Prevalence of atopic dermatitis in infants during the first six months of life: authors’ observations

Abstract

IntroductionAtopic dermatitis (AD) is a frequent chronic skin disease in infants. It creates great difficulties, both diagnostic and therapeutic.AimTo assess the prevalence of atopic dermatitis in infants during the first 6 months of life.Material and methodsThe analysis comprised 2256 children at the age of not more than 6 months, treated at the 2nd Department of Paediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz, Poland, during seven years. Out of all the patients, children with cutaneous changes were isolated, and the location, type and aetiology of changes were assessed.ResultsDermal changes were diagnosed in 471 children, including 391 (17.3% of all the patients) with atopic dermatitis. Out of the children with AD, IgE-dependent allergy was identified in 39.9%. Cow's milk protein was the most frequent sensitising allergen. In 71.6% of the infants, cutaneous changes were disseminated and involved at least two areas of the body. All of them were strongly itching. An applied elimination diet, together with anti-allergic medications in some of the children, provided a clear clinical improvement.ConclusionsPerformed studies demonstrated the prevalence of atopic dermatitis in 17.3% of examined children. The changes in children with AD were disseminated, what was confirmed already at the infantile age. The obtained clinical improvement after the applied therapy indicates a relationship between the observed symptoms and allergic disease.

Allergic diseases: the price of civilisational progress

“…There are epidemiological and experimental data to substantiate various hypotheses: original hygiene hypothesis: improved hygiene in early life, reduction of family size and number of siblings [4, 5, 14, 15], extended hygiene hypothesis: replacement of traditional anthroposophic way of living, combining elements of conventional medicine (restrictive use of antibiotics, antipyretics and vaccination) with homeopathy and naturopathy (biodynamic diet) by modern lifestyle and new medical recommendations [6, 13, 16, 17]; reduced early exposure to infectious and microbial agents [9, 17–24]; shorter period of breast feeding with unfavourable changes in the gut flora [2, 11, 25, 26], first dietary antioxidant hypothesis: antioxidant-depleted Western diet [1, 3, 11, 27–29], second dietary antioxidant hypothesis: increased availability of antioxidant-rich (“healthy’’) foods, especially dietary supplements such as vitamins, food preservatives or colorants and traditional Chinese or Vietnamese herbal medicine extracts [1, 30, 31], dietary lipid hypothesis: decreased consumption of saturated animal fat (butter, lard) and oily fish containing long chain n-3 polyunsaturated fatty acids (PUFA), increased intake of margarine, vegetable oils and fast food meals rich in n-6-PUFAs [1, 11, 27, 32, 33], dietary sodium hypothesis: sodium-rich Western diet [11, 24, 34], vitamin D deficiency hypothesis: decreased vitamin D synthesis in skin due to environmental, behavioural and intrinsic factors, in particular reduced exposure to solar radiation because of urban living, indoor occupation, pollution, skin coverage and excessive use of sunscreen for skin cancer prevention [1, 35, 36], vitamin D supplementation hypothesis: delayed side effect of early rickets prophylaxis with vitamin D supplements or excessive maternal concentration of 25(OH)-vitamin D in pregnancy [1, 37–40], maternal diet hypothesis: low maternal vitamin D, antioxidants and 3-ω-PUFAs intake in pregnancy [1, 3, 11, 25],parental smoking during pregnancy and postnatal exposure to environmental tobacco smoke [2, 5, 29, 41...…”

“…A number of studies have demonstrated an increase in the prevalence of asthma, allergic rhinitis (AR) and atopic dermatitis (AD) over the last four decades, particularly in children. This increase has been observed in both industrialized and developing countries [ 1 – 6 ]. World Health Organization estimates that 400 million people suffer from AR and 300 million from asthma.…”

“…Many hypotheses link the allergy epidemic to stringent hygiene in early life, replacement of a traditional way of living by a westernized lifestyle and an accelerated pace of life [ 1 , 2 , 4 , 5 , 7 , 13 ]. There are epidemiological and experimental data to substantiate various hypotheses: original hygiene hypothesis: improved hygiene in early life, reduction of family size and number of siblings [ 4 , 5 , 14 , 15 ], extended hygiene hypothesis: replacement of traditional anthroposophic way of living, combining elements of conventional medicine (restrictive use of antibiotics, antipyretics and vaccination) with homeopathy and naturopathy (biodynamic diet) by modern lifestyle and new medical recommendations [ 6 , 13 , 16 , 17 ]; reduced early exposure to infectious and microbial agents [ 9 , 17 – 24 ]; shorter period of breast feeding with unfavourable changes in the gut flora [ 2 , 11 , 25 , 26 ], first dietary antioxidant hypothesis: antioxidant-depleted Western diet [ 1 , 3 , 11 , 27 – 29 ], second dietary antioxidant hypothesis: increased availability of antioxidant-rich (“healthy’’) foods, especially dietary supplements such as vitamins, food preservatives or colorants and traditional Chinese or Vietnamese herbal medicine extracts [ 1 , 30 , 31 ], dietary lipid hypothesis: decreased consumption of saturated animal fat (butter, lard) and oily fish containing long chain n-3 polyunsaturated fatty acids (PUFA), increased intake of margarine, vegetable oils and fast food meals rich in n-6-PUFAs [ 1 , 11 , 27 , 32 , 33 ], dietary sodium hypothesis: sodium-rich Western diet [ 11 , 24 , 34 ], vitamin D deficiency hypothesis: ...…”

Diagnosing atopic dermatitis in infancy: Questionnaire reports vs criteria‐based assessment

“…1 Other studies have utilised electronic medical records 7,8 seeking a diagnosis by an attending physician, while others relied on parentreported physician diagnosis, where parents were typically asked "Has your child been diagnosed with eczema?". [9][10][11][12] Some studies have employed direct examination of the child by a health care professional, [13][14][15][16] while others have combined more than one of these methods. 13,15 It is unknown if these methods are comparable.…”

Relationship of primary immune thrombocytopenic purpura and atopia among children: a case control study

“…Symptoms occur in 45% of patients within the first 6 months of life, and face and neck are involved in more than 90% of them. Another point to note is that 60% of infants and children with this disease recover up to 12 years of age and rarely persist until adulthood 2 , 3 .…”