This is the first study to demonstrate that wrist activities, nonintrusively measured by the DigiTrac monitor at home, are closely correlated with the objective clinical scores and levels of peripheral blood chemokine markers for AD but not with the reported symptoms of pruritus or sleep loss. We propose that wrist activities between 1 and 3 Hz for the first 3 h are a good indicator of AD severity in children and should substitute for the pruritus and sleep-loss components of the SCORAD.

The TCHM concoction is efficacious in improving quality of life and reducing topical corticosteroid use in children with moderate-to-severe AD. The formulation was palatable and well tolerated.

Quality of life, disease severity scores and laboratory atopic markers represent different domains in AD assessment. They do not necessarily correlate well with each other and all three aspects must be individually evaluated to assess the well-being of these patients.

Serum levels of BDNF and substance P correlate with the clinical score and quality of life score in patients with AD. The strong correlations with nocturnal wrist movements suggest that they may be the pathogenic factors of the annoying symptoms of scratching.

Issues on empirical dietary restriction or supplementation are important but inadequately studied in children with atopic eczema (AE). The dietary habits of children with AE followed at a paediatric dermatology clinic (n = 179) were compared with those without eczema (n = 78). The mothers of 53% of the patients with or without eczema did not breastfeed their children. Common food items avoided by parents whose children have moderate-to-severe AE included fish or seafood [64% vs. 32% of controls, odds ratio (OR) 3.84, 95% CI 2.12-6.95], beef (42% vs. 17%; OR = 3.57, 95% CI 1.79-7.11), eggs (34% vs. 14%; OR = 3.05, 95% CI 1.46-6.34) and cows' milk (18% vs. 4%; OR = 5.56, 95% CI 1.61-19.12); whereas their avoidance was less frequent in children with noneczematous diseases. The avoidance of these foods were often based on belief, but 66% of all AE patients who had avoided any of the above foods reported previous experience of eczema exacerbation by these items. Patients with moderate-to-severe AE were more likely to have consumed 'bird's nest' soup and traditional Chinese medicines. It is important to evaluate whether the AE patients are genuinely 'allergic' to some of these food items. Management is suboptimal if children with food allergy and severe disease continue to consume the culprit food. Conversely, avoidance of common foods in children without food allergy could result in food faddism or malnutrition.

Our results suggest the importance of understanding the nature and extent to which GC fears, regardless of eczema severity, are prevalent so that sound advice can be offered in a timely manner to parents and patients.

Issues related to empirical dietary restriction are important, but they have been inadequately studied among children with atopic dermatitis (AD). To evaluate whether any association exists between food atopy, food avoidance, and AD severity, investigators in the present study reviewed all skin prick tests (SPTs) performed between January 2005 and April 2006 at a pediatric dermatology clinic and correlated findings with history of food avoidance and eczema severity. Only 13% of 114 children with AD had a positive SPT for beef. The most commonly sensitized foods were egg yolk (53%), egg white (42%), shrimp (35%), peanuts (31%), and crab (29%). Disease severity was not associated with prevalence of sensitization to these foods. The investigators concluded that immediate immunoglobulin E reaction to beef, as suggested by positive SPT findings, is unlikely to occur in most children with AD. SPT information may be useful in reassuring parents about the unlikelihood of a severe and immediate reaction to beef. As for other foods, it is sensible to advise parents about specific avoidance strategies only in more severely affected children with a definite history of eczema exacerbation by specific food allergens.

AE correlates significantly with various objective clinical scores and chemokine markers of AD, and is a useful indicator for predicting moderate to severe AD in children.