The impact of autonomic nervous system on the course of Neurodermitis Circumscripta

Abstract

Neurodermitis Circumscripta (NC) is a common dermatosis characterized by lichenification of skin as a result of excessive pruritus. It elicits a scratch response, starting the itch-scratch cycle, which in turn aggravate the inflammatory response and exacerbate disease severity. Disorders of autonomic regulation are described as a trigger or enhance pathological symptoms of NC. The aim of the study is to assess the impact of disorders of autonomic regulation on severity of disease.

Materials and Methods: The presented study enrolls 107 out patients (58 female and 49 male; mean age 55.98; range 25-83 years).We used several clinical and instrumental methods, including, questionnaire on subjective and objective signs of autonomic dysfunction Kerdo autonomic index, skin response and the Hildebrand‘s coefficient, to evaluate the fluctuations of autonomic nervous system (ANS).

Results and Discussion: The results show deviations from the normal status of ANS in 88 (82.2%) of all patients The frequency of subjective signs of autonomic dysfunction was 82.2% (p=0.043) and expression of subjective symptoms 29.7+4.4 (p=0.046) The frequency of objective signs of autonomic dysfunction was 75.70% (p=0.001) and expression of objective symptoms 34.6 + 3.8 (p=0.048) Kerdo autonomic index, evaluation of skin response and the Hildebrand‘ s coefficient show a prevalence of sympathetic tone of autonomic nervous system - 46.59% of all patients, followed by a group of patients with mix response - 40.9% and the smallest group were patients with parasympathicotonia - 12.5% The results show a statistically significant correlation between severity of LSC and deviations from the normal status of ANS. In patients with normal autonomic reactivity we observed mostly stage I of the disease, 50.0% followed by stage II- 36.11% and stage III-13.88% On the contrary was distribution in patients with abnormal autonomic responses. In this group the highest proportion of patients was with stage III-48.07% followed by those with stage II-38.46% and the least were patients with stage I of disease 13.46% (p=0.021) Conclusion ANS play an important role in pathogenesis of LSC. Autonomic dysfunctions correlate with severity of the disease.