Staphylococcal and human dander IgE antibodies in superinfected atopic dermatitis

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Abstract
Ten patients (Group 1) with Staphylococcus aureus superinfected atopic dermatitis (SAD) were compared with 3 control groups without SAD. One control group (Group 2) was comprised of 10 atopic patients with total IgE levels of > 1000 u/ml, another control group, of 6 atopic patients (Group 3) with total IgE levels of < 1000 u/ml and a 3rd group of 10 non-atopics (Group 4), 5 of whom were infected with S. aureus. Total and specific anti-staphylococcal IgE levels and anti-human dander IgE were high in Group 1. Specific IgE levels to S. aureus were slightly increased in some Group 2 patients but were normal (< 7%) for Group 3. No specific IgE to human dander antigen was detected in either Group 2 or Group 3. In the non-atopic control group (Group 4), 6 of 10 patients had both low total, and specific IgE antibodies to both staphylococcal, and human dander antigens. Two had increased total IgE and specific anti-staphylococcal IgE antibodies, and 2 more with a severe, chronic infection, also had anti-staphylococcal IgE antibodies. In SAD patients, a good correlation was seen between cutaneous basophil hypersensitivity and high specific IgE antibodies against staphylococcal and human dander allergens. Delayed type hypersensitivity reactions to staphylococcal antigen were negative or poorly positive in the SAD group by comparison to controls. A paradoxical anaphylactic type of response to the offending bacterial agent in SAD patients, associated with auto-atopy to human dander, is discussed.