Epidemiology and Clinical Pattern of Atopic Dermatitis in a North Indian Pediatric Population

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.

Atopic dermatitis in infants and children in India

“…Acute eczema was seen in 28.79%, subacute in 23.38%, chronic in 47.40% and follicular in 0.43% of the children. [12] Another hospital-based North Indian study later on documented an incidence of 29.9% of total patients. The population comprised of 125 patients, including 26 infants and 99 children, showing a mean duration of disease of 3 months in infants and 6 years in children.…”

The effect of environmental humidity and temperature on skin barrier function and dermatitis

“…Cold and dry weather increase the overall risk of flares in patients with AD and further increase its incidence and prevalence (Table ) . Accordingly, a higher prevalence of AD was found in American states with low humidity, low UV exposure, low outdoor temperature, use of indoor heating and frequent precipitation .…”

Scoring atopic dermatitis and six sign atopic dermatitis: Comparison of prognostic and predictive value in atopic dermatitis

“…In the present study, the male to female ratio was 1.08:1. Previous studies have also reported a male predominance, i.e., 2.13:1 for infants and 1.09:1 for children, [10] 1.8:1, [12] 2.25:1 for infants and 1.6:1 for children, [13] 1.3:1 [14] and 1.56:1. [13] The mean age of onset in the present study was 2.49 years.…”

“…The corresponding figures in the childhood AD patients were 58% and 32.9%, respectively. [10] On the contrary, in the study by Dhar et al in different climatic conditions in Eastern India, 40% patients had aggravation during summers and only 15% had winter exacerbation. [14] AD is more common in the urban than in the rural set up.…”

“…[8] Various studies done in India have reported the incidence to be 0.01% [9] to as high as 28.46% [10] from different parts of the country.…”