Effect of oral cyclosporin A in children with Staphylococcus aureus‐colonized vs. S. aureus‐infected severe atopic dermatitis
- 21 February 2003
- journal article
- research article
- Published by Wiley in Pediatric Allergy and Immunology
- Vol. 14 (1), 55-59
- https://doi.org/10.1034/j.1399-3038.2003.02105.x
Abstract
Atopic dermatitis (AD) is frequently associated with skin colonization or infection with Staphylococcus aureus strains producing exotoxins. The aim of this investigation was to evaluate the effect of oral cyclosporin A (CsA) on disease severity and bacterial counts in colonized and infected patients. Eleven children with severe AD (SCORAD index >50, mean objective SCORAD score >40) were treated for 8 weeks with 2.5-5 mg/kg CsA. In five patients, the skin was only colonized with S. aureus whereas the remaining six patients presented clinically relevant suppurative S. aureus skin infections characterized by small pustules, crustings, pus and increased pruritus in the presence of S. aureus as determined by contact sampling and culture which regularly resulted in the indication for antibiotic treatment. Clinical and microbiological investigations were performed before and after CsA therapy. Clinical signs and symptoms of AD improved in all patients with a reduction in mean SCORAD index from 74 to 29 (p < 0.001). However, disease severity and bacterial counts were more reduced by CsA in the colonized patients compared with the patients with clinical overt infections. In conclusion, treatment with CsA resulted in an improvement of clinical symptoms in children suffering from severe AD. However, anti-infective treatment administered before immunomodulatory therapy is likely to be decisive for the long-term therapeutic effect.Keywords
This publication has 19 references indexed in Scilit:
- Effect of Low-Dose Cyclosporin A Microemulsion on Disease Severity, Interleukin-6, Interleukin-8 and Tumor Necrosis Factor Alpha Production in Severe Pediatric Atopic DermatitisInternational Archives of Allergy and Immunology, 2001
- Tacrolimus ointment reduces staphylococcal colonization of atopic dermatitis lesions.Journal of Allergy and Clinical Immunology, 2001
- Staphylococcal toxin-induced T cell proliferation in atopic eczema correlates with increased use of superantigen-reactive Vβ-chains in cutaneous lymphocyte-associated antigen (CLA)-positive lymphocytesClinical and Experimental Immunology, 2000
- Evidence for a disease-promoting effect of Staphylococcus aureus–derived exotoxins in atopic dermatitisJournal of Allergy and Clinical Immunology, 2000
- Cyclosporin for severe childhood atopic dermatitis: short course versus continuous therapyBritish Journal of Dermatology, 2000
- Role of T Cells in Atopic DermatitisInternational Archives of Allergy and Immunology, 1998
- Superantigens: Biology, immunology, and potential role in diseaseJournal of Clinical Immunology, 1992
- Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapyBritish Journal of Dermatology, 1988
- Bacterial infection and atopic eczema.Archives of Disease in Childhood, 1986
- Staphylococcus aureus in the lesions of atopic dermatitisBritish Journal of Dermatology, 1974