Atopic Dermatitis In Schoolchildren Research Articles

Exposure to biocides and its association with atopic dermatitis among children and adolescents: A population-based cross-sectional study in South Korea

BackgroundBiocides have emerged as a contributor to the rising cases of atopic dermatitis among children and adolescents. Previous animal studies suggested that phenols, parabens, and pyrethroid insecticides present in these products might play a role in atopic dermatitis. However, there's limited epidemiological evidence confirming the individual or combined effects of exposure to these chemicals on atopic dermatitis in young populations. This study aimed to investigate the association between phenol, paraben, and pyrethroid metabolite levels in urine and atopic dermatitis among Korean children and adolescents MethodsWe analyzed 556 preschool children (3–5 years), 701 schoolchildren (6–11 years), and 731 adolescents (12–17 years) enrolled in the 4th Korean National Environmental Health Survey (KoNEHS) (2018–2020). We used logistic regression and Bayesian kernel machine regression to evaluate the association between atopic dermatitis and individual or mixed exposure to urinary triclosan (TCS), parabens (methylparaben, ethylparaben, propylparaben, and butylparaben), and 3-phenoxybenzoic acid (3-PBA) levels. ResultsUrinary TCS levels were positively associated with atopic dermatitis in schoolchildren. When stratified by sex, male schoolchildren exhibited an increasing prevalence of atopic dermatitis as their urinary TCS and 3-PBA levels increased. The combined effect of biocide mixtures on atopic dermatitis was also significantly increased in male schoolchildren, with TCS as the main contributor. ConclusionsThese study findings suggest that biocides at levels found in Korean children and adolescents affect atopic dermatitis.

Personal Exposure to Total VOC Is Associated With Symptoms of Atopic Dermatitis in Schoolchildren.

BackgroundThe urinary levels of volatile organic compound (VOC) metabolites provide individual exposure levels compared to data obtained by measuring these compounds in ambient air. We aimed to investigate the association between personal urinary concentrations of VOC metabolites and symptoms of atopic dermatitis in schoolchildren.MethodsNine urinary VOC metabolites were analyzed from urine samples of 149 children. Diagnosis of atopic dermatitis was determined using standardized questionnaires. Pediatricians visited the schools and rated the severity of symptoms using the SCORing Atopic Dermatitis (SCORAD) in all children.ResultsForty-five children (30.2%) had atopic dermatitis based on the International Study of Asthma and Allergies in Childhood (ISAAC) results and 35 children (23.8%) had symptoms of atopic dermatitis with positive SCORAD index values (defined as SCORAD ≥ 5). Children with benzylmercapturic acid detected in personal urines were associated with presence of atopic dermatitis and positive SCORAD index values. Children in the highest quartile of mandelic acid concentration were associated with presence of atopic dermatitis and positive SCORAD results.ConclusionPersonal exposure to VOCs, as indicated by urinary levels of VOC metabolites, was associated with presence of atopic dermatitis and the SCORAD index value.

Atopic dermatitis in schoolchildren and adolescents: a critical review of Italian epidemiological data and systemic treatments

The epidemiology of atopic dermatitis (AD) is largely different in pre-school and schoolchildren. We summarized the available epidemiological data on schoolchildren (6-11 years) and adolescents (12-17 years) in Italy and reviewed information on systemic treatments for moderate-to-severe AD in adolescents.In January 2019, we searched for data on prevalence and/or incidence of AD and on the efficacy, effectiveness and safety of systemic AD therapies. Papers were evaluated and selected, and relevant information was extracted. Twenty papers from 17 studies reported original epidemiological information on AD in Italy.Most studies were conducted before 2005. Though variations emerged between studies, the lifetime prevalence of AD was estimated between 15-17% in schoolchildren and between 8-13% in adolescents. The (12-months) period prevalence of AD was estimated between 8-10% in children and between 8-11% in adolescents. Up-to-date information on the prevalence of severe AD is not available. Cyclosporine A may be used in pediatric age patients (children and adolescents) with persistent or severe AD refractory to topical treatments, but its use has several limitations, and is not recommended in patients younger than 16 years. The treatment paradigm of AD is still far from being satisfactory.We provided a quantitative synthesis of AD epidemiology in Italian schoolchildren and adolescents. Recent data are needed, as most information dates back to the 1990s or early 2000s, and data on the incidence of AD, the proportion of severe cases, and treatment of severe cases in the real-world setting are scanty.

Atopic dermatitis in schoolchildren and adolescents: a critical review of Italian epidemiological data and systemic treatments

The epidemiology of atopic dermatitis (AD) is largely different in pre-school and schoolchildren. We summarized the available epidemiological data on schoolchildren (6-11 years) and adolescents (12-17 years) in Italy and reviewed information on systemic treatments for moderate-to-severe AD in adolescents. In January 2019, we searched for data on prevalence and/or incidence of AD and on the efficacy, effectiveness and safety of systemic AD therapies. Papers were evaluated and selected, and relevant information was extracted. Twenty papers from 17 studies reported original epidemiological information on AD in Italy. Most studies were conducted before 2005. Though variations emerged between studies, the lifetime prevalence of AD was estimated between 15-17% in schoolchildren and between 8-13% in adolescents. The (12-months) period prevalence of AD was estimated between 8-10% in children and between 8-11% in adolescents. Up-to-date information on the prevalence of severe AD is not available. Cyclosporine A may be used in pediatric age patients (children and adolescents) with persistent or severe AD refractory to topical treatments, but its use has several limitations, and is not recommended in patients younger than 16 years. The treatment paradigm of AD is still far from being satisfactory. We provided a quantitative synthesis of AD epidemiology in Italian schoolchildren and adolescents. Recent data are needed, as most information dates back to the 1990s or early 2000s, and data on the incidence of AD, the proportion of severe cases, and treatment of severe cases in the real-world setting are scanty.

Phenotypes of Atopic Dermatitis in School Children

Atopic dermatitis (AD) develops from a complex interplay between environmental and immunologic factors incomplete understanding of its pathophysiology. AD is characterized by heterogeneous features in its onset and severity. The aim was to define the distinct phenotypes of AD children aged 6 to 13 years.

The PCDH1 gene and asthma in early childhood

Previous studies have suggested that variants in the protocadherin-1 (PCDH1) gene, which is important for cell-cell adhesion, are associated with asthma, bronchial, hyperresponsiveness and atopic dermatitis in school children. Our aim was to associate common variants of the PCDH1 gene with longitudinally assessed asthma phenotypes and atopic dermatitis in early childhood. We analysed eight single-nucleotide polymorphisms in PCDH1 from 411 children born to asthmatic mothers from the Copenhagen Prospective Studies on Asthma in Childhood birth cohort. Asthma and atopic dermatitis were diagnosed prospectively to the age of 7 years and asthma was categorised by temporal pattern: transient early respiratory symptoms, persistent symptoms and late-onset symptoms. Bronchial responsiveness was measured at age 6 years. We used additive genetic models. Kaplan-Meier plots revealed early onset in hetero- and homozygotes for the rs10063472-T allele. Significant association was observed between the transient early phenotype and rs10063472-T (transient early versus all: OR 1.91, 95% CI 1.21-3.01, p=0.0058; transient early versus asymptomatic: OR 2.00, 95% CI 1.23-3.25, p=0.0053). No association was observed for other symptom patterns or bronchial responsiveness. Significant association was observed for atopic dermatitis and rs11167761-A (OR 1.85, 95% CI 1.24-2.75, p=0.0026). Common variations in PCDH1 increase the risk of developing both transient early asthma and atopic dermatitis in early childhood.

Roles of pollution in the prevalence and exacerbations of allergic diseases in Asia

The prevalence of asthma and allergic diseases has been found to be increasingly rapidly, especially in developing countries. Environmental factors have been found to be important contributors to the manifestations of allergic diseases. Air pollution has been extensively studied in different regions of the world. The levels of ambient air pollutants in many Asian countries are very high when compared with those in developed Western countries. However, the prevalence of asthma was relatively low across many Asian countries. Many studies have clearly documented that environmental air pollution is an important factor resulting in exacerbations of asthma. In particular, levels of traffic-related pollutants are increasing rapidly across many Asian countries in parallel with the level of urbanization and economic development. The loss of protective factors associated with a rural environment will further contribute to the adverse effect on patients with allergic diseases such as asthma. In this review the roles of air pollution were examined in relation to the inception and exacerbations of allergic diseases in Asia.

The Environmental and Educational Management Effects of Atopic Dermatitis in a Seoul Elementary School

Methods:A modified Korean version of written questionnaires from the International Study of Asthma and Allergies in Childhood was completed by the parents of 125 first-grade children. Skin prick tests (SPTs) for nine common inhalants and food allergens were performed. Air cleaners, HEPA vacuum cleaners, wet blackboards, and wet towels were used to clean the floor in the class- room. Students and their parents participated in school-based educational programs about atopic dermatitis. A follow-up questionnaire and SPTs were performed at 6 months after improving the classroom conditions. Indoor air quality was measured at the 3 months interval in July and September of the same year after the school-based program. Results:The prevalence of itchy eczema ever and a diagnosis of atopic dermatitis, within the last 12 months was 26.4% and 12.0%, respectively. Eleven students (34.4%) showed positive results among 32 students who were examined with SPTs. All children who showed positive results were sensitized with house dust mites. After the environmental change, the prevalence of itchy eczema within the last 6 months and diagnosis of atopic dermatitis within the last 6 months was 14.7% and 7.8%, respectively. Skin reactivity assessed by mean wheal diameter decreased. Mea- sured indoor air quality values improved in all classrooms by September. Conclusion:School-based environmental changes and educational programs including a partner- ship among home, school, society, and the public health care center could be applied to better manage atopic dermatitis in school children. (Pediatr Allergy Respir Dis(Korea) 2011;21:285-293)

Effect of Living Close to Major Roadways on the Development of Asthma and Atopic Dermatitis in Children: Longitudinal Analyses of the Childrenʼs Health and Environmental Research (CHEER)

PP-29-002 Background/Aims: The objective in our study is to assess the association between individual-based exposure to traffic-related air pollutants and the development of allergy and related symptoms in a prospective children's cohort study in South Korea. Methods: We studied 2754 children ages 6–8 years from 16 schools in 7 South Korean cities, who were recruited in 2005 and 2006 as part of the first Children's Health and Environmental Research (CHEER) survey. In 2007 and 2008 all children were invited to participate in a follow-up survey. The prevalence of allergic diseases was assessed by an ISAAC questionnaire completed by the parents. We determined estimated 5-year averaged concentrations of air pollutants using measurements from nearby monitoring stations. Residential distances to the nearest major roadway and road density within a 200-m buffer were used as surrogates for traffic-related air pollutants. Subjects reporting symptoms or doctor-diagnosed allergic diseases at follow-up were considered new onset cases. Analyses of odds ratio (OR) were based on logistic regression models. Results: Urban living less than 75 m from a major roadway was associated with an increased risk of new onset wheeze and new onset doctor-diagnosed atopic dermatitis, adjusted OR = 2.06 (95% CI: 1.07–3.94) and 1.61 (95% CI: 1.01–2.58), respectively, whereas no association was found for new onset allergic rhinitis. Moreover, road density within a 200 m buffer had a dose-response relationship with new onset wheeze and new onset atopic dermatitis. The adjusted OR per increase of 100 m of total length of major roadways within a 200 m buffer was 1.21 (95% CI: 1.05–1.14) for new onset wheeze and 1.09 (95% CI: 0.99–1.20) for doctor-diagnosed atopic dermatitis. Conclusion: The results suggest that living in close proximity to a major roadway is associated with an increased risk of asthma and atopic dermatitis in school children.

Prevalence of Atopic Dermatitis in Schoolchildren in Granada, Spain

Introduction Atopic dermatitis is a common and increasingly prevalent disorder. The International Study of Asthma and Allergies in Childhood (ISAAC) made a major contribution to the understanding of its epidemiology. Objectives The aim of this study was to estimate the prevalence and severity of atopic dermatitis in a representative sample of 6 to 7-year-old and 13 to 14-year-old children from the province of Granada, Spain, using validated questionnaires and to analyze potential differences between coastal and inland regions. Material and methods This was a descriptive cross-sectional observational study of schoolchildren from Granada, Spain, aged between 6 and 7 years and 13 and 14 years. The main instrument was the core questionnaire module for dermatitis used in phase I of the ISAAC study. Results Statistically significant differences were found in Granada schoolchildren aged 6 to 7 years in terms of prevalence of dermatitis at some time, typical site, resolution in the last 12 months, and diagnosis of atopic dermatis. No significant differences were observed on comparison of the prevalence of atopic dermatitis between coastal and inland populations. Finally, in the comparison of schoolchildren aged 6 to 7 years, we observed almost significant differences for dermatitis at some time, resolution in the last 12 months, and diagnosis of atopic dermatitis on considering age and geographic location of the study population. Conclusions The prevalence of atopic dermatitis is similar in the coastal population and the provincial capital. In terms of clinical symptoms and disease course, atopic dermatitis tends to stabilize with age.

Exhaled nitric oxide: Interactions between asthma, hayfever, and atopic dermatitis in school children

Clinicians frequently rely on reported symptoms and basic pulmonary function testing to assess asthma prevalence in the community. However, given that spirometry results are often normal for asthmatic children and the fact that there is no equivalent word for 'wheeze' in languages other than English, the assessment of asthma prevalence can be troublesome. To evaluate in a population based setting, whether FeNO as a non-invasive marker, contributes to the detection of asthma. This cross-sectional study was carried out on primary school children from Northern and Southern Tyrol. FeNO measurements were made using the online single breath technique prior to spirometry. Symptom status including asthma, hayfever and atopic dermatitis was determined by the ISAAC questionnaire. Six hundred and forty-four Tyrolean children aged 8-10 years participated. In terms of FEV1 % predicted, the asthma and hayfever group had significantly lower values compared to the asymptomatic group, the hayfever only, and the atopic dermatitis only groups. For FeNO, participants with asthma and hayfever, asthma and atopic dermatitis, and hayfever only recorded significantly greater FeNO values when compared to the asymptomatic group. Moreover, the asthma and atopic dermatitis group recorded significantly greater FeNO when compared to the asthma only group. Multivariate regression revealed that asthma had a small significant inverse association with FEV1 % predicted for the individual model and when combined with hayfever. For FeNO, each of the individual and combined model analyses achieved significance. Although FeNO appears to be influenced by asthma, the presence of other atopic conditions confounds the relationship. Elevated levels of FeNO do not distinguish between asthma and other atopic conditions. Therefore, FeNO does not contribute to the detection of asthma in the community. FeNO is not a valuable tool for the detection of asthma in the community as it is confounded by other atopic conditions.

The epidemiology of atopic dermatitis in Italian schoolchildren.

Atopic dermatitis (AD) is common in children in industrialized countries. Only one large population study on its prevalence has been conducted in Italy, based on self-report questionnaire. The present study was designed to estimate the prevalence of AD in schoolchildren in Italy by dermatologists' assessment and by UK Working Party criteria, and to investigate associated symptoms and factors. Cross-sectional survey on a random sample of 9-year-old schoolchildren from seven Italian cities. Children were examined by experienced dermatologists. Parents and teachers answered standardized questionnaires. Of the 1369 children examined, 88 had a diagnosis of AD, with an estimated point prevalence of 5.8% (95% CI 4.5-7.1) in the reference population. The reported lifetime prevalence was 15.2 (95% CI 12.2-18.2) for AD, 11.9% (95% CI 9.0-14.8) for asthma, and 17.6% (95% CI 14.6-20.7) for rhino-conjunctivitis. The strongest associated factor was the presence of AD in at least one parent. No association of AD with maternal smoking during pregnancy, birth weight, maternal age at the time of the child birth and breast-feeding was observed. The environmental characteristics of the house and the school did not correlate with the prevalence of AD. Episodes of lower respiratory tract infections were associated with asthma, and to a lower extent also with AD and rhinitis. The prevalence of doctor-diagnosed AD in Italian schoolchildren is comparable to those reported for other developed countries. Family history of atopy was the single most important associated factor, while the complex interplay of environmental factors remains to be elucidated.

Trends in the prevalence of atopic dermatitis in school children: longitudinal study in Osaka Prefecture, Japan, from 1985 to 1997

The authors have carried out questionnaire surveys of health symptoms in school children (aged 7-12 years) in Osaka Prefecture, Japan. In this study, the geographical distribution of and trends in the prevalence of atopic dermatitis were evaluated. To assess the relationship between the prevalence of atopic dermatitis in children and the environmental factors, and to estimate future changes of the prevalence of atopic dermatitis. A total of seven population surveys were carried out at 2-year intervals between 1985 and 1997 in a total of about 4 million primary school children (460 000-740 000 per survey). The lifetime prevalence of atopic dermatitis increased from 15.0% in 1985 to 24.1% in 1993 but levelled off thereafter. According to the school year, the prevalence was higher in lower-year pupils. However, the prevalence stopped rising earlier in lower-year pupils and began to decrease in 1997 in first- to third-year pupils. The prevalence according to areas was significantly correlated negatively with air pollution and positively with the income index. According to the income classes, the prevalence increased until 1993 but levelled off thereafter in all classes, which reduced the differences among the classes. The increase of the prevalence of atopic dermatitis in school children stopped in 1993 in Osaka Prefecture, Japan. It is conceivable that the prevalence had reached the saturation level.

Prevalence of atopic dermatitis in Korea.

This study was designed to estimate the prevalence and personal or family history of atopic dermatitis in school children in 3 areas of Korea: urban (Seoul), industrial (Ulsan) and rural (Chunchon). On the basis of dermatologists' physical examinations and the questionnaires completed by parents or guardians, the prevalence of atopic dermatitis was estimated to be 3.3% in the industrial area, 6.6% in the rural area and 7.8% in the urban area. The frequency of atopic dermatitis decreased with age and was significantly lower in the industrial area than in the rural and urban areas.

Month of birth and prevalence of atopic dermatitis in schoolchildren: Dry skin in early infancy as a possible etiologic factor

Background: Month of birth has been shown to affect later development of allergic diseases. Objective: We sought to evaluate the relationship between month of birth and the prevalence of atopic dermatitis (AD) in a large-scale general population of schoolchildren and to elucidate the possible mechanism for this relationship. Methods: Questionnaire data on the prevalence of allergic diseases were obtained for 33,725 schoolchildren aged 7 to 15 years. In a separate study the water-holding capacity of “uninvolved” skin was compared for children with and without AD. Results: We found striking differences in the prevalence of AD according to the month of birth (χ 2 = 34.9, P < .0001). Overall, those born in autumn showed the highest (7.5%), and those born in spring showed the lowest (5.5%), prevalence of AD. There was little or no such tendency for the prevalence of bronchial asthma (χ 2 = 17.2, P = .103) and allergic rhinitis (χ 2 = 24, P = .01). We found no statistical variation across birth month in the ratio of AD with no other allergic disease/total AD, indicating that this deviation was observed whatever the allergic predisposition of the subjects. In a separate study a significantly lower water-holding capacity of uninvolved skin was observed in children with AD even from early infancy. Conclusion: These findings lead us to speculate that the climate in early infancy affects the skin condition and that those born in autumn have dry skin in early infancy, which may ultimately result in a higher prevalence of AD among young schoolchildren. This might be at least one of the “nonallergic” etiologic factors of this complex disease. (J Allergy Clin Immunol 1999;103:1148-52.)