Atopic dermatitis is associated with several autoimmune diseases

Atopic dermatitis is associated with 11 autoimmune diseases, especially in smokers.

The researchers recruited 8,112 Danish adults who were diagnosed with atopic dermatitis between January 1, 1997 and December 31, 2012. These patients were compared with a control group of 40,560 patients based on age and gender. The average age of patients was 42.4 years in both groups.

Autoimmune diseases that have been associated with atopic dermatitis included: alopecia areata, vitiligo, chronic urticaria, celiac disease, chronic glomerulonephritis, Sjögren's syndrome, systemic lupus erythematosus, ankylosing spondylitis, Crohn's disease, unspecified inflammatory bowel disease, ulcerative colitis, and rheumatoid arthritis.

Allergic dermatitis was also found to have a stronger correlation with the presence of three or fewer autoimmune diseases compared with one or two comorbidities.

A history of smoking was associated with the presence of one or more autoimmune diseases in patients with atopic dermatitis (p = 0.001).

Because of the common occurrence of autoimmune comorbidities, especially in patients who smoke, and the association with high standards of living and urban lifestyle, atopic dermatitis and autoimmune diseases may share a common genetic background and common environmental triggers, the researchers said.

“Clinicians who care for patients with atopic dermatitis should be aware of the association with autoimmune diseases and smoking in their patients,” the researchers concluded.

Atopic dermatitis

Atopic dermatitis \AD\ appears on the skin as small blisters \vesicles\, red spots \erythema\, peeling, scabs, cracks, erosion - all this is accompanied by severe itching of the skin. The onset of the disease is possible at any age, but most often in the infant period vesicles and persistent erythema appear on the face, body, and legs.
The main and only mechanism of the disease is the autoimmune process. This means that the body’s own immune system, designed to protect the body, behaves aggressively towards the elements of the skin. The skin has become a target. We see a “picture” on the skin, and the main events in the development and implementation of the disease occur in the thymus gland, lymph nodes, and blood cells.
Why does the immune system behave aggressively towards its own tissues, why is it so variable in its function? Because this is a dual task of natural selection, those who are resistant to outside influences survive, because objectively there is a so-called binary opposition: good and evil, love and hate, light and darkness, life as creation and death as destruction, in the end after all... the Creator and Satan, because development comes through the negation of opposites, their mutual transformation, and all this is reflected in the law of knowledge of “unity and struggle of opposites.”
The disease, which began in infancy, accompanies the child for many years, despite all the efforts of doctors and parents, a grueling diet and numerous ointments and antihistamines. Moreover, it is believed that in 60% of cases atopic dermatitis progresses and turns into atopic rhinitis and then into bronchial asthma. In fact, this percentage is even higher, since there is such a group as children who are often and long-term ill, for whom any cold ends with a cough. Two or three days in kindergarten, then two weeks of illness, and so on ad infinitum. When structuring the anamnesis of such a child, the mother always remembers that very early after birth the child had a rash and redness of the skin, then it went away or did not go away, but the child began to get sick often, a cough accompanies the child all the time.
The local pediatrician recommends that parents of such children purchase a nebulizer. Next comes the heavy artillery: pulmicort and berodual. As the child grows older, he carries his inhaler to school along with ABC.
You remember that skin manifestations are just a picture, the main events occur deeper, where immunity reigns. Essentially, atopic dermatitis is a model that demonstrates how a chronic disease develops in a conventional medical system, in a system where symptoms are suppressed. Therefore, the task of a homeopathic doctor, using his own means, is to stop the autoimmune process, thereby stopping the progression of the disease.
When choosing a drug, everything is important: the mother’s emotions during pregnancy, for example, pressure on her to terminate the pregnancy, the speed at which the birth proceeded, vaccination; often dermatitis begins immediately or two weeks after the next DTP, the mentality of aggressiveness or creativity of the child’s psyche and much more.
Homeopathy remedies allow you to restore the immune system, remove aggression towards your own tissues and, accordingly, the clinical manifestations of the disease. Moreover, recovery occurs in the reverse order. What has arisen recently is the first to recover. Naturally, recovery takes time.

It won't take long. Our specialist will contact you to discuss issues.

Autoimmune dermatosis

Autoimmune dermatosis- a skin disease that develops due to dysfunction of healthy organs and tissues of the body under the influence of the body’s own immune system.

The reasons for this reaction of the immune system are different:

destruction/death of tissue due to infection or transformation of their antigenic structure in such a way that the altered tissue causes an aggressive reaction from the host’s immune system;
damage to the body by an infectious agent whose proteins are similar to some components of healthy tissues of the host;
violation of the unity of tissue barriers that normally separate some tissues and organs from the blood, and, therefore, protect them from aggression of the host’s immune system;
disruption of the body's control over the excessive development of aggressive cells of the immune system.

Factors contributing to the development of autoimmune disease:

stress;
chronic infections;
gene mutations;
genetic predisposition.

The most common autoimmune dermatoses are:

some types of alopecia;
psoriasis;
vitiligo;
bullous autoimmune dermatoses;
isolated skin vasculitis;
chronic urticaria;
discoid lupus erythematosus;
local forms of scleroderma.

Diagnostics

Experts diagnose autoimmune dermatoses based on identifying an immune factor that contributes to damage to tissues and organs.
An initial consultation with a doctor involves examining the patient’s skin and taking a medical history. After which the patient, depending on the indications, must undergo the following medical procedures:

general urinalysis;
general blood test;
biochemical blood test;
coagulogram;
immunological blood tests;
skin biopsy for histological examination (if necessary for diagnosis);
determination of antibodies to HIV infection, hepatitis B and C, syphilis;
chest x-ray;
Ultrasound of the abdominal organs;
computer or magnetic resonance imaging.

If necessary, the attending physician may prescribe the patient consultations with other specialists:
therapist;
rheumatologist;
immunologist;
anesthesiologist-resuscitator (when planning afferent blood surgery).

Treatment of autoimmune dermatoses

Monitoring and treatment of patients suffering from autoimmune diseases require a long time.
Typically, the main treatment for autoimmune dermatoses consists of taking anti-inflammatory drugs and drugs that suppress the immune system, internally and/or externally:

antibiotics;
corticosteroids;
antiseptics;
immunomodulators.
non-steroidal anti-inflammatory drugs.

Also, specialists at the K+31 Clinic medical center treat autoimmune dermatoses using modern effective techniques extracorporeal hemocorrection (EG). Treatment with EG methods helps to quickly achieve remission, significantly reduce the manifestations of the disease and allows you to reduce the doses of medications used.

Autoimmune progesterone dermatitis (APD syndrome) in women: what it is, treatment, causes, symptoms, signs, pregnancy

What is autoimmune progesterone dermatitis?

Autoimmune progesterone dermatitis (APD) is a rare disease with premenstrual exacerbations associated with increased sensitivity to progesterone.

Historical information

The first case of cyclic rash, which could be caused by an allergy to endogenous sex hormones, was reported by Geber in 1921. The patient he described suffered from urticaria, which could be caused by injection of autologous serum taken before menstruation. The concept of hypersensitivity to sex hormones was further developed in 1945 when Zondek and Bromberg described several patients with skin lesions (including cyclic urticaria) associated with menstruation and menopause. They identified in these patients a delayed-type allergic reaction to intradermally administered progesterone, signs of passive transfer of reagents into the skin, and clinical improvement after desensitizing therapy. Patients in the control group had no reaction to intradermal administration of progesterone.

In 1951, Guy et al reported a patient with premenstrual urticaria. With intradermal administration of corpus luteum extracts, she experienced a severe allergic reaction. The patient later underwent successful desensitization therapy. The term "autoimmune progesterone dermatitis" was proposed by Shelly et al. in 1964, who first demonstrated the partial effect of estrogen therapy and cure after oophorectomy.

Symptoms and signs of autoimmune progesterone dermatitis

The clinical picture of autoimmune progesterone dermatitis is varied. It can manifest itself as eczema, erythema multiforme exudative, urticaria, dyshidrosis, stomatitis and a rash resembling dermatitis herpetiformis. The morphological and histological features of the elements do not differ from those in the acyclic form of the disease. These diseases are observed only in women of reproductive age. The onset of the disease usually occurs at a young age, sometimes the first symptoms appear after pregnancy. The course is variable, spontaneous remissions are possible. In two thirds of patients, the appearance of a rash is preceded by taking progesterone as part of oral contraceptives. In typical cases, dermatosis worsens in the second half of the menstrual cycle, its manifestations reach a maximum before menstruation and gradually decrease with its onset. In the first half of the menstrual cycle, the elements of the rash are weakly expressed or absent. In typical cases, the rash appears during each ovulatory cycle.

Mechanism of sensitization

The mechanism of a woman’s sensitization to her own progesterone is not clear. According to one of the most common hypotheses, taking drugs containing progesterone promotes sensitization to endogenous progesterone. It is believed that synthetic progesterone is antigenic enough to produce antibodies, which then cross-react with natural progesterone and mediate the immune response in the premenstrual period. However, not all women with APD take synthetic gestagens. Schoenmakers et al. It is believed that another mechanism for the development of ARS may be cross-sensitization to glucocorticoid hormones. They identified cross-sensitization to hydrocortisone and 17-hydroxyprogesterone in 5 of 19 patients with hypersensitivity to glucocorticoids, two of them had symptoms of APD. However, Stephens et al. it was not possible to detect cross-sensitization to glucocorticoids in 5 patients with APD; According to their data, these women had no reaction to intradermal administration of 17-hydroxyprogesterone.

Pregnancy

In three clinical observations cited in the literature, the onset or exacerbation of skin diseases coincided with pregnancy and subsequently the latter occurred before menstruation. This is likely due to increased concentrations of progesterone and estrogen during pregnancy. In two cases spontaneous abortion occurred. However, there are reports of patients in whom the manifestations of APD spontaneously resolved during pregnancy.

It is known that during pregnancy, the condition of many patients with allergic diseases improves. This suggests that increased cortisol secretion during pregnancy reduces immune reactivity. It is also possible that gradual increases in hormone concentrations have a desensitizing effect in some patients.

Signs of hypersensitivity to progesterone

All patients with APD experience cyclic premenstrual exacerbation of the rash. A comparison of the dynamics of the disease, reflected in the diary, with the time of the onset of menstruation indicates that exacerbations coincide with a postovulatory increase in the concentration of progesterone in the blood serum. APD is often resistant to conventional therapy regardless of the clinical form, but drugs that suppress ovulation usually have a good effect. Apparently, individual hypersensitivity to sex hormones is more common, and an antibody-mediated immune reaction to progesterone accompanies these processes.

Allergy to progesterone can be detected using allergy tests with intradermal, intramuscular administration of progesterone or with its oral administration, or by detecting antibodies to progesterone or the corpus luteum in the blood. Two cases have been described in which APD was caused by the presence of immunoglobulin in the blood serum that binds to 17-hydroxyprogesterone.

Intradermal progesterone test

An intradermal test with synthetic progesterone usually causes a urticarial rash as an immediate reaction, but a delayed allergic reaction is also possible. Despite the frequent use of intradermal progesterone test, we consider its results unreliable, since progesterone is insoluble in water, and all solvents have a pronounced irritant property. Skin reactions at the site of progesterone injection are often difficult to interpret and false-positive results are possible. In addition, skin necrosis often develops at the site of drug administration, epithelializing with the formation of a scar. However, a persistent delayed reaction at the injection site indicates increased sensitivity to progesterone.

When conducting a progesterone test, 0.2 ml of progesterone in various dilutions and the same amount of pure solvent as a control are injected intradermally on the anterior surface of the forearm until a blister forms. Purified progesterone powder is dissolved in a 60% ethanol solution prepared in an isotonic sodium chloride solution. Progesterone solution is used in dilution 1; 0.1 and 0.01%. As a control, a 60% ethanol solution prepared with isotonic sodium chloride solution and not containing progesterone, and pure isotonic sodium chloride solution serve as a control.

To determine sensitivity to estrogen, prepare a solution of estradiol with the same solvent. The test results are assessed every 10 minutes for half an hour, then every 30 minutes for 4 hours, and then after 24 and 48 hours. If a reaction occurs in the first minutes due to the irritating effect of the solvent, the early test results are considered a consequence of the irritating effect of the solvent and are not taken into account .

The reaction to progesterone is considered positive if redness and swelling appear within 24 to 48 hours only at the sites of progesterone administration.

Intramuscular and oral progesterone test

A test with intramuscular injection of progesterone, performed in 6 patients, caused a rash in all cases. The test is performed in the first half of the menstrual cycle, when manifestations of APD are minimal. After the administration of progesterone, careful monitoring of patients is necessary, since a sharp increase in the rash and the development of angioedema are possible, although this is rare. For intramuscular administration, we use the progesterone drug Geston (Ferring) at a dose of 25 mg/ml.

A test with oral progesterone is also carried out in the first half of the menstrual cycle. You can give dydrogesterone 10 mg daily for 7 days or levonorgestrel 30 mcg in lactose capsules (up to 500 mg) daily for 7 days, followed by 7 days of lactose capsules only. An oral test is less reliable, since the rash may be erased. It can be difficult to interpret the test result in such cases.

Progesterone test after chemical oophorectomy

If the manifestations of APD are so severe that the question of surgical oophorectomy arises, chemical oophorectomy can be performed by subcutaneous injections of GL antagonists for 6 months. The cessation of ovulation is confirmed by the disappearance of the rash. For chemical oophorectomy, goserelin can be used as a subcutaneous injection at a dose of 3.6 mg. If progesterone administration then causes a rash, then there is strong evidence of increased sensitivity to progesterone.

Treatment of autoimmune progesterone dermatitis

In most cases of APD, conventional therapy was unsuccessful, but the administration of oral prednisone (prednisolone) in moderate doses led to the disappearance of manifestations of APD. Many patients had a good effect when prescribing conjugated estrogens, which may be due to the fact that these drugs suppress ovulation and prevent a postovulatory increase in progesterone levels. In practice, however, estrogen therapy is often inappropriate due to the age of the patients. If estrogen therapy is unsuccessful, the antiestrogenic anovulatory drug tamoxifen can be recommended. This drug at a dose of 30 mg causes complete remission of APD, but leads to amenorrhea. In one patient, administration of tamoxifen in small doses allowed the restoration of menstruation, eliminating the manifestations of APD. There were no side effects of tamoxifen. In two patients, a good effect was obtained when treated with the anabolic steroid danazol (the drug is prescribed at a dose of 200 mg 2 times a day 1-2 days before the expected onset of menstruation and is discontinued after 3 days).

In severe cases, with drug intolerance, oophorectomy has to be performed. Successful treatment of APD by chemical oophorectomy with buserelin (an analogue of GL) has also been reported.

Our experience shows that in many cases of successful treatment, the manifestations of APD gradually disappear.

What are autoimmune skin diseases - causes, symptoms and treatment

All types of such diseases are united by one feature - the human immune system, aggressively tuned to its own cells, takes part in the development of each. Autoimmune skin diseases are very insidious: the disease can affect both individual cells or organs and entire body systems, as in systemic lupus erythematosus, which first affects the skin, and then the kidneys, liver, brain, heart, lungs, endocrine system and joints .

What are autoimmune skin diseases

All diseases that appear as a result of aggressively acting cells of the immune system on healthy cells of the body are called autoimmune. More often, such diseases are systemic, since they affect not only an individual organ, but also entire systems, and sometimes the entire body. Autoimmune skin disease is an example of one of the many ailments that arise due to the fault of the immune system. In this case, the cells of the entire skin are mistakenly attacked by specific immune bodies.

Symptoms

There are several options for the development of symptoms of an autoimmune disease. In general, they are characterized by the following processes:

inflammation, redness of the skin;
deterioration of health;
general weakness.

Depending on the type of skin disease, there are some differences in the clinical picture of the disease, which is manifested in different symptoms and the depth of damage to the epidermis. Frequent symptoms:

The appearance of a rash in the form of blisters on different parts of the skin. The bubble can be of different sizes, most often appear on the mucous membrane and folds of the skin - this is how pemphigus manifests itself.
The appearance of deep red spots that infiltrate and turn into plaques; foci of inflammation are painful; when they develop into chronic inflammation, the foci atrophy (the skin turns pale and thinner). These are the general symptoms of lupus erythematosus.
The appearance of bluish or yellowish-brown spots of different sizes. The affected area gradually grows; at the peak of acute inflammation, plaques form in the middle of the spot, and scars may appear. These are the common symptoms of scleroderma.

Each of the above diseases can have a wide range of different symptoms, for example, pemphigus can have a number of the following manifestations:

Nikolsky’s symptom – sliding of the upper layers of the epidermis of seemingly unaffected skin;
Asbo-Hansen's symptom - when pressing on the bubble, its area increases;
symptom of peripheral growth and others.

Reasons

Scientists have not yet identified the exact reasons why this disease may develop. There are several theories that describe the possible reasons for the aggressive behavior of immune bodies towards the cells of the body. All autoimmune diseases can occur due to a number of internal and external causes. Internal mutations include various types of gene mutations that are inherited, and external ones can be:

pathogens of infectious diseases;
radiation exposure;
ultraviolet radiation;
physical and even regular mechanical impact.

In children

A common reason why autoimmune pathologies may appear in a young child may be an allergic reaction. Defender cells of a fragile immune system can react overly aggressively to the allergen. At an early age, when immunity is just developing, any factors can cause a malfunction in the body's defenses and cause an exaggerated response to stimuli. The disease can also be transmitted from mother to child - the antibodies of the disease can pass through the placenta.

Who suffers from autoimmune diseases

More often, those patients who have a hereditary predisposition suffer from disorders associated with the functioning of the immune system. This is due to gene mutations:

The first type. Lymphocytes cease to distinguish between cells of a certain type, so there is a risk of developing pathology of the organ that was affected by this disease in close relatives. Such mutations can cause diabetes, psoriasis, multiple sclerosis, and rheumatoid arthritis.
The second type. The body's defenders, lymphocytes, begin to multiply uncontrollably, fight against cells of different organs and thereby cause systemic pathologies, which can simultaneously affect not only organs, but also glands, arteries, and various tissues.

List of autoimmune diseases

People who have a hereditary predisposition to the appearance of autoimmune diseases may experience pathologies of various organs. Pathology can form in the same organ that was affected in close relatives for a similar reason. In women, lesions of the skin, blood vessels, joints, intestines and the general gastrointestinal tract are more common. The most common skin diseases include:

scleroderma;
acrosclerosis;
lupus erythematosus or systemic lupus;
psoriasis;
pemphigus;
psoriasis
pemphigoid;
Dühring's dermatitis herpetiformis;
dermatomyositis;
allergic vasculitis.

Diagnostics

A doctor can make an accurate diagnosis only after testing the blood for certain antibodies. Each syndrome is characterized by certain types of antibodies in the blood, for example, lupus erythematosus can only be characterized by the presence of lupus erythematosus cells in the blood. If the analysis of these antibodies does not reveal, then the painful skin condition is caused by another ailment. The form of autoimmune reactions may resemble ordinary dermatitis and only an increased level of antibodies in the blood can confirm the autoimmune process.

Treatment

In the treatment of autoimmune reactions, corticosteroids are widely used, which show positive results in treatment. In some cases, therapy also includes hormonal medications and physical therapy. Intolerance to hormonal medications and corticosteroids is common among patients. In such cases, only drug therapy and symptomatic treatment of autoimmune diseases are prescribed.

It is assumed that in the development of this condition, the balance between the levels of estrogen and progesterone is disturbed, and an allergy to progesterone is also possible.

Clinically, autoimmune progesterone dermatitis appears in the form of polycyclic urticarial rash, eczema, polymorphic exudative erythema, urticaria, dyshidrosis, stomatitis, a rash resembling dermatitis herpeteformis, and nonspecific papular erythema.

The diagnosis can be confirmed using skin tests with progesterone, which is still rarely used in practice.

Hormonal allergy

Features of allergy treatment

The main principle in the treatment of autoimmune diseases is their correct diagnosis. As mentioned above, the body's hyperimmune response to hormones is often confused with any other type of allergy. Therefore, the observation of the patient himself will be a great help for the doctor, who will be able to indicate that the allergy manifests itself after strong experiences, at a certain phase of the cycle (in women), and so on.

Specific treatment is selected individually. The difficulty here is that in this case it is impossible to completely eliminate the factor causing the allergy, that is, to force the body not to produce hormones. Therefore, allergists-immunologists literally “walk the edge” in order to improve the patient’s condition without going too far and without harming his health.

The symptoms of such allergies are combated with antihistamines. Histamine is a substance that is released from the connective tissue cells of the body when an allergen comes into contact with the skin, blood or esophagus. External manifestations of allergies - dermatitis, ulcerations on mucous membranes, etc. - are a reaction with histamine of special receptors in cells. Antihistamines block these reactions and thus eliminate allergy symptoms.

Currently, there are 4 generations of antihistamines. The first generation, developed back in 1936, is still used today because it has a powerful healing effect. But only a doctor can prescribe a drug of one or another generation of the antihistamine group, since many of them have specific side effects.

Individuals suffering from stress allergies may be advised to avoid stressful situations and possibly take sedatives or tranquilizers.

Treatment of gesterone or estrogen dermatitis can be carried out, oddly enough, with the help of hormonal drugs, the selection of which is carried out by an allergist-immunologist. These can be ointments for external use that restore damaged skin, or tablets or capsules for oral use. As part of complex treatment, it is recommended to take vitamins A, D and E, which improve the functioning of the immune system.

Self-medication in this case, especially with hormonal drugs, is strictly contraindicated. Only a doctor can prescribe complex therapy.

Autoimmune progesterone dermatitis (APD syndrome) in women: what it is, treatment, causes, symptoms, signs, pregnancy

What is autoimmune progesterone dermatitis?

Autoimmune progesterone dermatitis (APD) is a rare disease with premenstrual exacerbations associated with increased sensitivity to progesterone.

Historical information