Immunodeficiencies in Severe Atopic Dermatitis: Depressed Chemotaxis and Lymphocyte Transformation

Various reports have indicated assorted immune defects in atopic dermatitis, but the prevalence and degree of the defects remain unclear. We assessed various immunological factors in 14 patients with atopic dermatitis to determine whether immunodeficiencies were present consistently and were reflected by the patients' clinical characteristics. A high incidence of cutaneous infection was noted. Cutaneous delayed-hypersensitivity testing showed anergy in eight (67%) patients. Only the seven patients with the most severe condition showed altered leukocyte function, as determined by polymorphonuclear and mononuclear leukocyte chemotaxis and by lymphocyte responsiveness to phytohemaglutinin. All three cell types were shown to be simultaneously dysfunctional during severe atopic flares. Chemotactic studies during clinical remissions disclosed notable improvement in cell migration. Serum IgE levels were elevated in each patient, but did not correlate with the degree of cutaneous anergy or altered leukocyte function.