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What plays a role in the severity of atopic dermatitis in children?
1Division of Pediatric Allergy and Immunology, Department of Pediatrics, Mardin State Hospital, Mardin, Turkey.
Insights
Severe atopic dermatitis (AD) in children is linked to early onset, food sensitivity, rural living, family history of atopy, and passive smoking. Eosinophil count may serve as a severity marker for pediatric AD.
Area of Science:
- Pediatric Dermatology
- Immunology
- Environmental Health
Background:
- Atopic dermatitis (AD) prevalence is increasing globally.
- Identifying severe AD characteristics and risk factors is crucial for effective management.
- Pediatric AD poses a significant health burden, necessitating focused research.
Purpose of the Study:
- To investigate the clinical features of pediatric atopic dermatitis.
- To identify factors associated with severe AD in children.
- To explore correlations between clinical parameters and disease severity.
Main Methods:
- Study included 304 pediatric patients diagnosed with atopic dermatitis.
- Data collected: age at admission/onset, family history of atopy, eosinophil levels, smoking exposure, residence.
- Disease severity assessed using the SCORAD index; epidermal prick tests performed.
Main Results:
- Early onset, food sensitization, rural residence, familial atopy, and passive smoking correlated with higher SCORAD scores.
- Food allergy and passive smoking significantly increased AD severity.
- Eosinophil count showed a positive correlation with SCORAD scores (r = 0.531, p < 0.001).
Conclusions:
- Early-onset AD, food sensitivity, rural environment, familial atopy, and passive smoking are risk factors for severe pediatric AD.
- Eosinophil count is a potential biomarker for assessing AD severity in children.
- These findings aid in targeted interventions and risk stratification for pediatric AD.
Background/Aim:
Determining the characteristics and risk factors of severe disease is extremely important to combat atopic dermatitis (AD), which has recently shown increasing prevalence. In this study, we aimed to investigate the clinical characteristics of pediatric patients with AD and identifying the factors associated with the severity of the disease.
Materials And Methods:
A total of 304 pediatric patients diagnosed with atopic dermatitis were included in the study. The patients’ age at admission, age at onset of symptoms, the presence of atopy history in their family, eosinophil levels obtained from blood counts were recorded, together with the data of cigarette exposure, and area of residence. Disease severity was determined according to the SCORAD index. Epidermal prick tests (EPT) were applied to all patients.
Results:
There was a negative correlation between the SCORAD score and both age at admission (r = 0.277, p < 0.001) and age at onset of the symptoms (r = –0.474, p < 0.001). Food sensitization rates were higher in individuals with moderate-severe disease (90.7% vs. 23.1%; p < 0.001) and patients with food allergy (FA) had significantly higher SCORAD scores [33 (IQR: 22–44) vs. 14 (IQR: 12–16); p < 0.001]. SCORAD scores of the individuals living in rural areas were higher than the ones living in urban [22 (IQR: 15–39.5) vs. 15 (IQR: 12–22); p < 0.001]. Familial atopy history was more common in patients with moderate-severe disease (66.5% vs. 17.5%; p < 0.001). The SCORAD scores were higher in patients exposed to passive smoking [21 (IQR:14.75–38) vs. 13 (IQR: 12–16); p < 0.001]. The eosinophil count found to be positively correlated with SCORAD scores (r = 0.531, p < 0.001).
Conclusion:
Our findings show that early-onset, food sensitivity, living in rural areas, having familial atopy history and passive cigarette smoke exposure play a role in severe AD. Since it is remarkably correlated with SCORAD scores, eosinophil count can be used as a marker to assess the severity of AD in children.
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