Recent investigations on the relationship between fungal skin diseases and atopic dermatitis

Atopic dermatitis may be associated with chronic dermatophyte infections and Pityrosporum related disorders. Recent epidemiologic studies in school children and young recruits have confirmed that atopic individuals have an increased susceptibility to Trichophyton rubrum infections of the feet and an increased risk for persistent infections. In contrast, an investigation on skin reactivity in dermatophyte infected atopic patients indicated that a group of these patients is fully able to eliminate the fungi concominant with the development of a delayed type skin reactivity. Facial erythema and scaling, often including neck and shoulders, is present in many young adults with atopic dermatitis. Preliminary data for a Danish-Swedish investigation have shown that atopic dermatitis patients with head-neck-shoulder dermatitis compared to a group without this disorder and normal individuals more often demonstrate positive prick test, RAST and specific histamine release using extract of Pityrosporum ovale. These findings indicate that the presence of Pityrosporum ovale in the skin may cause an allergic reaction leading to dermatitis.