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Infraorbital crease and atopic dermatitis
1Department of Dermatology & Venereology, Government Medical College Hospital, Chandigarh, India.
Insights
A prominent infraorbital skin crease is not a reliable indicator for diagnosing atopic dermatitis (AD) in children. This study found the crease appeared less frequently in children with AD, suggesting poor validity for population-based studies.
Area of Science:
- Pediatrics
- Dermatology
- Clinical Epidemiology
Background:
- Atopic dermatitis (AD) is a common inflammatory skin condition in children.
- Identifying reliable clinical markers for AD diagnosis is crucial for early intervention.
- The infraorbital skin crease (also known as the Dennie-Morgan fold) has been anecdotally associated with AD.
Purpose of the Study:
- To evaluate the diagnostic utility of a prominent infraorbital skin crease as a marker for atopic dermatitis in school-aged children.
- To assess the validity and repeatability of the infraorbital crease as an indicator of AD.
Main Methods:
- A cross-sectional study involving 500 school children aged 3 to 11 years.
- Infraorbital creases were assessed by two trained observers using a standardized protocol.
- Atopic dermatitis diagnosis was confirmed by a dermatologist blinded to the crease assessment.
Main Results:
- A prominent infraorbital crease was observed in 20% of children with AD versus 35.6% of children without AD.
- The difference in crease prevalence between children with and without AD was not statistically significant (p > .05).
- Poor validity and repeatability of the infraorbital crease were noted.
Conclusions:
- The infraorbital skin crease demonstrates limited utility as a diagnostic marker for atopic dermatitis in population-based studies.
- While potentially useful in specific clinical settings, its poor performance in this study suggests caution in its application.
- Further research may be needed to explore other potential clinical signs for AD diagnosis in pediatric populations.
Abstract:
The usefulness of a prominent infraorbital skin crease as a marker of atopic dermatitis (AD) was examined in 500 consecutive school children 3 to 11 years of age. Infraorbital crease was recorded by two trained observers according to a strict protocol, and AD was determined by an independent dermatologist who was blinded to the study design. A prominent infraorbital crease was present in only 4 of 20 (20%) children with AD, compared with 171 of 480 (35.6%) children who did not have AD (p > .05). While infraorbital crease may be of some use in diagnosing individual cases of AD in a hospital setting, it appears to be less useful in population-based studies because of its poor validity and repeatability.