title: IgE-mediated sensitization to malassezia in atopic dermatitis: more common in male patients and in head and neck type.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a common chronic inflammatory skin disease. Malassezia, the predominant skin microbiota fungus, is considered to exacerbate AD, especially in a subset of patients with head and neck type AD (HNAD). In the present study, the relationship between AD and sensitization to Malassezia antigens was investigated.
  
  
  METHODS
  We assessed 173 patients with AD. The severity of eczema was determined with Eczema Area and Severity Index (EASI); the type of AD, namely, head and neck type, was reported as well. The total serum IgE and specific IgE to Malassezia were determined and correlated with clinical picture of AD, sex, age, and the EASI.
  
  
  RESULTS
  Total IgE was elevated in 77.7% of patients. Specific IgE to Malassezia was positive (≥0.35 kU/L) in 49.1% of patients. Men were significantly more often sensitized to Malassezia antigen (58% of men vs 42% of women; P value, 0.04). Concurrently, 58% of patients with HNAD versus 42% non-HNAD patients had higher levels of specific IgE to Malassezia, this difference being nearly significant (P value, 0.06). Patients with atopy were also more frequently sensitized to Malassezia. No significant relationship between EASI and the level of total IgE or specific IgE to Malassezia was observed.
  
  
  CONCLUSIONS
  In our population, IgE-mediated sensitization was found in up to 49% of all patients with AD, most common in men and in head and neck type.
authors.affiliation: From the *Department of Dermatovenereology, University Hospital in Pilsen, Czech Republic; †Allergy Unit, Department of Dermatology, University Hospital of Zurich, Switzerland; and ‡Department of Immunology and Allergology, University Hospital in Pilsen, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Brodská
authors.forename: Petr
authors.initials: P
authors.lastname: Panzner
authors.forename: Karel
authors.initials: K
authors.lastname: Pizinger
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid-Grendelmeier
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000908:Antibodies, Fungal / Q000032:analysis / Q000276:immunology*; D002648:Child; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology*; D003881:Dermatomycoses / Q000453:epidemiology* / Q000276:immunology*; D005260:Female; D005858:Germany; D006257:Head; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis / Q000276:immunology*; D008290:Malassezia / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009333:Neck; D010328:Patch Tests / Q000379:methods; D011379:Prognosis; D012016:Reference Values; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors
chemical_list: D000908:Antibodies, Fungal; D007073:Immunoglobulin E