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Predictive factors of persistent infantile atopic dermatitis up to 6 years old in Taiwan: a prospective birth cohort
M M-H Guo1, W-N Tseng1, C-Y Ou2
1Division of Allergy Immunology and Rheumatology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Insights
Infantile atopic dermatitis (eczema) persisting to age six is linked to egg white sensitization and widespread skin involvement at six months. Persistent eczema increases a child's risk of developing asthma by age six.
Area of Science:
- Pediatric Dermatology
- Allergy and Immunology
Background:
- Atopic dermatitis (eczema) is a prevalent childhood condition, affecting 15-30% globally.
- Onset typically occurs within the first year, with over half of cases resolving by age six.
Purpose of the Study:
- To identify risk factors predicting the persistence of infantile atopic dermatitis up to six years of age.
Main Methods:
- A birth cohort study followed 246 children diagnosed with infantile atopic dermatitis at six months.
- Data collected included family history, maternal/paternal and cord blood Immunoglobulin E (IgE) levels.
- Clinical exams, questionnaires, and IgE measurements were performed at follow-up visits until age six.
Main Results:
- 19.5% of patients (48/246) had persistent atopic dermatitis at age six.
- Egg white sensitization (OR: 3.801) and involvement of two or more body areas at six months (OR: 2.921) were significant risk factors.
- Persistent atopic dermatitis correlated with a higher risk of developing asthma by age six (39.6% vs 24.2%).
Conclusions:
- Egg white sensitization and extensive skin involvement at six months predict persistent infantile atopic dermatitis.
- Children with persistent infantile atopic dermatitis face an elevated risk of developing asthma by age six.
Background:
Atopic dermatitis affects 15-30% of children worldwide. Onset of disease usually occurs within the first year of life, over half of which regress by 6 years of age. The aim of this study was to investigate the risk factors related to the persistence of infantile atopic dermatitis.
Methods:
In this birth cohort study, patients were enrolled prenatally and followed until 6 years of age; 246 patients had infantile atopic dermatitis at 6 months of age. Family history, maternal and paternal total and specific Immunoglobulin E (IgE) levels, and cord blood IgE were recorded. Clinical examination, questionnaire survey, and blood samples for total and specific IgE of the children were collected at each follow-up visit.
Results:
Of the 246 patients with infantile atopic dermatitis at 6 months of age, 48 patients had persisted atopic dermatitis at 6 years of age (19.5%). Risk factors associated with persistent infantile atopic dermatitis included egg white sensitization (odds ratio: 3.801, P = 0.020), and atopic dermatitis involving two or more areas at 6 months old (odds ratio: 2.921, P = 0.018) after multivariate analysis with logistic regression. Patients with persistent infantile atopic dermatitis had a higher risk of asthma before 6 years old (39.6% vs 24.2%, P = 0.032).
Conclusion:
Egg white sensitization and the initial involvement of two or more areas at 6 months of age were associated with the persistent infantile atopic dermatitis. Patients with persistent infantile atopic dermatitis are more likely to develop asthma by 6 years of age.
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