الفهرس 
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Abstract
Atopic dermatitis is a chronic and relapsing inflammatory skin disease that often begins in infancy. It is characterized by typically distributed eczematoid skin lesions with lichenification and pruritic excoriations. As in other atopic diseases a familial disposition and an increasing incidence have beenreported over the last few years. Diagnosis of AD depends mainly on history, morphology and distribution of the disease according to initiating allergen is very important but noteasy and can be reached by careful history taking and prick test which can provide a confirmatory evidence to suspected allergen. Immunologically it had been found that there is a defect in the suppressor T-cell (T8) population in AD patients which permits the formation of excess anaphylactic antibodies mainly IgE. The etiology in chronic urticaria remains unknown in most cases;
the term chronic idiopathic urticaria indicates exclusion urticarial vasculitis, predominant physical urticarias, causative food or drugs. In this group of patients, no etiological factor can be considered responsible for the diseasestate despite thorough initial evaluation and follow up for several years. Even when other diseases are discovered in association, no causal relationship can be demonstrated, as removal of the presumed underlying etiology does not result in resolution of the urticaria. Chronic urticaria is a frustrating problem that taxes the physician
and worries the patient, although its diagnosis is very simple as urticaria
wheals are distinctive from other dermatological lesions, but to search for
a cause or to classify the type, this is the challenging problem.
Among the most common etiologic factors for chronic urticaria is
the drugs, almost any drug can be aggravating factor for urticaria
especially penicillins, aspirin and nun-steroidal anti-inflammatory drugs.
Food additives and food dyes are incriminated to cause urticaria;
various infectious agents can produce urticaria.
Internal diseases are the light as a hidden aggravating factor for
urticaria. Stress and psyche are truely important urticariogenic factors,
most patients even children complain of appearance of wheals or
aggravation of the condition when emotional factors, are involved.
There are different philosophies about the evaluation of chronic
urticaria patients, one approach states that since the treatment of chronic
urticaria is almost the same regardless of the cause, and since routine,
investigations rarely discover an etiology, thorough evaluation of the
patient is unnecessary and warranted. A different school of though
recommends extensive investigations to determine the underlying
etiology. Their point of view is that even if the investigations cannot point
towards avoiding offending agents, it can reassure the patient systemic or
life-threatening problem does not exist.
Thus, in the assessment of a chronic urticaria patient, a thorough,
detailed history must obtained with review of all systems. For selected
patients only, according to the findings obtained from the detailed his
way, investigations are done for example a complete blood count, serum
chemistries total protein, (albumin), liver function tests, etc Anti DNA
antibodies are measured when there are symptoms of collagen-vascular diseases. Allergy skin tests and routine food testing are often not helpful
in evaluating patients-with chronic urticaria.
Neopterin is a biochemical marker for the activation of cellular
immune response. Increased neoptcrin levels was demonstrated in acute
viral, intracellular bacterial and protozoa infection, autoimmune diseases
and certain malignant diseases.
- The aim of this work was to evaluate the level of neopterin in patient of
urticaria and a topic dermatitis.
- This study was conducted on total number of 40 subject: 20 urticaria
patient, 20 a topic dermatitis patient and 20 age and sex match
healthy control subject. The studied subjects were classified into
three groups.
- All patients had detailed history taking of full dermatology sheet with
stress upon certain point such as age, sex, occupation, duration of the
diseases and provoking factor and family history.
- 10 ML of blood was drawn from every subject into plain tube,
centrifuged and the sera obtained were kept frozen at 20 C until
determination and evaluation of neopterin.
- We found that serum level of neopterin was significantly higher in
patients group than control.
- The level of neopterin is highly significant increase in patients with
acute urticaria than chronic urticaria and atopic dermatitis.
- The net result is increased the neopterin level in patients of urticaria
and atopic dermatitis.
- There for the neopterin could be used as a Biomarker of degree of
activation of immune system Neopterin could be used as biomarker of immune system activation
in AD & SU.
• Neopeterin is increase in ASU and to lesser extent in CSI & AD.
• The raised of serum neopterin level does not seem to related to the
prognosis.