الفهرس | Only 14 pages are availabe for public view |
Abstract Atopic dermatitis is a chronic and relapsing inflammatory skin disease that often begins in infancy. It is characterized by typically distributed eczematoid skin lesions with lichenification and pruritic excoriations. As in other atopic diseases a familial disposition and an increasing incidence have beenreported over the last few years. Diagnosis of AD depends mainly on history, morphology and distribution of the disease according to initiating allergen is very important but noteasy and can be reached by careful history taking and prick test which can provide a confirmatory evidence to suspected allergen. Immunologically it had been found that there is a defect in the suppressor T-cell (T8) population in AD patients which permits the formation of excess anaphylactic antibodies mainly IgE. The etiology in chronic urticaria remains unknown in most cases; the term chronic idiopathic urticaria indicates exclusion urticarial vasculitis, predominant physical urticarias, causative food or drugs. In this group of patients, no etiological factor can be considered responsible for the diseasestate despite thorough initial evaluation and follow up for several years. Even when other diseases are discovered in association, no causal relationship can be demonstrated, as removal of the presumed underlying etiology does not result in resolution of the urticaria. Chronic urticaria is a frustrating problem that taxes the physician and worries the patient, although its diagnosis is very simple as urticaria wheals are distinctive from other dermatological lesions, but to search for a cause or to classify the type, this is the challenging problem. Among the most common etiologic factors for chronic urticaria is the drugs, almost any drug can be aggravating factor for urticaria especially penicillins, aspirin and nun-steroidal anti-inflammatory drugs. Food additives and food dyes are incriminated to cause urticaria; various infectious agents can produce urticaria. Internal diseases are the light as a hidden aggravating factor for urticaria. Stress and psyche are truely important urticariogenic factors, most patients even children complain of appearance of wheals or aggravation of the condition when emotional factors, are involved. There are different philosophies about the evaluation of chronic urticaria patients, one approach states that since the treatment of chronic urticaria is almost the same regardless of the cause, and since routine, investigations rarely discover an etiology, thorough evaluation of the patient is unnecessary and warranted. A different school of though recommends extensive investigations to determine the underlying etiology. Their point of view is that even if the investigations cannot point towards avoiding offending agents, it can reassure the patient systemic or life-threatening problem does not exist. Thus, in the assessment of a chronic urticaria patient, a thorough, detailed history must obtained with review of all systems. For selected patients only, according to the findings obtained from the detailed his way, investigations are done for example a complete blood count, serum chemistries total protein, (albumin), liver function tests, etc Anti DNA antibodies are measured when there are symptoms of collagen-vascular diseases. Allergy skin tests and routine food testing are often not helpful in evaluating patients-with chronic urticaria. Neopterin is a biochemical marker for the activation of cellular immune response. Increased neoptcrin levels was demonstrated in acute viral, intracellular bacterial and protozoa infection, autoimmune diseases and certain malignant diseases. - The aim of this work was to evaluate the level of neopterin in patient of urticaria and a topic dermatitis. - This study was conducted on total number of 40 subject: 20 urticaria patient, 20 a topic dermatitis patient and 20 age and sex match healthy control subject. The studied subjects were classified into three groups. - All patients had detailed history taking of full dermatology sheet with stress upon certain point such as age, sex, occupation, duration of the diseases and provoking factor and family history. - 10 ML of blood was drawn from every subject into plain tube, centrifuged and the sera obtained were kept frozen at 20 C until determination and evaluation of neopterin. - We found that serum level of neopterin was significantly higher in patients group than control. - The level of neopterin is highly significant increase in patients with acute urticaria than chronic urticaria and atopic dermatitis. - The net result is increased the neopterin level in patients of urticaria and atopic dermatitis. - There for the neopterin could be used as a Biomarker of degree of activation of immune system Neopterin could be used as biomarker of immune system activation in AD & SU. • Neopeterin is increase in ASU and to lesser extent in CSI & AD. • The raised of serum neopterin level does not seem to related to the prognosis. |