소아의 두경부 피부염 환자에서 Malassezia 특이항체가 갖는 의미 = Significance of Malassezia-specific IgE in children with dermatitis involving the head and neck

다국어 초록 (Multilingual Abstract)

Purpose: Even though Malassezia yeast may play an important role in the exacerbation of atopic dermatitis (AD), only a few studies of Malassezia infection have been conducted in children with AD. Thus, we compared each of clinical findings, including the severity of head and neck dermatitis and laboratory results depending on specific IgE against Malassezia furfur. Methods: This cross-sectional study was carried out on 121 children aged 3 months to 18 years between April and July of 2014. Retrospective data was collected using the medical records, and patients were divided into 2 groups according to the presence of Malassezia sensitization. Results: Specific IgE against Malassezia (group 1) was observed in 28 of all patients (23.1%). Group 1 children were at an older age (9.1±6.9 vs. 2.1±3.7, P<0.001). Group 1 children had a higher SCORing Atopic Dermatitis (SCORAD) index (46.4±21.0 ng/mL vs. 37.2±13.4 ng/mL, P=0.001), and total IgE (1,324.2±1,166.0 IU/mL vs. 209.5±532.5 IU/mL, P<0.001) compared to group 2 children (Malassezia-). In the group 1, the correlation between the Malassezia-specific IgE and 25-hydroxyvitamin D3 was negatively weak (r=?0.106) and not statistically significant (P=0.246). Furthermore, Malassezia-specific IgE and the SCORAD index (r=0.281, P=0.002) or total IgE (r=0.380, P<0.001) were positively correlated. Conclusion: The results of this study suggest that specific IgE against M. furfur may be helpful in assessing the severity of prepubertal children and early adolescents with AD involving the head and neck.

참고문헌 (Reference)

1 Darabi K, "The role of Malassezia in atopic dermatitis affecting the head and neck of adults" 60 : 125-136, 2009

2 Ljubojevic S, "The role of Malassezia furfur in dermatology" 20 : 179-182, 2002

3 Devos SA, "The relevance of skin prick tests for Pityrosporum ovale in patients with head and neck dermatitis" 55 : 1056-1058, 2000

4 Gueho E, "The genus Malassezia with description of four new species" 69 : 337-355, 1996

5 Lintu P, "Systemic ketoconazole is an effective treatment of atopic dermatitis with IgE-mediated hypersensitivity to yeasts" 56 : 512-517, 2001

6 Mayser P, "Sympodialis and Pityrosporum orbiculare in patients with atopic dermatitis, seborrheic eczema or pityriasis versicolor, and identification of respective allergens" 80 : 357-361, 2000

7 Chiu YE, "Serum 25-hydroxyvitamin D concentration does not correlate with atopic dermatitis severity" 69 : 40-46, 2013

8 Casagrande BF, "Sensitization to the yeast Malassezia sympodialis is specific for extrinsic and intrinsic atopic eczema" 126 : 2414-2421, 2006

9 Lange L, "Sensitization to Malassezia in infants and children with atopic dermatitis: prevalence and clinical characteristics" 63 : 486-487, 2008

10 Suh SH, "Prevalence of allergic diseases in Korean children, 2010" 4 : 425-431, 2011

11 Oranje AP, "Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score" 157 : 645-648, 2007

12 Lindgren L, "Occurrence and clinical features of sensitization to Pityrosporum orbiculare and other allergens in children with atopic dermatitis" 75 : 300-304, 1995

13 Leung DY, "New insights into atopic dermatitis" 113 : 651-657, 2004

14 Aspres N, "Malassezia yeasts in the pathogenesis of atopic dermatitis" 45 : 199-205, 2004

15 Pedrosa AF, "Malassezia infections: a medical conundrum" 71 : 170-176, 2014

16 Back O, "Ketoconazole in atopic dermatitis: therapeutic response is correlated with decrease in serum IgE" 287 : 448-451, 1995

17 Nissen D, "IgE-sensitization to cellular and culture filtrates of fungal extracts in patients with atopic dermatitis" 81 : 247-255, 1998

18 Zargari A, "IgE-reactivity to seven Malassezia species" 58 : 306-311, 2003

19 Brodska P, "IgE-mediated sensitization to malassezia in atopic dermatitis: more common in male patients and in head and neck type" 25 : 120-126, 2014

20 Selander C, "Higher pH level, corresponding to that on the skin of patients with atopic eczema, stimulates the release of Malassezia sympodialis allergens" 61 : 1002-1008, 2006

21 Bayrou O, "Head and neck atopic dermatitis and malassezia-furfur-specific IgE antibodies" 211 : 107-113, 2005

22 Nikkels AF, "Framing the future of antifungals in atopic dermatitis" 206 : 398-400, 2003

23 Bischoff-Ferrari HA, "Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes" 84 : 18-28, 2006

24 Spergel JM, "Epidemiology of atopic dermatitis and atopic march in children" 30 : 269-280, 2010

25 Hanifin JM, "Diagnostic features of atopic dermatitis" 92 : 44-47, 1980

26 Tengvall Linder M, "Detection of Pityrosporum orbiculare reactive T cells from skin and blood in atopic dermatitis and characterization of their cytokine profiles" 26 : 1286-1297, 1996

27 Kato H, "Detection and quantification of specific IgE antibodies against eight Malassezia species in sera of patients with atopic dermatitis by using an enzyme-linked immunosorbent assay" 50 : 851-856, 2006

28 Peroni DG, "Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children" 164 : 1078-1082, 2011

29 Ramasastry P, "Chemical composition of human skin surface lipids from birth to puberty" 54 : 139-144, 1970

30 Johansson C, "Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients" 148 : 479-488, 2003

31 Ring J, "Atopic eczema: role of microorganisms on the skin surface" 47 (47): 265-269, 1992

32 Leung DY, "Atopic dermatitis" 361 : 151-160, 2003

33 Koyama T, "Antigenic components of Malassezia species for immunoglobulin E antibodies in sera of patients with atopic dermatitis" 26 : 201-208, 2001

34 Kanda N, "Anti-mycotics suppress interleukin-4 and interleukin-5 production in anti-CD3 plus anti-CD28-stimulated T cells from patients with atopic dermatitis" 117 : 1635-1646, 2001

35 Zhang E, "Anti-Malassezia-specific IgE antibodies production in Japanese patients with head and neck atopic dermatitis: relationship between the level of specific IgE antibody and the colonization frequency of cutaneous Malassezia species and clinical severity" 2011 : 645-670, 2011

36 Kaffenberger BH, "A retrospective descriptive study of oral azole antifungal agents in patients with patch test-negative head and neck predominant atopic dermatitis" 71 : 480-483, 2014