Beneficial effect of Helicobacter pylori eradication in dermatologic diseases.
BACKGROUND
A relationship between skin diseases, particularly rosacea and chronic urticaria, and H. pylori infection has been suggested.


METHODS
We preformed a prospective evaluation of the effect of H. pylori eradication in patients with a variety of chronic skin diseases. Patients were followed monthly for at least one year after cure of the infection. The effect of therapy was scored using a three point scale: complete remission (> 90% improvement), partial remission (50-90% improvement) or no improvement (< 50 improvement). The relationship between response and anti-H. pylori Ig G and E to specific H. pylori antigens was analyzed by Western blot analysis.


RESULTS
Eighty-eight H. pylori-infected patients with skin disease were enrolled. Treatment was successful in 73% of patients with chronic urticaria as 23% (6 of 26) had complete and 50% had partial remission. Sixty-two percent (18 of 29) with pruritus cutaneus had partial remission as well as 30% with prurigo chronica multiformis had complete remission. Western blotting was done on 24 patients with skin disease and a 44K H. pylori antigen was detected by Ig E analysis in 100% (5 of 5) patients with complete remission compared to 23% (3 of 13) in those without skin disease.


CONCLUSIONS
These results suggest it may be prudent to test patients with chronic urticaria, prurigo chronica multiformis, pruritus cutaneus, and eczema nummulare for H. pylori infection and to eradicate the infection in those whose test is positive.
Shiotani
A
A
Second Department of Internal Medicine andDepartment of Dermatology, Wakayama Medical University, Japan.
Okada
K
K
Yanaoka
K
K
Itoh
H
H
Nishioka
S
S
Sakurane
M
M
Matsunaka
M
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000032:analysis; D001426:Bacterial Proteins / Q000032:analysis; D015153:Blotting, Western; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D012008:Recurrence; D016036:Seroepidemiologic Studies; D012871:Skin Diseases / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D054328:Proton Pump Inhibitors; C080866:cagA protein, Helicobacter pylori; D008795:Metronidazole; D017291:Clarithromycin