الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND CONCLUSIONS
Atopic dermatitis is a chronic, hereditable and highly pruritic inflammatory dennatosis which occurs in all age groups and may be associated with asthma and/or allergic rhinitis.
The disease lacks a primary skin lesion and must be identified using a constellation of clinical features. Most notable, however, is the intense pruritus. The subsequent scratching, excoriation and chronic rubbing cause
most of the skin changes and lead to lichenification.
The pathogenesis of atopic dermatitis may be related to both functional and numerical deficiencies of circulating suppressor T cells. Inadequate T-lymphocyte suppression of B-cell IgE production may follow challenge with common environmental antigens. Though these findings in blood are of considerable importance, little is known of their relation to localized dermal reactions in atopic dermatitis patients.
The aim of this work was to confirm and add to previously reported clinical, histopathological and immunofluorescence findings of AD. The study included 50 AD patients. All were subjected to full history taking, clinical and histopathological examination. Also, direct and indirect (with monoclonal
antibodies) immunofluorescent techniques were carried out for each case. The following results were obtained:
1- Male to female ratio was 1.9:1 with a mean age 7.9 years for males and 13.1 years for females.
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2-Thirty three patients (66%) gave positive family history of atopic disorders as allergic rhinitis, bronchial asthma and/or AD.
3-Nineteen patients (38%) gave positive personal history of other atopic
disorders.
4-The histopathological changes observed in AD skin lesions were not specific and looked like those of a subacute or chronic eczema.
5-Electron microscopic studies showed widening of spaces between the intercellular bridges of keratinocytes which were completely intact and normal.Langerhans cells were seen in apposition to T cells in the dermis.
6-Direct immunofluorescence studies showed IgE stained dendritic cells not only in the epidermis but also in the dermis.
7-Indirect immunofluoresence studies showed that T4 cells predominated over T8 cells. T8 cells were found mainly in the superficial dermis, by contrast, T4 cells were found deeply located in the dermis. The lesions were characterized by dramatic increase in the number of LCs. They were organized into a tight network extending from the superficial stratum corneum to the basal epidermal layer.
In conclusion, the pathognetic mechanisms involved in AD are
complex and are likely to include both immunological and pharmacological abnormalities which may be interrelated (Hanifin, 1983 and Archer et at, 1983). Our findings in this study lead us to conclude that, the dermatitis lesions in AD seem to be due to an IgE-mediated delayed type hypersensitivity mechanism.