Basal serum cortisol and adrenocorticotropic hormone levels in patients with atopic dermatitis

Zohreh Tehranchinia; Hoda Rahimi; Sara Lotfi

doi:10.5826/dpc.0704a07

Basal serum cortisol and adrenocorticotropic hormone levels in patients with atopic dermatitis

Authors

Zohreh Tehranchinia Department of Dermatology, Skin Research Center, Shahid Behehshti University of Medical Sciences, Tehran, Iran
Hoda Rahimi Department of Dermatology, Skin Research Center, Shahid Behehshti University of Medical Sciences, Tehran, Iran
Sara Lotfi Department of Dermatology, Skin Research Center, Shahid Behehshti University of Medical Sciences, Tehran, Iran

Keywords:

adrenocorticotropic hormone, atopic dermatitis, cortisol, IgE

Abstract

Background: Certain studies suggest that percutaneous absorption of topical steroids may cause suppression of hypothalamic–pituitary–adrenal axis (HPAA) in atopic dermatitis (AD) patients. This study aimed to investigate the basal serum cortisol, adrenocorticotropic hormone (ACTH), and IgE levels in patients with AD and their correlation with the disease severity.

Methods: Levels of basal serum cortisol, ACTH, and IgE were assessed by ELISA in 31 patients with AD and 31 controls. Clinical severity of AD was evaluated by the scoring of atopic dermatitis (SCORAD) index.

Results: No statistical difference was observed between the two groups for basal serum cortisol and ACTH levels. The serum IgE level was significantly higher in the AD group. The SCORAD index was correlated with serum IgE level.

Conclusions: Basal serum cortisol and ACTH levels are normal in AD patients. Serum IgE level is significantly higher in AD patients and is correlated with the disease severity.

References

Hanifin JM, Rajka G. Diagnstic features of atopic dermatitis. Acta Derm Venreol. 1980; 92: 44-47.

Williams HC. Epidemiology of human atopic dermatitis--seven areas of notable progress and seven areas of notable ignorance. Vet Dermatol. 2013 ;24:3-9.e1-2.

Madhok V, Futamura M, Thomas KS, Barbarot S. What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 1. Epidemiology, mechanisms of disease and methodological issues. Clin Exp Dermatol. 2015 ;40 :238-42.

Van Moerbeke D. European Allergy white paper. Allergic disease as a public health problem in Europe. Brussels. UCB Institute of Allergy 1997.

Yaghmaie P, Koudelka CW, Simpson EL. Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol. 2013 ;131:428-33.

Kong TS, Han TY, Lee JH, Son SJ. Correlation between Severity of Atopic Dermatitis and Sleep Quality in Children and Adults. Ann Dermatol. 2016;28 :321-6.

Palit A, Handa S, Bhalla AK, Kumar B. A mixed longitudinal study of physical growth in children with atopic dermatitis. Indian J Dermatol Venereol Leprol. 2007 ;73 :171-5.

Whiteley J, Emir B, Seitzman R, Makinson G. The burden of atopic dermatitis in US adults: results from the 2013 National Health and Wellness Survey. Curr Med Res Opin. 2016 21:1-7

Al Shobaili HA. The impact of childhood atopic dermatitis on the patients' family. Pediatr Dermatol. 2010 ;27:618-23.

McKenna SP, Doward LC. Quality of life of children with atopic dermatitis and their families. Curr Opin Allergy Clin Immunol. 2008 ;8 :228-31.

Lewis-Jones S. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract. 2006 ;60:984-92.

Eichenfield LF, Tom WL, Berger TG et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014 ;71:116-32.

Silverberg JI, Nelson DB, Yosipovitch G. Addressing treatment challenges in atopic dermatitis with novel topical therapies. J Dermatolog Treat. 2016; 11:1-9.

Siegfried EC, Jaworski JC, Kaiser JD, Hebert AA. Systematic review of published trials: long-term safety of topical corticosteroids and topical calcineurin inhibitors in pediatric patients with atopic dermatitis. BMC Pediatr. 2016 ;16:75.

Buske-Kirschbaum A, von Auer K, Krieger S, Weis S, Rauh W, Hellhammer D . Blunted cortisol responses to psychosocial stress in asthmatic children: a general feature of atopic disease? Psychosom Med. 2003; 65 :806-10.

Haeck IM,Timmer-de Mik L, Lentjes EGWM et al. Low basal serum cortisol in patients with severe atopic dermatitis: potent topical corticosteroids wrongfully accused. Br J Dermatol. 2007; 156: 979-85.

Matsuda K, Katsunuma T, Iikura Y, Kato H, Saito H, Akasawa A. Adrenocortical function in patients with severe atopic dermatitis. Ann Allergy Asthma Immunol. 2000; 85: 35-9.

Gelmetti C, Colonna C. The value of SCORAD and beyond. Towards a standardized evaluation of severity? Allergy 2004;59: 61-5.

Patel L, Clayton PE, Addison GM, Price DA, David TJ. Adernal function following topical steroid treatment in children with atopic dermatitis. Br J Dermatol 1995; 132: 950-5.

Haeck IM,Timmer-de Mik L, Lentjes EGWM et al. Erratum to Low basal serum cortisol in patients with severe atopic dermatitis: potent topical corticosteroids wrongfully accused. Br J Dermatol. 2009;161:218.

Nutan, Kanwar AJ, Bhansali A, Parsad D. Evaluation of hypothalamic-pituitary-adrenal axis in patients with atopic dermatitis. Indian J Dermatol Venereol Leprol. 2011;77:288-93.

Afsar FS, Isleten F, Sonmez N. Children with atopic dermatitis do not have more anxiety or different cortisol levels compared with normal children. J Cutan Med Surg. 2010;14:13-8.

Cheon BR, Shin JE, Kim YJ et al. Relationship between serum 25-hydroxyvitamin D and interleukin-31 levels, and the severity of atopic dermatitis in children. Korean J Pediatr. 2015 ;58:96-101.