Eczema's Gene Mutation Picture

Recent research has discovered the gene defect that causes genetic skin conditions such as eczema. Although shielding lotions are effective treatment for eczema in many cases, if you find you are resistive to treatment, you may be one of the estimated 60 million people worldwide that carry these gene defects, and it may be causing your eczema.The research, conducted by experts on genetic skin disorders at the University of Dundee, with collaborators in Dublin, Glasgow, Seattle and Copenhagen, was published in two consecutive papers in the March and April editions of Nature Genetics.The defect involves a gene that produces filaggrin, a protein that helps form a protective layer on the skin surface to keep moisture in, and toxins out. It is normally found in large quantities in the outermost layers of the skin.When the level of filaggrin is inadequate, the protective barrier is compromised, causing the skin to dry out too easily and the outer layers to flake off. Additionally, the lack of protection allows toxins to enter the skin, which then causes the inflamed condition known as eczema. The researchers also concluded that, in addition to causing eczema, the absorption of the toxins through the skin, which then later enter the lungs, may also lead to the asthmatic conditions which often accompany the skin problems.The Dundee group is currently working on developing methods to treat the underlying causes of the defect, and to thereby find something to treat and prevent the diseases.One report also stated that the currently available treatments for eczema only relieve the symptoms - emollients to prevent the skin from drying out, and steroids to treat the inflammation – and this discovery presents the opportunity to treat the cause.Although the discovery of filaggrin deficiency may open the door to some form of treatment in the future, there is a solution available right now that thousands of doctors recommend – shielding lotions. A good barrier then locks in your own natural oils and moisture, keeps the irritants out, and allows your skin to heal.

Hand Eczema May Be Caused By Soaps And Other Irritants In The Workplace

Hand eczema caused by soaps and other irritants in the workplace may lead to unemployment or prolonged sick leaves from work for some individuals, according to an article in the March issue of Archives of Dermatology.
Hand eczema or dermatitis is characterized by redness and inflammation of the hands, often due to irritants in soap, chemicals or detergents. "Occupational hand eczema (OHE) has become a disease of increasing importance during recent decades because of its serious consequences, such as frequent eruptions and risk of prolonged sick leave," background information in the article states. OHE also greatly affects quality of life (QOL). Past studies name OHE as the most frequently recognized occupational disease in Denmark and many Western countries.
Rikke Skoet Cvetkovski, M.D., Ph.D., of the University of Copenhagen, Hellerup, Denmark, and colleagues studied patients with OHE to identify predictive risk factors for the disease. Patients listed in the Danish National Board of Industrial Injuries Registry as having OHE between Oct. 1, 2001, and Nov. 10, 2002, received questionnaires regarding sick leave, loss of job, depression, health-related quality of life and their eczema's severity. A follow-up questionnaire was sent one year after the first was returned. Of the 621 patients who responded to the first questionnaire, 564 (386 women and 178 men) completed the follow-up.
During follow-up, 25 percent of surveyed patients had persistently severe or aggravated OHE, 41 percent improved and 34 percent of patients experienced unchanged minimal or mild to moderate OHE. The groups most affected by OHE were butchers, kitchen workers and cooks, hairdressers and patients aged 25 to 29 years. Having a severe case of OHE, being 40 years of age or older and having a low self-rated quality of life predicted unemployment and prolonged sick leave (more than five weeks in the past year). Also, patients with a lower socioeconomic status (based on education and job status) were at high risk for prolonged sick leave, a change of job and unemployment.
"Predictive factors could be used by clinicians to guide treatment and to select early risk management strategies," the authors write. "To avoid prolonged sick leave that may lead to social and economic decline, physicians must try to identify subgroups of patients who are at greater risk of a poor outcome."

Basic Skin Care For Eczema

Initial and ongoing treatment for dermatitis should include:
Avoiding dry skin. Keep your skin hydrated through proper bathing and using moisturizers. This includes bathing in warm water, bathing for only 3 to 5 minutes, avoiding gels and bath oils, and using only nondrying soaps;
Apply a moisturizer immediately after bathing; avoiding irritants that causes a rash or make a rash worse. These include soaps that dry the skin, perfumes, and scratchy clothing or bedding;
Avoiding possible allergens that cause a rash or make a rash worse. These may include dust and dust mites, animal dander, and certain foods, such as eggs, peanuts, milk, wheat, or soy products;
Controlling itching and scratching. Keep your fingernails trimmed and filed smooth to help prevent damaging the skin when scratching. You may want to use protective dressings to keep from rubbing the affected area. Put mittens or cotton socks on a baby's hands to help prevent him or her from scratching the area.

Immunosuppressant May Help in Refractory Eczema

The immunosuppressant Imuran (azathioprine) may offer some relief to patients with eczema that is refractory to standard topical treatment, according to researchers here.
Twelve weeks of treatment with the drug resulted in modest but significant improvements in eczema symptoms and overall quality of life, reported Simon J. Meggitt, M.D., a dermatologist at the Royal Victoria Infirmary here, in the March 11 issue of The Lancet.
The parallel-group, double-blind, placebo-controlled trial included 63 patients with moderate-to-severe eczema not responding to topical steroid treatment. Two-thirds received Imuran and one-third placebo once-daily. Dosing of Imuran was based upon ability to metabolize the drug, as judged by measurements of the activity of the thiopurine methyltransferase enzyme.
At week 12, the treatment group had a 37% reduction of symptoms compared with 20% for the placebo group. This 17% difference was statistically significant (95% confidence interval=4%-29%).
Compared with placebo, the treatment group also had significant improvements in global assessment and quality of life scores as rated by patients (P=.05) and investigators (P=.01).
Although the difference in symptom reduction between the treatment and placebo groups was modest, the authors said, "in view of the significant improvements that were also seen in secondary outcome variables, we feel that overall azathioprine treatment does produce a clinically relevant change in eczema severity, in particular because quality of life and global response are thought to be meaningful indicators of change in eczema."
Adverse events were generally mild, with nausea the most commonly reported side effect, which necessitated dose reduction in seven individuals. Four participants could not tolerate even small doses and withdrew from the study. Drug hypersensitivity (fever and myalgia) occurred in two participants.
There was a wide variation among individuals in response to the drug, and its mechanism of action in atopic eczema is not known, the investigators said.
The results of this study warrant further investigation of Imuran for eczema and other inflammatory disease, they concluded.
In the United States, the drug is used to treat rheumatoid arthritis and to prevent rejection of kidneys after transplant. Off-label uses include treatment of inflammatory bowel disease and lupus erythematosus.

Top Ten Contact Dermatitis Allergens Identified

Almost anything that comes in contact with the skin can cause allergic contact dermatitis. It occurs when the body's immune system senses a known allergen and reacts to expel it. This skin reaction or inflammation usually manifests with swollen, reddened and itchy skin.
The top ten contact dermatitis allergens indentified in this study were:

Nickel (nickel sulfate hexahydrate)Nickel is found in many products.
It can be found in jewelry, buckles, zippers, snaps, buttons, hair-pins, and metal clips. Be aware that any metal product may contain nickel.

Gold (gold sodium thiosulfate)Gold is a precious metal often found in jewelry and also used in the denistry field.

Balsam of Peru (myroxylon pereirae)Balsam of Peru originates from a tree resin and is used in fragrances, skin care products, flavoring in foods, health and beauty aids, and medicinal creams and oitments. Not only is Balsam of Peru aromatic, but it delays evaporation and also acts as a mild antibacterial, antifungal and antiparasitic.

Thimerosal Thimerosal is a mercury compound used in local antiseptics and in vaccines. It is used as a perservative in many items such as cosmetics, pharmaceutical products, vaccines, and skin prict test antigens.

Neomycin sulfate Neomycin sulfate is an antibacterial used widely in first-aid or antibiotic creams and ointments, eye and ear preparations. It is also used in combination with other antibacterials corticosteroids. These combination preparations treat a variety of skin, eye, and ear infections.

Fragrance mix Fragrance mix is a sceening agent that is used to pinpoint the cause of a large percentage of skin allergies. This fragrance mix contains eight known skin sensitizers which are found in foods, cosmetic products, insecticides, antiseptics, soaps, perfumes, and dental products.

Formaldehyde Formaldehyde is a chemical widely used in many building materials and household products. It is a preservative with multiple uses. Some of the sources of formaldehyde include paper products, paints, medications, household cleaners, cosmetic products and fabric finishes. It is impossible to list all the sources of formaldehyde exposure.

Cobalt chloride Cobalt chloride is a metal that is found in medical products such as Vitamin B12 preparations, metal prostheses and dental plates. It is also present in many metal plated objects such as snaps, button, or tools. Because cobalt pigment produces light brown shades of hair, it is used in hair dye. It can also be found in antiperspirant preparations. Cobalt blue pigment can be found in porcelain, glass, pottery, ceramics, enamels, and blue or green water colour paints and crayons.

Bacitracin Bacitracin is a topical antibiotic that is used for a variety of localized skin and eye infections.

Quaternium 15 Quaternium 15 is a formaldehyde-releasing preservative found in cosmetics products such as eye make-up, foundations, powders. It can also be found in shampoos, soaps, self-tanners, baby powders, nail polish and sunscreen. Commercial and industrial products such as adhesives, floor waxes or polishes, latex paints, paperboard, laundry starch, and water based inks also may contain Quaternium.

New Drug Extends Remission of Atpic Dermatitis

Stiefel Laboratories, the world's largest independent pharmaceutical company specializing in dermatology, announced that a recent study shows MimyX(TM) Cream extends the remission period of atopic dermatitis (AD) by 48 percent when used in conjunction with an emollient compared to emollient alone. MimyX(TM) Cream, Stiefel's new product for managing the signs and symptoms of atopic dermatitis, is a steroid-free, topical Rx therapy for the management of the disease, commonly referred to as eczema.
Most eczema patients will experience periods of "flares" where they have noticeable signs and symptoms of AD alternating with periods of remission where no symptoms are present. According to the 12-week MimyX study involving 74 individuals, MimyX(TM) Cream extends AD remission by 48 percent and may actually reduce the total number of flares a person experiences. The study also shows a 25 percent greater incidence of AD flare-ups on the side of the body where only an emollient was used, as opposed to the side of the participant's body where MimyX(TM) Cream was used in conjunction with an emollient.
"The data collected in this study is very beneficial for understanding and managing atopic dermatitis," said Dr. Joseph Fowler, University of Louisville. "By extending the remission of eczema, we can reduce the total number of flares a patient may experience, and quite possibly lessen the need for adjunctive therapy such as steroids, immunomodulators and systemic antihistamines."
MimyX(TM) Cream is unique from other eczema treatments in that it can be used throughout the AD continuum. MimyX(TM) Cream can be used along with a short-term anti-inflammatory agent during flares and it can also be used without the anti-inflammatory for daily management during remission. (1)
According to Jim Hartman, Vice President, U.S. Marketing, Stiefel, this is a significant finding.
"This study justifies MimyX(TM) as a potential foundation therapy for atopic dermatitis," Hartman said. "Not only is it useful for the management of the signs and symptoms of AD, it has also been shown clinically to extend remission periods of the disease."
Time To Flare Study Background
The objective of the MimyX(TM) Cream Time to Flare (TTF) study was to determine the efficacy of twice daily application of MimyX(TM) Cream added to twice daily emollient maintenance therapy in reducing the risk of relapse of chronic AD. Specifically, the addition of MimyX(TM) Cream to emollient therapy was compared to emollient therapy alone with regard to time until flare.
This was a six-center, investigator-blinded, randomized bilateral study in which subjects with AD were assigned to one of two groups. Group 1 applied MimyX(TM) Cream twice daily to all affected areas on the right side of the body. Group 2 applied MimyX(TM) Cream twice daily on all affected areas on the left side of the body. After applying MimyX(TM) Cream, subjects in both groups applied a non-medicated emollient (Eucerin® Cream) twice daily to the same areas on both sides of the body and any other areas of dry skin. Therapy occurred over a 12-week period with examinations of the subjects initially (week 0, visit 1) and at weeks 2, 4, 6, 8, 10 and 12 (visits 2-7). Rescue medication (Triamcinolone Cream 0.1%) was provided in the event of flare.
Approximately 4 percent of patients experienced adverse events (possibly or probably) related to the use of MimyX Cream like burning (n=1), uticaria (n=1) and headache (n=1) during the study.