VARIANTS 86 9.4
MANIFESTATIONS OF ATOPIC ECZEMA AT SPECIAL BODY AREAS 88 9.5 STIGMATA OF
ATOPY 89 9.6 DIAGNOSTIC CRITERIA FOR ATOPIC ECZEMA 90 9.7 DIFFERENTIAL
DIAGNOSIS OF ATOPIC ECZEMA 95 9.8 ALLERGY DIAGNOSIS IN ATOPIC ECZEMA 96
REFERENCES 97 10 DIFFERENTIAL DIAGNOSIS OF ATOPIC ECZEMA B. WEDI, A.
KAPP 100 10.1 INTRODUCTION 100 10.2 CHRONIC INFLAMMATORY SKIN DISEASES
100 10.3 INFECTION AND INFESTATION 101 10.4 IMMUNOLOGIC DISORDERS 101
10.5 MALIGNANT DISEASES 102 10.6 CONGENITAL DISORDERS 102 10.7
IMMUNODEFICIENCIES 103 10.8 METABOLIC DISEASES 104 10.9 CONCLUSION 106
REFERENCES 107 11 RESPIRATORY SYMPTOMS IN ATOPIC ECZEMA - FOCUS ON
ASTHMA AND EARLY TREATMENT T. HAAHTELA 108 11.1 INTRODUCTION 108 11.2
OCCURRENCE 108 11.3 RISK FACTORS 109 11.4 EARLY TREATMENT OF ATOPIC
ECZEMA OR RHINITIS 110 11.5 EARLY TREATMENT OF EOSINOPHILIC INFLAMMATION
AND ASTHMA 110 11.6 IMPROVING EARLY DIAGNOSIS 112 11.7 PRESENT AND
FUTURE 112 REFERENCES 113 12 COMPLICATIONS AND DISEASES ASSOCIATED WITH
ATOPIC ECZEMA D. VIELUF, J. RIEKER, T. RUZICKA 115 12.1 INTRODUCTION 115
12.2 INFECTIONS IN ATOPIC ECZEMA: GENERAL REMARKS 115 12.3 BACTERIAL
INFECTIONS 115 12.4 MYCOTIC INFECTIONS 115 12.5 VIRAL INFECTIONS 117
12.6 PARASITIC DISORDERS 123 12.7 EXFOLIATIVE ERYTHRODERMA 124 12.8
ASSOCIATED OCULAR DISEASES 124 12.9 ASSOCIATED GASTROINTESTINAL
DISORDERS .... 126 12.10 CYSTIC FIBROSIS 127 12.11 STEROID-RESPONSIVE
NEPHROTIC SYNDROME .. 128 12.12 METABOLIC DISORDERS 128 12.13 CUTANEOUS
LYMPHOMAS 129 12.14 ANHIDROTIC CONGENITAL ECTODERMAL DYSPLASIA 129 12.15
GROWTH IMPAIRMENT 129 12.16 SLEEP DISTURBANCES 130 12.17 PSORIASIS 130
12.18 PHOTOSENSITIVITY 130 12.19 DRUG SENSITIVITY 130 12.20 INSECT VENOM
ALLERGY 131 12.21 CONGENITAL PERCEPTIVE HEARING LOSS 131 12.22 VITILIGO
131 12.23 HAIR ANOMALIES 131 12.24 NETHERTON S SYNDROME 132 12.25 DOWN S
SYNDROME 132 12.26 SUDDEN INFANT DEATH SYNDROME 132 12.27 DUBOWITZ
SYNDROME 132 12.28 ECZEMATOUS SKIN LESIONS IN X-LINKED IMMUNODEFICIENCY
WITH HYPERIMMUNO- GLOBULINEMIA M SYNDROME 132 12.29 CUTANEOUS
AMYLOIDOSIS 133 12.30 GYNECOLOGICAL DISEASES 133 12.31 NEUROLOGICAL
DISORDERS 133 12.32 AUTOIMMUNE DISORDERS 133 12.33 HYPOPROTEINEMIA 134
12.34 PITYRIASIS ROSEA 134 12.35 PALMAR-PLANTAR KERATODERMA OF UNNA-
THOST 134 12.36 MULTIPLE DERMATOFIBROSARCOMATA 134 REFERENCES 134
CONTENTS 13 DISEASES RARELY ASSOCIATED WITH ATOPIC ECZEMA A. BRAAE
OLESEN 144 13.1 ATOPIC ECZEMA AND INSULIN-DEPENDENT DIABETES MELLITUS
144 13.2 ATOPIC ECZEMA AND PSORIASIS 145 13.3 ATOPIC ECZEMA AND
RHEUMATOID ARTHRITIS .. 146 13.4 ATOPIC ECZEMA AND MELANOCYTIC NEVI 147
13.5 CONCLUDING REMARKS 147 REFERENCES 148 14 NATURAL HISTORY OF ATOPIC
ECZEMA B. WUTHRICH 150 14.1 STUDIES ON THE LONG-TERM PROGNOSIS OF ATOPIC
ECZEMA AFTER CHILDHOOD 150 14.2 STUDIES REPORTING DATA ON THE LONG-TERM
PROGNOSIS OF ATOPIC ECZEMA BASED ON COMMUNITY SAMPLES 150 14.3 THE
ATOPIC MARCH: ATOPIC ECZEMA AND THE DEVELOPMENT OF ASTHMA AND HAY FEVER
.... 151 14.4 THE ATOPIC MARCH: EARLY SENSITIZATION TO FOODS AND
AEROALLERGENS IS THE MAIN RISK FACTOR FOR THE DEVELOPMENT OF ASTHMA 153
14.5 CHILDREN WITH THE NON-IGE-ASSOCIATED VARIETY OF ATOPIC ECZEMA
(INTRINSIC ATOPIC ECZEMA) RARELY GET ASTHMA 154 14.6 CONCLUSIONS 155
REFERENCES 155 15 DRY SKIN N. Y. SCHIIRER 157 15.1 THE STRATUM CORNEUM
157 15.2 PATHOPHYSIOLOGY OF DRY SKIN 159 15.3 CONCLUSION 163 REFERENCES
163 16 OCCUPATIONAL ASPECTS OF ATOPIC ECZEMA WITH EMPHASIS ON ATOPIC
HAND ECZEMA T.L. DIEPGEN 166 16.1 INTRODUCTION 166 16.2 CLINICAL ASPECTS
OF ATOPIC HAND ECZEMA.... 166 16.3 ATOPIC SKIN DIATHESIS AND HAND
ECZEMA.... 168 16.4 THE TRIANGLE OF ATOPIC ECZEMA, HAND ECZEMA, AND
OCCUPATIONAL SKIN DISEASE .... 168 16.5 SICK LEAVE AND CHANGING
OCCUPATIONS DUE TO ATOPIC ECZEMA 170 16.6 ATOPIC ECZEMA AS AN EFFECT
MODIFIER OR RISK FACTOR FOR HAND ECZEMA 171 16.7 ATTRIBUTABLE RISK FOR
OCCUPATIONAL SKIN DISEASES 172 16.8 ON THE QUANTIFICATION OF RISK 173
16.9 OCCUPATIONAL GUIDELINES FOR INDIVIDUALS WITH ATOPIC ECZEMA 175
16.10 KEY POINTS 175 REFERENCES 176 17 ALLERGIC CONTACT DERMATITIS AND
ATOPIC ECZEMA A. SCHNUCH, W. UTER, K. REICH 178 17.1 CLINICAL FINDINGS
178 17.2 PREIMMUNOLOGIC MECHANISMS IN ALLERGIC CONTACT DERMATITIS 181
17.3 ATOPIC ECZEMA AND IMPAIRMENT OF THE EPIDERMAL SKIN BARRIER 183 17.4
IMMUNOLOGIC MECHANISMS IN ALLERGIC CONTACT DERMATITIS 184 17.5 THE
IMMUNOPATHOGENESIS OF ATOPIC ECZEMA - POSSIBLE INTERFERENCE WITH
ALLERGIC CONTACT DERMATITIS 188 17.6 CONCLUSION 191 REFERENCES 194 18
IMMUNODEFICIENCY SYNDROMES AND ATOPIC ECZEMA M. LAIMER, H. HINTNER, P.
FRITSCH 202 18.1 PRIMARY AND SECONDARY IMMUNE DEFICIENCIES 202 18.2 THE
IMMUNE DEFECT IN ATOPIC ECZEMA 203 18.3 ECZEMA IN PRIMARY
IMMUNODEFICIENCY DISORDERS 204 18.4 PRIMARY IMMUNODEFICIENCY DISORDERS
FREQUENTLY ASSOCIATED WITH ATOPIC ECZEMA 204 18.5 PRIMARY
IMMUNODEFICIENCY DISORDERS OCCASIONALLY OR POSSIBLY ASSOCIATED WITH
ATOPIC ECZEMA 207 18.6 IS ATOPIC ECZEMA A FEATURE OF ACQUIRED
IMMUNODEFICIENCY DISORDERS? 210 18.7 COMMENTS AND CONCLUSIONS 210
REFERENCES 211 19 ATOPIC DISEASES IN FAMILIES M. UEHARA 213 19.1
INTRODUCTION 213 19.2 FAMILY HISTORY OF ATOPIC DISEASES 213 19.3
SUBTYPES OF ATOPIC DERMATITIS 214 19.4 PERSONAL HISTORY OF ATOPIC
RESPIRATORY DISEASES 214 19.5 DESCENDANT FAMILY HISTORY OF ATOPIC ECZEMA
215 19.6 PATERNAL AND MATERNAL EFFECT 215 REFERENCES 216 CONTENTS 20
HISTOPATHOLOGIC AND ULTRASTRUCTURAL ASPECTS OF ATOPIC ECZEMA M. FARTASCH
218 20.1 ECZEMATOUS SKIN IN ATOPIC ECZEMA 218 20.2 NONECZEMATOUS SKIN IN
ATOPIES 219 REFERENCES 220 21 PATHOPHYSIOLOGY AND CLINICAL MANIFESTATION
OF ITCH IN ATOPIC ECZEMA U. DARSOW, E. RIPPHOFF, J. RING 222 21.1
INTRODUCTION 222 21.2 PATHOPHYSIOLOGY 222 21.3 PROBLEMS OF MEASURING
CLINICAL ITCH WITH VISUAL ANALOG SCALES 223 21.4 THE EPPENDORF ITCH
QUESTIONNAIRE 224 21.5 THERAPY FOR ITCH 225 REFERENCES 227 22 CLINICAL
BASICS OF ATOPIC ECZEMA: SYNOPSIS B. PRZYBILLA, J. RING, T. RUZICKA 228
22.1 EPIDEMIOLOGY 228 22.2 CLINICAL PRESENTATION 228 22.3 HISTOPATHOLOGY
229 22.4 DIAGNOSIS 229 22.5 COMPLICATIONS 230 22.6 ASSOCIATED DISEASES
230 22.7 PSYCHOSOMATIC ASPECTS 231 22.8 NATURAL HISTORY 231 II
PATHOPHYSIOLOGY OF ATOPIC ECZEMA 23 CLINICAL GENETICS OF ATOPIC ECZEMA
F. SCHULTZ LARSEN 235 23.1 INTRODUCTION 235 23.2 METHODS FOR MAPPING
COMPLEX DISEASES... 235 23.3 ATOPIC ECZEMA/DERMATITIS SYNDROME 235 23.4
LINKAGE STUDIES 236 23.5 STATISTICS OF LINKAGE ANALYSIS 237 23.6
CANDIDATE GENE 237 23.7 GENOME SCREENS IN ATOPIC ECZEMA 238 23.8
CANDIDATE GENES IN ATOPIC ECZEMA 238 23.9 OTHER CHROMOSOMES 240 23.10
MATERNAL EFFECT AND GENOMIC IMPRINTING.. 241 23.11 CONCLUSIONS 241
REFERENCES 241 24 THE MOLECULAR GENETICS OF ATOPY W. COOKSON 244 24.1
INTRODUCTION 244 24.2 CANDIDATE GENES 244 24.3 GENOME SCREENS 245 24.4
SINGLE GENE DISORDERS 248 24.5 MATERNAL EFFECTS 249 24.6 CONCLUSIONS 249
REFERENCES 250 25 GENETICS OF ATOPIC ECZEMA YOUNG-AE LEE, C. SODERHALL,
U. WAHN 255 25.1 GENETIC EPIDEMIOLOGY 255 25.2 APPROACHES TO THE GENETIC
ANALYSIS OF ATOPIC ECZEMA 256 25.3 CONCLUSION 262 REFERENCES 263 26
MECHANISMS OF IGE-REGULATION M. WORM, T. JAKOB 265 26.1 INTRODUCTION 265
26.2 MECHANISMS OF ALLERGIC SENSITIZATION: ALLERGEN UPTAKE, PROCESSING,
AND PRESENTATION 265 26.3 ACTIVATION, MIGRATION, AND MATURATION OF
ANTIGEN-PRESENTING CELLS 266 26.4 T CELL ACTIVATION AND POLARIZATION OF
THE T CELL RESPONSE 267 26.5 ORIGIN AND MATURATION OF B CELLS 269 26.6
IMMUNOGLOBULINS 270 26.7 ISOTYPE SWITCHING 270 26.8 ADDITIONAL FACTORS
OF IGE REGULATION 271 26.9 THERAPEUTIC IMPLICATIONS 272 REFERENCES 273
27 DENDRITIC CELLS IN ATOPIC ECZEMA T. KOPP, G. STINGL 275 27.1
INTRODUCTION 275 27.2 ANTIGEN-PRESENTING CELL SUBPOPULATIONS IN ATOPIC
ECZEMA SKIN 275 27.3 TYPES OF ANTIGEN-PRESENTING CELLS IN PERIPHERAL
BLOOD 278 27.4 IGE-FACILITATED AMPLIFICATION OF THE IMMUNE RESPONSE 279
27.5 ROLE OF DENDRITIC CELLS IN INITIATING, MAINTAINING, AND/OR
SILENCING THE ALLERGIC TISSUE INFLAMMATION 281 27.6 EFFECTS OF TOPICAL
CALCINEURIN INHIBITORS 282 REFERENCES 282 28 INFLAMMATORY DENDRITIC
EPIDERMAL CELLS^ A. WOLLENBERG ... 288 28.1 LANGERHANS CELLS 288 28.2
INFLAMMATORY DENDRITIC EPIDERMAL CELLS ... 288 28.3 DELINEATION OF
INFLAMMATORY DENDRITIC EPIDERMAL CELLS FROM LANGERHANS CELLS .... 289
CONTENTS XI 28.4 ONTOGENESIS OF INFLAMMATORY DENDRITIC EPIDERMAL CELLS
290 28.5 INFLAMMATORY DENDRITIC EPIDERMAL CELLS ARE PRESENT IN EARLY
ATOPIC ECZEMA LESIONS 290 28.6 INFLAMMATORY DENDRITIC EPIDERMAL CELLS
ARE PRESENT IN EXTRINSIC AND INTRINSIC ATOPIC ECZEMA 290 28.7
IGE-RECEPTOR EXPRESSION OF INFLAMMATORY DENDRITIC EPIDERMAL CELLS 290
28.8 IN SITU EXPRESSION OF COSTIMULATORY MOLECULES ON INFLAMMATORY
DENDRITIC EPIDERMAL CELLS 291 28.9 PINOCYTOSIS AND RECEPTOR-MEDIATED
ENDOCYTOSIS OF EPIDERMAL DENDRITIC CELLS 291 28.10 DIAGNOSTIC EPIDERMAL
DENDRITIC CELL PHENOTYPING 292 28.11 EPIDERMAL DENDRITIC CELLS IN SKIN
LESIONS UNDER TOPICAL THERAPY 292 28.12 OUTLOOK 293 REFERENCES 293 29
EXTRINSIC AND INTRINSIC ATOPIC ECZEMA N. NOVAK, T. BIEBER 296 29.1
INTRODUCTION 296 29.2 ALLERGIC ATOPIC ECZEMA 296 29.3 SKIN 297 29.4 THE
ROLE OF AEROALLERGENS AND FOOD ALLERGENS AND THE ATOPY PATCH TEST 299
29.5 THE ROLE OF MICROBIAL INFECTIONS 300 29.6 BLOOD 300 29.7 CONCLUSION
301 REFERENCES 301 30 MAST CELLS IN THE SKIN M.K. CHURCH 303 30.1 MAST
CELL ACTIVATION 304 30.2 MAST CELL MEDIATORS 305 30.3 CONCLUSIONS 308
REFERENCES 309 31 THE ROLE OF EOSINOPHILS IN ATOPIC ECZEMA D. SIMON 313
31.1 EVIDENCE FOR EOSINOPHIL INVOLVEMENT IN ATOPIC ECZEMA 313 31.2
MECHANISMS CAUSING EOSINOPHILIA 315 31.3 ACTIVATION OF AND
IMMUNOREGULATION BY EOSINOPHILS 317 31.4 EOSINOPHILS AS A THERAPEUTIC
TARGET 318 REFERENCES 319 32 ROLE OF T CELLS IN ATOPIC ECZEMA M. AKDIS,
J. VERHAGEN, K. BLASER, C.A. AKDIS 323 32.1 SKIN-SELECTIVE HOMING OF T
CELLS 323 32.2 MECHANISMS OF CUTANEOUS LYMPHOCYTE- ASSOCIATED ANTIGEN
EXPRESSION ON HUMAN T CELLS 324 32.3 T CELL CHEMOTAXIS IN ATOPIC ECZEMA
325 32.4 ROLE OF IL-5 AND IL-13 IN ATOPIC ECZEMA 326 32.5 ROLE OF
APOPTOSIS IN ALLERGIC INFLAMMATION 326 32.6 CONCLUSION 329 REFERENCES
329 33 KERATINOCYTES IN ATOPIC ECZEMA G. GIROLOMONI, F. MASCIA, C.
DATTILO, A. GIANNETTI, S. PASTORE 332 33.1 INTRODUCTION 332 33.2
KERATINOCYTES ACTIVELY PARTICIPATE IN THE INITIATION AND AMPLIFICATION
OF SKIN INFLAMMATORY RESPONSES 332 33.3 THE ROLE OF KERATINOCYTES IN THE
RECRUIT- MENT OF INFLAMMATORY CELLS IN ATOPIC ECZEMA 333 33.4
KERATINOCYTES FROM ATOPIC ECZEMA PATIENTS PRODUCE INCREASED AMOUNTS OF
GM-CSF AND OTHER PROINFLAMMATORY CYTOKINES 335 33.5 DYSREGULATED
ACTIVATION OF AP-1 TRANS- CRIPTION FACTORS MAY BE IMPLICATED IN THE
ENHANCED EXPRESSION OF INFLAMMATORY GENES BY ATOPIC ECZEMA KERATINOCYTES
335 33.6 CONCLUDING REMARKS 336 REFERENCES 336 34 INFLAMMATORY MEDIATORS
AND CHEMOKINES IN ATOPIC ECZEMA B. HOMEY, T. RUZICKA 340 34.1 THE
CHEMOKINE SUPERFAMILY 340 34.2 CHEMOKINE RECEPTORS AND TH1 AND TH2 CELLS
342 34.3 MEMORY T CELL RECRUITMENT TO THE SKIN 342 34.4 DENDRITIC CELL
TRAFFICKING 344 34.5 EOSINOPHIL RECRUITMENT 345 34.6 CONCLUSION AND
PERSPECTIVE 346 REFERENCES 346 35 CYTOKINES IN ATOPIC DERMATITIS
(ECZEMA) H. MIZUTANI 350 35.1 INTRODUCTION 350 35.2 GENETIC BACKGROUND
AND CYTOKINES 350 35.3 THL AND TH2 CYTOKINES 350 35.4 INFILTRATING CELLS
AND KERATINOCYTES 351 XII CONTENTS 35.5 CHRONIC LESION AND FIBROSIS 352
35.6 ACQUIRED TYPE ATOPIC ECZEMA/INNATE TYPE ATOPIC ECZEMA AND IL-18 352
35.7 EFFECTS OF SKIN LESIONS ON SYSTEMIC IMMUNITY 353 35.8 INTRINSIC AND
EXTRINSIC ATOPIC ECZEMA 353 35.9 CONCLUSION 354 REFERENCES 354 36
NEUROPEPTIDES AND ATOPIC ECZEMA F. FANTINI, C. PINCELLI 357 36.1
NEUROPEPTIDES AND THE SKIN 357 36.2 ROLE OF NEUROPEPTIDES IN ATOPIC
ECZEMA .... 358 36.3 NEUROTROPHINS AND ATOPIC ECZEMA 359 REFERENCES 360
37 EPIDERMAL LIPIDS IN ATOPIC ECZEMA E. PROKSCH, R. FOLSTER-HOLST, J.-M.
JENSEN ... 362 37.1 INTRODUCTION 362 37.2 PHYSIOLOGICAL ROLE OF LIPIDS
IN THE EPIDERMIS 362 37.3 ABNORMALITIES OF EPIDERMAL LIPIDS IN ATOPIC
ECZEMA 363 37.4 IMPAIRED CERAMIDE CONTENT AND METABOLISM IN ATOPIC
ECZEMA 363 37.5 CERAMIDES BOUND TO CORNIFIED ENVELOPE PROTEINS IN ATOPIC
ECZEMA 366 37.6 ROLES FOR FATTY ACIDS IN ATOPIC ECZEMA 366 37.7
DISTURBED EPIDERMAL BARRIER FUNCTION AND ENHANCED SKIN ALLERGEN
PENETRATION IN ATOPIC ECZEMA 368 37.8 LIPIDS IN THE TREATMENT OF ATOPIC
ECZEMA .. 368 REFERENCES 369 38 THE PHENOMENON OF IRRITABLE SKIN IN
ATOPIC ECZEMA J. HUSS-MARP, B. EBERLEIN-KONIG, J. RING 373 38.1
INTRODUCTION 373 38.2 DEFINITION OF IRRITABLE SKIN 373 38.3
QUANTIFICATION OF IRRITABLE SKIN 373 38.4 DEFINITION OF IRRITABLE SKIN
IN ATOPIC ECZEMA 374 38.5 CLINICAL EVIDENCE OF IRRITABLE SKIN IN ATOPIC
ECZEMA 376 38.6 EXPERIMENTAL EVIDENCE OF IRRITABLE SKIN IN ATOPIC ECZEMA
376 38.7 PATHOPHYSIOLOGY OF IRRITABLE SKIN IN ATOPIC ECZEMA 377 38.8
CONCLUSION 378 REFERENCES 378 39 ENVIRONMENTAL POLLUTION AND ATOPIC
ECZEMA B. EBERLEIN-K6NIG, J. HUSS-MARP, H. BEHRENDT, J. RING 381 39.1
INTRODUCTION 381 39.2 FORMALDEHYDE 381 39.3 CONCLUSION 387 REFERENCES
388 40 THE ROLE OF INHALANT ALLERGENS IN ATOPIC DERMATITIS E.A. ERWIN,
J.A. WOODFOLK, T.A.E. PLATTS-MILLS 390 40.1 INTRODUCTION 390 40.2
PARALLELS TO ALLERGIC DISEASE 391 40.3 ATOPY PATCH TESTS 391 40.4
IMMUNOLOGY 392 40.5 AVOIDANCE 394 40.6 THE RELEVANCE OF OTHER ALLERGENS
395 40.7 CONCLUSION 396 REFERENCES 396 41 ROLE OF FOOD ALLERGY IN ATOPIC
ECZEMA T. WERFEL, K. BREUER 399 41.1 INTRODUCTION 399 41.2 PREVALENCE OF
FOOD ALLERGY IN ATOPIC ECZEMA 399 41.3 LATE ECZEMATOUS REACTIONS TO
FOODS IN ATOPIC ECZEMA 400 41.4 RATE OF LATE REACTIONS TO CHALLENGES
WITH FOODS 400 41.5 PREDICTIVE VALUES OF DIAGNOSTIC TOOLS 401 41.6
ALLERGEN-SPECIFIC T CELL RESPONSES IN ATOPIC ECZEMA 402 41.7
POLLEN-ASSOCIATED FOOD ALLERGY IN ATOPIC ECZEMA 402 REFERENCES 403 42
STAPHYLOCOCCUS AUREUS AND ATOPIC ECZEMA M. MEMPEL 406 42.1 SKIN
COLONIZATION 406 42.2 MECHANISMS OF ADHERENCE 406 42.3 VIRULENCE FACTORS
407 42.4 CONCLUDING REMARKS 408 REFERENCES 408 43 ANIMAL MODELS OF
ATOPIC ECZEMA A. TANAKA, H. MATSUDA 410 43.1 INTRODUCTION ^ 410 43.2
SPONTANEOUS ANIMAL MODELS FOR ATOPIC ECZEMA 410 43.3 INDUCIBLE ANIMAL
MODELS OF ATOPIC ECZEMA 415 43.4 GENE-OPERATED ANIMAL MODELS FOR ATOPIC
ECZEMA 415 CONTENTS XIII 43.5 FINAL REMARKS 415 REFERENCES 416 44
AUTOANTIBODIES IN ATOPIC ECZEMA N. MOTHES, I. MITTERMANN, K. AICHBERGER,
P. VALENT, R. VALENTA 417 44.1 INTRODUCTION 417 44.2 SIMILARITIES AND
CROSS-REACTIVITIES BETWEEN ENVIRONMENTAL ALLERGENS AND HUMAN PROTEINS:
THE CONCEPT OF IGE AUTOIMMUNITY IS REBORN 418 44.3 THE DISCOVERY THAT
THE OCCURRENCE OF IGE AUTOANTIBODIES IS FREQUENTLY ASSOCIATED WITH
ATOPIC ECZEMA 419 44.4 IDENTIFICATION OF IGE-REACTIVE AUTOANTIGENS BY
MOLECULAR CLONING 420 44.5 HOW INTRACELLULAR ANTIGENS CAN CONTRIBUTE TO
THE PATHOGENESIS OF ATOPIC ECZEMA 421 44.6 IGE AUTOREACTIVITY AS A
POSSIBLE MARKER FOR CHRONIC INFLAMMATION AND TISSUE DAMAGE IN ATOPIC
ECZEMA 421 44.7 IGG AUTOANTIBODIES IN ATOPIC ECZEMA PATIENTS 421 44.8
PATHOMECHANISMS OF IGE AUTOREACTIVITY ... 422 REFERENCES 422 45
PATHOPHYSIOLOGY OF ATOPIC ECZEMA: SYNOPSIS J. RING, T. RUZICKA, B.
PRZYBILLA 426 45.1 INTRODUCTION 426 45.2 GENETIC PREDISPOSITION 426 45.3
DISTURBED SKIN BARRIER FUNCTION ( DRY SKIN ) 427 45.4 ITCH AS A MAJOR
SYMPTOM OF ECZEMA 427 45.5 PSYCHOSOMATIC INTERACTION AND AUTONOMIC
NERVOUS SYSTEM DYSREGULATION 427 45.6 ROLE OF ALLERGY IN ATOPIC ECZEMA
428 45.7 ROLE OF IGE-MEDIATED SENSITIZATION 428 45.8 ROLE OF MICROBIAL
COLONIZATION AND INFECTION 428 45.9 ROLE OF CONTACT ALLERGY 429 45.10
ROLE OF IRRITANTS AND POLLUTANTS 429 45.11 CONCLUSION 429 MANAGEMENT OF
PATIENTS WITH ATOPY ECZEMA 46 PRIMARY PREVENTION OF ATOPY U. WAHN, R.
NICKEL, S. ILLI, S. LAU, C. GRUBER, E. HAMELMANN 433 46.1 INTRODUCTION
AND DEFINITION 433 46.2 THE NATURAL HISTORY OF ATOPIC MANIFESTATIONS 433
46.3 HEREDITARY FACTORS 434 46.4 NONGENETIC FACTORS 435 46.5 THE
DOMESTIC ENVIRONMENT 435 46.6 POSSIBLE CONSEQUENCES FOR PREVENTION 436
46.7 PRIMARY PREVENTION 437 46.8 SECONDARY PREVENTION 438 46.9
PERSPECTIVES AND CHALLENGES 438 REFERENCES 438 47 ROLE OF ALLERGY
TESTING IN ATOPIC ECZEMA U. DARSOW, J. RING 441 47.1 INTRODUCTION 441
47.2 FOOD ALLERGY IN ATOPIC ECZEMA 441 47.3 PRACTICAL APPROACH TO THE
PATIENT WITH SUSPECTED FOOD ALLERGY AND AE 442 47.4 AEROALLERGENS AND
ATOPIC ECZEMA 443 47.5 ATOPY PATCH TEST WITH AEROALLERGENS 444 47.6
OUTLOOK 446 REFERENCES 447 48 PROBIOTICS IN ATOPIC ECZEMA C. SCHNOPP 449
48.1 THE HYGIENE HYPOTHESIS 449 48.2 PRIMARY PREVENTION STRATEGIES IN
ATOPIC ECZEMA 449 48.3 PROBIOTICS FOR PRIMARY PREVENTION IN HIGH-RISK
FAMILIES 450 48.4 SUGGESTED MECHANISMS 452 48.5 REMAINING QUESTIONS 453
48.6 CONCLUSION 453 REFERENCES 454 49 MEASURING DISTURBED BARRIER
FUNCTION IN ATOPIC ECZEMA S. SEIDENARI, F. GIUSTI 456 49.1
TRANSEPIDERMAL WATER LOSS (TEWL) 456 49.2 SKIN HYDRATION AND TEWL 457
49.3 SKIN LIPIDS AND TEWL 458 49.4 REACTIVITY TO IRRITANTS 458 49.5
BARRIER FUNCTION IN ATOPIC PATIENTS WITHOUT DERMATITIS 459 49.6 TEWL AND
TOPICAL AGENTS FOR ATOPIC ECZEMA 459 REFERENCES 460 50 BASIC TOPICAL
THERAPY WITH EMOLLIENTS IN ATOPIC ECZEMA W. GEHRING 463 50.1
INTRODUCTION 463 XIV CONTENTS 50.2 AMPHIPHILIC SYSTEMS 464 50.3
HYDROPHILIC SYSTEMS 465 50.4 DESIRED VEHICLE EFFECTS: HYDRATION OF THE
STRATUM CORNEUM AND INDUCTION OF A DIFFUSION BARRIER AGAINST HYDROPHILIC
IRRITANTS 466 50.5 MODULATION OF VEHICLE EFFECTS BY GLYCEROL OR UREA 466
50.6 VEHICLE INFLUENCE UPON BIOLOGIC EFFECT OF TOPICALLY APPLIED DRUGS
466 REFERENCES 467 51 SYNDETS IN THE TREATMENT OF ATOPIC ECZEMA O.
BRAUN-FALCO, H.C. KORTING 468 51.1 CLEANSING OF ECZEMATOUS SKIN - THE
SCOPE OF THE PROBLEM 468 51.2 THE DEVELOPMENT OF SYNTHETIC DETERGENTS -
A REAL OPTION 469 51.3 DESIRABLE AND UNDESIRABLE EFFECTS OF SYNDETS ON
HUMAN SKIN - THE ROLE OF PH ... 471 51.4 SYNDETS AND ECZEMATOUS SKIN -
CLINICAL ASSESSMENT 474 REFERENCES 474 52 TOPICAL TREATMENT WITH
GLUCOCORTICOIDS M. KERSCHER, S. WILLIAMS, P. LEHMANN 477 52.1
INTRODUCTION 477 52.2 MECHANISM OF ACTION 478 52.3 CORTICOSTEROID
CLASSIFICATION 480 52.4 LOCAL AND SYSTEMIC UNWANTED EFFECTS OF TOPICAL
GLUCOCORTICOIDS 482 52.5 INFLUENCE OF THE VEHICLE ON THE EFFECT OF
TOPICAL CORTICOSTEROID PREPARATIONS 484 52.6 ADDITIONAL ACTIVE
INGREDIENTS IN TOPICAL CORTICOSTEROID PREPARATIONS 485 52.7 ACCEPTANCE
OF THE USE OF TOPICAL CORTICOSTEROIDS 486 52.8 PRINCIPLES OF TOPICAL
TREATMENT WITH CORTICOSTEROIDS IN ATOPIC ECZEMA 487 52.9 TOPICAL
CORTICOSTEROIDS VERSUS TOPICAL INHIBITORS OF CALCINEURIN 488 REFERENCES
489 53 ANTIMICROBIAL THERAPY IN ATOPIC ECZEMA A. GAUGER, J. RING 492
53.1 ANTISEPTIC THERAPY 492 53.2 ANTIBIOTIC THERAPY 493 53.3
NONANTIBIOTIC THERAPY 495 53.4 ANTIMYCOTIC THERAPY 496 53.5 ANTIVIRAL
THERAPY 497 53.6 FUTURE PERSPECTIVES 498 53.7 CONCLUSION 499 REFERENCES
499 54 ANTIHISTAMINES IN ATOPIC ECZEMA T. ZUBERBIER 503 54.1
INTRODUCTION 503 54.2 FIRST GENERATION ANTIHISTAMINES 503 54.3
SECOND-GENERATION ANTIHISTAMINES 504 54.4 CLINICAL STUDIES 504
REFERENCES 505 55 CLIMATOTHERAPY IN ATOPIC ECZEMA E. VOCKS 507 55.1
INFLUENCE OF CLIMATE ON ATOPIC ECZEMA 507 55.2 HISTORY OF CLIMATOTHERAPY
508 55.3 CLIMATE AND WEATHER, CLIMATE ADAPTATION ..511 55.4 HUMAN
BIOMETEOROLOGICAL RESEARCH 512 55.5 BASIC PRINCIPLES OF CLIMATOTHERAPY
513 55.6 CLIMATOTHERAPY IN ATOPIC ECZEMA 513 55.7 APPLICATION OF
CLIMATOTHERAPY 516 55.8 THERAPY RESULTS 517 55.9 CONCLUSION 520
REFERENCES 520 56 SKIN CARE IN ATOPIC ECZEMA M. KERSCHER, S. WILLIAMS
524 56.1 INTRODUCTION 524 56.2 GENERAL RECOMMENDATIONS 525 56.3
CLEANSING SEBOSTATIC SKIN IN ATOPIC ECZEMA 526 56.4 REHYDRATING
SEBOSTATIC SKIN IN ATOPIC ECZEMA 528 56.5 DECORATIVE COSMETIC 531
REFERENCES 531 57 DIETARY MANAGEMENT OF ATOPIC ECZEMA C. KUGLER 534 57.1
DEFINITIONS 534 57.2 PREVALENCE OF ADVERSE REACTION TO FOOD IN ATOPIC
ECZEMA 534 57.3 DIAGNOSIS 534 57.4 DIAGNOSTIC TYPES OF DIET 535 57.5
NUTRITIONAL RECOMMENDATIONS WHEN THERE IS A FOOD ALLERGY 537 57.6
PROGNOSIS FOR FOOD ALLERGIES 537 REFERENCES 538 58 PHOTOTHERAPY FOR
ATOPIC ECZEMA * J. KRUTMANN, A. MORITA 539 58.1 INTRODUCTION 539 58.2
UVA1 PHOTOTHERAPY FOR ACUTE, SEVERE ATOPIC ECZEMA 539 CONTENTS XV 58.3
PHOTOTHERAPY OF CHRONIC, MODERATE ATOPIC ECZEMA 540 58.4 PHOTOTHERAPY OF
ATOPIC HAND AND FOOT ECZEMA 541 58.5 MECHANISM OF ACTION 541 58.6
CONCLUDING REMARKS 541 REFERENCES 542 59 ATOPIC ECZEMA - PSYCHOSOMATIC
AND PSYCHOBIOLOGICAL ASPECTS U. GIELER 544 59.1 INTRODUCTION AND
HISTORICAL ASPECTS 544 59.2 QUALITY OF LIFE IN ATOPIC ECZEMA 544 59.3
PSYCHOLOGICAL ASPECTS - COMORBIDITY WITH ATOPIC ECZEMA 545 59.4 STRESS
AND ATOPIC ECZEMA 546 59.5 PSYCHOIMMUNOLOGY 546 59.6 COPING AND
COMPLIANCE IN ATOPIC ECZEMA 548 59.7 PSYCHODYNAMIC ASPECTS IN ATOPIC
ECZEMA 548 59.8 FAMILY ASPECTS 549 59.9 PATIENT MANAGEMENT PROGRAMS 549
59.10 MEASURES TO INFLUENCE THE ITCH- SCRATCH CYCLE 550 59.11 MEASURES
TO REDUCE NEGATIVE EFFECTS ON SOCIAL RELATIONSHIPS BY ATOPIC ECZEMA
PREVENTION PROGRAMS 551 59.12 STATUS OF THE EMPIRICAL RESEARCH CONCERN-
ING ATOPIC ECZEMA PREVENTION PROGRAMS ..551 59.13 THE PSYCHOLOGICAL
TRAINING PROGRAM IN ATOPIC ECZEMA PREVENTION 553 REFERENCES 553 60
PHOSPHODIESTERASE 4 INHIBITORS FOR ATOPIC ECZEMA L.F. SANTAMARIA-BABI
557 60.1 GENERAL ANTI-INFLAMMATORY EFFECTS OF PDE 4 INHIBITORS 558 60.2
PDE 4 INHIBITORS IN SKIN INFLAMMATION ... 558 60.3 POSSIBLE EFFECTS OF
PDE 4 INHIBITORS IN DIFFERENT PHASES OF ATOPIC ECZEMA 559 60.4
CONCLUSION 561 REFERENCES 561 61 MUSIC THERAPY IN ATOPIC ECZEMA D. MUNCH
565 61.1 WHEN IS IT REASONABLE TO USE MUSIC THERAPY? 565 61.2 FORMS OF
MUSIC THERAPY 566 61.3 SKIN AND PSYCHE 567 61.4 USE OF MUSICAL
COMPONENTS IN MUSIC THERAPY 568 61.5 EFFECT OF MUSIC ON HUMANS:
CONCLUSION ... 568 61.6 CONCLUSION 568 REFERENCES 569 62 TOPICAL
IMMUNOMODULATORS IN THE TREATMENT OF ATOPIC ECZEMA S. REITAMO, A. REMITZ
570 62.1 INTRODUCTION 570 62.2 ACTIVATION OF INFLAMMATORY CELLS IN
ATOPIC ECZEMA 570 62.3 THE MODE OF ACTION OF TOPICAL IMMUNOMODULATORY
AGENTS 570 62.4 STAPHYLOCOCCAL COLONIZATION CONTRIBUTES TO SEVERITY OF
ATOPIC ECZEMA 571 62.5 TREATMENT WITH TOPICAL IMMUNOMODULATORS DOES NOT
SUPPRESS CONNECTIVE TISSUE .... 571 62.6 EFFICACY OF TOPICAL
IMMUNOMODULATORS USED AS MONOTHERAPY IN ATOPIC ECZEMA ... 571 62.7
EFFICACY OF TOPICAL IMMUNOMODULATORS USED TOGETHER WITH TOPICAL
CORTICOSTEROIDS 572 62.8 COMPARISON OF TACROLIMUS OINTMENT AND
PIMECROLIMUS CREAM 572 62.9 SAFETY 573 62.10 ADVERSE EVENTS ARE RELATED
TO DISEASE SEVERITY 573 62.11 DOES TOPICAL IMMUNOMODULATION INCREASE THE
RISK OF SKIN CANCER? 573 62.12 PRACTICAL USE OF TOPICAL IMMUNO-
MODULATORS 574 62.13 CONCLUSIONS 574 REFERENCES 574 63 ECZEMA SCHOOL:
PRACTICAL APPROACHES IN AN EFFICIENT MODULE OF TERTIARY PREVENTION
PROGRAMS M. PREMERLANI, Y. LUDEWIG, C. SCHNOPP, J. RING 576 63.1
INTRODUCTION 576 63.2 ECZEMA SCHOOL AT THE WOLFGANG CHILDREN S HOSPITAL
IN DAVOS, SWITZERLAND 577 63.3 PEDAGOGIC BACKGROUND OF ECZEMA SCHOOLING
578 63.4 INTRODUCTION TO ECZEMA SCHOOL SESSIONS .. 578 63.5 PEDAGOGIC
MODULES FOR THE MAIN PART 578 63.6 PEDAGOGIC METHODS FOR THE
CONCLUSION.... 579 63.7 PEDAGOGIC TOOLS TO INCREASE SELF-ESTEEM AND
SELF-RESPECT 579 XVI CONTENTS 63.8 ORGANIZATION OF ECZEMA SCHOOL 579
63.9 CONCLUSION 580 REFERENCES 580 64 UNCONVENTIONAL TREATMENTS IN
ATOPIC ECZEMA T. SCHAFER 582 64.1 DEFINITION 582 64.2 USAGE IN THE
GENERAL POPULATION 582 64.3 USAGE OF COMPLEMENTARY ALTERNATIVE MEDICINE
FOR ATOPIC ECZEMA 583 64.4 UTILIZATION OF COMPLEMENTARY ALTERNATIVE
MEDICINE BY DERMATOLOGISTS 584 64.5 SPECIFIC COMPLEMENTARY ALTERNATIVE
MEDICINE MODALITIES 585 64.6 PHYTOTHERAPY 586 64.7 CHINESE HERBAL
MEDICINE 586 64.8 ACUPUNCTURE 586 64.9 AUTOLOGOUS BLOOD THERAPY 587
64.10 BIORESONANCE 587 64.11 HOMOEOPATHY 587 64.12 MASSAGE THERAPY AND
AROMA THERAPY .... 587 64.13 SALT BATHS 588 64.14 VITAMINS AND MINERALS
588 64.15 HARMFUL EFFECTS 589 REFERENCES 589 65 ALTERNATIVE MEDICINE FOR
ATOPIC ECZEMA: A COMMENT R. HAPPLE 592 65.1 ROMANTICISM 592 65.2
TRADITIONAL CHINESE MEDICINE CAUSING COMPLETE RENAL FAILURE 592 65.3
ACUPUNCTURE 593 65.4 HOMEOPATHY 593 65.5 ALTERNATIVE MEDICINE WILL
ALWAYS EXIST ... 594 REFERENCES 594 66 THERAPY OF ATOPIC ECZEMA:
SYNOPSIS T. RUZICKA, S. ARTIK, J. RING, B. PRZYBILLA ... 596 66.1
INTRODUCTION 596 66.2 SKIN CARE 597 66.3 GLUCOCORTICOIDS 598 66.4
ANTIHISTAMINES 598 66.5 ANTI-INFECTIOUS TREATMENT 599 66.6 ULTRAVIOLET
TREATMENT 599 66.7 DIET 600 66.8 ENVIRONMENTAL CONTROL AND PREVENTION
... 601 66.9 PSYCHOTHERAPEUTIC APPROACHES 602 66.10 IMMUNOMODULATORS AND
IMMUNO- SUPPRESSIVE DRUGS 602 66.11 UNCONVENTIONAL THERAPY OPTIONS 603
66.12 SUMMARY AND OUTLOOK 603 SUBJECT INDEX 605
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J. RING, B. PRZYBILLA, T. RUZICKA (EDS.) HANDBOOK OF ATOPIC EAEMA SECOND
EDITION WITH 187 FIGURES IN 236 PARTS AND 113 TABLES 4Y SPRINGER
CONTENTS I CLINICAL ASPECTS OF ATOPIC ECZEMA 1 ATOPY: CONDITION,
DISEASE, OR SYNDROME? J. RING 3 1.1 HISTORY 3 1.2 CLINICAL SYMPTOMS 4
1.3 ETIOPATHOPHYSIOLOGICAL ASPECTS 5 1.4 DEFINITION OF ATOPY 7 1.5
CONCLUSION 7 REFERENCES 7 2 THE HISTORY OF ATOPIC ECZEMA/DERMATITIS A.
TAIEB, D. WALLACH, G. TILLES 10 2.1 INTRODUCTION 10 2.2 PRECURSORS OF
ATOPIC ECZEMA 10 2.3 TOWARD A MODERN DEFINITION 14 2.4 HISTORICAL
LANDMARKS IN THE MODERN HISTORY OF ATOPIC ECZEMA 16 2.5 THE HISTORY OF
ATOPIC ECZEMA TREATMENTS . 18 2.6 WHAT HISTORY TELLS US TODAY 18
REFERENCES 19 3 EPIDEMIOLOGY OF ATOPIC ECZEMA T. SCHAFER 21 3.1
DEFINITIONS 21 3.2 DIAGNOSTIC CRITERIA 21 3.3 ASSESSMENT IN
EPIDEMIOLOGICAL STUDIES 22 3.4 MEASURES OF FREQUENCY 22 3.5 TRENDS AND
FREQUENCY OF ATOPIC ECZEMA 23 3.6 ATOPIC ECZEMA IN EAST AND WEST GERMANY
. 23 3.7 INTRINSIC AND EXTRINSIC ATOPIC ECZEMA 24 3.8 RISK FACTORS
AND CHARACTERISTICS 24 3.9 PROGNOSTIC FACTORS 27 REFERENCES 27 4 THE
BURDEN OF ATOPIC ECZEMA A.Y. FINLAY 31 4.1 INTRODUCTION 31 4.2 NATURE OF
THE BURDEN 31 4.3 MEASUREMENT OF BURDEN 32 4.4 STRATEGIES FOR IMPROVING
BURDEN 35 4.5 DECLARATION OF INTEREST 35 REFERENCES 35 5 CLINICAL
SYMPTOMS OF ATOPIC ECZEMA M. DELEURAN, A. BRAAE OLESEN, K. THESTRUP-
PEDERSEN 37 5.1 INTRODUCTION 37 5.2 EVOLUTION OF ATOPIC ECZEMA 38 5.3
COURSE OF ATOPIC ECZEMA 39 5.4 SOME TYPICAL CLINICAL FEATURES 40 5.5
ATOPIC ECZEMA IN THE ADULT PATIENT 42 5.6 THE PROGNOSIS OF ATOPIC ECZEMA
43 5.7 ATOPIC ECZEMA AND DIFFERENTIAL DIAGNOSES . 43 5.8 CONCLUSION 43
REFERENCES 44 6 ATOPIC ECZEMA IN INFANTS A. TAIEB, F. BORALEVI 45 6.1
INTRODUCTION 45 6.2 INFANTILE ECZEMA: WHAT IT IS AND WHAT IT IS NOT 45
6.3 HISTORICAL BACKGROUND: HALL'S THESIS (1905) .46 6.4 REVIEW OF
CURRENT DIAGNOSTIC CRITERIA 48 6.5 TIME COURSE OF CLINICAL ASPECTS IN
INFANCY . 49 6.6 DIFFERENTIAL DIAGNOSIS 50 6.7 COMPLICATIONS 53 6.8
MANAGEMENT 54 6.9 PROGNOSIS OF INFANTILE ECZEMA 59 6.10 CONCLUSIONS 59
REFERENCES 59 7 STIGMATA OF THE ATOPIC CONSTITUTION B. PRZYBILLA, C.
BAUER 61 7.1 FEATURES OF ATOPY 61 7.2 CONSTITUTIONAL STIGMATA OF ATOPY
63 7.3 CONSTITUTIONAL STIGMATA AS MARKERS OF ATOPY 70 REFERENCES 72 VIII
CONTENTS 8 MINIMAL VARIANTS OF ATOPIC ECZEMA B. WUTHRICH 74 8.1
LOCALIZED MINIMAL VARIANTS OF ATOPIC ECZEMA 74 8.2 JUVENILE PLANTAR
DERMATOSIS 77 8.3 JUVENILE PAPULAR DERMATOSIS: THE PAPULAR FORM OF
ATOPIC ECZEMA 78 8.4 PATCHY PITYRIASIFORM LICHENOID ECZEMA: THE
FOLLICULAR FORM OF ATOPIC ECZEMA 79 8.5 COMMENTS 81 REFERENCES 82 9
DIAGNOSIS OF ATOPIC ECZEMA S. WEIDINGER, J. RING 84 9.1 INTRODUCTION 84
9.2 MORPHOLOGY OF SKIN LESIONS 84 9.3 MORPHOLOGICAL VARIANTS 86 9.4
MANIFESTATIONS OF ATOPIC ECZEMA AT SPECIAL BODY AREAS 88 9.5 STIGMATA OF
ATOPY 89 9.6 DIAGNOSTIC CRITERIA FOR ATOPIC ECZEMA 90 9.7 DIFFERENTIAL
DIAGNOSIS OF ATOPIC ECZEMA 95 9.8 ALLERGY DIAGNOSIS IN ATOPIC ECZEMA 96
REFERENCES 97 10 DIFFERENTIAL DIAGNOSIS OF ATOPIC ECZEMA B. WEDI, A.
KAPP 100 10.1 INTRODUCTION 100 10.2 CHRONIC INFLAMMATORY SKIN DISEASES
100 10.3 INFECTION AND INFESTATION 101 10.4 IMMUNOLOGIC DISORDERS 101
10.5 MALIGNANT DISEASES 102 10.6 CONGENITAL DISORDERS 102 10.7
IMMUNODEFICIENCIES 103 10.8 METABOLIC DISEASES 104 10.9 CONCLUSION 106
REFERENCES 107 11 RESPIRATORY SYMPTOMS IN ATOPIC ECZEMA - FOCUS ON
ASTHMA AND EARLY TREATMENT T. HAAHTELA 108 11.1 INTRODUCTION 108 11.2
OCCURRENCE 108 11.3 RISK FACTORS 109 11.4 EARLY TREATMENT OF ATOPIC
ECZEMA OR RHINITIS 110 11.5 EARLY TREATMENT OF EOSINOPHILIC INFLAMMATION
AND ASTHMA 110 11.6 IMPROVING EARLY DIAGNOSIS 112 11.7 PRESENT AND
FUTURE 112 REFERENCES 113 12 COMPLICATIONS AND DISEASES ASSOCIATED WITH
ATOPIC ECZEMA D. VIELUF, J. RIEKER, T. RUZICKA 115 12.1 INTRODUCTION 115
12.2 INFECTIONS IN ATOPIC ECZEMA: GENERAL REMARKS 115 12.3 BACTERIAL
INFECTIONS 115 12.4 MYCOTIC INFECTIONS 115 12.5 VIRAL INFECTIONS 117
12.6 PARASITIC DISORDERS 123 12.7 EXFOLIATIVE ERYTHRODERMA 124 12.8
ASSOCIATED OCULAR DISEASES 124 12.9 ASSOCIATED GASTROINTESTINAL
DISORDERS . 126 12.10 CYSTIC FIBROSIS 127 12.11 STEROID-RESPONSIVE
NEPHROTIC SYNDROME . 128 12.12 METABOLIC DISORDERS 128 12.13 CUTANEOUS
LYMPHOMAS 129 12.14 ANHIDROTIC CONGENITAL ECTODERMAL DYSPLASIA 129 12.15
GROWTH IMPAIRMENT 129 12.16 SLEEP DISTURBANCES 130 12.17 PSORIASIS 130
12.18 PHOTOSENSITIVITY 130 12.19 DRUG SENSITIVITY 130 12.20 INSECT VENOM
ALLERGY 131 12.21 CONGENITAL PERCEPTIVE HEARING LOSS 131 12.22 VITILIGO
131 12.23 HAIR ANOMALIES 131 12.24 NETHERTON'S SYNDROME 132 12.25 DOWN'S
SYNDROME 132 12.26 SUDDEN INFANT DEATH SYNDROME 132 12.27 DUBOWITZ
SYNDROME 132 12.28 ECZEMATOUS SKIN LESIONS IN X-LINKED IMMUNODEFICIENCY
WITH HYPERIMMUNO- GLOBULINEMIA M SYNDROME 132 12.29 CUTANEOUS
AMYLOIDOSIS 133 12.30 GYNECOLOGICAL DISEASES 133 12.31 NEUROLOGICAL
DISORDERS 133 12.32 AUTOIMMUNE DISORDERS 133 12.33 HYPOPROTEINEMIA 134
12.34 PITYRIASIS ROSEA 134 12.35 PALMAR-PLANTAR KERATODERMA OF UNNA- "
THOST 134 12.36 MULTIPLE DERMATOFIBROSARCOMATA 134 REFERENCES 134
CONTENTS 13 DISEASES RARELY ASSOCIATED WITH ATOPIC ECZEMA A. BRAAE
OLESEN 144 13.1 ATOPIC ECZEMA AND INSULIN-DEPENDENT DIABETES MELLITUS
144 13.2 ATOPIC ECZEMA AND PSORIASIS 145 13.3 ATOPIC ECZEMA AND
RHEUMATOID ARTHRITIS . 146 13.4 ATOPIC ECZEMA AND MELANOCYTIC NEVI 147
13.5 CONCLUDING REMARKS 147 REFERENCES 148 14 NATURAL HISTORY OF ATOPIC
ECZEMA B. WUTHRICH 150 14.1 STUDIES ON THE LONG-TERM PROGNOSIS OF ATOPIC
ECZEMA AFTER CHILDHOOD 150 14.2 STUDIES REPORTING DATA ON THE LONG-TERM
PROGNOSIS OF ATOPIC ECZEMA BASED ON COMMUNITY SAMPLES 150 14.3 THE
ATOPIC MARCH: ATOPIC ECZEMA AND THE DEVELOPMENT OF ASTHMA AND HAY FEVER
. 151 14.4 THE ATOPIC MARCH: EARLY SENSITIZATION TO FOODS AND
AEROALLERGENS IS THE MAIN RISK FACTOR FOR THE DEVELOPMENT OF ASTHMA 153
14.5 CHILDREN WITH THE NON-IGE-ASSOCIATED VARIETY OF ATOPIC ECZEMA
(INTRINSIC ATOPIC ECZEMA) RARELY GET ASTHMA 154 14.6 CONCLUSIONS 155
REFERENCES 155 15 DRY SKIN N. Y. SCHIIRER 157 15.1 THE STRATUM CORNEUM
157 15.2 PATHOPHYSIOLOGY OF DRY SKIN 159 15.3 CONCLUSION 163 REFERENCES
163 16 OCCUPATIONAL ASPECTS OF ATOPIC ECZEMA WITH EMPHASIS ON ATOPIC
HAND ECZEMA T.L. DIEPGEN 166 16.1 INTRODUCTION 166 16.2 CLINICAL ASPECTS
OF ATOPIC HAND ECZEMA. 166 16.3 ATOPIC SKIN DIATHESIS AND HAND
ECZEMA. 168 16.4 THE TRIANGLE OF ATOPIC ECZEMA, HAND ECZEMA, AND
OCCUPATIONAL SKIN DISEASE . 168 16.5 SICK LEAVE AND CHANGING
OCCUPATIONS DUE TO ATOPIC ECZEMA 170 16.6 ATOPIC ECZEMA AS AN EFFECT
MODIFIER OR RISK FACTOR FOR HAND ECZEMA 171 16.7 ATTRIBUTABLE RISK FOR
OCCUPATIONAL SKIN DISEASES 172 16.8 ON THE QUANTIFICATION OF RISK 173
16.9 OCCUPATIONAL GUIDELINES FOR INDIVIDUALS WITH ATOPIC ECZEMA 175
16.10 KEY POINTS 175 REFERENCES 176 17 ALLERGIC CONTACT DERMATITIS AND
ATOPIC ECZEMA A. SCHNUCH, W. UTER, K. REICH 178 17.1 CLINICAL FINDINGS
178 17.2 PREIMMUNOLOGIC MECHANISMS IN ALLERGIC CONTACT DERMATITIS 181
17.3 ATOPIC ECZEMA AND IMPAIRMENT OF THE EPIDERMAL SKIN BARRIER 183 17.4
IMMUNOLOGIC MECHANISMS IN ALLERGIC CONTACT DERMATITIS 184 17.5 THE
IMMUNOPATHOGENESIS OF ATOPIC ECZEMA - POSSIBLE INTERFERENCE WITH
ALLERGIC CONTACT DERMATITIS 188 17.6 CONCLUSION 191 REFERENCES 194 18
IMMUNODEFICIENCY SYNDROMES AND ATOPIC ECZEMA M. LAIMER, H. HINTNER, P.
FRITSCH 202 18.1 PRIMARY AND SECONDARY IMMUNE DEFICIENCIES 202 18.2 THE
IMMUNE DEFECT IN ATOPIC ECZEMA 203 18.3 ECZEMA IN PRIMARY
IMMUNODEFICIENCY DISORDERS 204 18.4 PRIMARY IMMUNODEFICIENCY DISORDERS
FREQUENTLY ASSOCIATED WITH ATOPIC ECZEMA 204 18.5 PRIMARY
IMMUNODEFICIENCY DISORDERS OCCASIONALLY OR POSSIBLY ASSOCIATED WITH
ATOPIC ECZEMA 207 18.6 IS ATOPIC ECZEMA A FEATURE OF ACQUIRED
IMMUNODEFICIENCY DISORDERS? 210 18.7 COMMENTS AND CONCLUSIONS 210
REFERENCES 211 19 ATOPIC DISEASES IN FAMILIES M. UEHARA 213 19.1
INTRODUCTION 213 19.2 FAMILY HISTORY OF ATOPIC DISEASES 213 19.3
SUBTYPES OF ATOPIC DERMATITIS 214 19.4 PERSONAL HISTORY OF ATOPIC
RESPIRATORY DISEASES 214 19.5 DESCENDANT FAMILY HISTORY OF ATOPIC ECZEMA
215 19.6 PATERNAL AND MATERNAL EFFECT 215 REFERENCES 216 CONTENTS 20
HISTOPATHOLOGIC AND ULTRASTRUCTURAL ASPECTS OF ATOPIC ECZEMA M. FARTASCH
218 20.1 ECZEMATOUS SKIN IN ATOPIC ECZEMA 218 20.2 NONECZEMATOUS SKIN IN
ATOPIES 219 REFERENCES 220 21 PATHOPHYSIOLOGY AND CLINICAL MANIFESTATION
OF ITCH IN ATOPIC ECZEMA U. DARSOW, E. RIPPHOFF, J. RING 222 21.1
INTRODUCTION 222 21.2 PATHOPHYSIOLOGY 222 21.3 PROBLEMS OF MEASURING
CLINICAL ITCH WITH VISUAL ANALOG SCALES 223 21.4 THE EPPENDORF ITCH
QUESTIONNAIRE 224 21.5 THERAPY FOR ITCH 225 REFERENCES 227 22 CLINICAL
BASICS OF ATOPIC ECZEMA: SYNOPSIS B. PRZYBILLA, J. RING, T. RUZICKA 228
22.1 EPIDEMIOLOGY 228 22.2 CLINICAL PRESENTATION 228 22.3 HISTOPATHOLOGY
229 22.4 DIAGNOSIS 229 22.5 COMPLICATIONS 230 22.6 ASSOCIATED DISEASES
230 22.7 PSYCHOSOMATIC ASPECTS 231 22.8 NATURAL HISTORY 231 II
PATHOPHYSIOLOGY OF ATOPIC ECZEMA 23 CLINICAL GENETICS OF ATOPIC ECZEMA
F. SCHULTZ LARSEN 235 23.1 INTRODUCTION 235 23.2 METHODS FOR MAPPING
COMPLEX DISEASES. 235 23.3 ATOPIC ECZEMA/DERMATITIS SYNDROME 235 23.4
LINKAGE STUDIES 236 23.5 STATISTICS OF LINKAGE ANALYSIS 237 23.6
CANDIDATE GENE 237 23.7 GENOME SCREENS IN ATOPIC ECZEMA 238 23.8
CANDIDATE GENES IN ATOPIC ECZEMA 238 23.9 OTHER CHROMOSOMES 240 23.10
MATERNAL EFFECT AND GENOMIC IMPRINTING. 241 23.11 CONCLUSIONS 241
REFERENCES 241 24 THE MOLECULAR GENETICS OF ATOPY W. COOKSON 244 24.1
INTRODUCTION 244 24.2 CANDIDATE GENES 244 24.3 GENOME SCREENS 245 24.4
SINGLE GENE DISORDERS 248 24.5 MATERNAL EFFECTS 249 24.6 CONCLUSIONS 249
REFERENCES 250 25 GENETICS OF ATOPIC ECZEMA YOUNG-AE LEE, C. SODERHALL,
U. WAHN 255 25.1 GENETIC EPIDEMIOLOGY 255 25.2 APPROACHES TO THE GENETIC
ANALYSIS OF ATOPIC ECZEMA 256 25.3 CONCLUSION 262 REFERENCES 263 26
MECHANISMS OF IGE-REGULATION M. WORM, T. JAKOB 265 26.1 INTRODUCTION 265
26.2 MECHANISMS OF ALLERGIC SENSITIZATION: ALLERGEN UPTAKE, PROCESSING,
AND PRESENTATION 265 26.3 ACTIVATION, MIGRATION, AND MATURATION OF
ANTIGEN-PRESENTING CELLS 266 26.4 T CELL ACTIVATION AND POLARIZATION OF
THE T CELL RESPONSE 267 26.5 ORIGIN AND MATURATION OF B CELLS 269 26.6
IMMUNOGLOBULINS 270 26.7 ISOTYPE SWITCHING 270 26.8 ADDITIONAL FACTORS
OF IGE REGULATION 271 26.9 THERAPEUTIC IMPLICATIONS 272 REFERENCES 273
27 DENDRITIC CELLS IN ATOPIC ECZEMA T. KOPP, G. STINGL 275 27.1
INTRODUCTION 275 27.2 ANTIGEN-PRESENTING CELL SUBPOPULATIONS IN ATOPIC
ECZEMA SKIN 275 27.3 TYPES OF ANTIGEN-PRESENTING CELLS IN PERIPHERAL
BLOOD 278 27.4 IGE-FACILITATED AMPLIFICATION OF THE IMMUNE RESPONSE 279
27.5 ROLE OF DENDRITIC CELLS IN INITIATING, MAINTAINING, AND/OR
SILENCING THE ALLERGIC TISSUE INFLAMMATION 281 27.6 EFFECTS OF TOPICAL
CALCINEURIN INHIBITORS 282 REFERENCES 282 28 INFLAMMATORY DENDRITIC
EPIDERMAL CELLS^ A. WOLLENBERG ". 288 28.1 LANGERHANS CELLS 288 28.2
INFLAMMATORY DENDRITIC EPIDERMAL CELLS . 288 28.3 DELINEATION OF
INFLAMMATORY DENDRITIC EPIDERMAL CELLS FROM LANGERHANS CELLS . 289
CONTENTS XI 28.4 ONTOGENESIS OF INFLAMMATORY DENDRITIC EPIDERMAL CELLS
290 28.5 INFLAMMATORY DENDRITIC EPIDERMAL CELLS ARE PRESENT IN EARLY
ATOPIC ECZEMA LESIONS 290 28.6 INFLAMMATORY DENDRITIC EPIDERMAL CELLS
ARE PRESENT IN EXTRINSIC AND INTRINSIC ATOPIC ECZEMA 290 28.7
IGE-RECEPTOR EXPRESSION OF INFLAMMATORY DENDRITIC EPIDERMAL CELLS 290
28.8 IN SITU EXPRESSION OF COSTIMULATORY MOLECULES ON INFLAMMATORY
DENDRITIC EPIDERMAL CELLS 291 28.9 PINOCYTOSIS AND RECEPTOR-MEDIATED
ENDOCYTOSIS OF EPIDERMAL DENDRITIC CELLS 291 28.10 DIAGNOSTIC EPIDERMAL
DENDRITIC CELL PHENOTYPING 292 28.11 EPIDERMAL DENDRITIC CELLS IN SKIN
LESIONS UNDER TOPICAL THERAPY 292 28.12 OUTLOOK 293 REFERENCES 293 29
EXTRINSIC AND INTRINSIC ATOPIC ECZEMA N. NOVAK, T. BIEBER 296 29.1
INTRODUCTION 296 29.2 ALLERGIC ATOPIC ECZEMA 296 29.3 SKIN 297 29.4 THE
ROLE OF AEROALLERGENS AND FOOD ALLERGENS AND THE ATOPY PATCH TEST 299
29.5 THE ROLE OF MICROBIAL INFECTIONS 300 29.6 BLOOD 300 29.7 CONCLUSION
301 REFERENCES 301 30 MAST CELLS IN THE SKIN M.K. CHURCH 303 30.1 MAST
CELL ACTIVATION 304 30.2 MAST CELL MEDIATORS 305 30.3 CONCLUSIONS 308
REFERENCES 309 31 THE ROLE OF EOSINOPHILS IN ATOPIC ECZEMA D. SIMON 313
31.1 EVIDENCE FOR EOSINOPHIL INVOLVEMENT IN ATOPIC ECZEMA 313 31.2
MECHANISMS CAUSING EOSINOPHILIA 315 31.3 ACTIVATION OF AND
IMMUNOREGULATION BY EOSINOPHILS 317 31.4 EOSINOPHILS AS A THERAPEUTIC
TARGET 318 REFERENCES 319 32 ROLE OF T CELLS IN ATOPIC ECZEMA M. AKDIS,
J. VERHAGEN, K. BLASER, C.A. AKDIS 323 32.1 SKIN-SELECTIVE HOMING OF T
CELLS 323 32.2 MECHANISMS OF CUTANEOUS LYMPHOCYTE- ASSOCIATED ANTIGEN
EXPRESSION ON HUMAN T CELLS 324 32.3 T CELL CHEMOTAXIS IN ATOPIC ECZEMA
325 32.4 ROLE OF IL-5 AND IL-13 IN ATOPIC ECZEMA 326 32.5 ROLE OF
APOPTOSIS IN ALLERGIC INFLAMMATION 326 32.6 CONCLUSION 329 REFERENCES
329 33 KERATINOCYTES IN ATOPIC ECZEMA G. GIROLOMONI, F. MASCIA, C.
DATTILO, A. GIANNETTI, S. PASTORE 332 33.1 INTRODUCTION 332 33.2
KERATINOCYTES ACTIVELY PARTICIPATE IN THE INITIATION AND AMPLIFICATION
OF SKIN INFLAMMATORY RESPONSES 332 33.3 THE ROLE OF KERATINOCYTES IN THE
RECRUIT- MENT OF INFLAMMATORY CELLS IN ATOPIC ECZEMA 333 33.4
KERATINOCYTES FROM ATOPIC ECZEMA PATIENTS PRODUCE INCREASED AMOUNTS OF
GM-CSF AND OTHER PROINFLAMMATORY CYTOKINES 335 33.5 DYSREGULATED
ACTIVATION OF AP-1 TRANS- CRIPTION FACTORS MAY BE IMPLICATED IN THE
ENHANCED EXPRESSION OF INFLAMMATORY GENES BY ATOPIC ECZEMA KERATINOCYTES
335 33.6 CONCLUDING REMARKS 336 REFERENCES 336 34 INFLAMMATORY MEDIATORS
AND CHEMOKINES IN ATOPIC ECZEMA B. HOMEY, T. RUZICKA 340 34.1 THE
CHEMOKINE SUPERFAMILY 340 34.2 CHEMOKINE RECEPTORS AND TH1 AND TH2 CELLS
342 34.3 MEMORY T CELL RECRUITMENT TO THE SKIN 342 34.4 DENDRITIC CELL
TRAFFICKING 344 34.5 EOSINOPHIL RECRUITMENT 345 34.6 CONCLUSION AND
PERSPECTIVE 346 REFERENCES 346 35 CYTOKINES IN ATOPIC DERMATITIS
(ECZEMA) H. MIZUTANI 350 35.1 INTRODUCTION 350 35.2 GENETIC BACKGROUND
AND CYTOKINES 350 35.3 THL AND TH2 CYTOKINES 350 35.4 INFILTRATING CELLS
AND KERATINOCYTES 351 XII CONTENTS 35.5 CHRONIC LESION AND FIBROSIS 352
35.6 ACQUIRED TYPE ATOPIC ECZEMA/INNATE TYPE ATOPIC ECZEMA AND IL-18 352
35.7 EFFECTS OF SKIN LESIONS ON SYSTEMIC IMMUNITY 353 35.8 INTRINSIC AND
EXTRINSIC ATOPIC ECZEMA 353 35.9 CONCLUSION 354 REFERENCES 354 36
NEUROPEPTIDES AND ATOPIC ECZEMA F. FANTINI, C. PINCELLI 357 36.1
NEUROPEPTIDES AND THE SKIN 357 36.2 ROLE OF NEUROPEPTIDES IN ATOPIC
ECZEMA . 358 36.3 NEUROTROPHINS AND ATOPIC ECZEMA 359 REFERENCES 360
37 EPIDERMAL LIPIDS IN ATOPIC ECZEMA E. PROKSCH, R. FOLSTER-HOLST, J.-M.
JENSEN . 362 37.1 INTRODUCTION 362 37.2 PHYSIOLOGICAL ROLE OF LIPIDS
IN THE EPIDERMIS 362 37.3 ABNORMALITIES OF EPIDERMAL LIPIDS IN ATOPIC
ECZEMA 363 37.4 IMPAIRED CERAMIDE CONTENT AND METABOLISM IN ATOPIC
ECZEMA 363 37.5 CERAMIDES BOUND TO CORNIFIED ENVELOPE PROTEINS IN ATOPIC
ECZEMA 366 37.6 ROLES FOR FATTY ACIDS IN ATOPIC ECZEMA 366 37.7
DISTURBED EPIDERMAL BARRIER FUNCTION AND ENHANCED SKIN ALLERGEN
PENETRATION IN ATOPIC ECZEMA 368 37.8 LIPIDS IN THE TREATMENT OF ATOPIC
ECZEMA . 368 REFERENCES 369 38 THE PHENOMENON OF IRRITABLE SKIN IN
ATOPIC ECZEMA J. HUSS-MARP, B. EBERLEIN-KONIG, J. RING 373 38.1
INTRODUCTION 373 38.2 DEFINITION OF IRRITABLE SKIN 373 38.3
QUANTIFICATION OF IRRITABLE SKIN 373 38.4 DEFINITION OF IRRITABLE SKIN
IN ATOPIC ECZEMA 374 38.5 CLINICAL EVIDENCE OF IRRITABLE SKIN IN ATOPIC
ECZEMA 376 38.6 EXPERIMENTAL EVIDENCE OF IRRITABLE SKIN IN ATOPIC ECZEMA
376 38.7 PATHOPHYSIOLOGY OF IRRITABLE SKIN IN ATOPIC ECZEMA 377 38.8
CONCLUSION 378 REFERENCES 378 39 ENVIRONMENTAL POLLUTION AND ATOPIC
ECZEMA B. EBERLEIN-K6NIG, J. HUSS-MARP, H. BEHRENDT, J. RING 381 39.1
INTRODUCTION 381 39.2 FORMALDEHYDE 381 39.3 CONCLUSION 387 REFERENCES
388 40 THE ROLE OF INHALANT ALLERGENS IN ATOPIC DERMATITIS E.A. ERWIN,
J.A. WOODFOLK, T.A.E. PLATTS-MILLS 390 40.1 INTRODUCTION 390 40.2
PARALLELS TO ALLERGIC DISEASE 391 40.3 ATOPY PATCH TESTS 391 40.4
IMMUNOLOGY 392 40.5 AVOIDANCE 394 40.6 THE RELEVANCE OF OTHER ALLERGENS
395 40.7 CONCLUSION 396 REFERENCES 396 41 ROLE OF FOOD ALLERGY IN ATOPIC
ECZEMA T. WERFEL, K. BREUER 399 41.1 INTRODUCTION 399 41.2 PREVALENCE OF
FOOD ALLERGY IN ATOPIC ECZEMA 399 41.3 LATE ECZEMATOUS REACTIONS TO
FOODS IN ATOPIC ECZEMA 400 41.4 RATE OF LATE REACTIONS TO CHALLENGES
WITH FOODS 400 41.5 PREDICTIVE VALUES OF DIAGNOSTIC TOOLS 401 41.6
ALLERGEN-SPECIFIC T CELL RESPONSES IN ATOPIC ECZEMA 402 41.7
POLLEN-ASSOCIATED FOOD ALLERGY IN ATOPIC ECZEMA 402 REFERENCES 403 42
STAPHYLOCOCCUS AUREUS AND ATOPIC ECZEMA M. MEMPEL 406 42.1 SKIN
COLONIZATION 406 42.2 MECHANISMS OF ADHERENCE 406 42.3 VIRULENCE FACTORS
407 42.4 CONCLUDING REMARKS 408 REFERENCES 408 43 ANIMAL MODELS OF
ATOPIC ECZEMA A. TANAKA, H. MATSUDA 410 43.1 INTRODUCTION ^ 410 43.2
SPONTANEOUS ANIMAL MODELS FOR ATOPIC ECZEMA 410 43.3 INDUCIBLE ANIMAL
MODELS OF ATOPIC ECZEMA 415 43.4 GENE-OPERATED ANIMAL MODELS FOR ATOPIC
ECZEMA 415 CONTENTS XIII 43.5 FINAL REMARKS 415 REFERENCES 416 44
AUTOANTIBODIES IN ATOPIC ECZEMA N. MOTHES, I. MITTERMANN, K. AICHBERGER,
P. VALENT, R. VALENTA 417 44.1 INTRODUCTION 417 44.2 SIMILARITIES AND
CROSS-REACTIVITIES BETWEEN ENVIRONMENTAL ALLERGENS AND HUMAN PROTEINS:
THE CONCEPT OF IGE AUTOIMMUNITY IS REBORN 418 44.3 THE DISCOVERY THAT
THE OCCURRENCE OF IGE AUTOANTIBODIES IS FREQUENTLY ASSOCIATED WITH
ATOPIC ECZEMA 419 44.4 IDENTIFICATION OF IGE-REACTIVE AUTOANTIGENS BY
MOLECULAR CLONING 420 44.5 HOW INTRACELLULAR ANTIGENS CAN CONTRIBUTE TO
THE PATHOGENESIS OF ATOPIC ECZEMA 421 44.6 IGE AUTOREACTIVITY AS A
POSSIBLE MARKER FOR CHRONIC INFLAMMATION AND TISSUE DAMAGE IN ATOPIC
ECZEMA 421 44.7 IGG AUTOANTIBODIES IN ATOPIC ECZEMA PATIENTS 421 44.8
PATHOMECHANISMS OF IGE AUTOREACTIVITY . 422 REFERENCES 422 45
PATHOPHYSIOLOGY OF ATOPIC ECZEMA: SYNOPSIS J. RING, T. RUZICKA, B.
PRZYBILLA 426 45.1 INTRODUCTION 426 45.2 GENETIC PREDISPOSITION 426 45.3
DISTURBED SKIN BARRIER FUNCTION ("DRY SKIN") 427 45.4 ITCH AS A MAJOR
SYMPTOM OF ECZEMA 427 45.5 PSYCHOSOMATIC INTERACTION AND AUTONOMIC
NERVOUS SYSTEM DYSREGULATION 427 45.6 ROLE OF ALLERGY IN ATOPIC ECZEMA
428 45.7 ROLE OF IGE-MEDIATED SENSITIZATION 428 45.8 ROLE OF MICROBIAL
COLONIZATION AND INFECTION 428 45.9 ROLE OF CONTACT ALLERGY 429 45.10
ROLE OF IRRITANTS AND POLLUTANTS 429 45.11 CONCLUSION 429 MANAGEMENT OF
PATIENTS WITH ATOPY ECZEMA 46 PRIMARY PREVENTION OF ATOPY U. WAHN, R.
NICKEL, S. ILLI, S. LAU, C. GRUBER, E. HAMELMANN 433 46.1 INTRODUCTION
AND DEFINITION 433 46.2 THE NATURAL HISTORY OF ATOPIC MANIFESTATIONS 433
46.3 HEREDITARY FACTORS 434 46.4 NONGENETIC FACTORS 435 46.5 THE
DOMESTIC ENVIRONMENT 435 46.6 POSSIBLE CONSEQUENCES FOR PREVENTION 436
46.7 PRIMARY PREVENTION 437 46.8 SECONDARY PREVENTION 438 46.9
PERSPECTIVES AND CHALLENGES 438 REFERENCES 438 47 ROLE OF ALLERGY
TESTING IN ATOPIC ECZEMA U. DARSOW, J. RING 441 47.1 INTRODUCTION 441
47.2 FOOD ALLERGY IN ATOPIC ECZEMA 441 47.3 PRACTICAL APPROACH TO THE
PATIENT WITH SUSPECTED FOOD ALLERGY AND AE 442 47.4 AEROALLERGENS AND
ATOPIC ECZEMA 443 47.5 ATOPY PATCH TEST WITH AEROALLERGENS 444 47.6
OUTLOOK 446 REFERENCES 447 48 PROBIOTICS IN ATOPIC ECZEMA C. SCHNOPP 449
48.1 THE HYGIENE HYPOTHESIS 449 48.2 PRIMARY PREVENTION STRATEGIES IN
ATOPIC ECZEMA 449 48.3 PROBIOTICS FOR PRIMARY PREVENTION IN HIGH-RISK
FAMILIES 450 48.4 SUGGESTED MECHANISMS 452 48.5 REMAINING QUESTIONS 453
48.6 CONCLUSION 453 REFERENCES 454 49 MEASURING DISTURBED BARRIER
FUNCTION IN ATOPIC ECZEMA S. SEIDENARI, F. GIUSTI 456 49.1
TRANSEPIDERMAL WATER LOSS (TEWL) 456 49.2 SKIN HYDRATION AND TEWL 457
49.3 SKIN LIPIDS AND TEWL 458 49.4 REACTIVITY TO IRRITANTS 458 49.5
BARRIER FUNCTION IN ATOPIC PATIENTS WITHOUT DERMATITIS 459 49.6 TEWL AND
TOPICAL AGENTS FOR ATOPIC ECZEMA 459 REFERENCES 460 50 BASIC TOPICAL
THERAPY WITH EMOLLIENTS IN ATOPIC ECZEMA W. GEHRING 463 50.1
INTRODUCTION 463 XIV CONTENTS 50.2 AMPHIPHILIC SYSTEMS 464 50.3
HYDROPHILIC SYSTEMS 465 50.4 DESIRED VEHICLE EFFECTS: HYDRATION OF THE
STRATUM CORNEUM AND INDUCTION OF A DIFFUSION BARRIER AGAINST HYDROPHILIC
IRRITANTS 466 50.5 MODULATION OF VEHICLE EFFECTS BY GLYCEROL OR UREA 466
50.6 VEHICLE INFLUENCE UPON BIOLOGIC EFFECT OF TOPICALLY APPLIED DRUGS
466 REFERENCES 467 51 SYNDETS IN THE TREATMENT OF ATOPIC ECZEMA O.
BRAUN-FALCO, H.C. KORTING 468 51.1 CLEANSING OF ECZEMATOUS SKIN - THE
SCOPE OF THE PROBLEM 468 51.2 THE DEVELOPMENT OF SYNTHETIC DETERGENTS -
A REAL OPTION 469 51.3 DESIRABLE AND UNDESIRABLE EFFECTS OF SYNDETS ON
HUMAN SKIN - THE ROLE OF PH . 471 51.4 SYNDETS AND ECZEMATOUS SKIN -
CLINICAL ASSESSMENT 474 REFERENCES 474 52 TOPICAL TREATMENT WITH
GLUCOCORTICOIDS M. KERSCHER, S. WILLIAMS, P. LEHMANN 477 52.1
INTRODUCTION 477 52.2 MECHANISM OF ACTION 478 52.3 CORTICOSTEROID
CLASSIFICATION 480 52.4 LOCAL AND SYSTEMIC UNWANTED EFFECTS OF TOPICAL
GLUCOCORTICOIDS 482 52.5 INFLUENCE OF THE VEHICLE ON THE EFFECT OF
TOPICAL CORTICOSTEROID PREPARATIONS 484 52.6 ADDITIONAL ACTIVE
INGREDIENTS IN TOPICAL CORTICOSTEROID PREPARATIONS 485 52.7 ACCEPTANCE
OF THE USE OF TOPICAL CORTICOSTEROIDS 486 52.8 PRINCIPLES OF TOPICAL
TREATMENT WITH CORTICOSTEROIDS IN ATOPIC ECZEMA 487 52.9 TOPICAL
CORTICOSTEROIDS VERSUS TOPICAL INHIBITORS OF CALCINEURIN 488 REFERENCES
489 53 ANTIMICROBIAL THERAPY IN ATOPIC ECZEMA A. GAUGER, J. RING 492
53.1 ANTISEPTIC THERAPY 492 53.2 ANTIBIOTIC THERAPY 493 53.3
NONANTIBIOTIC THERAPY 495 53.4 ANTIMYCOTIC THERAPY 496 53.5 ANTIVIRAL
THERAPY 497 53.6 FUTURE PERSPECTIVES 498 53.7 CONCLUSION 499 REFERENCES
499 54 ANTIHISTAMINES IN ATOPIC ECZEMA T. ZUBERBIER 503 54.1
INTRODUCTION 503 54.2 FIRST GENERATION ANTIHISTAMINES 503 54.3
SECOND-GENERATION ANTIHISTAMINES 504 54.4 CLINICAL STUDIES 504
REFERENCES 505 55 CLIMATOTHERAPY IN ATOPIC ECZEMA E. VOCKS 507 55.1
INFLUENCE OF CLIMATE ON ATOPIC ECZEMA 507 55.2 HISTORY OF CLIMATOTHERAPY
508 55.3 CLIMATE AND WEATHER, CLIMATE ADAPTATION .511 55.4 HUMAN
BIOMETEOROLOGICAL RESEARCH 512 55.5 BASIC PRINCIPLES OF CLIMATOTHERAPY
513 55.6 CLIMATOTHERAPY IN ATOPIC ECZEMA 513 55.7 APPLICATION OF
CLIMATOTHERAPY 516 55.8 THERAPY RESULTS 517 55.9 CONCLUSION 520
REFERENCES 520 56 SKIN CARE IN ATOPIC ECZEMA M. KERSCHER, S. WILLIAMS
524 56.1 INTRODUCTION 524 56.2 GENERAL RECOMMENDATIONS 525 56.3
CLEANSING SEBOSTATIC SKIN IN ATOPIC ECZEMA 526 56.4 REHYDRATING
SEBOSTATIC SKIN IN ATOPIC ECZEMA 528 56.5 DECORATIVE COSMETIC 531
REFERENCES 531 57 DIETARY MANAGEMENT OF ATOPIC ECZEMA C. KUGLER 534 57.1
DEFINITIONS 534 57.2 PREVALENCE OF ADVERSE REACTION TO FOOD IN ATOPIC
ECZEMA 534 57.3 DIAGNOSIS 534 57.4 DIAGNOSTIC TYPES OF DIET 535 57.5
NUTRITIONAL RECOMMENDATIONS WHEN THERE IS A FOOD ALLERGY 537 57.6
PROGNOSIS FOR FOOD ALLERGIES 537 REFERENCES 538 58 PHOTOTHERAPY FOR
ATOPIC ECZEMA * J. KRUTMANN, A. MORITA 539 58.1 INTRODUCTION 539 58.2
UVA1 PHOTOTHERAPY FOR ACUTE, SEVERE ATOPIC ECZEMA 539 CONTENTS XV 58.3
PHOTOTHERAPY OF CHRONIC, MODERATE ATOPIC ECZEMA 540 58.4 PHOTOTHERAPY OF
ATOPIC HAND AND FOOT ECZEMA 541 58.5 MECHANISM OF ACTION 541 58.6
CONCLUDING REMARKS 541 REFERENCES 542 59 ATOPIC ECZEMA - PSYCHOSOMATIC
AND PSYCHOBIOLOGICAL ASPECTS U. GIELER 544 59.1 INTRODUCTION AND
HISTORICAL ASPECTS 544 59.2 QUALITY OF LIFE IN ATOPIC ECZEMA 544 59.3
PSYCHOLOGICAL ASPECTS - COMORBIDITY WITH ATOPIC ECZEMA 545 59.4 STRESS
AND ATOPIC ECZEMA 546 59.5 PSYCHOIMMUNOLOGY 546 59.6 COPING AND
COMPLIANCE IN ATOPIC ECZEMA 548 59.7 PSYCHODYNAMIC ASPECTS IN ATOPIC
ECZEMA 548 59.8 FAMILY ASPECTS 549 59.9 PATIENT MANAGEMENT PROGRAMS 549
59.10 MEASURES TO INFLUENCE THE ITCH- SCRATCH CYCLE 550 59.11 MEASURES
TO REDUCE NEGATIVE EFFECTS ON SOCIAL RELATIONSHIPS BY ATOPIC ECZEMA
PREVENTION PROGRAMS 551 59.12 STATUS OF THE EMPIRICAL RESEARCH CONCERN-
ING ATOPIC ECZEMA PREVENTION PROGRAMS .551 59.13 THE PSYCHOLOGICAL
TRAINING PROGRAM IN ATOPIC ECZEMA PREVENTION 553 REFERENCES 553 60
PHOSPHODIESTERASE 4 INHIBITORS FOR ATOPIC ECZEMA L.F. SANTAMARIA-BABI
557 60.1 GENERAL ANTI-INFLAMMATORY EFFECTS OF PDE 4 INHIBITORS 558 60.2
PDE 4 INHIBITORS IN SKIN INFLAMMATION . 558 60.3 POSSIBLE EFFECTS OF
PDE 4 INHIBITORS IN DIFFERENT PHASES OF ATOPIC ECZEMA 559 60.4
CONCLUSION 561 REFERENCES 561 61 MUSIC THERAPY IN ATOPIC ECZEMA D. MUNCH
565 61.1 WHEN IS IT REASONABLE TO USE MUSIC THERAPY? 565 61.2 FORMS OF
MUSIC THERAPY 566 61.3 SKIN AND PSYCHE 567 61.4 USE OF MUSICAL
COMPONENTS IN MUSIC THERAPY 568 61.5 EFFECT OF MUSIC ON HUMANS:
CONCLUSION . 568 61.6 CONCLUSION 568 REFERENCES 569 62 TOPICAL
IMMUNOMODULATORS IN THE TREATMENT OF ATOPIC ECZEMA S. REITAMO, A. REMITZ
570 62.1 INTRODUCTION 570 62.2 ACTIVATION OF INFLAMMATORY CELLS IN
ATOPIC ECZEMA 570 62.3 THE MODE OF ACTION OF TOPICAL IMMUNOMODULATORY
AGENTS 570 62.4 STAPHYLOCOCCAL COLONIZATION CONTRIBUTES TO SEVERITY OF
ATOPIC ECZEMA 571 62.5 TREATMENT WITH TOPICAL IMMUNOMODULATORS DOES NOT
SUPPRESS CONNECTIVE TISSUE . 571 62.6 EFFICACY OF TOPICAL
IMMUNOMODULATORS USED AS MONOTHERAPY IN ATOPIC ECZEMA . 571 62.7
EFFICACY OF TOPICAL IMMUNOMODULATORS USED TOGETHER WITH TOPICAL
CORTICOSTEROIDS 572 62.8 COMPARISON OF TACROLIMUS OINTMENT AND
PIMECROLIMUS CREAM 572 62.9 SAFETY 573 62.10 ADVERSE EVENTS ARE RELATED
TO DISEASE SEVERITY 573 62.11 DOES TOPICAL IMMUNOMODULATION INCREASE THE
RISK OF SKIN CANCER? 573 62.12 PRACTICAL USE OF TOPICAL IMMUNO-
MODULATORS 574 62.13 CONCLUSIONS 574 REFERENCES 574 63 ECZEMA SCHOOL:
PRACTICAL APPROACHES IN AN EFFICIENT MODULE OF TERTIARY PREVENTION
PROGRAMS M. PREMERLANI, Y. LUDEWIG, C. SCHNOPP, J. RING 576 63.1
INTRODUCTION 576 63.2 ECZEMA SCHOOL AT THE WOLFGANG CHILDREN'S HOSPITAL
IN DAVOS, SWITZERLAND 577 63.3 PEDAGOGIC BACKGROUND OF ECZEMA SCHOOLING
578 63.4 INTRODUCTION TO ECZEMA SCHOOL SESSIONS . 578 63.5 PEDAGOGIC
MODULES FOR THE MAIN PART 578 63.6 PEDAGOGIC METHODS FOR THE
CONCLUSION. 579 63.7 PEDAGOGIC TOOLS TO INCREASE SELF-ESTEEM AND
SELF-RESPECT 579 XVI CONTENTS 63.8 ORGANIZATION OF ECZEMA SCHOOL 579
63.9 CONCLUSION 580 REFERENCES 580 64 UNCONVENTIONAL TREATMENTS IN
ATOPIC ECZEMA T. SCHAFER 582 64.1 DEFINITION 582 64.2 USAGE IN THE
GENERAL POPULATION 582 64.3 USAGE OF COMPLEMENTARY ALTERNATIVE MEDICINE
FOR ATOPIC ECZEMA 583 64.4 UTILIZATION OF COMPLEMENTARY ALTERNATIVE
MEDICINE BY DERMATOLOGISTS 584 64.5 SPECIFIC COMPLEMENTARY ALTERNATIVE
MEDICINE MODALITIES 585 64.6 PHYTOTHERAPY 586 64.7 CHINESE HERBAL
MEDICINE 586 64.8 ACUPUNCTURE 586 64.9 AUTOLOGOUS BLOOD THERAPY 587
64.10 BIORESONANCE 587 64.11 HOMOEOPATHY 587 64.12 MASSAGE THERAPY AND
AROMA THERAPY . 587 64.13 SALT BATHS 588 64.14 VITAMINS AND MINERALS
588 64.15 HARMFUL EFFECTS 589 REFERENCES 589 65 ALTERNATIVE MEDICINE FOR
ATOPIC ECZEMA: A COMMENT R. HAPPLE 592 65.1 ROMANTICISM 592 65.2
TRADITIONAL CHINESE MEDICINE CAUSING COMPLETE RENAL FAILURE 592 65.3
ACUPUNCTURE 593 65.4 HOMEOPATHY 593 65.5 ALTERNATIVE MEDICINE WILL
ALWAYS EXIST . 594 REFERENCES 594 66 THERAPY OF ATOPIC ECZEMA:
SYNOPSIS T. RUZICKA, S. ARTIK, J. RING, B. PRZYBILLA . 596 66.1
INTRODUCTION 596 66.2 SKIN CARE 597 66.3 GLUCOCORTICOIDS 598 66.4
ANTIHISTAMINES 598 66.5 ANTI-INFECTIOUS TREATMENT 599 66.6 ULTRAVIOLET
TREATMENT 599 66.7 DIET 600 66.8 ENVIRONMENTAL CONTROL AND PREVENTION
. 601 66.9 PSYCHOTHERAPEUTIC APPROACHES 602 66.10 IMMUNOMODULATORS AND
IMMUNO- SUPPRESSIVE DRUGS 602 66.11 UNCONVENTIONAL THERAPY OPTIONS 603
66.12 SUMMARY AND OUTLOOK 603 SUBJECT INDEX 605 |
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| index_date | 2024-07-02T14:27:15Z |
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| spelling | Handbook of atopic eczema with 113 tables J. Ring ... (ed.) 2. ed. Berlin [u.a.] Springer 2006 XXII, 613 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Literaturangaben Clinical aspects of atopic eczema: Atopy: condition, disease or syndrome?.- History.- Epidemiology.- The burden of atopic eczema.- Clinical symptoms.- Atopic eczema in infants.- Stigmata of the atopic constitution.- Minimal forms.- Diagnosis.- Differential diagnosis.- Scoring systems.- Co-existing respiratory atopic diseases.- Complications and diseases associated with atopic eczema.- Diseases rarely associated with atopic eczema.- Natural history of atopic eczema.- Dry skin.- Occupational aspects with emphasis on atopic hand eczema.- Allergic contact dermatitis and atopic eczema.- Immunodeficiency syndromes and atopic eczema.- Atopic eczema as a psychosomatic disease.- Atopic diseases in families.- Histopathological and ultrastructural aspects.- Clinical manifestation of the itch sensation.- Clinical aspects of atopic eczema: Synopsis Pathophysiology of Atopic Eczema: Clinical genetics.-Molecular genetics of atopy.- Methods to study gene loci for atopic eczema.- IgE and regulation of IgE synthesis.- Langerhans cells in the pathophysiology.- Inflammatory dendritic epidermal cells (IDEC).- Intrinsic versus extrinsic atopic eczema.- IgG subclasses.- Mast cells in the skin.- Role of eosinophils.- T-lymphocytes.- Keratinocytes.- Inflammatory mediators and chemokines.- Cytokines.- Vascular reactivity.- Neuropeptides.- Pathophysiology of itch.- Epidermal lipids.- The phenomenon or irritable skin.- Role of aeroallergens.- Role of food allergy.- Microbial products and atopic eczema.- Environmental pollution and atopy.- Animal models.- Autoimmunity.- Pathophysiology of atopic eczema: Synopsis Management of patients with atopic eczema: Primary prevention of atopy.- Role of allergy testing.- Probiotic foods in the prevention.- Measuring disturbed barrier function.- Vehicles of topical treatment: Composition, principles of application and action.- Topical glucocorticosteroids.- Antimicrobial agents.- Antihistamines.- Clima-therapy.- Skin care and aesthetic medicine.- Dietary management.- Ultraviolet radiation therapy.- Psychotherapeutic approaches.- Phosphodiesterase inhibitors.- Therapy.- Systemic and topical immunomodulatory treatment.- Patient education programs.- Unconventional treatments.- Health economics.- Sense and nonsense of unconventional methods.- Management of patients with atopic eczema: Synopsi Endogenes Ekzem (DE-588)4223208-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Endogenes Ekzem (DE-588)4223208-9 s DE-604 Ring, Johannes 1945- Sonstige (DE-588)121882160 oth HEBIS Datenaustausch Mainz application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014753845&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Handbook of atopic eczema with 113 tables Endogenes Ekzem (DE-588)4223208-9 gnd |
| subject_GND | (DE-588)4223208-9 (DE-588)4143413-4 |
| title | Handbook of atopic eczema with 113 tables |
| title_auth | Handbook of atopic eczema with 113 tables |
| title_exact_search | Handbook of atopic eczema with 113 tables |
| title_exact_search_txtP | Handbook of atopic eczema with 113 tables |
| title_full | Handbook of atopic eczema with 113 tables J. Ring ... (ed.) |
| title_fullStr | Handbook of atopic eczema with 113 tables J. Ring ... (ed.) |
| title_full_unstemmed | Handbook of atopic eczema with 113 tables J. Ring ... (ed.) |
| title_short | Handbook of atopic eczema |
| title_sort | handbook of atopic eczema with 113 tables |
| title_sub | with 113 tables |
| topic | Endogenes Ekzem (DE-588)4223208-9 gnd |
| topic_facet | Endogenes Ekzem Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014753845&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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