mometasone-furoate and Staphylococcal-Skin-Infections

Atopic dermatitis (AD) is aggravated by mechanical irritation and bacterial colonization.. This study compared the efficacy of an antimicrobial silk fabric (DermaSilk) with that of a topical corticosteroid in the treatment of AD.. Fifteen children were enrolled and wore a dress, where the left side was made of DermaSilk and the right side was made of cotton. The right arm and leg were treated daily with the corticosteroid mometasone for 7 days. The treatment efficacy was measured with a modified EASI (Eczema Area and Severity Index) and with an assessment by the patients/parents and by a physician. All patients were evaluated at baseline, as well as 7 and 21 days after the initial examination.. All parameters showed that, irrespective of the treatment, there was a significant decrease of eczema after 7 days. No significant difference between DermaSilk-treated and corticosteroid-treated skin could be observed.. DermaSilk showed potential to become an effective treatment of AD.

Topics: Administration, Cutaneous; Anti-Allergic Agents; Anti-Bacterial Agents; Child; Child, Preschool; Clothing; Colony Count, Microbial; Dermatitis, Atopic; Eczema; Female; Humans; Infant; Male; Microbial Sensitivity Tests; Mometasone Furoate; Pregnadienediols; Silk; Staphylococcal Skin Infections; Staphylococcus aureus; Treatment Outcome

Staphylococcus aureus has important implications for the pathogenesis of atopic dermatitis (AD). In some patients S. aureus can be eradicated from the skin during anti-inflammatory treatment, while in others bacterial colonization is persistent. Potential mechanisms and features of these two distinct groups of patients are not known.. Accordingly, we studied relationships between the ability to eliminate S. aureus during an anti-inflammatory treatment and selected clinical and immunological features.. Quantitative assessment of S. aureus on the skin, in nasal vestibule and throat, serum IgE levels, CD4/CD8 T-cell ratio, lymphocyte proliferation and phagocyte oxidative burst were determined during the exacerbation and after 4 and 12 weeks of the treatment using topical steroid and oral antihistamine in 34 patients with AD.. S. aureus was found on the skin of all 34 patients during exacerbation. Disease severity scoring of atopic dermatitis (SCORAD) correlated with the density of bacteria. Treatment with oral antihistamine and topical steroid resulted in a significant alleviation of symptoms, which correlated with the elimination of S. aureus from the skin in 70% of patients. In the remaining 30% of patients, dense (more than 10(10)/cm2) S. aureus skin colonization, persisted despite the treatment. Patients with persistent S. aureus presented with higher serum IgE levels, lower lymphocyte proliferation in response to staphylococcal enterotoxin B, phytohaemagluttinin and anti-CD3. Persistence of S. aureus was more common in men.. Patients with AD differ in the ability to clear S. aureus from the skin during anti-inflammatory treatment, which appears to be related to the abnormalities in immunological parameters. Local antibiotic therapy should be considered only in patients with persistent S. aureus colonization.

Topics: Administration, Topical; Adult; Anti-Allergic Agents; CD4-CD8 Ratio; Cetirizine; Dermatitis, Atopic; Female; Histamine H1 Antagonists, Non-Sedating; Humans; Immunoglobulin E; Male; Mometasone Furoate; Nose; Pharynx; Pregnadienediols; Skin; Staphylococcal Skin Infections; Staphylococcus aureus