Predictive factors of persistent infantile atopic dermatitis up to 6 years old in Taiwan: a prospective birth cohort study

Guo, Mindy Ming‐Huey; Tseng, W.-N.; Ou, Chia-Yu; Hsu, Te‐Yao; Kuo, Ho‐Chang; Yang, Kuender D.

doi:10.1111/all.12706

Cited by 19 publications

(27 citation statements)

References 28 publications

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“…A higher prevalence of AD in infants is consistent with our previous findings that the disease prevalence decreases with age. In a prospective birth cohort study of Taiwan, 246 (33.9%) children out of the 724 patients with adequate follow‐up data were confirmed with diagnosis of infantile AD at 6 months old . In a long‐term follow‐up of allergic diseases in Iceland, the prevalence of eczema was as high as 31% at the age of 2 years .…”

Section: Discussionmentioning

confidence: 95%

“…In a prospective birth cohort study of Taiwan, 246 (33.9%) children out of the 724 patients with adequate follow-up data were confirmed with diagnosis of infantile AD at 6 months old. 13 In a long-term follow-up of allergic diseases in Iceland, the prevalence of eczema was as high as 31% at the age of 2 years. 14 The data above were consistent with our result.…”

Section: Discussionmentioning

confidence: 98%

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Phenotypic analysis of atopic dermatitis in children aged 1–12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

Guo

Zhang

Liu

et al. 2019

Acad Dermatol Venereol

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Background Atopic dermatitis (AD) is the most common skin disorder in infancy. However, the diagnosis and definite significance of infantile AD remains a debated issue. Objective To analyse the phenotypes of AD in infancy, to establish diagnostic criteria and to estimate the prevalence of this condition in China. Methods This is a multicentric study, in which 12 locations were chosen from different metropolitan areas of China. Following careful and complete history‐taking and skin examination, the definite diagnosis of AD was made and the severity based on the SCORAD index was determined by local experienced dermatologists. Based on the detailed phenotyping, the major and representative clinical features of infantile AD were selected to establish the diagnostic criteria and evaluate their diagnostic efficacy. Results A total of 5967 infants were included in this study. The overall point prevalence of AD was 30.48%. The infantile AD developed as early as at the second month of life, and its incidence peaked in the third month of life at 40.81%. The proportion of mild, moderate and severe AD was 67.40%, 30.57% and 2.03%, respectively. The most commonly seen manifestations in the infantile AD were facial dermatitis (72.07%), xerosis (42.72%) and scalp dermatitis (27.93%). We established the novel diagnostic criteria of infants, which included: (i) onset after 2 weeks of birth; (ii) pruritus and/or irritability and sleeplessness comparable with lesions; and (iii) all two items above with one of the following items can reach a diagnosis of AD: (i) eczematous lesions distributed on cheeks and/or scalp and/or extensor limbs, and (ii) eczematous lesions on any other parts of body accompanied by xerosis. Conclusions In China, the prevalence of AD in infancy is 30.48% according to clinical diagnosis of dermatologists. The novel Chinese diagnostic criteria for AD in infants show a higher sensitivity and comparable specificity.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

Phenotypic analysis of atopic dermatitis in children aged 1–12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

Guo

Zhang

Liu

et al. 2019

Acad Dermatol Venereol

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“…The birth cohort was described in detail in previous works [4, 7, 17, 34, 35]. In brief, 1,848 newborns were recruited prenatally between December 1998 and April 2009, crossing 11 years.…”

Section: Methodsmentioning

confidence: 99%

A prospective birth cohort study of different risk factors for development of allergic diseases in offspring of non-atopic parents

Lee

et al. 2017

Oncotarget

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Background: Allergic diseases are thought to be inherited. Prevalence of allergic diseases has, however, increased dramatically in last decades, suggesting environmental causes for the development of allergic diseases.Objective: We studied risk factors associated with the development of atopic dermatitis (AD), allergic rhinitis (AR) and asthma (AS) in children of non-atopic parents in a subtropical country.Methods: In a birth cohort of 1,497 newborns, parents were prenatally enrolled and validated for allergic diseases by questionnaire, physician-verified and total or specific Immunoglobulin E (IgE) levels; 1,236 and 756 children, respectively, completed their 3-year and 6-year follow-up. Clinical examination, questionnaire, and blood samples for total and specific IgE of the children were collected at each follow-up visit.Results: Prevalence of AD, AR and AS was, respectively, 8.2%, 30.8% and 12.4% in children of non-atopic parents. Prevalence of AR (p<.001) and AS (p=.018) was significantly higher in children of parents who were both atopic. A combination of Cesarean section (C/S) and breastfeeding for more than 1 month showed the highest risk for AD (OR=3.111, p=.006). Infants living in homes with curtains and no air filters had the highest risk for AR (OR=2.647, p<.001), and male infants of non-atopic parents living in homes without air filters had the highest risk for AS (OR=1.930, p=.039).Conclusions: Breastfeeding and C/S affect development of AD. Gender, use of curtains and/or air filters affect AR and AS, suggesting that control of the perinatal environment is necessary for the prevention of atopic diseases in children of non-atopic parents.

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“…43 Some genetic factors have been associated with persistent dermatitis, but these factors are not easy to use in clinical practice. 44 Some studies suggest that children with atopy from house dust mites or foods before their first year should be considered at risk of AD persistence; 45,46 although it is not clear if atopy is a consequence of greater severity, it could be used as a duration predictor.…”

Section: Can Atopic Dermatitis Be Prevented?mentioning

confidence: 99%

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

Sánchez

Sánchez²,

Macías-Weinmann

et al. 2019

RAM

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The Latin American Society of Allergy, Asthma, and Immunology (SLAAI) conducted a systematic search in the Medline and LILACS' database in order to get articles linked to 10 current questions about dermatitis. The assessment of the quality of the evidence and the strength of the recommendations was made through the GRADE system. The completeness and transparency of the recommendations for this clinical guide were assessed with the AGREE Reports Verification Checklist. The final document was shared with physicians, allergists, dermatologists, and pediatricians, and with patients and academic institutions such as universities and medical scientific societies for external assessment. According to the review, clinical scales should be used to measure the severity of the dermatitis, and some interventions such as the use of probiotics may benefit the patient; nevertheless, more studies are required before this management option can be used in the everyday practice. Other interventions such as dietary restrictions and the use of antihistamines seem to be well-founded only in particular cases and they should not be a general recommendation for all patients. This practical guide presents recommendations for the treatment of atopic dermatitis; these recommendations can be helpful for medical staff, patients, and health systems.

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Predictive factors of persistent infantile atopic dermatitis up to 6 years old in Taiwan: a prospective birth cohort study

Abstract: Egg white sensitization and the initial involvement of two or more areas at 6 months of age were associated with the persistent infantile atopic dermatitis. Patients with persistent infantile atopic dermatitis are more likely to develop asthma by 6 years of age.

Cited by 19 publications

References 28 publications

Phenotypic analysis of atopic dermatitis in children aged 1–12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

Phenotypic analysis of atopic dermatitis in children aged 1–12 months: elaboration of novel diagnostic criteria for infants in China and estimation of prevalence

A prospective birth cohort study of different risk factors for development of allergic diseases in offspring of non-atopic parents

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

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