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| |  Study Characterises Eczema Patients Most at Risk for Dangerous Viral Infections DENVER, Colo -- June 26, 2009 -- Patients with eczema at risk for serious viral infections have more severe disease, are more likely to be allergic to food and other allergens, and have a frequent history of staph infections, according to a study published in the June 22 online version of []The Journal of Allergy and Clinical Immunology. []The findings could help identify people at risk for serious complications of smallpox vaccination, and point to defects in the skin barrier and antimicrobial-protein production as possible causes for the increased susceptibility.“Previous studies have suggested that eczema is not only becoming more prevalent, but that patients have increased susceptibility to disseminated viral infections,” said senior author Donald Leung, MD, Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado.“Our study is the largest and first in the United States to carefully characterize eczema patients who have suffered widespread herpes simplex viral infections of their skin. It is also the first to report that these patients are more susceptible to []staphylococcus[] and other infections of the skin and eye.”Researchers from the Atopic Dermatitis Vaccinia Network (ADVN) believed that they might be able to identify patients with eczema at high risk for these infections and to obtain clues about the mechanisms of susceptibility by studying a large cohort of patients who had suffered eczema herpeticum, the herpes simplex viral skin infections.They examined a wide variety of demographic, pathologic, and biologic characteristics in 901 individuals, 138 of whom had suffered eczema herpeticum.They found that patients with eczema susceptible to herpes simplex infections had more severe disease, earlier age of disease onset, more frequent history of other allergic diseases such as food allergy, asthma and hay fever, more allergic biomarkers, and more frequent skin infections with other microbes.“These characteristics associated with eczema herpeticum should help us identify young patients at greater risk for eczema herpeticum so that we can be more vigilant with them and better equipped to prevent this serious complication of eczema,” said Dr. Leung.The greater allergic disease and sensitisation, as well as infection by other microbes, point to a potential mechanism for the increased susceptibility to viral skin infections. An emerging model of eczema highlights the importance of skin-barrier defects and a lack of antimicrobial proteins among eczema patients. The skin-barrier defect is believed to result in the greater allergic sensitization among eczema patients in general. The even higher allergic sensitization among EH patients suggests the skin-barrier defect is particularly acute in those patients.The higher levels of infections with []staphylococcus[] and other microbes suggests that EH patients may be particularly lacking in antimicrobial proteins.SOURCE: National Jewish Health
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