Does antioxidant-rich diet during pregnancy protect against atopic multimorbidity in children?

BACKGROUND: Genetics and prenatal environmental exposures are indicated in the complex etiopathogenesis and clinical expression of atopic diseases. This study examined the clinical features of infantile-onset atopic dermatitis (AD) in relation to maternal diet during pregnancy. METHODS: Maternal dietary habits were evaluated in terms of the frequency of intake of six different food categories rich in antioxidants or omega-3 fatty acids. RESULTS: One hundred mother-child pairs were recruited, 47 infants (<12 months) and 53 children aged 12-36 months. Forty-six of the children had mild, 41 moderate and 13 severe AD. The other atopic manifestations (alone or associated) included: asthma in 9 cases, allergic rhinitis in 22 cases and food allergy in 33 cases. The presence of asthma in children was significantly associated with a lower level of maternal dietary intake of fruits and vegetables as well as chocolate confectionery, while associations with whole grain breakfast cereals, nuts and seeds, non-alcoholic beverages (coffee, tea, fruit juices) and fish and fish products, were not statistically significant. The age of onset and severity of infantile-onset AD were not linked to any of the food categories considered for analyses. CONCLUSIONS: Healthy diet in pregnant women that is rich especially in antioxidants may provide protection against atopic comorbidities of AD. Further prospective reasearch on the role of maternal diet in primary prevention of atopic diseases is warranted.

Associations between Disease Activity/Severity and Damage and Health-Related Quality of Life in Adult Patients with Localized Scleroderma-A Comparison of LoSCAT and Visual Analogue Scales.

Localized scleroderma (LoS) is a chronic fibrosing disorder of the skin and, less commonly, subcutaneous tissues. As the disease causes subjective symptoms, cosmetic defects, and, at times, functional disability, subjects with LoS experience deterioration of their health-related quality of life (HRQoL). The influence of disease activity/severity and damage status on HRQoL measures in patients with LoS is scarcely known. Physician-reported measures (modified LoS skin severity index, LoS skin damage index, physician global assessments of the disease activity/severity and damage) and patient-derived measures (patient global assessments of the disease activity/severity and damage) were obtained in adult LoS patients. Their HRQoL was measured with Skindex-29 and Short Form-36. The patients' assessments of disease activity/severity and damage in LoS differed from the assessments by the physicians. The patients' predominant concerns centered on LoS-related damage, whereas the physicians' concerns focused on features of disease activity. Visual analogue scales bore some relation to the HRQoL, and they seem to be important in a holistic approach to the patient and should not be omitted in LoS evaluation.

Facts and speculations on vitamin d in prevention and treatment of atopic dermatitis

Recently, age- and weight-specific recommendations for prevention, supplementation and treatment of vitamin D (VD) deficiency in the general population and in groups at increased risk of the deficiency (i.a. atopic dermatitis) has been presented by the Polish Experts group. VD regulates many physiological processes in the skin ranging from cellular proliferation, differentiation, and apoptosis to barrier maintenance and immune functions. VD deficiency has been associated with increased incidence and severity of atopic dermatitis. In addition, VD supplementation was shown to decrease atopic dermatitis severity in several studies, but the findings obtained in systematic reviews and meta-analyses are controversial.

Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) adapted for use in adult patients: report from an initial validation study.

BACKGROUND: Localized scleroderma (LoS) affects both children and adults and is associated with permanent functional and cosmetic impairment, and reduced quality of life predominating in adults. The Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) is a clinical instrument designed to measure an activity and damage of LoS. It has been validated for use with pediatric LoS patients. This study assessed the validity and reliability of the LoSCAT adapted for use in adults. METHODS: Before the initiation of the study two examiners participated in an intensive training course carried out by an expert in LoS. Appendices describing each LoSCAT domain were prepared. Features determining disease activity and damage in adult LoS patients were identified to properly evaluate the physician (Phys) and patient (Pt) global assessment (GA) of disease activity (A)/severity (S) and damage (D), which were used to assess convergent validity of the LoSCAT. Correlations of physician- and patient-derivied measures with Skindex-29 were also analysed. RESULTS: The study included 40 adult LoS patients (33 females and 7 males) with different subtypes of LoS. Intra and inter-rater reliability of the LoSCAT was found to be excellent. Positive correlations were observed between the PhysGA-A, PhysGA-D, PtGA-A and the LoSCAT's domains, while no correlations between them and the PtGA-D were found. There were no relationships between LoSCAT's components and Skindex-29. CONCLUSIONS: Despite the LoSCAT is a reliable tool for an assessment of cutaneous lesions, additional health status instruments are necessary to a holistic approach to LoS in adults.

Dietary strategies for primary prevention of atopic diseases - what do we know?

The paper refers to the recently published empirical data and systematic reviews on the impact of diets, foods, nutrients and bioactive substance exposures in pregnancy and in early infancy, on the development of atopic disorders. The results of studies referring to a broad range on dietary factors are mostly conflicting. There are several limitations of these researches. Based on the existing information, it is not possible to establish the role of antioxidants and vitamin D supplementation in atopic disease development. There is no evidence of major effects of prenatal use of folic acid on asthma or allergies. The association of some nutritional interventions with less atopic sensitization seems rather speculative even if such an effect has not been found for some other foods. The findings indicate rather a balanced and diverse diet without restrictions than a special dietary protocol. Farming-related exposures may protect against the development of atopic disorders in children. The hypothesis that the early introduction of complementary food, including the potentially allergenic foods, may reduce the risk of food allergy and atopic dermatitis is currently tested. Long-chain polyunsaturated fatty acids and probiotics seem to be promising candidates for allergy prevention. But specific recommendations regarding pre- and postnatal supplementation strategies, dose, treatment duration etc., are still undetermined. Longitudinal intervention studies in cohorts of pregnant women or newborn infants are needed to match the proper strategies in these issues.

[Phototherapy in dermatology]. / Zastosowanie swiatloterapii w dermatologii.

Treatment of some skin diseases by exposure to ultraviolet radiation is presented. Phototherapy including radiation of different lenghts of waves has been used in medicine for along period of time, it also plays an importaint role in modern dermatology. The study presents the modern methods of phototherapy and photochemiotherapy as well as history, indications, contraindications and side effects of phototherapy.