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  Authority of Polish Society of Allergology

vol 16. no 4. December 2011  

 Review articles
Fungal infections in atopic eczema patients
Roman Nowicki

Atopic dermatitis (AD) is a multifactorial, chronic inflammatory skin
disease with a genetic predisposition, which can be triggered by different
allergens and various environmental factors. Patients with AD
exhibit defects in innate and acquired immune responses resulting
in a heightened susceptibility to bacterial, viral and fungal infections
(dermatophytes, Malassezia spp, Candida spp). Defective immunity is
related to: damaged barrier of stratum corneum (genetic defect of
filaggrin gene and ceramides), and reduced production of antimicrobial
peptides by keratinocytes. Especially patients with head and neck
atopic dermatitis (HND) are more likely to have positive skin prick test
results and Malassezia-specific IgE compared with healthy control subjects
and patients with atopy without HND. Clinically, Malassezia allergy
may be suspected in patients with AD and: head and neck lesions,
exacerbations during adolescence and severe lesions recalcitrant to conventional
therapy. The reaction to fungal infections is related to both
humoral- and cell-mediated immunity. The fungal infections are well
documented triggers of AD and always deserve critical consideration in
a patient whose condition has deteriorated. During the exacerbations
of AD, treatment with proper antimycotic agents has been shown to
be of great value.

keywords: atopowe zapalenie skóry, bariera naskórkowa, C. albicans, Malassezia spp, leczenie, atopic dermatitis, skin barrier, C. albicans, Malassezia spp, treatment

pages: from 177 to 180

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