[Are shifts in circadian cortisol rhythm an endocrine symptom of atopic eczema?].

Marked nocturnal pruritus in patients with atopic eczema (AE) may depend partly on alterations in circadian neuroendocrine rhythms, e.g. cortisol rhythm. We analysed the serum cortisol levels every 2 h between 8 p.m. and 8 a.m. and at 2 p.m. (profile I) in 20 adult in-patients with florid AE not pretreated with any systemic corticosteroid or ACTH therapy (profile I). The results were compared with those recorded in 19 healthy women. In 14 patients we checked the profiles again after marked improvement of AE (profile II). On profile I, the lowest cortisol levels were after midnight for 9 of the 20 patients, while on profile II this was true for 12 of the 14 tested. The mean cortisol levels over the period examined were found to be approximately the same for patients and controls for profile I, yet the mean level on profile II was found to be lower. The mean time interval between minimum and maximum cortisol levels was shorter in patients with AE than in controls (8.5 h), and was shorter still on profile II (4.6 h). The shift in the serum cortisol minimum after midnight resulted in an extremely steep rise in the cortisol level between the level in the late hours of the night, and the 24 h-maximum in the early morning hours.(ABSTRACT TRUNCATED AT 250 WORDS)