title: Cedar pollen aggravates atopic dermatitis in childhood monozygotic twin patients with allergic rhino conjunctivitis.
abstract: We report a case of 7-year-old monozygotic twin patients with atopic dermatitis. The HLA haplotypes were HLA A2, A11, B27, B61, DR1, and DR4. Both serum IgE levels and cedar pollen radioallergosorbent test (RAST) scores were high in the twins (elder/younger sister: IgE: 5170/3980 IU/ml and Japansese cedar pollen: >100/64.0) in contrast to low mite and food RAST scores (Dermatophagoides Pterygonium; 0.59/0.4 and egg white 9.24/4.6). The patients showed positive immediate (20 min in both sisters) and delayed (24 hours in elder sister, 24, 48, 72 hours in younger sister) reactions to a scratch test with Japanese cedar pollen. Skin lesions on the face were aggravated and extended to the trunk and extremities during the Japanese cedar pollen season and gradually subsided in summer. Oral provocation with egg white or cow milk showed no exacerbations, and topical corticosteroid did not improve the eczema. In contrast, successful protection from severe scratching behaviors was achieved by use of topical anti-allergic eye drops and wearing nightgowns made by the mother.
authors: Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Japan.
authors: Yukako
authors: Y
authors: Murakami
authors: Saki
authors: S
authors: Matsui
authors: Akiko
authors: A
authors: Kijima
authors: Shun
authors: S
authors: Kitaba
authors: Hiroyuki
authors: H
authors: Murota
authors: Ichiro
authors: I
authors: Katayama
mesh_terms: D000485:Allergens / Q000276:immunology*; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D002648:Child; D003233:Conjunctivitis, Allergic / Q000150:complications; D032485:Cryptomeria / Q000276:immunology*; D003876:Dermatitis, Atopic / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D004200:Diseases in Twins / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D005260:Female; D006680:HLA Antigens / Q000235:genetics; D006239:Haplotypes; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D011058:Pollen / Q000276:immunology*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D012867:Skin / Q000473:pathology; D014430:Twins, Monozygotic
chemical_list: D000485:Allergens; D018926:Anti-Allergic Agents; D006680:HLA Antigens; D007073:Immunoglobulin E