38 一位五歲小女孩來診間，顯得焦躁不安，皮膚乾燥且在臉部與全身出現許多苔癬化斑塊伴隨鱗屑和抓痕，尤其是四肢彎曲處更為明顯，據母親所述，小女孩皮膚從小就不好，請根據以上所述，下列何者錯誤？

進一步詢問病史、家族史和完成身體檢查即可獲得診斷

病人血中IgE通常會升高

此疾病急性期與Th1細胞（typeⅠ T-helper cell）所分泌的interferon-γ和tumor necrosis factor-α增加有密切關聯

若合併有頭髮異常，應考慮Netherton syndrome

answer is C

this is a case about atopic dermatitis

The immune hypothesis invokes an imbalance in the T lymphocytes, with T_H 2 cells predominating; this results in cytokine production of interleukins 4, 5, 12, and 13 and granulocyte macrophage colony-stimulating factor, causing an increase in IgE and lowered interferon gamma levels. Later, in persons with chronic atopic dermatitis, the T_H 1-type cells predominate. Other cell types are also involved in the process, including eosinophils, Langerhans cells, keratinocytes, and B cells.

Netherton syndrome

What is Netherton syndrome?

Netherton syndrome is a rare inherited disorder that presents with the three following characteristics:

• Ichthyosiform erythroderma – inflamed, red, scaly skin
• Trichorrhexis invaginata (“bamboo hair”) – short, brittle, lustreless hair
• Atopic diathesis – predisposition to allergy problems

Individuals with Netherton syndrome may show some or all of these features with varying degrees of severity of their symptoms.