SummaryA study was carried out of 45 adults with atopic eczema sequentially admitted to the Dermatology wards in the Royal Infirmary, Edinburgh. The clinical course of the eczema, the associated atopic conditions and the possible role of inhalant and food allergens were assessed. Most subjects had developed eczema in early childhood, but nine of the 45 developed it for the first time after the age of 15 yr. Eleven subjects outgrew their eczema around puberty only to experience recrudescence in their late teens. In 18 subjects the eczema was flexural until the late teens, when it became widespread. In this group of severely affected subjects, 25 had a history of asthma, 29 had either seasonal or perennial rhinitis, and 10 had current symptoms of food allergy. All but one had elevated total serum IgE concentrations (range 63–50 000 kU/1). Using dilutions of the subjects' serum in the radio‐allergosorbent test, an estimate of the specific IgE to 10 allergens (three inhalants, seven foods) was obtained, where 1 RAST unit is roughly equivalent to 1 IU total IgE. Most of the IgE was produced in response to the inhalant allergens tested (grass pollen, house dust mite and cat epithelium), 32 of the subjects having a RAST score of 3 or 4 to each of the three inhalant allergens, with the remaining 13 having a RAST score of 3 or 4 to at least one. The highest levels were to house dust mite, exceeding 1000 RAST units in 13 subjects. Thirteen subjects had a RAST score of 4 to at least one food allergen, with levels up to 1000 RAST units. Although this usually correlated with a history of allergy to the food (except in the case of wheat), some subjects with a positive RAST to a specific food could eat the food without problem. Overall these findings indicate that almost all subjects with severe atopic eczema have inhalant allergy, and produce high concentrations of IgE to inhalant allergens: roughly 25 of such subjects also have IgE‐mediated food allergy, and they have high IgE concentrations to certain food allergens. The role of inhalant and food allergy in adult atopic eczema remains questionable, but should be considered in the overall management of the su
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机译：摘要一项研究对 45 名患有特应性湿疹的成人进行了研究，这些成人依次入住爱丁堡皇家医院的皮肤科病房。评估了湿疹的临床病程、相关的特应性疾病以及吸入剂和食物过敏原的可能作用。大多数受试者在儿童早期就患上了湿疹，但 45 人中有 9 人在 15 岁后首次患上了湿疹。11名受试者在青春期前后摆脱了湿疹，但在十几岁时才复发。在18名受试者中，湿疹是弯曲的，直到十几岁时才变得普遍。在这组严重受影响的受试者中，25 人有哮喘病史，29 人患有季节性或常年性鼻炎，10 人目前有食物过敏症状。除一例外，所有患者血清总IgE浓度均升高（范围为63-50 000 kU/1）。在放射性过敏吸附试验中使用受试者血清的稀释液，获得了对 10 种过敏原（三种吸入剂、七种食物）的特异性 IgE 的估计值，其中 1 个 RAST 单位大致相当于 1 IU 总 IgE。大多数 IgE 是在测试的吸入剂过敏原（草花粉、屋尘螨和猫上皮）的反应下产生的，其中 32 名受试者对三种吸入剂过敏原中的每一种的 RAST 评分为 3 或 4，其余 13 名受试者的 RAST 评分为 3 或 4 到至少一种。最高水平是容纳尘螨，在13个受试者中超过1000个RAST单位。13 名受试者对至少一种食物过敏原的 RAST 评分为 4，水平高达 1000 RAST 单位。虽然这通常与对食物过敏史有关（小麦除外），但一些对特定食物呈阳性 RAST 的受试者可以毫无问题地吃这种食物。总体而言，这些发现表明，几乎所有患有严重特应性湿疹的受试者都有吸入性过敏，并且对吸入性过敏原产生高浓度的IgE：大约25%的此类受试者也有IgE介导的食物过敏，并且他们对某些食物过敏原具有高浓度的IgE。吸入剂和食物过敏在成人特应性湿疹中的作用仍值得怀疑，但在 su 的整体管理中应予以考虑。
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