Association between progression of skin lesions and pathogens,inflammatory reactions of elderly patients with eczematous dermatitis
OBJECTIVE To observe the association between the progression of skin lesions and the pathogens,in-flammatory reactions of the elderly patients with eczematous dermatitis.METHODS A total of 338 elderly patients with eczematous dermatitis who were treated in Shanghai Fifth People's Hospital Affiliated to Fudan University from Jun 2018 to Dec 2020 were recruited as the research subjects and were divided into the skin lesion group with 165 cases(the skin lesion patients with eczematous dermatitis)and the non-skin lesion group with 173 cases(the eczematous dermatitis patients without skin lesion)according to the status of skin lesion,meanwhile,245 healthy people who received physical examination in the hospital were chosen as the healthy control group.The patients of the skin lesion group were divided into the skin lesion progression group with 68 cases and the no skin lesion pro-gression group with 97 cases according to the clinical manifestations;the patients were also divided into the sec-ondary infection group with 26 cases and the no secondary infection group with 139 cases.The distribution of pathogens was observed;the levels of serum helper T cell 1/helper T cell 2(Th1/Th2)cytokines and inflammato-ry mediators were observed and compared between the skin lesion progression group and the no skin lesion pro-gression group.RESULTS The total isolation rate of bacteria and isolation rate of S.aureus were higher in the skin lesion group and non-skin lesion group than in the healthy control group(P＜0.05).The isolation rate of Malasse-zia of the skin lesion group was higher than that of the non-skin lesion group and the healthy control group(P＜0.05).The total isolation rate of bacteria and isolation rate of S.aureus were higher in the skin lesion progression group and the secondary infection group than in the no skin lesion progression group and the no secondary infection group(P＜0.05).The levels of serum interferon-γ(IFN-γ),tumor necrosis factor-a(TNF-a),interleukin(IL)-12,IL-4,IL-10,IL-2,transforming growth factor-β1(TGF-β1),serum amyloid A(SAA),IL-1β,IL-6,IL-22 and IL-17 of the skin lesion progression group were higher than those of the no skin lesion progression group(P＜0.05).CONCLUSION The skin lesion infection in the elderly patients with eczematous dermatitis is associated with the distribution of S.aureus and Malassezia.The S.aureus involves in the progression of skin lesion and process of secondary infection,and the severity of skin lesion is associated with the changes of serum Th1/Th2 cytokines and inflammatory mediators.
DermatitisEczemaSkin lesionThe elderlyInfectionPathogenHelper T cell 1Helper T cell 2Inflammatory mediator
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