"My patients understand itch is transferred like nerve pain," said Gil Yosipovitch, MD, director of the Miami Itch Center and chair of the National Eczema Association scientific advisory committee.
But clinicians have argued whether atopic dermatitis is a "rash that itches" or an "itch that rashes," he acknowledged.
New evidence supports the patient-reported sensation that "eczema is the itch that rashes," Yosipovitch told Medscape Medical News.
The research, published in Nature and presented during the President's Symposium at the 28th European Academy of Dermatology and Venereology Congress in Madrid, shows that neurons serving the skin directly interact with mast cells to trigger the massive histamine release associated with atopic dermatitis inflammation.
These new findings confirm a direct role for the nervous system, which is responsible for the itchiness and was already implicated in the inflammation.
"We, as a profession, have this thinking that eczema is an immune condition, and we forget that the immune system works with nerves," Yosipovitch explained. "Ten years ago, you wouldn't accept it because there weren't any data."
Atopic dermatitis, a form of eczema, is far more than just itching skin. The condition cycles through flares and remissions and can take over the entire body, leading to discomfort and inflammation. In fact, the root of "eczema" is a Greek word for boiling, which is an apt description of the burning inflammation and itching people experience.
Eczema affects about one in five children, some of whom show signs of it shortly after birth. Genetic variants can increase susceptibility.
For newborns at high risk for eczema, the pre-emptive application of petroleum jelly might delay onset or limit escalation, one study suggests. However, studies on the use of cream emollients and oil baths have yielded disappointing results, as reported by Medscape Medical News.
The investigators used dust mite antigens from the skin of reactive patients to induce a reaction in mice.
The condition is so similar in mice and humans that it is difficult to distinguish samples from one another at the microscopic level, presenter Nicolas Gaudenzio, PhD, an immunologist at INSERM in Toulouse, France, told Medscape Medical News.
For their study, Gaudenzio and his colleagues used several mouse models to show that sensory neurons and immune cells work together to detect allergens related to the common dust mite.
The team pursued this research question because levels of neuropeptides signaling molecules produced by sensory neurons called nociceptors are elevated in people with atopic dermatitis, as are markers for mast cells.
To examine the association between neurons and mast cells, the researchers exposed mice to dust mite allergens and monitored their skin. They found that nociceptors, which transmit pain and itch messages, and mast cells do not chat with each other from a distance. Instead, they cluster together and make physical contact, with the mast cells gathering around the nociceptors like bees around a hive.
We don't really know why some people are reacting and others are not.
We don't really know why some people are reacting and others are not.
Although these neuronmast cell units seem to be part of normal immune defense, not everyone reacts to ubiquitous dust mite allergens. In some people, "they can literally fire up the nerve fibers," he pointed out, "but we don't really know why some people are reacting and others are not. That's a black box."
Nociceptors and mast cells occur in other tissues that show an allergic response, the researchers explain, including the lungs, upper airways, and gut.
After his presentation, audience questions to Gaudenzio homed in on the same subject: Does this discovery mean new therapeutic possibilities for this sometimes-intractable condition?
That is not clear, Gaudenzio said, but the next steps will be to block the interaction between the sensory neuron and the mast cells to see if doing so forestalls the cascade of events that leads to the inflammation.
28th European Academy of Dermatology and Venereology (EADV) Congress. Presented October12, 2019.
Follow Medscape on Facebook, Twitter, Instagram, and YouTube
See the original post:
Evidence Growing That Eczema Itch More Than Skin Deep - Medscape
- Eczema: Read About Symptoms and Medications - October 15th, 2014 [October 15th, 2014]
- Dermatitis - Wikipedia, the free encyclopedia - October 15th, 2014 [October 15th, 2014]
- Eczema and Your Skin | Eczema Types, Symptoms, Causes, and ... - October 15th, 2014 [October 15th, 2014]
- Kangen Water Testimony - Eczema, Weight Loss, Headaches - Video - October 15th, 2014 [October 15th, 2014]
- Controlling eczema - Video - October 17th, 2014 [October 17th, 2014]
- Eczema update! - When To Seek Medical Attention - Video - October 18th, 2014 [October 18th, 2014]
- My Makeup Routine For Eczema & Psoriasis - Video - October 18th, 2014 [October 18th, 2014]
- Dyson launches humidifier to combat eczema and psoriasis - October 20th, 2014 [October 20th, 2014]
- Sanofi, Regeneron Begin Phase 3 Study For Eczema Drug Dupilumab - October 20th, 2014 [October 20th, 2014]
- Ayurvedic treatment for Atopic Eczema - Video - October 20th, 2014 [October 20th, 2014]
- How To Treating Eczema at Home? EASY! Find it On This Video - Video - October 20th, 2014 [October 20th, 2014]
- Topical BioMedics Announces "Soothe the Skin They're in," a New Program for Children Who Suffer with Eczema - October 21st, 2014 [October 21st, 2014]
- Vitamin D Might Help Kids With Eczema - October 21st, 2014 [October 21st, 2014]
- Edguard tube cream for acne, eczema, scars and pregnancy blemishes - Video - October 21st, 2014 [October 21st, 2014]
- Cara Veldman #1848200 Eczema Cream - Video - October 21st, 2014 [October 21st, 2014]
- Tampa dermatologists clinical trial for sufferers of eczema ongoing - October 23rd, 2014 [October 23rd, 2014]
- Eczema - A recurrent rash everyone complains about - October 23rd, 2014 [October 23rd, 2014]
- My Essentials for Dry Skin & Eczema - Video - October 23rd, 2014 [October 23rd, 2014]
- Taking a 'Selfie' May Help With Dermatology Care, Study Shows - October 24th, 2014 [October 24th, 2014]
- EP.2 Cures Thermales : Business ou Sant ? - EczemaHelp - Video - October 24th, 2014 [October 24th, 2014]
- EP.1 Cures Thermales : Business ou Sant ? - EczemaHelp - Video - October 24th, 2014 [October 24th, 2014]
- Home remedy for eczema - Beat eczema - Video - October 24th, 2014 [October 24th, 2014]
- Trailer - EczemaHelp - Video - October 24th, 2014 [October 24th, 2014]
- Family First: Calming the symptoms of severe eczema - October 25th, 2014 [October 25th, 2014]
- what causes eczema - Eczema Free Providing ... - October 27th, 2014 [October 27th, 2014]
- Atopic eczema - Treatment - NHS Choices - Your health ... - October 27th, 2014 [October 27th, 2014]
- Atopic dermatitis - Wikipedia, the free encyclopedia - October 27th, 2014 [October 27th, 2014]
- Atopic eczema - NHS Choices - October 27th, 2014 [October 27th, 2014]
- Eczema Treatment Options : How To Cure Eczema & Home Remedies For Eczema - Video - October 27th, 2014 [October 27th, 2014]
- Chamomile: A herbal medicine of the past with bright future - October 29th, 2014 [October 29th, 2014]
- How SELFIES can help cure skin conditions - October 30th, 2014 [October 30th, 2014]
- Eczema linked to bone fractures, injuries in new Northwestern study - October 30th, 2014 [October 30th, 2014]
- Adult eczema may be unrecognized risk factor for fracture, other injuries - October 30th, 2014 [October 30th, 2014]
- Mom Tips: Relief for Baby Eczema - Video - October 30th, 2014 [October 30th, 2014]
- BEST BABY ECZEMA PRODUCTS - Video - October 30th, 2014 [October 30th, 2014]
- Eczema Tied to Bone Fracture Risk in Study - October 30th, 2014 [October 30th, 2014]
- Accident prone eczema patients - October 30th, 2014 [October 30th, 2014]
- Eczema girl's agony is over thanks to allergen-busting extra washing machine rinse cycles - November 1st, 2014 [November 1st, 2014]
- Helping Healing Eva's Eczema with Applied Kinesiology - Video - November 1st, 2014 [November 1st, 2014]
- Eczema May Increase Risk of Injury - Video - November 1st, 2014 [November 1st, 2014]
- treatmyeczema - November 2nd, 2014 [November 2nd, 2014]
- My Eczema Care Routine March 2014 | ... ... - November 2nd, 2014 [November 2nd, 2014]
- The Psoriasis Eczema Skin Puzzle #42 - Video - November 3rd, 2014 [November 3rd, 2014]
- Can some patients' bodies become 'addicted' to topical steroids? - November 5th, 2014 [November 5th, 2014]
- How To Treat Eczema Naturally Review DO NATURAL REMEDIES REALLY WORK - Video - November 5th, 2014 [November 5th, 2014]
- I Will Beat Anyone I Find Eczema On His/Her Body - Video - November 5th, 2014 [November 5th, 2014]
- Proper amount of bathing and moisturizing your baby may help prevent skin disease - November 8th, 2014 [November 8th, 2014]
- How to get rid of super dry skin psoriasis, eczema and more! - Video - November 12th, 2014 [November 12th, 2014]
- Easy Homemade Remedy For Eczema - Pulse Daily - Video - November 13th, 2014 [November 13th, 2014]
- Aveeno Eczema Therapy Moisturizing Cream - Video - November 15th, 2014 [November 15th, 2014]
- aveeno eczema moisturizing cream | Sample Promo - Video - November 16th, 2014 [November 16th, 2014]
- Psoriasis & Eczema : Rain soul by Johnny - Video - November 16th, 2014 [November 16th, 2014]
- aveeno baby eczema therapy moisturising cream | Sample Promo - Video - November 17th, 2014 [November 17th, 2014]
- aveeno baby eczema therapy reviews | Sample Promo - Video - November 18th, 2014 [November 18th, 2014]
- Peanut in household dust linked to peanut allergies, especially for children with eczema - November 19th, 2014 [November 19th, 2014]
- Peanut in household dust linked to peanut allergy in children with eczema during infancy - November 19th, 2014 [November 19th, 2014]
- 10 Tips to Manage Psoriasis and Eczema this Winter - November 19th, 2014 [November 19th, 2014]
- Tampa dermatologist excited over eczema clinical trial results - November 20th, 2014 [November 20th, 2014]
- aveeno baby eczema moisturizing cream | Sample Promo - Video - November 20th, 2014 [November 20th, 2014]
- Why I am sharing my eczema journey and what I deal with everyday living with eczema - Video - November 20th, 2014 [November 20th, 2014]
- Cetaphil Restoraderm Restoring Formulated Eczema - Video - November 20th, 2014 [November 20th, 2014]
- Cetaphil Restoraderm Restoring Moisturizer 10 Fluid - Video - November 20th, 2014 [November 20th, 2014]
- Childhood Eczema Cure With Kangen Water - Testimonial - Video - November 22nd, 2014 [November 22nd, 2014]
- Natural Remedies for Eczema - The Best Eczema Treatment - Video - November 23rd, 2014 [November 23rd, 2014]
- Eczema in Kids - Read More About It - Video - November 23rd, 2014 [November 23rd, 2014]
- Hypoallergenic labels may not be accurate - November 23rd, 2014 [November 23rd, 2014]
- Danielle Sheehan's life transformed after Botox eradicates her eczema - November 25th, 2014 [November 25th, 2014]
- Eczema's effects can be bone-deep - November 25th, 2014 [November 25th, 2014]
- New recommendations for treating kids with eczema - November 25th, 2014 [November 25th, 2014]
- Eczema cases rising among U.S. children - November 25th, 2014 [November 25th, 2014]
- Eczema Cases Rising Among U.S. Children: Report - November 25th, 2014 [November 25th, 2014]
- New guidelines released for treating kids with eczema - Video - November 25th, 2014 [November 25th, 2014]
- TCM Recipe Natural Herbal Eczema Cream Review - Video - November 25th, 2014 [November 25th, 2014]
- New product to heal eczema to use topically and progress pictures - Video - November 25th, 2014 [November 25th, 2014]
- 15 Proven Natural Cures for Eczema - Baby dermatitis: how ... - November 26th, 2014 [November 26th, 2014]
- Aveeno Moisturizing Bar - Aveeno Eczema Therapy Moisturizing Cream - Video - November 26th, 2014 [November 26th, 2014]
- How to psychologically & physically confront eczema in you. - Video - November 26th, 2014 [November 26th, 2014]
- Woman, 21, left looking sunburnt by severe eczema finally has the perfect complexion - thanks to a 'magical' cream - November 27th, 2014 [November 27th, 2014]
- Aveeno Baby Sunscreen - Aveeno Baby Coupons - Aveeno Baby Eczema - Video - November 27th, 2014 [November 27th, 2014]
- How I cured my eczema in just over 10 days and you can to. My personal review - Video - November 28th, 2014 [November 28th, 2014]