Samueli S, Orsolini G, Migliaccio P, Baldini G, Paci A
Clinica Pediatrica, Centro di Fisiopatologia Respiratoria e Allergologia, Università degli Studi di Pisa, Italia.
Pediatr Med Chir. 1994 May-Jun;16(3):247-9.
The etiopathogenetic bases of atopic dermatitis are still much discussed and controversial. Nevertheless most of the Authors agree upon the pathogenetic role of an IgE mediated hypersensitivity mechanisms with respect to many alimentary and/or environmental allergens. We have looked for the IgE mediated sensitization to the house dust mites by means of skin tests (prick) and/or haematic dosage of specific IgE (F.A.S.T.) in a group of 40 children aged less than 6 with atopic dermatitis. We have divided the examined children into three groups according to their age and found out a high percentage of dust mites sensitization in the children of the oldest age group. This datum could give credit to the hypothesis of a pathogenetic role developed by the allergy to dust mites in the keeping of eczematous lesions. From the anamnestic search emerge both the leading role developed by dust mites on the development of allergic breathing pathology in the subjects with atopic dermatitis and the finding out of a settled exordium of breathing manifestations due to dust mites at an older age in comparison with the age in which the cutaneous disease manifests itself. These observations lead us to recommend a very accurate environmental cleaning since the first manifestations of atopic dermatitis prescinding from the checking of a demonstrated IgE mediated house dust mites hypersensitivity.
特应性皮炎的病因发病基础仍存在诸多争议且讨论不断。然而，大多数作者都认同IgE介导的超敏反应机制在许多食物和/或环境过敏原方面的致病作用。我们通过皮肤试验（点刺）和/或特异性IgE的血液检测（F.A.S.T.），对一组40名6岁以下患有特应性皮炎的儿童进行了针对屋尘螨的IgE介导致敏情况的检测。我们根据年龄将受检儿童分为三组，发现年龄最大组的儿童中屋尘螨致敏比例很高。这一数据支持了尘螨过敏在维持湿疹性皮损方面具有致病作用这一假说。从病史调查中可以看出，尘螨在特应性皮炎患者过敏性呼吸疾病的发展中起主要作用，并且发现与皮肤疾病出现的年龄相比，尘螨导致的呼吸症状在年龄较大时才开始出现。这些观察结果使我们建议，自特应性皮炎首次出现症状起，就应进行非常彻底的环境清洁，而无需先确认是否存在IgE介导的屋尘螨超敏反应。
