Community validation of the U.K. diagnostic criteria for atopic dermatitis in Japanese elementary schoolchildren.

BACKGROUND: A simple list of diagnostic criteria for atopic dermatitis for use in epidemiological studies was developed by a U.K. working party. This list served well for both hospital patients with skin diseases and in general population within the U.K. OBJECTIVES: To validate the U.K. diagnostic criteria in Japanese elementary schoolchildren, we collected the questionnaires on regular health checkups, which had been completed by parents of schoolchildren in 2001/2002 and 2004/2005. METHODS: Elementary schoolchildren were examined by dermatologists in eight areas (16,152 children) in 2001/2002 and in three areas (3849 children) in 2004/2005. The questionnaire was distributed to the parents 2 weeks before the skin examination, completed by the parents and collected after the survey. RESULTS: In 2002/2002 comparing the U.K. diagnostic criteria with the findings on clinical examination used as the reference standard, the U.K. criteria (1-year prevalence measure) showed a sensitivity of 71.8%, specificity of 89.3% and positive predictive value of 44.7%. In 2004/2005 we confirmed that the U.K. criteria for a point prevalence measure showed a higher positive predictive value (59.9%) compared with that for 1-year prevalence measure (49.3%). CONCLUSION: Now that we know the sensitivity and specificity of the U.K. criteria in the population examined in this study, we will be able in the near future to estimate the prevalence of atopic dermatitis in a similar population with reverse operation by questionnaires alone using these criteria without examination by dermatologists. Therefore, the validation study of U.K. criteria could be useful for future epidemiologic surveys.

Effects of surface wetness of etched dentin on bonding durability of a total-etch adhesive system: comparison of conventional and dumbbell-shaped specimens.

The dentin bonding durability of a total-etch adhesive system (Prime & Bond NT) was investigated by tensile bond test using conventional and dumbbell-shaped specimens. Two bonding techniques were compared. After etching and rinsing, dentin surface was either blotted by cotton ball (wet-bonding) or air-dried (dry-bonding) before bonding agent was applied. The bond strength of wet-bonding specimens was significantly higher than that of dry-bonding for both conventional and dumbbell-shaped specimens after one day. The bond strength of wet-bonded conventional specimens did not decrease after two years of water immersion, but cohesive failure in demineralized dentin was observed after two years. Wet-bonded dumbbell-shaped specimens showed cohesive failure within demineralized dentin after only one day. The bond strength of dry-bonded conventional specimens decreased significantly after one year, and cohesive failure in demineralized dentin was confirmed after three months. As for dry-bonded dumbbell-shaped specimens, they showed cohesive failure in demineralized dentin after one month. The results of the present study showed that the bonding durability of dry-bonded Prime & Bond NT restorations was lower than that of wet-bonded restorations. Further, by using tensile bond test, cohesive failure in demineralized dentin was detected earlier in dumbbell-shaped specimens than in conventional specimens.

Nuclear factor kappaB (NF-kappaB) activation by hydrogen peroxide in human epidermal keratinocytes and the restorative effect of interleukin-10.

The heterodimeric form of nuclear factor kappaB (NF-kappaB), NF-kappaB1/RelA, is one of the pluripotential transcription factors that activates various genes encoding cytokines and cell adhesion molecules. To clarify the involvement of radical oxygen species in the NF-kappaB activation pathway in keratinocytes, we examined the effect of hydrogen peroxide (H(2)O(2)) on the activation of NF-kappaB in cultured normal human epidermal keratinocytes. After the treatment of keratinocytes with 300 microM H(2)O(2), a translocation of NF-kappaB from the cytoplasm to nucleus was observed in an immunofluorescence study using anti-human NF-kappaB1 and anti-human RelA antibodies. Specific DNA binding was observed with the nuclear extract prepared from the H(2)O(2)-treated keratinocytes by the electrophoretic mobility shift assay. The presence of N-acetyl-L-cysteine or pyrrolidine dithiocarbamate during H(2)O(2) treatment prevented the nuclear localization of NF-kappaB. The involvement of radical oxygen species in the NF-kappaB activation pathway was suggested. Pretreatment of keratinocytes with 10 ng/ml of recombinant human interleukin-10 (IL-10) for 24 h suppressed the nuclear translocation of NF-kappaB induced by H(2)O(2). IL-10, which increases in ultraviolet-irradiated skin and suppresses delayed type hypersensitivity in vivo, may play an inhibitory role in cutaneous inflammation by inhibiting the NF-kappaB activation pathway in keratinocytes.

Coexistence of Riehl's melanosis and lichen planus.

A 61-year-old man presented with purple-red papules and plaques. These lesions on the nape and dorsal aspects of both hands displayed the histological findings characteristic of lichen planus. Riehl's melanosis, which is synonymous with pigmented contact dermatitis, was present on the forehead and bald scalp. Riehl's melanosis typically appears on the face and is induced by cosmetics. Causative factors in this case, however, remained undefined. The coexistence of lichen planus and Riehl's melanosis at separate sites in a single patient suggests that the two diseases represent manifestations of specific immune responses characteristic of lichenoid tissue reaction and situate in the same spectrum. The differences in the skin manifestations of lichen planus and Riehl's melanosis might depend on the severity of immune responses against intrinsic or extrinsic antigens. In addition, the skin manifestations of lichenoid tissue reaction might depend on the disposition of the lesion sites.