Comparison of different activity parameters in atopic dermatitis: correlation with clinical scores.
BACKGROUND
Several laboratory markers have been described to correlate positively with disease activity of atopic dermatitis (AD). These include soluble adhesion molecules and eosinophil granular proteins. Although the correlation of these parameters with the severity and extent of skin involvement has been repeatedly studied in the past, no systematic investigation has been performed over a lengthy period of time. In addition, no subjective disease parameters recorded by the patient have been included in studies dealing with disease activity.


OBJECTIVE
To assess the validity of different objective and subjective parameters [soluble E-selectin (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1), eosinophil cationic protein (ECP), urinary nitrate excretion (reflecting endogenous nitric oxide formation) and the patients' impressions of pruritus, sleeplessness and skin status] as markers of AD disease activity.


METHODS
Twenty patients were examined for 1 year and their skin status was evaluated by an established score (SCORAD). sE-selectin, sVCAM-1 and ECP were analysed by commercial test kits. Urinary nitrate concentration was measured by gas chromatography-mass spectrometry. The subjective parameters, pruritus, sleeplessness and impression of skin status, were recorded by the patients on a visual analogue scale.


RESULTS
In this long-term trial, only sE-selectin and the subjective parameters showed a statistically significant correlation with the SCORAD score.


CONCLUSIONS
Our data indicate that basic clinical scoring remains a most effective and relevant method of recording skin disease activity in AD.
Gutgesell
C
C
Department of Dermatology, University of Göttingen, von-Siebold-Strasse 3, D-37075 Göttingen, Germany. cgutges@gwdg.de
Heise
S
S
Seubert
A
A
Stichtenoth
D O
DO
Frölich
J C
JC
Neumann
C
C
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism; D003876:Dermatitis, Atopic / Q000097:blood* / Q000150:complications / Q000473:pathology; D019040:E-Selectin / Q000097:blood*; D047091:Eosinophil Granule Proteins; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017942:Nitric Acid / Q000652:urine; D011537:Pruritus / Q000209:etiology; D012260:Ribonucleases; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D001798:Blood Proteins; D019040:E-Selectin; D047091:Eosinophil Granule Proteins; D019010:Vascular Cell Adhesion Molecule-1; D017942:Nitric Acid; D012260:Ribonucleases