[Immedeate and delayed-type reactivity to fungi and effects of antifungal drugs on atopic dermatitis].
OBJECTIVE
To investigate immediate and delayed-type reactivity for fungi in atopic dermatitis (AD) patients and the effect of antifungal therapy.


METHODS
We examined immediate and delayed-type reactivity in AD patients for Candida albicans and Malassezia furfur by skin prick test (SPT), and estimated the effect of amphotericin B (AMPH) and itraconazole (ITCZ).


RESULTS
Twenty eight of 40 patients showed positive immediate-type reaction and 10 of 27 patients did delayed-type reaction for Candida albicans. As for Malassezia furfur, positive immediate-type reaction was shown in 30 of 40 patients and positive delayed-type reaction did in 4 of 27 patients. The RAST score of specific IgE to Candida albicans was low in the patients with positive delayed-type skin reaction for Candida albicans, while the score was high in the patients with the negative delayed-type skin reaction. Both of AMPH and ITCZ were effective to the patients with positive immediate-type reaction for Candida albicans in SPT. The skin reaction for Malassezia furfur was stronger in the patients treated with ITCZ effectively than in the patients treated not effectively. In addition, ITCZ was effective in all patients except one, who showed positive reaction for Malassezia furfur accompanied with negative reaction for Candida albicans in SPT.


CONCLUSIONS
Fungal allergy is one of the aggravation factors of AD, and SPT is useful to evaluate fungal allergy and to choose effective antifungal therapy.
Kobayashi
Teruko
T
Department of Dermatology, Yokohama City University Medical Center.
Yamada
Masako
M
Aihara
Michiko
M
Ikezawa
Zenro
Z
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000276:immunology; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology*; D006969:Hypersensitivity, Immediate / Q000276:immunology*; D017964:Itraconazole / Q000627:therapeutic use; D008290:Malassezia / Q000276:immunology; D008297:Male; D008875:Middle Aged
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B