紫爆(PM2.5)增加 幼童異位性皮膚炎門診

PM2.5危害 異位性皮膚炎患者增3成 更新： 2016年01月08日台北市立聯合醫院陽明院區小兒科主治醫師龍厚玲7日指出，近2個月只要環保署發布空汙警訊，隔天門診異位性皮膚炎幼童患者就比平常約增三成。台北市立聯合醫院陽明院區小兒科主治醫師龍厚玲7日指出，近2個月只要環保署發布空汙警訊，隔天門診異位性皮膚炎幼童患者就比平常約增三成。 【記者徐翠玲／綜合報導】細懸浮微粒（PM2.5）不只過敏體質要小心，異位性皮膚炎也受影響。台北市立聯合醫院陽明院區小兒科主治醫師龍厚玲7日指出，近2個月只要環保署發布空汙警訊，隔天門診異位性皮膚炎幼童患者就比平常約增三成。PM2.5能穿透皮膚的角質層，透過血液刺激真皮層免疫細胞，引發皮膚發炎並出現搔癢難耐，嚴重時可能引發敗血症。2歲的宥宥在6個月大時確診患異位性皮膚炎，去年秋冬後，宥宥出現紅疹、搔癢等症狀，經3週追蹤發現，宥宥異位性皮膚炎發作時間，竟與PM2.5高濃度警戒一致，確診為PM2.5引起。龍厚玲指出，目前國際對於PM2.5的研究，較明確結論有孕婦接觸高濃度PM2.5，特別再加上嬰兒出生後暴露在二手菸環境，會增加罹患異位性皮膚炎風險。而已得異位性皮膚炎的幼童，暴露在高濃度的PM2.5，會加重皮膚發炎程度及癢感。另外，根據國內大規模流行病學調查，住家距離車流量大的大馬路較近的過敏性疾病患者，較容易受影響。龍厚玲建議，孕婦及有過敏性體質的幼童，在PM2.5濃度較高的日子盡量不要外出，待在室內關上門窗，並且在家中裝設具有高效能過濾系統的空氣濾淨機（可過濾直徑達0.3微克的粒子）。即便不得已外出也盡量避開車流較多的大馬路，並配戴口罩。回家後盡快盥洗，換上乾淨衣物，以防過敏症狀加劇。◇

Influences of Environmental Chemicals on Atopic Dermatitis Toxicol Res. 2015 Jun; 31(2): 89–96. Atopic dermatitis is a chronic inflammatory skin condition including severe pruritus, xerosis, visible eczematous skin lesions that mainly begin early in life. Atopic dermatitis exerts a profound impact on the quality of life of patients and their families. The estimated lifetime prevalence of atopic dermatitis has increased 2~3 fold during over the past 30 years, especially in urban areas in industrialized countries, emphasizing the importance of life-style and environment in the pathogenesis of atopic diseases. While the interplay of individual genetic predisposition and environmental factors contribute to the development of atopic dermatitis, the recent increase in the prevalence of atopic dermatitis might be attributed to increased exposure to various environmental factors rather than alterations in human genome. In recent decades, there has been an increasing exposure to chemicals from a variety of sources. In this study, the effects of various environmental chemicals we face in everyday life - air pollutants, contact allergens and skin irritants, ingredients in cosmetics and personal care products, and food additives - on the prevalence and severity of atopic dermatitis are reviewed. CONCLUSION  In this study, we reviewed the effects of various environmental chemicals on the prevalence and severity of AD. Regarding air pollutant, a number of air pollutants – either particulate or gaseous form, indoor or outdoor - have been found to be related with the prevalence, development or exacerbation of AD. Those air pollutant chemicals include nitrogen oxide compounds, PM, CO, toluene, volatile organic compounds, benzene and its metabolites, formaldehyde, sulfur dioxide, and tobacco smoke. In addition to absorption of air pollutants, skin contact with chemicals such as metals (nickel, cobalt, chromium, cadmium, lead, platinum, copper, and mercury), some ingredients in cosmetics (fragrances, preservatives, paraphenylenediamine in hair and nail care products) could aggravate AD, similarly with allergic contact dermatitis. Despite the increased use of food additives, the prevalence of adverse reactions attributed to their use is very low in the general population but seems higher in AD patients. Several chemical added in food to improve its organoleptic properties may be associated with non-allergic food hypersensitivity. Those additives include preservatives, antioxidants, artificial dyes, stabilizers, flavorings and taste enhancers, emulsifiers, and artificial sweeteners. In summary, although the comprehensive effects of environmental chemicals as triggers of AD are still a subject of debate, eliminations of those with known correlation with AD might improve AD symptoms. Future studies should further investigate the specific mechanisms that contribute to these relationships for better management of AD in our daily life.