Clinical Effects of Probiotic Bifidobacterium breve Supplementation in Adult Patients with Atopic Dermatitis

Probiotics (live microbial food supplements) have been shown to be effective in allergic diseases, but the potential of probiotics for treatment of adult atopic dermatitis is not clear. The effect of probiotic Bifidobacterium breve (B. breve) for atopic dermatitis was assessed in this study. A total of 24 patients were given either B. breve strain YY or a placebo for 8 weeks. Clinical severity was evaluated by using the severity scoring of atopic dermatitis and quality of life was assessed by Skindex-29-J. In addition, blood and fecal samples were taken before and after the study. The objective severity scoring for atopic dermatitis significantly improved in the probiotic group compared with the placebo group. In the quality of life assessment, the total score showed significant improvement in the probiotic group. The proportion of B. breve in intestinal microflora was increased in the probiotic group. However, no significant change in thymus and activation-regulated chemokine (TARC/CCL17), immunoglobulin E or the number of eosinophils was found. Our results suggest that B. breve may be beneficial for the treatment of atopic dermatitis. However, since the severity of disease symptoms in the placebo group at the beginning of the study was milder than those in the probiotic group because the number of patients in the present pilot study was relatively small, further study is needed to determine the clinical value of B. breve in adult patients with atopic dermatitis

Adverse Skin Reactions due to Ribavirin in Hepatitis C Combination Therapy with Pegylated Interferon-a2a

The introduction of ribavirin to hepatitis C combination therapy with pegylated interferon (PEG-IFN)-α2a has improved sustained responses, but it has been accompanied by an increased incidence of cutaneous side effects. Most cases of drug eruption caused by ribavirin and PEG-IFN-α2 or IFN-α combination therapy were not severe and we progressed without discontinuation of the antiviral treatment. We describe a 59-year-old Japanese woman with a chronic hepatitis C infection who developed erythema during PEG-IFN-α2a and ribavirin combination therapy. The eruption at the injection site of IFN occurred after each injection, and then, eruption on her exposed skin was observed. Twenty milligrams of prednisolone was administered. The eruption recurred after each administration of prednisolone and ribavirin. She finally had infiltrative erythema without any mucosal symptoms on her body. It seemed to be an erythema multiforme type drug eruption of PEG-IFN-α2a, ribavirin and/or fluvastatin sodium from the clinical course. The lymphocyte transformation test (LTT) of ribavirin was positive. This is the first case of a positive result of an LTT for ribavirin. A photosensitive type drug eruption with ribavirin treatment has been reported. We should not only consider IFN, but also ribavirin in case of a generalized eruption, especially on an exposed area with combination therapy for HCV