The natural course of childhood atopic dermatitis: a retrospective cohort study

Wananukul, Siriwan; Chatproedprai, Susheera; Tempark, Therdpong; Phuthongkamt, Weena; Chatchatee, Pantipa

doi:10.12932/ap0498.33.2.2015

Cited by 29 publications

(42 citation statements)

References 20 publications

(35 reference statements)

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“…Most of the infants had mild to moderate severity; however, the EASI score increased with age, reaching >30% of that of severe adult patients. As in previous studies, the severity was either mild or moderate in >80% of the infants and children,1518 whereas a higher percentage (25%-31%) of patients in their adulthood had severe AD 734. Some other studies, however, showed contradictory data, with only 1.7% of adult patients having severe AD 19.…”

Section: Discussionmentioning

confidence: 49%

“…Family history, one of the major criteria in the diagnosis of AD, is known to be an important risk factor for AD. Studies from Western countries have found a positive family history of atopy in 53%-80% of patients 1516. In a recent study in Korean children with AD, about 40% had a family history,17 whereas a few others have shown a positive family history in 28% and 47.8% 1518.…”

Section: Discussionmentioning

confidence: 96%

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Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Chu

Shin

Park

et al. 2017

Allergy Asthma Immunol Res

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PurposeAtopic dermatitis (AD) is a chronic eczematous dermatitis that has a high prevalence and diverse clinical features. Although several hypotheses about its multifactorial pathogenesis have been suggested, the cause is not yet fully understood. A better understanding of the clinical features may helpful inelucidating the pathogenesis of AD.MethodsThis retrospective study analyzed the questionnaires, medical charts, and laboratory examination results of 5,000 patients diagnosed with AD at a single tertiary hospital in Korea.ResultsThe demographics, allergic comorbidities, family history, severity, and treatment experiences of the patients were analyzed. Most of the patients were adults, 76.3% of whom were classified as havingan extrinsic type of AD. The mean eczema area and severity index (EASI) score was found to be 13.68, and adult patients were found to have higher severity than the other age groups. The anatomical involvements were different among the age groups, with more involvements of the head and neck in adults. The patients reported seasonal changes and stress as the factors that aggravated their symptoms the most. Topical steroids and oral cyclosporine were the most used medications at our clinic, whereas 10.1% of the patients underwent allergen-specific immunotherapy.ConclusionsThis analysis of 5,000 patients would lead to a better understanding of various subtypes and diverse clinical features of AD in Koreans. Distinct characteristics were observed among different age groups; thus, treatment strategies may need to be differentiated accordingly.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 96%

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Chu

Shin

Park

et al. 2017

Allergy Asthma Immunol Res

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show abstract

“…Between 10 and 20% of children in Asia suffer from atopic dermatitis and up to 10% of these are severe . The prevalence of food allergy in most Asian populations is generally low, and egg is the commonest food allergen in the majority of Asian countries .…”

Section: Summary Of Existing Evidencementioning

confidence: 99%

Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective—An Asia Pacific Association of Pediatric Allergy, Respirology & Immunology (APAPARI) consensus statement

Tham

Shek

Bever

et al. 2017

Pediatric Allergy Immunology

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Emerging evidence for the early introduction of allergenic foods for the prevention of food allergies, such as peanut allergy in Western populations, has led to the recent publication of guidelines in the USA and Europe recommending early peanut introduction for high-risk infants with severe eczema or egg allergy. Peanut allergy is, however, much less prevalent in Asia compared to the West. Varying patterns of food allergy are seen even within Asian countries-such as a predominance of wheat allergy in Japan and Thailand and shellfish allergy in Singapore and the Philippines. Customs and traditions, such as diet and infant feeding practices, also differ between Asian populations.Hence, there are unique challenges in adapting guidelines on early allergenic food introduction to the Asian setting. In this paper, we review the evidence and discuss the possible approaches to guide the timely introduction of allergenic food in high-risk infants in Asia.

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“…Similarly, no significant difference was found in terms of sex in children with acute and chronic urticaria by Chang et al (10), in children with acute urticaria who presented to emergency department by Liu et al (11), or in children with food-induced urticaria by Wananukul et al (12). However, urticaria is observed more frequently in adult women compared with adult men (3).…”

Section: Discussionmentioning

confidence: 99%

“…The success of specifying triggering factors in urticaria ranges between 21% and 83% in different studies (10)(11)(12)(13)(14)(15)(16). In our study, we found no factors that could lead to urticaria in approximately one fifth of the children with acute urticaria, and in approximately half of the children with chronic urticaria.…”

Section: Discussionmentioning

confidence: 99%

High-dose anti-histamine use and risk factors in children with urticaria

Uysal¹,

Avcıl²,

Erge³

2016

Turk Pediatri Ars

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Aim: The drugs of choice in the treatment of urticaria in children are H1-antihistamines. The aim of the study was to evaluate children with urticaria and define risk factors for requirement of high-dose H1-antihistamines in children with urticaria. Material and Methods:The medical data of children who were diagnosed as having urticaria admitted to our outpatient clinic between January 2014 and January 2016 were searched. The medical histories, concomitant atopic diseases, parental atopy histories, medications, treatment responses, blood eosinophil and basophil counts, and serum total IgE levels were recorded. In addition, the urticaria activity score for seven days, autoimmune antibody tests, and skin prick test results were evaluated in children with chronic urticaria. Results:The numbers of the children with acute and chronic urticaria were 138 and 92, respectively. The age of the children with chronic urticaria was higher than that of those with acute urticaria (p<0.0001). There was no difference between the two groups in terms of blood eosinophil and basophil counts, and serum total IgE levels (p>0.05). There was a negative correlation between blood eosinophil count and the UAS7 score in children with chronic urticaria (r=-0.276, p=0.011). Chronic urticaria and requirement of high dose H1-antihistamines were significant in children aged ≥10 years (p<0.001, p=0.015). High UAS7 score (OR: 1.09; CI 95%: [1.03-1.15]) and basopenia (OR: 6.77; CI 95%: [2.01-22.75]) were associated with the requirement of high-dose H1-AH in children with chronic urticaria. Conclusion:The requirement of high-dose H1-antihistamines was higher with children's increasing age. Disease severity and basopenia were risk factors for the requirement of high-dose H1-antihistamines. (Turk Pediatri Ars 2016; 51: 198-203)

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The natural course of childhood atopic dermatitis: a retrospective cohort study

Abstract: Half of AD had completely disappeared at preschool age. Good prognosis was mostly determined by early onset AD and mild severity. Late onset, family history of atopy and increased serum IgE level are associated with respiratory allergy.

Cited by 29 publications

References 20 publications

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Clinical Diversity of Atopic Dermatitis: A Review of 5,000 Patients at a Single Institute

Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective—An Asia Pacific Association of Pediatric Allergy, Respirology & Immunology (APAPARI) consensus statement

High-dose anti-histamine use and risk factors in children with urticaria

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