Serum antibody to staphylococcal teichoic acid and alpha-haemolysin in dermatological patients.

Teichoic acid antibody (TAA) titres and antibody to alpha-haemolysin of Staphylococcus aureus (ASta) were measured in 274 dermatological patients and 200 normal controls. Positive ASta values (greater than or equal to 2.0 iu/ml) were common in patients with chronic pruritic dermatoses such as atopic dermatitis (44% ASta positive) and infective eczema (28% ASta positive), but patients with primary pyoderma were all ASTa negative. Positive TAA titres (greater than or equal to 1:4) were seen less frequently than positive ASta values, but still significantly more often in atopic dermatitis patients than in controls. Routine skin swabs were taken from all patients, but positive TAA or ASta tests correlated neither with growth of Staphylococcus aureus from skin lesions nor with signs of clinical infection. This study shows that the TAA test cannot be used as an indicator of septic staphylococcal infection in patients with atopic dermatitis.