Reduced secretion of IgA to skin surface of patients with atopic dermatitis.

To investigate whether the secretory form of immunoglobulin A (sIgA) was reduced on the skin surface in atopic dermatitis, the amount of sIgA present in sweat was measured in 40 patients with atopic dermatitis and in 50 healthy volunteers by attaching a cellulose membrane disk (10 x 10 mm) to the inner aspect of the upper arm skin for 24 hours. The secretory form of IgA, which was absorbed to the membrane and accumulated during the period of application, was revealed as dots by an enzyme immunoassay in which antibodies for IgA and for the secretory component were used. The density and number of dots (per mm2/day), which corresponded to the openings of eccrine excretory ducts, were determined with a densitometer. The mean amount of sIgA secreted by those patients was 3.86 +/- 0.71 pg/mm2/day (range, 0 to 21.17 pg/mm2/day), whereas that of the control subjects was significantly higher (p < 0.001), 16.79 +/- 2.80 pg/mm2/day (range, 0.79 to 133.77 pg/mm2/day). This may be related to the high incidence of bacterial and viral skin infections seen in patients with atopic dermatitis, and in addition, to the development of eczematous lesions through a defect in ridding the skin of allergens and/or microorganisms.