AbstractAtopic dermatitis is characterized by impaired skin and mucous membrane barrier function. Measures improving barrier integrity decrease the influence of environmental factors that might exacerbate inflammation. Ten adult patients with mild-to-moderate atopic dermatitis consumed for three months fermented with potent antioxidative probiotic, L. fermentum ME-3 (DSM 14241) goat milk 200 mg/day. A control group consisted of six patients, not supplemented by probiotic. All patients used emollients regularly. Skin iron levels, glutathione redox ratios (GSSG/GSH), diene conjugate (DC) amounts, blood glutathione status, oxidized low-density lipoprotein (oxLDL), and total antioxidativity was measured at the baseline and after three months. A significant decrease in skin iron levels, DC amounts, and glutathione redox ratio occurred in the probiotic-supplemented group compared to the control group (P < 0.05 for all indices). In the same group, blood levels of oxLDL decreased (p < 0.05), and GSH levels increased (P < 0.001) with concomitant improvement in the GSSG/GSH ratio. Blood antioxidativity markers also showed an improvement. The results of our study demonstrate that regular use of probiotics with antioxidative properties coupled with the use of lipid-containing emollients considerably decreases inflammation and concomitant oxidative stress in adult patients with mild-to-moderate atopic dermatitis. This effect was observed both in the skin and in the blood.

To assess the consequences of oxidative stress in allergic and irritant contact dermatitis, we compared the iron level, unsaturated iron-binding capacity, total iron binding capacity, the percentage saturation of iron-binding capacity, the amount of diene conjugates as well as the amounts of total glutathione, reduced glutathione, oxidized glutathione, and the oxidized glutathione/reduced glutathione ratio in skin homogenate from lesional and nonlesional skin. Lesional skin samples were obtained from positive patch test sites to 5% NiSO4 in five subjects, and from chronic contact dermatitis lesions on the hands, which had exacerbated over 3--9 wk in six subjects. Contact dermatitis caused at least a 4-fold increase in the iron level in the lesional skin area compared with the nonlesional skin area (p < 0.02). The increase in the iron level depended on the duration of contact dermatitis and was accompanied by high unsaturated iron-binding capacity and total iron-binding capacity values in the positive patch test sites (p < 0.05), and by a high percentage saturation value in the chronic contact dermatitis lesions (p < 0.05). We found high indices for iron, total iron-binding capacity and diene conjugates in the apparently healthy skin of the patients with persistent contact dermatitis that significantly (p < 0.05) exceeded the corresponding values in the patients with only patch test reactions. In summary, we have succeeded in providing evidence that generalized oxidative damage of the skin occurs as a consequence of contact dermatitis in a restricted area.

The aim of our study was to evaluate the clinical features, predisposing factors and pathogens of toenail onychomycosis in Estonia. During study period we interviewed and examined 436 dermatological patients with clinical signs of toenail onychomycosis in all counties of Estonia. In 69% of cases, the clinical diagnosis of onychomycosis was confirmed by the mycological analysis. The most common clinical symptoms of onychomycosis both in mycologically proven and non-proven cases were discolorization of nail plate, hyperkeratosis and brittle nails. The number of infected toenails positively correlated with patients' age. On average, patient had 5.4 infected nails. In 78% of culture-positive cases, a dermatophyte was isolated as the causative agent, in 10% yeasts and in 7% moulds. In 6% of culture-positive cases we reported mixed infections. Trichophyton rubrum was the most common pathogen. The high occurrence of mixed infections, clinical symptoms characteristic to long lasting or chronic infection and high number of infected toenails indicate that Estonian patients have more advanced stage of toenail onychomycosis compared with other western and central European countries.

Atopic dermatitis (AD) is a chronic, remitting, inflammatory skin disorder. It has a complex etiology in which immunological dysregulation and skin barrier alterations play an important role. [1][2][3] The fact that the expression of skin barrier proteins is downregulated by Th2 cytokines further emphasizes the interaction between the immune system and skin barrier in AD. 4,5 Investigating the expression of inflammatory mediators provides insight into specific immunopathological pathways that can be used to subclassify AD patients, monitor and potentially predict treatment responses. The invasive and laborious nature of many procedures used to obtain skin samples, such as biopsies, has led to the development of minimally invasive skin sampling methods such as tape stripping for analysis of biomarkers in AD, including proteins, [6][7][8]9,10 and lipids. 11,12 Although tape stripping is considered to only have a mild impact on the skin, this technique can induce skin irritation especially in patients with sensitive skin. 13,14 Non-invasive sampling of soluble biomarkers from the skin surface by skin-washing techniques without disrupting the stratum corneum has been used by several groups. These methods have involved collection of fluid from the surface using a sampling well placed on the skin 15,16 or nitrocellulose membranes pre-spotted with specific antibodies to

The reactive patch test reaction is a useful model to characterize oxidative stress in acute allergic contact dermatitis. This model was used to study oxidative stress in the skin of individuals allergic to nickel and epoxy resin. The study included six and five patients, respectively, whose skin was simultaneously biopsied from a positive patch test site and from an apparently healthy area. The biopsies were homogenized and used for determination of iron content, unbound iron binding capacity, diene conjugate levels, and glutathione redox ratio. A positive test reaction to 5% nickel sulphate was accompanied by 2.5-fold increase in iron level as compared to apparently healthy skin (P<0.1). The percentage saturation of iron-binding capacity and the glutathione redox ratio were significantly increased (P<0.01 and P<0.05, respectively). Reactive patch test responses to 1% epoxy resin were not accompanied by clear alterations in iron status or glutathione redox ratio. Our investigation showed that apart from oxidative burst caused by accumulation of inflammatory cells, hapten properties might also influence the oxidative stress status of the skin. The high incidence of nickel allergy may be attributed, at least in part, to the influence of nickel ions on the glutathione redox ratio and iron status of the skin.