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Epidemiology and clinical pattern of atopic dermatitis in a North Indian pediatric population
1Department of Dermatology, PGIMER, Chandigarh, India.
Insights
This study analyzed atopic dermatitis (AD) in 672 children, finding urban prevalence and winter exacerbation. Infantile AD onset averaged 4.2 months, while childhood AD began around 4.1 years.
Area of Science:
- Pediatrics
- Dermatology
- Epidemiology
Background:
- Atopic dermatitis (AD) is a common chronic inflammatory skin condition affecting children.
- Understanding the epidemiologic factors and clinical presentations of AD is crucial for effective management.
- Previous studies have highlighted variations in AD prevalence and characteristics across different age groups and geographic locations.
Purpose of the Study:
- To evaluate the epidemiologic factors and clinical patterns of atopic dermatitis in a cohort of 672 children.
- To differentiate between infantile and childhood atopic dermatitis regarding onset, duration, and clinical manifestations.
- To identify seasonal variations, personal/family history correlations, and common eczema types in pediatric atopic dermatitis.
Main Methods:
- A cross-sectional study involving 672 pediatric patients diagnosed with atopic dermatitis.
- Data collection included patient demographics, age at onset, disease duration, geographic origin (urban vs. rural), and seasonal patterns of exacerbation.
- Information on personal and family history of atopy and drug allergies, as well as clinical presentation (e.g., facial, flexural, extensor involvement) and eczema morphology (acute, subacute, chronic, follicular) was recorded.
Main Results:
- The study included 210 infants and 462 children. Infantile AD onset averaged 4.2 months (duration 3.3 months), while childhood AD onset averaged 4.1 years (duration 1.9 years).
- Urban prevalence was significantly higher in both groups. Winter exacerbation was most common (67.14% in infants, 58% in children).
- Personal and family history of atopy varied, with higher prevalence in childhood AD. Facial involvement was common in both groups (79% infants, 74.50% children). Chronic eczema was the most frequent type in childhood AD (47.40%).
Conclusions:
- Atopic dermatitis in children exhibits distinct patterns in infantile versus childhood onset, with urban and winter seasonality being significant factors.
- The high prevalence of facial involvement and varying eczema types underscore the need for tailored management strategies.
- Family history of atopy is a notable risk factor, emphasizing the genetic component of pediatric atopic dermatitis.
Abstract:
Various epidemiologic factors and clinical patterns of atopic dermatitis (AD) were evaluated in 672 children. Of these, 210 were infants (up to 1 year) and 462 were children. Mean age at onset and mean duration of the disease were 4.2 months and 3.3 months, respectively, in the "infantile AD" group. In the "childhood AD" group the corresponding figures were 4.1 years and 1.9 years. In both groups, patients from urban areas significantly outnumbered those from rural backgrounds. In the infantile AD group, the disease was aggravated in winter in 67.14%, in summer in 23.36% and in spring in 9.51% of patients. The corresponding figures in the childhood AD group were 58% in winter, 32.92% in summer, 7.43% in spring, and 1.74% in the rainy season. In the infantile AD group, personal and family history of atopy were seen in 0.91% and 36.19% of patients, respectively. No patient had a history of drug allergy. In the childhood AD group, 15.35% had a personal history of atopy, 36.44% had a family history of atopy, and 7.36% had both a personal and family history of atopy. A history of drug allergy was reported in 3.16% of children. In the infantile AD group, 79% had facial involvement, 42% had flexors affected, and 5.70% had both flexors and extensors affected. The types of eczema seen were acute in 52.72%, subacute in 23.35%, chronic in 23.35%, and follicular in 0.46%. In the childhood AD group, 74.50% had facial involvement, 35.53% had flexural involvement, 56.32% had extensor involvement, and 8.24% had both flexors and extensors involved. Acute eczema was seen in 28.79%, subacute in 23.38%, chronic in 47.40%, and follicular in 0.43% of the children.