Background: Several epidemiological studies have shown that the atopic tendency increases in the obese population. Objective: The aim of this study was to confirm the effect of weight reduction on improvement of atopic dermatitis (AD) symptoms and to investigate the relationship between AD severity and the level of serum adipokines. Methods: Forty subjects who were AD outpatients were recruited for this study. Obese patients were divided into a weight maintenance group and weight reduction group. During the study period, patient information was collected that included measured body mass index (BMI), Eczema Area and Severity Index (EASI), and visual analogue scale for pruritus. Adiponectin, leptin, eosinophil count, and total immunoglobulin E were also tested. Results: In the weight reduction group, there was a significant improvement in the EASI score, however, no significant improvement was determined in the weight maintenance group. BMI and EASI showed positive correlation. The adiponectin level was lower in AD patients compared to healthy controls, and it was significantly lower in obese patients compared with normal weight patients. Serum levels of leptin were significantly different among control, obese patient group, and normal weight patient group. There was no statistically significant relationship between serum adipokine level and EASI. Conclusion: In our study, weight reduction was associated with significant improvement of AD symptoms. Related adipokine levels were significantly different among the control, normal weight AD patient group, and obese AD patient group. (Ann Dermatol 32(4) 319∼326, 2020

Post-burn pruritus is the pruritus that occurs after burn during the rehabilitation and healing process of burn wounds. The post-burn pruritus is a common and serious complication of burn injury, which severely lowers the quality of life of the patient. Many potential treatments are available for pruritus but there is no consensus of the best single treatment yet. The precise mechanism of post-burn pruritus has not been elucidated, but it appears to have pruritogenic and neuropathic aspects. Clinically, post-burn pruritus tends to be intractable to conventional treatment but rather responds to neuroleptic agents, such as gabapentin and pregabalin. During wound healing, various neuropeptides secreted from the nerves of the skin control epidermal and vascular proliferation and connective tissue cells. When keratinocytes are activated by an itch-inducing substance, they secrete a variety of inflammatory substances that increase the susceptibility of the itch receptor. There are two mechanisms underlying post-burn neuropathic pruritus. The first one is peripheral sensitization. The second one is the intact nociceptor hypothesis. An effective treatment for post-burn pruritus will also be effective in other neuropathic and intractable itching. In this review, we summarized the interaction and mechanism of keratinocytes, immune cells, and nerve fibers related to post-burn pruritus.

BackgroundAtopic dermatitis (AD) is related to a deficiency of delta-6-desaturase, an enzyme responsible for converting linoleic acid to gamma-linolenic acid (GLA). Evening primrose oil (EPO) as a source of GLA has been of interest in the management of AD.ObjectiveThe aim of this randomized, double-blinded, placebo-controlled clinical study is to evaluate the efficacy and safety of EPO in Korean patients with AD.MethodsFifty mild AD patients with an Eczema Area Severity Index (EASI) score of 10 or less were enrolled and randomly divided into two groups. The first group received an oval unmarked capsule containing 450 mg of EPO (40 mg of GLA) per capsule, while placebo capsules identical in appearance and containing 450 mg of soybean oil were given to the other group. Treatment continued for a period of four months. EASI scores, transepidermal water loss (TEWL), and skin hydration were evaluated in all the AD patients at the baseline, and in months 1, 2, 3, and 4 of the study.ResultsAt the end of month 4, the patients of the EPO group showed a significant improvement in the EASI score (p=0.040), whereas the patients of the placebo group did not. There was a significant difference in the EASI score between the EPO and placebo groups (p=0.010). Although not statistically significant, the TEWL and skin hydration also slightly improved in the EPO patients group.ConclusionWe suggest that EPO is a safe and effective medicine for Korean patients with mild AD.

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