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Infraorbital crease, ethnic group, and atopic dermatitis
1St John's Institute of Dermatology, St Thomas' Hospital, London, England.
Archives of Dermatology
|January 1, 1996
Summary
The infraorbital crease is not a reliable indicator for diagnosing atopic dermatitis (AD) in children, especially in diverse populations. Its presence and accuracy vary significantly across ethnic groups, limiting its use in population studies.
Area of Science:
- Dermatology
- Pediatrics
- Allergy Research
Background:
- Atopic dermatitis (AD) is a common inflammatory skin condition in children.
- The infraorbital skin crease has been suggested as a potential clinical sign for AD.
- Reliability of this sign in diverse populations requires investigation.
Purpose of the Study:
- To evaluate the diagnostic utility of a prominent infraorbital skin crease for atopic dermatitis in children.
- To assess the prevalence and reliability of the infraorbital crease in a primary school population.
Main Methods:
- A population-based study involving 160 children aged 3-11 years in London.
- Infraorbital creases were assessed by two trained observers using a strict protocol.
- Atopic dermatitis diagnosis was confirmed by an independent, blinded dermatologist.
Main Results:
- A prominent infraorbital crease was observed in 27% of children with AD versus 34% without AD (P = .80).
- The crease was significantly more common in black children (49%) than white children (25%) (P = .02), irrespective of AD status.
- Low interobserver agreement (kappa = 0.38) was found for crease assessment.
Conclusions:
- The infraorbital crease demonstrates poor validity and repeatability for diagnosing AD in population studies.
- Ethnic variations in crease prevalence necessitate careful consideration in allergy assessments.
- Clinical utility may be limited to specific settings, with caution advised in diverse groups.