الفهرس 
Childhood Atopic DermatitisOnly 14 pages are availabe for public view
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Abstract
Atopic dermatitis (AD) is the most common chronic
inflammatory skin disease.
The prevalence has mainly increased in developed countries,
affecting around 15–20% of children and 1–3% of adults.
AD patients usually have personal or family history of asthma,
allergic rhinitis, food allergies or urticaria.
AD aetiology is also affected by obesity, which has been
demonstrated to produce a pro-inflammatory condition that locally
and systemically affects AD.
AD can be divided into extrinsic and intrinsic groups depending
on the presence or lack of immunoglobulin (Ig) E. High levels of Th2
cytokines have been found in the skin lesions of both AD phenotypes,
although some studies have suggested that Th2 polarisation is
predominant in extrinsic AD.
Obesity is considered as a risk factor due to its relationship with
insulin resistance, carcinogenesis, and cardiovascular, musculoskeletal
or brain diseases, as well as skin diseases.
Leptin acts as a pleiotropic hormone and activator of the
cytokine cascade. It is secreted mainly by white adipose tissue.
However, smaller amounts are also produced by the hypothalamus,
pituitary, gastric mucosa, bone marrow, mammary epithelium, skeletal
muscle, and placenta. Its secretion is increased in adiposity. Insulin,
glucose, estrogens, and cytokines such as TNF-α and IL-6 might also
enhance leptin secretion. Interestingly, the peripheral leptin level
follows a circadian rhythm with a peak level seen at night. by
increased leptin levels. Moreover, high serum leptin concentrations coexist with leptin receptors resistance, and these disturbances are
related to obesity.
Under physiological condition, leptin exerts the ability to limit
food intake, control body fat mass, and stimulate energy expenditure
by negative feedback at the hypothalamic nuclei. However, in obesity
status, the dysfunctional adipocyte may lead to an irrepressible
increase in circulating leptin.
Systemic administration of exogenous glucocorticoids has been
found to increase circulating leptin levels in adults and in children.
Infants and young children with atopic dermatitis (AD) are at great
risk of developing respiratory allergy later in life with rhinitis, eye
symptoms, and sometimes asthma.
In our study there is no statistically significant difference
between the studied groups as regarding age, gender and BMI.
This study aimed to assess serum leptin level in children with
AD.
The study was done at Dermatology, anderology and STD and
medical Biochemistry and Molecular Biology, faculty of medicine,
menoufyia university. It included 60 subjects divided in to 3 groups:
group (A): included 20 AD. Children not treated with topical
corticostyeroids
group (B): included 20 AD. Children treated with topical
corticosteroids.
group (C): included 20 age and gender matched healthy children as
controls.
The studied subjects were submitted to full history taking,
through clinical examination, local examination and laboratory
investigations including determination of serum leptin and IgE levels.