Clinico-etiological profile of atopic dermatitis in Northeast India

Abstract

Objectives: Atopic dermatitis (AD) is a chronic, inflammatory skin disorder with relapsing and remitting course affecting all age groups and has multifactorial pathogenesis. As multiple genetic and environmental factors contribute to the pathogenesis of AD, its prevalence and presentation vary among different ethnic groups residing in different geographical areas. This study was conducted to study the clinical profile and aggravating factors in cases of AD attending a tertiary hospital in Meghalaya, India, and to find a correlation of disease with serum immunoglobulin E (IgE) levels. Material and Methods: Patients suspected of AD were diagnosed on the basis of Hanifin and Rajka criteria and included in this study. All relevant demographic, anthropometric, clinical, and biochemical data were collected as per a preset pro forma. Serum IgE levels were tested for every patient using electrochemiluminescence immunoassay. Results: A total of 50 diagnosed cases of AD were included in our study with ages ranging from 5 months to 61 years, and the median age for the study population was 7.9 years. Male-to-female ratio was 1:1.17. Urban patients (66%) outnumbered rural patients and the majority of these patients (90%) belonged to the upper middle class (class II) according to the modified Kuppuswamy scale. The disease was aggravated in winters in 70%, in summer in 10%, due to wool in 48%, and due to food items in 22% of patients. Allergic rhinitis was found to be coexisting in 8% of patients, whereas asthma was found in 2% of patients. The predominant site of involvement was the face (91.9%) in children and the flexor surface (92.3%) among adults. The most common clinical presentation included pruritus (100%) and xerosis (98%). Serum IgE was raised in 58% of patients. Conclusion: Atopic dermatitis of chronic type with predominant facial involvement in children and predominant flexural involvement in adults was common in our study population. Seasonal changes, food items, and woolen clothes were common causative and exacerbating factors. Some atypical presentations included posterior thigh eczema, infra-auricular fissures, retroauricular fissures, eyelid eczema, genital dermatitis, juvenile plantar dermatoses, infranasal fissure, and follicular variant of the disease.