Endocrine and immune responses to stress in chronic inflammatory skin disorder (atopic dermatitis)

Psychoneuroimmunology, Two-Volume Set

Volumn 2, Issue , 2007, Pages 975-991

  Buske Kirschbaum, A ^a  

^a DRESDEN UNIVERSITY OF TECHNOLOGY   (Germany)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84882496236     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1016/B978-012088576-3/50053-8     Document Type: Chapter

References (116)

1. Abramovits V. Atopic dermatitis. J. Am. Acad. Dermatol. 2005, 53. S86-S93.
2. Akdis M., Klunker S., Schliz M., Blaser K., Akdis C.A. Expression of cutaneous lymphocyte-associated antigen on human CD4 (+) and CD8 (+) TH2 cells. Eur. J. Immunol. 2000, 30:3533-3541.
3. Akdis M., Trautmann A., Klunker S., Daigle I., Kucuksezer U.C., Deglmann W., Disch R., Blaser K., Akdis C.A. T helper (Th) 2 predominance in atopic diseases is due to preferential apoptosis of circulating memory/effector TH1 cells. FASEB 2003, 17:1026-1035.
4. Alexander F., French T.M. Studies in psychosomatic medicine 1948, Ronald Press, New York.
5. Allam J.P., Bieber T., Novak N. Recent highlights in the pathophysiology of atopic eczema. Int. Arch. Allergy Immunol. 2005, 136:191-197.
6. Benschop R.J., Rodriguez-Feuerhahn M., Schedlowski M. Catecholamine-induced leukocytosis: early observations, current research, and future directions. Brain, Behav. Immun. 1996, 10:77-91.
7. Bieber T., de la Salle H., Wollenberg A., Hakimi J., Chizzonite R., Ring J., Hanau D., de la Salle C. Human epidermal Langerhans cells express the high affinity receptor of immunoglobulin-E (Fc epsilon RI). J. Exp. Med. 1992, 175:1285-1290.
8. Boguniewicz M. Update on atopic dermatitis: insights into pathogenesis and new treatment paradigms. Allergy Asthma Proc. 2004, 25:279-282.
9. Bresciani M., Parisi C., Menghi G., Bonini S. The hygiene hypothesis: does it function worldwide?. Curr. Opin. Allergy Clin. Immunol. 2005, 5:147-151.
10. Brown D.G. Stress as a precipitant factor of eczema. J. Psychosom. Res. 1972, 16:321-327.
11. Bruijnzeel P.L., Juijper P.H., Rihs S., Betz S., Waringa R.A., Koenderman L. Eosinophil migration in atopic dermatitis: increased migratory responses to N-formyl-methionylleucyl-phenylalanine, neutrophil-activating factor, plateletacti. J. Invest. Dermatol. 1993, 100:137-142.
12. Buske-Kirschbaum A., Fischbach S., Rauh W., Hanker J., Hellhammer D.H. Increased responsiveness of the hypothalamus-pituitary-adrenal (HPA) axis to stress in newborns with atopic disposition. Psychoneuroendocrinol. 2004, 29:705-711.
13. Buske-Kirschbaum A., Geiben A., Hellhammer D.H. Psychobiological aspects of atopic dermatitis: an overview. Psychother. Psychosom. 2001, 70:6-16.
14. Buske-Kirschbaum A., Geiben A., Höllig H., Morschhäuser E., Hellhammer D.H. Altered responsiveness of the hypothalamus-pituitary-adrenal axis and the sympathetic adrenomedullary system to stress in patients with atopic dermatitis. J. Clin. Edocrinol. Metab. 2002, 87:4245-4251.
15. Buske-Kirschbaum A., Gierens A., Höllig H., Hellhammer D.H. Stress-induced immunomodulation is altered in patients with atopic dermatitis. J. Neuroimmunol. 2002, 129:161-167.
16. Buske-Kirschbaum A., Jobst S., Wustmans A., Kirschbaum C., Rauh W., Hellhammer D.H. Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. Psychosom. Med. 1997, 59:419-426.
17. Buske-Kirschbaum A., von Auer K., Krieger S., Weis S., Rauh W., Hellhammer D.H. Blunted cortisol responses to psychosocial stress in asthmatic children: a general feature of atopic disease?. Psychosom. Med. 2003, 65:806-810.
18. Calogero A.E., Sternberg E.M., Bagdy G., Smith C., Bernardini R., Aksentijevich S., Wilder R.L., Gold P.W., Chrousos G.P. Neurotransmitter-induced hypothalamic-pituitaryadrenal axis responsiveness is defective in inflammatory diseasesusceptible Lewis rats: in vivo and in vitro st. Neuroendocrinol. 1992, 55:600-608.
19. Cash J.M., Crofford L.J, Gallucci W.T., Sternberg E.M., Gold P.W., Wilder R.S. Pituitary-adrenal axis responsiveness to ovine CRH in patients with rheumatoid arthritis treated with low-dose prednisolone. J. Rheumatol. 1992, 19:1692-1696.
20. Chover-Gonzalez A.J., Jessops D.S., Tejedor-Real P., Gibert-Rahola J., Harbuz M.S. Onset and severity of inflammation in rats exposed to the learned helplessness paradigm. Rheumatol. 2000, 39:764-771.
21. Chrousos G.P. The hypothalamic-pituitary-adrenal axis and immune mediated inflammation. N. Engl. J. Med. 1995, 332:1351-1362.
22. Chrousos G.P. Organization and integration of the endocrine system. Pediatric endocrinology 2002, 1-14. Saunders, Philadelphia. J. Sperling (Ed.).
23. Coleman R., Trembath R.C., Harper J.I. Genetic studies of atopy and atopic dermatitis. Br. J. Dermatol. 1997, 136:1-5.
24. Chikanza I.C., Petrou P., Kingsley G., Chrousos G., Panayi G.S. Defective hypothalamic response to immune and inflammatory stimuli in patients with rheumatoid arthritis. Arthritis Rheum. 1992, 35:1281-1288.
25. Choi E.H., Brown B.E., Crumrine D., Chang S., Man M.Q., Elias P.M., Feingold K.R. Mechanisms by which psychologic stress alters cutaneous permeability barrier homeostasis and stratum corneum integrity. J. Invest. Dermatol. 2005, 124:587-595.
26. Cormia F.E. Experimental histamine pruritus. I. Influence of physical and psychological factors on threshold reactivity. J. Invest. Dermatol. 1952, 19:21-34.
27. Crespi H., Armando I., Tumilasci O., Levin G., Massimo J., Barontini M., Perec C. Catecholamine levels and parotid secretion in children with chronic atopic dermatitis. J. Invest. Dermatol. 1982, 78:493-497.
28. Cronstein B.N., Kimmel S.C., Levin R.I., Martiniuk F., Weissmann G. A mechanisms for the anti-inflammatory effects of corticosteroids: the glucocorticoid receptor regulates leukocyte adhesion to endothelial cells and expressio. Proc. Natl. Acad. Sci. USA 1995, 89:9991-9995.
29. Donnell A.T., Tripathi A. Atopic dermatitis. Allergy Asthma Proc. 2004, 25. S42-S43.
30. Edwards A.E., Shellow W.V.R., Wright E.T., Dignam T.F. Pruritic skin disease, psychological stress and the itch sensation. Arch. Dermatol. 1976, 112:339-343.
31. Ehlers A., Stangier U., Gieler U. Treatment of atopic dermatitis: a comparison of psychological and dermatological approaches to relapse prevention. J. Consult. Clin. Psychol. 1995, 63:624-635.
32. Eichenfield L.F., Hanifin J.M., Beck L.A., Lemanske R.F., Sampson H.A., Weis S.T., Leung D.Y. Atopic dermatitis and asthma: parallels in the evolution of treatment. Pediatrics 2003, 111:608-616.
33. Elenkov I.J., Chrousos G.P. Stress hormones, proin-flammatory and anti-inflammatory cytokines, and autoimmunity. Ann. N. Y. Acad. Sci. 2002, 966:290-303.
34. Elenkov I.J., Chrousos G.P., Wilder R.L. Neuroendocrine regulation of IL-12 and TNF-alpha/IL-10 balance. Clinical implications. Ann. N. Y. Acad. Sci. 2000, 917:94-105.
35. Elenkov I.J., Wilder R.L., Chrousos G.P., Vizi E.S. The sympathetic nerve-an integrative interface between the two supersystems: the brain and the immune system. Pharmacol. Rev. 2000, 52:595-638.
36. Engels W.D. Dermatologic disorders. Psychosom. 1982, 23:1209-1219.
37. Eskandari F., Sternberg E.M. Neural-immune interactions in health and disease. Ann. N. Y. Acad. Sci. 2002, 966:20-27.
38. Evers A.W., Lu Y., Duller P., van der Alk P.G., Kraaimaat F.W., van der Kerkho P.C. Common burden of chronic skin disease? Contributors to psychological distress in adults with psoriasis and atopic dermatitis. Br. J. Dermatol. 2005, 152:1275-1281.
39. Feijen M., Gerritsen J., Postma D.S. Genetics of allergic disease. Br. Med. Bull. 2000, 56:894-907.
40. Folster-Holst R., Moises H.W., Yang L., Fritsch W., Weissenbach J., Christophers E. Linkage between atopy and the IgE high-affinity receptor gene at 11q13 in atopic dermatitis families. Hum. Genet. 1998, 102:236-239.
41. Forrest S., Dunn K., Eliott K., Fitzpatrick E., Fullerton J., McCarthy M., Brown J., Hill D., Williamson R. Identifying genes predisposing to atopic eczema. J. Allergy Clin. Immunol. 1999, 104:1066-1070.
42. Franchimont D., Kino T., Galon J., Meduri G.U., Chrousos G. Glucocorticoids and inflammation revisited: the state of the art. Neuroimmunomodulation 2002, 10:247-260.
43. Francis D.D., Meaney M.J. Maternal care and the development of stress responses. Curr. Opin. Neurobiol. 1999, 9:128-134.
44. Fritz G.K. Psychological aspects of atopic dermatitis. Clin. Ped. 1979, 18:360-364.
45. Gehring U., Bolte G., Borte M., Bischof W., Fahlbusch B., Wichmann H.E., Heinrich J. Exposure to endotoxin decreases the risk of atopic eczema in infancy: a cohort study. J. Allergy Clin. Immunol. 2001, 108:847-854.
46. Gil K.M., Keef F.J., Sampson H.A., McCashill C.C., Rodin J., Crisson J.E. The relationship to stress and family environment to atopic dermatitis symptoms in children. J. Psychosom. Res. 1987, 31:673-684.
47. Gold M.S., Kemp A.S. Atopic disorders in childhood. Med. J. Aust. 2005, 182:298-304.
48. Goldsmith L.A. Biochemistry and physiology of the skin 1983, Oxford University Press, New York.
49. Grewe M., Bruijnzeel-Koomen C.A.F.M., Schöpf E., Thepen T., Langeveld-Wildschut A.G., Ruzicka T., Krutman J. A role for Th1 and Th2 cells in the immunopathogenesis of atopic dermatitis. Immunol. Today 1998, 19:359-361.
50. Grewe S.R., Chan S.C., Hanifin J.M. Elevated leukocyte cyclic AMP-phosphodiesterase in atopic disease: a possible mechanism for cyclic AMP-agonist hyporesponsiveness. J. Allergy Clin. Immunol. 1982, 70:452-457.
51. Hamid Q., Boguniewicz M., Leung D.Y. Differential in situ cytokine gene expression in acute versus chronic atopic dermatitis. J. Clin. Invest. 1994, 94:870-876.
52. Hanifin J.M., Chan S.C. Role of cyclic nucleotide metabolism in the pathophysiology of atopic eczema. Handbook of atopic eczema 1991, 232-244. Springer, Berlin. T. Ruzicka, J. Ring, B. Przybilla (Eds.).
53. Harbuz M.S., Chover-Gonzalez A.J., Jessop D.S. Hypothalamo-pituitary-adrenal axis and chronic immune activation. Ann. N. Y. Acad. Sci. 2003, 992:99-106.
54. Herrscher R.F., Kasper C., Sullivan T.J. Endogenous cortisol regulates immunoglobulin E-dependent late phase reactions. J. Clin. Invest. 1992, 90:596-603.
55. Ionescu G., Kiehl R. Plasma catecholamine levels in severe atopic dermatitis. Allergy 1988, 43:614-616.
56. Jelinek D.F. Regulation of B lymphocyte differentiation. Ann. Allergy Asthma Immunol. 2000, 84:375-385.
57. Kang D.H., Fox C. Th1 and Th2 cytokine responses to academic stress. Res. Nurs. Health 2001, 24:245-257.
58. Kapp A. The role of eosinophils in the pathogenesis of atopic dermatitis-eosinophil granule proteins as markers of disease activity. Allergy 1993, 48:1-5.
59. Katoh N., Hirano S., Suehiro M., Masuda K., Kishimoto S. The characteristics of patients with atopic dermatitis demonstrating a positive reaction in a scratch test after 48 hours against house dust mite antigen. J. Dermatol. 2004, 31:720-726.
60. King R.M., Wilson G.V. Use of a diary technique to investigate psychosomatic relations in atopic dermatitis. J. Psychosom. Res. 1991, 35:697-706.
61. Kirschbaum C., Pirke K.M., Hellhammer D.H. The "Trier Social Stress Test": a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiol. 1993, 28:76-81.
62. Kodama A., Horikawa T., Suzuki T., Ajiki W., Takashima T., Harada S., Ichihashi M. Effect of stress on atopic dermatitis: investigation in patients after the great Hanshin earthquake. J. Allergy Clin. Immunol. 1999, 104:173-176.
63. Laue L., Lotze M.T., Chrousos G.P., Barnes K., Loriaux D.L., Fleisher T.A. Effect of chronic treatment with the glucocorticoid antagonist RU 486 in man: toxicity, immunological and hormonal aspects. J. Clin. Endocrinol. Metab. 1990, 71:1474-1480.
64. Legat F.J., Armstrong C.A., Ansel J.C. The cutaneous neurosensory system in skin disease. Adv. Dermatol. 2002, 18:91-109.
65. Leung D.Y., Boguniewicz M., Howell M.D., Nomura I., Hamid Q.A. New insights into atopic dermatitis. J. Clin. Invest. 2004, 113:651-657.
66. Leung D.Y.M., Harbeck R., Bina P., Reiser R.F., Yang E., Noris D.A., Hanifin J.M., Sampson H.A. Presence of IgE antibodies to staphylococcal exotoxins on the skin of patients with atopic dermatitis: evidence for a new group of allergens. J. Clin. Invest. 1993, 92:1374-1380.
67. Leung D.Y.M., Soter N.A. Cellular and immunologic mechanisms in atopic dermatitis. J. Am. Acad. Dermatol. 2001, 44. S1-S12.
68. Maddox L., Schwarz D.A. The pathophysiology of asthma. Ann. Rev. Med. 2002, 53:477-498.
69. Mastorakos G., Chrousos G.P., Weber J.S. Recombinant interleukin-6 activates the hypothalamus-pituitary-adrenal axis in humans. J. Clin. Endocrinol. Metab. 1993, 77:1690-1694.
70. Meagher L.C., Cousin J.M., Seckl J.R., Haslett C. Opposing effects of glucocorticoids on the rate of apoptosis in neutrophilic and eosinophilic granulocytes. J. Immunol. 1996, 156:4422-4428.
71. Mortz C.G., Lauritsen J.M., Bindslev-Jensen C., Andersen K.E. Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The Odense Adolescence Cohort Study on Atopic Dise. Br. J. Dermatol. 2001, 144:523-532.
72. Mudde G.C., van Reijsen F.C., Boland G.J., De Gast G.C., Ruijnzeel P.L.B., Bruijnzeel C.A.F.M. Allergen presentation by Langerhans cells from patients with atopic dermatitis is mediated by IgE. Immunol. 1990, 69:335-341.
73. Murison R., Milde A.M. Long-term effects of two animal stress procedures on corticosterone: models for PTSD. Int. Soc. Psychoneuroendocrinol. 1999, (Abstract).
74. Niemeier V., Gieler U., Baerwald C., Kupfer J., Schill W.B., Happle R. Decreased density of á-adrenergic receptors on peripheral blood mononuclear cells in patients with atopic dermatitis. Eur. J. Dermatol. 1996, 6:377-380.
75. Nimmagadda S.R., Evans R. Allergy. Etiology and epidemiology. Ped. Rev. 1999, 20:111-115.
76. Paik I.H., Toh K.Y., Lee C., Kim J.J., Lee S.J. Psychological stress may induce increased humoral and decreased cellular immunity. Behav. Med. 2000, 26:139-141.
77. Panconesi E. Psychosomatic dermatology: past and future. Int. J. Dermatol. 2000, 39:732-734.
78. Panconesi E., Hautmann G. Psychophysiology of stress in dermatology. Dermatol. Clin. 1996, 14:399-421.
79. Pauli-Pott U., Darui A., Beckmann D. Infants with atopic dermatitis: maternal hopelessness, child-rearing attitudes and perceived infant temperament. Pychother. Psychosom. 1999, 68:39-45.
80. Picardi A., Abeni D. Stressful live events and skin diseases: disentangling evidence from myth. Psychother. Psychosom. 2001, 70:118-136.
81. Piemonti L., Monti P., Allavena P., Sironi M., Soldini L., Leone B.E., Socci C., Di Carlo V. Glucocorticoids affect human dendritic cell differentiation and maturation. J. Immunol. 1999, 162:6473-6481.
82. Raap U., Kapp A. Neuroimmunological findings in allergic skin disease. Curr. Opin. Allergy Clin. Immunol. 2005, 5:419-424.
83. Ray A., Hemady Z., Rocklin R.E. Glucocorticoidinduced enhancement of IgE-synthesis. Allergy Proc. 1987, 8:81-84.
84. Roll A., Cozzio A., Fischer B., Schmid-Grendelmeier P. Microbial colonization and atopic dermatitis. Curr. Opin. Allergy Clin. Immunol. 2004, 4:373-378.
85. Romagnani S. T-cell subsets (TH1 versus TH2). Ann. Allergy Asthma Immunol. 2000, 85:9-21.
86. Ruiz R.G.G., Kemeny D.M., Price J.F. Higher risk of infantile atopic dermatitis from maternal atopy than from paternal atopy. Clin. Exp. Allergy 1992, 22:762-766.
87. Rupprecht M., Hornstein O.P., Schlüter D., Schafers H.J., Koch H.U., Beck G., Rupprecht R. Cortisol, corticotropin, and beta-endorphin responses to corticotropin-releasing hormone in patients with atopic eczema. Psychoneuroendocrinol. 1995, 20:543-551.
88. Rupprecht M., Rupprecht R., Kornhuber J., Wodarz N., Koch H.U., Riederer P., Hornstein O.P. Elevated glucocorticoid receptor concentrations before and after glucocorticoid therapy in peripheral mononuclear leukocytes of patients with atopic dermatiti. Dermatol. 1991, 183:100-105.
89. Safko M.J., Chan S.C., Cooper K.D., Hanifin J.M. Heterologous desensitization of leukocytes: a possible mechanism of beta adrenergic blockade in atopic dermatis. J. Allergy Clin. Immuno. 1981, 68:218-225.
90. Salpietro D.C., Naccari F., Polimeni I., Pellegrino C. Reduced plasma c-AMP levels in children with atopic dermatitis. Pediatr. Allergy Immunol. 1998, 9:130-132.
91. Sanders V.M. The role of adrenoceptor-mediated signals in the modulation of lymphocyte function. Adv. Neuroimmunol. 1995, 5:283-298.
92. Scheich G., Florin I., Rudolph R., Wilhelm S. Personality characteristics and serum IgE levels in patients with atopic dermatitis. J. Psychosom. Res. 1993, 37:637-642.
93. Schleimer R.P. Interactions between the hypothalamicpituitary-adrenal axis and allergic inflammation. J. Allergy Clin. Immunol. 2000, 106. S270-S274.
94. Schmid-Ott G., Jaeger B., Adamek C., Koch H., Lamprecht F., Kapp A., Werfel T. Levels of circulating CD8+ cells, and eosinophils increase upon acute psychosocial stress in patients with atopic dermatitis. J. Allergy Clin. Immunol. 2001, 107:171-177.
95. Schmid-Ott G., Jaeger B., Meyer S., Stephan E., Kapp A., Werfel T. Different expression of cytokine and membrane molecules by circulating lymphocytes on mental stress in patients with atopic dermatitis in comparison with heal. J. Allergy Clin. Immunol. 2001, 108:455-462.
96. Shenefelt P.D. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?. Dermatol. Ther. 2003, 16:114-122.
97. Stangier U., Ehlers A., Gieler U. Predicting long-term outcome in group treatment of atopic dermatitis. Psychother. Psychosom. 2004, 73:293-301.
98. Stephan M., Jaeger B., Lamprecht F., Kapp A., Werfel T., Schmid-Ott G. Alteration of stress-induced expression of membrane molecules and intracellular cytokine levels in patients with atopic dermatitis depend on serum IgE levels. J. Allergy Clin. Immunol. 2004, 114:977-978.
99. Sternberg E.M., Hill J.M., Chrousos G.P., Kamilaris T., Listwak S.J., Gold P.W., Wilder R.L. Inflammatory mediator-induced hypothalamic-pituitary-adrenal axis activation is defective in streptococcal cell wall arthritis-susceptible Lewis rats. Proc. Natl. Acad. Sci. USA 1989, 86:2374-2378.
100. Sternberg E.M., Young W.S., Bernardini R., Calogero A.E., Chrousos G.P., Gold P.W., Wilder R.L. A central nervous system defect in biosynthesis of corticotropin releasing hormone is associated with susceptibility to streptococcal cell wall-induced arthri. Proc. Natl. Acad. Sci. 1989, 86:4771-4775.
101. Stewart A.C., Thomas S.E. Hypnotherapy as a treatment for atopic dermatitis in adults and children. Br. J. Dermatol. 1995, 132:778-783.
102. Sturgill S., Bernard L.A. Atopic dermatitis update. Curr. Opin. Pediatr. 2004, 16:396-401.
103. Szentivanyi A. The beta adrenergic theory of the atopic abnormality in bronchial asthma,. J. Allergy 1968, 42:203-210.
104. Thepen T., Langeveld-Wildschut G., Bihari I.C., van Wichen D.F., van Reijsen F.C., Mudde G.C., Bruijnzeel-Koomen C.A.F.M. Biphasic response against aeroallergen in atopic dermatitis showing a switch from an initial TH2 response to a TH1 response in situ: an immunocytochemical stu. J. Allergy Clin. Immunol. 1996, 97:828-837.
105. Trautmann A., Akdis M., Blaser K., Akdis C.A. Role of dysregulated apoptosis in atopic dermatitis. Apoptosis 2000, 5:425-429.
106. Turnbull A.V., Rivier C.L. Regulation of the hypothalamus-pituitary-adrenal axis by cytokines: actions and mechanisms of action. Physiol. Rev. 1999, 79:1-71.
107. Van Moerbeke D. European white paper. Allergic diseases as a public health problem in Europe 1997, UCB Institute of Allergy, Brussels.
108. Van Reijsen F.C., Bruijnzeel-Koomen C.A., Kalthoff F.S., Maggi E., Romagnani S., Westland J.K., Mudde G.C. Skinderived aeroallergen-specific T-cell clones of Th2 phenotype in patients with atopic dermatitis. J. Allergy Clin. Immunol. 1992, 90:184-193.
109. Verboom P., Hekkart Van L., Sturkenboom M., De Zeeuw R., Menke H., Rutten F. The costs of atopic dermatitis in the Netherlands: an international comparison. Br. J. Dermatol. 2002, 147:716-724.
110. Wallander J.L., Varui J.W. Effects of pediatric chronic physical disorders on child and family adjustment. J. Child Psychol. Psychiatry 1998, 39:29-46.
111. Wamboldt M.Z., Laudenslager M., Wamboldt F.S., Kelsay K., Hewitt J. Adolescents with atopic disorders have an attenuated cortisol response to laboratory stress. J. Allergy Clin. Immunol. 2003, 111:509-514.
112. Weiland S.K., Husing A., Strachan D.P., Rzehak P., Pearce N. ISAAC Phase One Study Group. Climate and the prevalence of symptoms of asthma, allergic rhinitis, and atopic eczema in children. Occup. Environ. Med. 2004, 61:609-615.
113. Weinmann S., Kamtsirius P., Henke K.D., Wickman M., Jenner A., Wahn U. The costs of atopy and asthma in children: assessment of direct costs and their determinants in a birth cohort. Pediatr. Allergy Immunol. 2003, 14:18-26.
114. Wilson E. Diseases of the skin 1857, Churchill, London.
115. Wittkowski A., Richards H.L., Griffith C.E., Main C.J. The impact of psychological and clinical factors on quality of life in individuals with atopic dermatitis. J. Psychosom. Res. 2004, 57:195-200.
116. Wollenberg A., Kraft S., Hanau D., Bieber T. Immunomorphological and ultrastructural characterization of Langerhans cells and a novel, inflammatory dendritic epidermal cell (IDEC) population in lesional. J. Invest. Dermatol. 1996, 106:446-453.