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[Atopic dermatitis at 18-months physical examination]
H Kawaguchi1, M Takeuchi, Y Tanaka
1Division of Dermatology, National Sagamihara Hospital.
Insights
Atopic dermatitis prevalence in 18-month-olds is 9.0%, with most cases mild. Eruption locations and seasonal prevalence differ from infancy, with many cases resolving by 18 months.
Area of Science:
- Pediatrics
- Dermatology
- Epidemiology
Context:
- Atopic dermatitis (AD) is a common chronic inflammatory skin condition in infants and children.
- Understanding the prevalence, severity, and clinical course of AD is crucial for effective management.
- Previous studies have focused on early infancy, necessitating data for later toddlerhood.
Purpose:
- To determine the prevalence and severity of atopic dermatitis in 18-month-old children.
- To compare findings with data from 4-month-old infants.
- To analyze changes in eruption location, seasonal variations, and resolution rates of AD.
Summary:
- A study of 769 18-month-old children found a 9.0% prevalence of atopic dermatitis, predominantly mild.
- Eruption patterns shifted from the head/face/trunk in infancy to the trunk/extremities in toddlers.
- Of 501 children assessed at both 4 and 18 months, 83% of initial cases resolved, and severity decreased.
Impact:
- Provides essential epidemiological data on atopic dermatitis progression in early childhood.
- Highlights the dynamic nature of AD, with significant resolution and changes in presentation by 18 months.
- Informs clinical practice regarding the natural history and monitoring of atopic dermatitis.
Abstract:
In order to know the prevalence rate and severity of atopic dermatitis, and to compare them to those previously done for 4-month-old infants, the authors examined atopic dermatitis of 18-month-old children at regular health checks at a health center. Among 769 children examined, 69 were diagnosed as having atopic dermatitis, giving a prevalence rate of 9.0%. Most of cases were mild, and no severe cases were observed. In contrast to the location of eruptions on head, face, and trunk at 4-month-old, the eruptions were seen mainly on the trunk and extremities. The prevalence rate in summer and autumn was significantly lower than that in winter and spring. Among 501 children whom we could examine both at 4-month and 18-month-old, 102 cases were diagnosed as having atopic eruptions at 4 months. The eruptions, however, were disappeared in 83 cases when they were 18-month-old. The severity of atopic dermatitis also came to be mild when they grew up. Altogether, a quarter of children had atopic eruptions either at 4 months or 18 months, or both. It will be of interest to observe the transition of atopic dermatitis in childhood and we are planning to follow them at next physical examination at 3-year-old.