Asthma, smoking history and staph aureus enterotoxin sensitization; and the effectiveness of bleach versus warm baths in children with significant atopic dermatitis
The November issue of the Annals of Allergy, Asthma and Immunology has a variety of features for our practicing clinician readers. There are features and information about many aspects of our specialty. There are two articles in particular that are worth mentioning.
The first is an original investigation reported by Dr. Tadao Nagasaki and colleagues who categorized over 170 individuals with asthma on the basis of their smoking history (current ex or never smoked) then determined their sensitization to Staph aureus enterotoxin (SE) which was highest in current smokers and least in never smokers. SE sensitization was associated with higher total and allergen-specific IgE, higher blood eosinophils, greater bronchial obstruction and more severe disease compared to non-sensitized individuals. SE sensitization in smokers was reduced with duration of abstinence which suggests both a mechanism for more severe asthma in smokers and an additional value for smoking cessation in these patients.
Another very important clinical study from Dr. Jonathan Silverberg’s group looked at the literature for and against the use of bleach baths in children with significant atopic dermatitis. In this systematic review and meta-analysis of the existing data (which, admittedly is limited – only five studies were included in the meta-analysis), the authors reached the conclusion that water baths are as effective as bleach baths in the treatment regimen for significant atopic dermatitis. They call for large scale, randomized clinical trials to better prospectively evaluate where bleach baths should fit into the evidence-based therapeutic plan for children with atopic dermatitis.
I hope you will enjoy these and other features in you November issue of Annals. Be sure and check out the Annals website for additional features that will improve your practice. As always, I am always open to hearing how we can better meet the educational and informational needs of you, our reader.