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The impact of comorbidities on the severity of atopic dermatitis in children
Vojko Berce1, Teja Marhold2, Vid Delopst2
1Department of Paediatrics, University Medical Centre Maribor, Maribor, Slovenia.
Insights
Children with atopic dermatitis (AD) and allergies, low IgM, or impetigo history face more severe disease. Early identification and management of these factors are crucial for better outcomes in pediatric AD.
Area of Science:
- Pediatric Dermatology
- Immunology
- Genetics
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition in children.
- AD is linked to allergies, skin barrier dysfunction, and infections.
Purpose of the Study:
- To identify comorbidities and risk factors impacting AD severity in children.
- To correlate clinical presentation with specific biomarkers and genetic factors.
Main Methods:
- Cross-sectional study of 52 newly diagnosed pediatric AD patients.
- Assessed AD severity using the SCORAD index.
- Measured serum tryptase, zinc, selenium, immunoglobulins (IgA, IgG, IgM, IgE), and allergen-specific IgE.
- Screened for filaggrin gene mutations.
Main Results:
- Atopy was associated with significantly higher SCORAD scores (47.8 vs. 27.2, p < 0.01).
- Low serum IgM levels correlated with increased AD severity (SCORAD 61.2 vs. 34.9, p = 0.03).
- History of impetigo also linked to higher SCORAD scores (56.2 vs. 34.0, p = 0.01).
Conclusions:
- Children with AD, allergen sensitization, low IgM, or impetigo history are prone to more severe disease.
- These patients require heightened attention, diligent skincare, and proactive management.
- Effective management includes addressing comorbidities when feasible.
Introduction:
Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease. It is associated with atopy, impaired skin barrier, skin infections and several other comorbidities.
Aim:
To identify comorbidities and risk factors that influence the severity of AD in children.
Material And Methods:
We performed a cross-sectional study involving 52 children newly diagnosed with AD. The severity of AD was assessed with the SCORing Atopic Dermatitis (SCORAD) clinical tool. Levels of serum tryptase, zinc, selenium, and immunoglobulins A, G, M and E (IgA, IgG, IgM, and total IgE, respectively) were determined as well as allergen-specific E antibodies (IgE) to the most common allergens. DNA samples from venous blood were screened for the most common mutations in the filaggrin gene.
Results:
The median age of patients was 30 months. The median SCORAD index in patients with atopy was 47.8, compared to 27.2 in non-atopic patients (p < 0.01). We also found a significantly higher median SCORAD of 61.2 in patients with low serum IgM levels compared to 34.9 in patients with normal serum IgM levels (p = 0.03). A history of impetigo was also associated with a higher median SCORAD of 56.2 compared to 34.0 in patients without impetigo (p = 0.01).
Conclusions:
Patients with AD and sensitisation to common allergens, low levels of IgM or a history of impetigo are at risk for more severe disease and, therefore, need more attention, meticulous skin care, proactive management and treatment of comorbidities, when possible.
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