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Hradetzky S.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Heratizadeh A.,Abteilung fur Immundermatologie und Experimentelle Allergologie
Allergologie | Year: 2015

The saprophytic yeast Malassezia sympodialis is a member of the skin microflora of healthy as well as of diseased skin. Skin colonization with Malassezia species can be found particularly in a subgroup of adult patients with AD, but may already be detected in diseased infants and children. However, specific characteristics of colonisation significantly differing from healthy individuals could not be identified so far. Regarding therapeutic intervention topical application of ciclopiroxolamine 1% cream over a period of 4 weeks or oral administration of itraconazole over 1 - 2 months is possible. Patients who may benefit from this treatment should suffer from a more severe, recalcitrant course of the disease with involvement of the headneck-shoulder region and sensitization to Malassezia species. Whereas the role of irritating metabolites and enzymes for AD is not clear yet, the sensitization to allergens from Malassezia sympodialis is specific for AD and might contribute to perpetuation and exacerbation of the disease, especially when those allergens share homology to other Malassezia species as well as to human proteins. © 2015 Dustri-Verlag Dr. Karl Feistle. Source


Heratizadeh A.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Werfel T.,Abteilung fur Immundermatologie und Experimentelle Allergologie
Allergologie | Year: 2015

During the last decade numerous studies focusing on strategies in primary prevention of allergic diseases have been published which are characterized by a broad variety of study concepts and hypotheses. However, for life-style risk factors such as consumption of tobacco or overweight specific effects on inflammation have now been observed also for atopic dermatitis (AD). Recently published studies on the relevance of a dysfunction of the epidermal barrier in AD revealed further promising results. In infants with filaggrinloss- of-function mutations exposure to cats significantly increased the risk of eczema. Indeed, there is now sufficient evidence for the benefit of cat's avoidance in predisposed families. Since IgE-sensitization to distinct food allergens has been demonstrated to correlate with the severity of the disease, sensitization via the skin in children predisposed for AD is discussed. Systematic analyses of the type-IV sensitization profile of individuals with AD versus non-atopic controls also revealed a higher risk of selected contact sensitizations. With regard to prevention strategies focusing on stabilizing the skin barrier function, a consequent use of emollients in predisposed infants during their first weeks of life has been demonstrated to significantly reduce the incidence of eczema. Table 1 represents an overview on studies cited in this article. © 2015 Dustri-Verlag Dr. Karl Feistle. Source


Heratizadeh A.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Werfel T.,Abteilung fur Immundermatologie und Experimentelle Allergologie
Monatsschrift fur Kinderheilkunde | Year: 2015

This article presents an overview of recent study data on the prevention of atopic dermatitis (AD) and sensitization during childhood. Recommendations from the current German guidelines on prevention of allergic diseases are presented from the dermatologist’s perspective while focusing on environmental conditions, such as keeping pets and exposure to house dust mites, topical therapy and life style conditions as well as aspects of topical therapy in children with AD predisposed to AD. © 2015, Springer-Verlag Berlin Heidelberg. Source


Heratizadeh A.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Werfel T.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Rosner L.M.,Abteilung fur Immundermatologie und Experimentelle Allergologie
Hautarzt | Year: 2014

Due to a broad variety of extrinsic trigger factors, patients with atopic dermatitis (AD) are characterized by complex response mechanisms of the adaptive immune system. Notably, skin colonization with Staphylococcus aureus seems to be of particular interest since not only exotoxins, but also other proteins of S. aureus can induce specific humoral and cellular immune responses which partially also correlate with the severity of AD. In a subgroup of AD patients Malassezia species induce specific IgE- and T cell-responses which has been demonstrated by atopy patch tests. Moreover, Mala s 13 is characterized by high cross-reactivity to the human corresponding protein (thioredoxin). Induction of a potential autoallergy due to molecular mimicry seems therefore to be relevant for Malassezia-sensitized AD patients. In addition, sensitization mechanisms to autoallergens aside from cross-reactivity are under current investigation. Regarding inhalant allergens, research projects are in progress with the aim to elucidate allergen-specific immune response mechanisms in more depth. For grass-pollen allergens a flare-up of AD following controlled exposure has been observed while for house dust mite-allergens a polarization towards Th2 and Th2/Th17 T cell phenotypes can be observed. These and further findings might finally contribute to the development of specific and effective treatments for aeroallergen-sensitized AD patients. © 2014, Springer-Verlag Berlin Heidelberg. Source


Wichmann K.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Heratizadeh A.,Abteilung fur Immundermatologie und Experimentelle Allergologie | Werfel T.,Abteilung fur Immundermatologie und Experimentelle Allergologie
Hautarzt | Year: 2012

Food allergy predominantly affects children rather than adult patients with atopic dermatitis (AD). Early sensitization to foods has been found to be significantly associated with AD. Three different patterns of clinical reactions to food allergens in AD patients exist: i. immediate-type reaction, ii. isolated late-type reaction, iii. combined reaction (i. + ii.). While in children allergens from cow's milk, hen's egg, soy, wheat, fish, peanut or tree nuts are mostly responsible for allergic reactions, birch-pollen related food allergens seem to play a major role in adolescent and adults with AD in Central and Northern Europe. Defects of the epidermal barrier function seem to facilitate the development of sensitization to allergens following epicutaneous exposure. The relevance of defects of the gut barrier as well as genetic characteristics associated with an increased risk for food allergy remain to be further investigated. Numerous studies focus on prevention strategies which include breast-feeding or feeding with hydrolyzed milk substitute formula during the first 4 months of life. © Springer-Verlag 2012. Source

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