Topical dinitrochlorobenzene therapy in the treatment of refractory atopic dermatitis: Systemic immunotherapy - 05/09/11
Abstract |
Background: Repeated dinitrochlorobenzene (DNCB) application has been proposed as a systemic immunotherapy on the basis of its ability to stimulate T helper 1 (TH1) responses, such as those for systemic lupus erythematosus and HIV infection. Objective: We report the effect of topical DNCB therapy in an open trial in patients with refractory atopic dermatitis (AD). Methods: Eight patients with refractory AD received weekly application of 0.2% to 1% DNCB to a 2.5-cm2 area on the upper arm after sensitization with 5% DNCB; the position was rotated at each application. Disease activity was monitored by pruritus score, percentage of body involvement, clinical severity score, eosinophil counts, serum IgE levels, and serum soluble interleukin 2 receptor levels. Results: Six of 8 patients (patients 1-6) showed apparent improvement both on clinical scores and laboratory data until 16 weeks after DNCB therapy (week 16). The clinical severity scores of patients 1 to 6 were significantly correlated with eosinophil counts, IgE levels, and serum soluble interleukin 2 receptor levels. One patient did not show clear improvement, and another (patient 8) showed deterioration. DNCB therapy was discontinued at week 12 for patient 8. Conclusion: Topical DNCB may systemically stimulate TH1 cell responses of patients with AD, resulting in restoration of the TH1/TH2 imbalance and possible clinical improvement. These results, however, should be interpreted with caution until additional documentation is obtained. (J Am Acad Dermatol 2000;42:258-62.)
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Reprint requests: Yusuke Yoshizawa, MD, Department of Dermatology, Saitama Medical Center, Saitama Medical School, 1981 Kamoda-Tsujido, Kawagoe, Saitama, 350-8550, Japan. |
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0190-9622/2000/$12.00 + 0 16/1/103040 |
Vol 42 - N° 2P1
P. 258-262 - février 2000 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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