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Allergic Conditions & Atopia

Allergic Rhinitis

Allergic Rhinitis is a common in Singapore, and these are the patients coming in with an itchy, dripping or blocked nose. It is a form of catarrhal inflammation, like a tap that doesn’t stop flowing. People who suffer from allergic rhinitis may also feel itchy around the eyes or suffer from post-nasal drip resulting in chronic cough.

Sinusitis may accompany Allergic Rhinitis, because a blocked nose often ends up blocking the sinuses. Sinusitis may present as acute or chronic, infectious or non-infectious. In all cases, the ethmoid and/or maxillary sinuses will feel swollen and inflammed.

Acupuncture can be very helpful in relieving inflammation and that ‘blocked’ feeling in both allergic rhinitis and sinusitis, while herbs can be very helpful in both acute and chronic phases.

Asthma / Allergic Bronchitis

Allergic Bronchitis involves inflammation of the bronchi caused by an allergen, and can often occur as part of the atopic triad. This form of inflammation involves elevated IgE, elevated mast cell degranulation, elevated eosinophilic infiltration in the lungs and airway hyper-responsiveness.

Chinese herbs can be helpful in balancing out an over-active immune system, hence preventing an inflammatory cascade from spiraling out of control. For example, Cortex Mori Radicis is able to enhance TReg levels, while inhibiting expression of Th2 cytokines. As another example, Fritillaria ussuriensis inhibits the production of inflammatory cytokines and MAPKs in mast cells. All this and more helps in reducing Th2 excess in cytokine mediated bronchitis.

Allergic Dermatitis / Eczema

The immunologicalhallmark of Atopic Dermatitis is a Th2 dominance that produces IgE and activation of eosinophil granulocytes

 

Urticaria / Hives

Urticaria is also called Angioedema or Hives. Urticaria presents as itchy wheals that vary in size and may disappear as the allergic reaction runs its course. 

What about Psoriasis?

Pathophysiology of Psoriasis

Psoriasis often present so similarly to Atopic Dermatitis that most patients cannot tell the difference, and just think of it as eczema.

Here are possible ways to differentiate:

1. Location

 

Although both Atopic Dermatitis (commonly categorically referred to as Eczema) and Psoriasis can manifest anywhere in the body,

a. You are more like to find Psoriasis lesions on your hairline or your scalp, or in your butt crack. Additionally, Psoriasis tends to present at the kneecap or on the pointy parts of your elbows, while the classical presentation (especially in children) would be in the inner elbow or behind the knees. Both of them are as likely to have lesions appearing around the ears.

b. Psoriasis is an autoimmune condition characterized by excessive production of skin cells. What appears are these silvery/whitish scales that leave a small blood stain when peeled off. Atopic Dermatitis is an atopic condition, and may be accompanied other atopic conditions Allergic Rhinitis and/or Asthma. It has a more complex etiology (including genetic causes, a compromised skin barrier and environmental/food triggers. Eczema lesions present with great variety.

c. Atopic Dermatitis is generally much more itchy than than Psoriasis, although there is a component of itch in both conditions.

 

 

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