Atopic Palmoplantar Eczema

ISBN-13: 9783540178637 / Angielski / Miękka / 1988 / 144 str.

Hans Joachim Schwanitz

Opis

The field of dermatology has very much changed during the last decades. An ever-increasing knowledge about the pathogenesis of diseases of the skin has made it possible to not only better classify but also to make dermatoses better explainable and understandable. The present book exemplifies this with a very common disease, the dyshidrotic eczema of the hands. Most current textbooks still describe "dyshidrosis" as a disease of the eccrine sweat glands, as was first postulated in 1873 by T. Fox. In 1962, R. D. G. P. Simons challenged this concept and since then, it has not been possible to establish a uniform pathogenetic concept regarding "dyshidrosis." The only generally accepted view is that the dermatosis has multiple etiologies. This monograph is intended to be a follow-up to Simons' book published in 1966, entitled Eczema of the Hands. Investigations into Dyshidrosiform Eruptions. It repre sents an attempt to view the clinical and experimental aspects of atopic palmoplantar eczema as a basis for an understanding of the entire entity of dyshidrosis. My special thanks go to Prof. Dr. E. Macher, Miinster, who made it possible for me to complete this work, to Prof. Dr. S. Nolting, Miinster, who aroused my interest in the subject, and to Prof. Dr. P. Frosch, Heidelberg, who generously provided the necessary technical equipment for investiga tional use. Clinical examinations are impossible without patients and control per sons. I would like to thank all the people who took part in this project."

Spis treści

1 What is “Dyshidrosis”?.- 1.1 Symptoms.- 1.2 Sweat Glands.- 1.3 Parasites.- 1.4 ID Reactions to Dermatophytes.- 1.5 Allergy.- 1.6 Atopy.- 1.7 Various Other Theories.- 1.8 “Dyshidrotic Eczema” — An Eczema of Unknown Etiology.- 1.8.1 “Dyshidrosis” — An Eczema.- 1.8.2 The Unknown Etiology of “Dyshidrosis”.- 1.8.3 The Problematic Nature of the Terms Dyshidrosis, Dyshidrotic and Dyshidrosiform.- 1.8.4 Aims of the Present Investigations.- 2 Clinical Investigations.- 2.1 Statistics.- 2.2 Age.- 2.3 Sex.- 2.4 Age of Manifestation and Course of the Disease.- 2.5 Clinical Features.- 2.5.1 Symmetry.- 2.5.2 Vesicles.- 2.5.3 Redness.- 2.5.4 Scaling.- 2.5.5 Itching.- 2.5.6 Relationship between Symptoms and Severity of the Eczema.- 2.5.7 Changes of the Nail.- 2.6 Cigarette Smoking.- 2.7 Familial Predisposition.- 2.8 Triggering Mechanisms.- 2.8.1 Exogenous Factors.- 2.8.2 Endogenous Factors.- 2.9 Psychosocial Consequences.- 3 Experimental Studies.- 3.1 Thermometry.- 3.1.1 Methods.- 3.1.2 Results.- 3.1.3 Discussion.- 3.2 Hygrometry.- 3.2.1 Methods.- 3.2.2 Results.- 3.2.3 Discussion.- 3.3 Mycology.- 3.3.1 Materials and Methods.- 3.3.2 Results.- 3.3.3 Discussion.- 3.4 Allergy.- 3.4.1 Materials and Methods.- 3.4.2 Results.- 3.4.3 Discussion.- 3.5 Inflammatory Mediators.- 3.5.1 Materials and Methods.- 3.5.2 Results.- 3.5.3 Discussion.- 4 Studies Concerning the Atopy Syndrome.- 4.1 Patient History.- 4.2 Eosinophils.- 4.3 Immunoglobulin E.- 4.4 White Dermographism.- 5 Atopic Palmoplantar Eczema — Discussion of the Experimental Results.- 5.1 Historical Aspects.- 5.2 Genetic Factors.- 5.3 Clinical Aspects.- 5.4 Causes.- 5.4.1 Theoretical Considerations.- 5.4.2 Practical Aspects.- 5.5 Secondary Effects of the Disease.- 5.5.1 Secondary Infections or Infestations.- 5.5.2 Allergic Sensitization.- 5.5.3 Increased Sweating.- 5.6 Differential Diagnosis.- 6 Therapy.- 6.1 Previous Methods.- 6.2 Current Status.- 6.3 New Approaches.- 6.3.1 Effect of Topical Psoralen Application and UVA Radiation (PUVA) — a Unilateral Controlled Study.- 6.3.1.1 Materials and Methods.- 6.3.1.2 Results.- 6.3.1.3 Discussion.- 6.3.2 Etretinate Therapy.- 6.3.2.1 Materials and Methods.- 6.3.2.2 Results.- 6.3.2.3 Discussion.- 7 Future Aspects.- References.