A ROLE FOR EOSINOPHILS IN THE PATHOGENESIS OF SKIN-LESIONS IN PATIENTS WITH FOOD-SENSITIVE ATOPIC-DERMATITIS

Background: Atopic dermatitis is associated with skin and blood eosino philia, but the role of eosinophils in the pathogenesis of the skin le sions is poorly understood. Methods: To determine whether eosinophils play a role in the pathogenesis of the skin lesions in atopic dermatit is, we studied the relationship between the severity of the disease an d both the number and the extent of activation of eosinophils in 15 pa tients with food-sensitive atopic dermatitis. Furthermore, this relati onship was re-evaluated in eight of these patients who after a period of elemental diet or total pal enteral nutrition, showed significant c linical improvement. Results: A clear relationship was found between t he number of light-density eosinophils and the severity of the disease both during the active disease and after clinical improvement. Furthe rmore, we describe an adhesion-stimulating activity for eosinophils in patients' plasma, which does not change after recovery, Conclusions: Taken together, these observations strongly indicate that eosinophils play a pivotal role in the pathogenesis of the skin lesions in atopic dermatitis. In particular, the light-density phenotype seems to be an essential feature of eosinophils involved in this process The adhesion -promoting activity that we observed in the patients' plasma could be important in the recruitment of eosinophils from the blood into the sk in.