[Abnormal vasomotor, sudoral and sebaceous reactions in atopic dermatitis (author's transl)]. 1982

E Grosshans, and M Woehl

Putting forward disturbances of cutaneous vasomotricity, sweating and sebaceous excretion is of slight diagnostical value in atopy, but contributes to a better knowledge of its physiopathology. Abnormal vascular reactions are probably correlated with a functional disturbance of beta-adrenergic receptors of the blood vessels; clinical symptoms of apparently paradoxical vasoconstriction occur in most cases of atopic dermatitis, i. e. white dermographism in 80 p. 100, delayed cholinergic blanch in 70 p. 100 or absence of erythema to rubefacients in 55 to 70 p. 100. The troubles of eccrine sweating are more complex: in the eczematous lesions there is a spontaneous and experimentally provoked increase of sweating; in atopic patients the level of acetylcholine induced sweating is lowered and the mean excretion rate is increased; these parameters are not modified by beta-blockers which enhance cholinergic sweating in normals. On the contrary, in atopics beta 2-agonists increase eccrine sweating in summer, but become inefficient in autumn and winter, just as if there was a less severe beta-blockade during warm season. In atopics, sweat is mainly of the cholinergic type and contains more chlorides and less acid mucopolysaccharides; therefore its tensio-activity is increased and its thermolytic evaporative rate correlatively decreased; eccrine sweat glands of atopics are less able to adapt to wintry adrenergic stress, because catecholamines stimulate in preference the dark muciparous cells of the glomerular coil. Eccrine sweat of atopics contains also high amounts of IgE and that is probably the reason of its whealing effect by intradermal injection. The cutaneous dryness of atopic patients seems unrelated to these sudoral troubles, but rather to a excessive transepidermal water loss due to the extensive eczematous microscopical spongiosis of the epidermis and the loss of the barrier function of its horny layer. Decrease of the sebaceous secretion contributes also to the xerosis and following disturbances have been registered: decrease of the total excretion rate, decrease of the lipids of sebo-glandular origin such as waxes, squalen and triglycerides, higher amount of cholesterol, decrease of surfaces and density of sebaceous glands and lower labelling of cells in S phase. Troubles of apocrine sweating have not yet been reported. Abnormal vasomotor, sudoral and sebaceous functions in atopic patients can be satisfactorily interpreted if one accepts the theory of a constitutional blockade of beta 2- and H2-receptors.

UI MeSH Term Description Entries
D003876 Dermatitis, Atopic A chronic inflammatory genetically determined disease of the skin marked by increased ability to form reagin (IgE), with increased susceptibility to allergic rhinitis and asthma, and hereditary disposition to a lowered threshold for pruritus. It is manifested by lichenification, excoriation, and crusting, mainly on the flexural surfaces of the elbow and knee. In infants it is known as infantile eczema. Eczema, Atopic,Eczema, Infantile,Neurodermatitis, Atopic,Neurodermatitis, Disseminated,Atopic Dermatitis,Atopic Eczema,Atopic Neurodermatitis,Disseminated Neurodermatitis,Infantile Eczema
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012627 Sebaceous Glands Small, sacculated organs found within the DERMIS. Each gland has a single duct that emerges from a cluster of oval alveoli. Each alveolus consists of a transparent BASEMENT MEMBRANE enclosing epithelial cells. The ducts from most sebaceous glands open into a HAIR FOLLICLE, but some open on the general surface of the SKIN. Sebaceous glands secrete SEBUM. Gland, Sebaceous,Glands, Sebaceous,Sebaceous Gland
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.
D013546 Sweating The process of exocrine secretion of the SWEAT GLANDS, including the aqueous sweat from the ECCRINE GLANDS and the complex viscous fluids of the APOCRINE GLANDS.
D014666 Vasomotor System The neural systems which act on VASCULAR SMOOTH MUSCLE to control blood vessel diameter. The major neural control is through the sympathetic nervous system. System, Vasomotor,Systems, Vasomotor,Vasomotor Systems

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