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Growth in atopic eczema
A A Massarano1, S Hollis, J Devlin
1Department of Child Health, University of Manchester.
Insights
Children with atopic eczema affecting less than 50% of skin area show normal growth. However, those with more extensive eczema are significantly shorter, indicating impaired growth is linked to disease severity.
Area of Science:
- Pediatric Endocrinology
- Dermatology
- Clinical Pediatrics
Background:
- Atopic eczema is a common chronic inflammatory skin condition in children.
- Growth impairment is a potential concern in children with severe atopic eczema.
- Understanding factors influencing growth in this population is crucial for clinical management.
Purpose of the Study:
- To investigate the relationship between the extent of atopic eczema and growth parameters in children.
- To identify factors contributing to growth variations in children with atopic eczema.
Main Methods:
- Study included 68 children aged 2-12 years diagnosed with atopic eczema.
- Height Standard Deviation (SD) scores were calculated and correlated with the percentage of skin surface area affected.
- Regression analysis was performed to assess the influence of parental height, disease extent, and treatments on growth.
Main Results:
- Height SD scores showed a significant negative correlation with the surface area affected by eczema.
- Children with less than 50% skin involvement (Group I) had normal mean height SD scores (-0.11).
- Children with more than 50% skin involvement (Group II) were significantly shorter (mean SD score -0.83) than expected, even accounting for parental target height.
Conclusions:
- Impaired growth in children with atopic eczema is primarily associated with extensive skin surface area involvement (over 50%).
- Parental height is the most significant determinant of a child's height.
- Disease extent has a notable impact on growth, while dietary and topical steroid treatments have minimal effects.
Abstract:
Growth was studied in 68 children aged 2-12 years with atopic eczema. Height SD scores were significantly correlated with the surface area of skin affected by eczema. The mean height of 41 patients with less than 50% of their skin surface affected (group I) was normal (mean SD score -0.11). The 27 children with more than 50% of their skin affected (group II) were significantly shorter (SD score -0.83) and were also short allowing for their parental target height. The predicted heights were also normal in group I but were lower than expected in group II. Regression analysis suggested that height was most dependent on parental height. The extent of the disease had a significant additional effect, whereas dietary treatment and treatment with topical steroids had only marginal additional effects. The growth of children with eczema affecting less than 50% of the skin surface area appears to be normal, and impaired growth is confined to those with more extensive disease.