Frequency Of Atopic Dermatitis Research Articles

Frequency of atopic dermatitis and psoriasis in the elderly - Cross-sectional findings from the German AugUR study.

Introduction Atopic Dermatitis (AD) and psoriasis appear to affect 2-3% (lifetime prevalence) people worldwide. However, there is little epidemiological data on the prevalence of those two chronic inflammatory skin diseases in the elderly. The aim of this study was to provide frequency estimates of AD and psoriasis obtained from an elderly population in Germany. Methods We examined baseline data from the AugUR study, a cohort study focusing on an aging population within the vicinity of Regensburg, Germany (comprising 1,133 participants with a median age of 76.7 years, 45% being female). We estimated raw frequencies of physician-diagnosed AD and psoriasis from participants' self-reports in personal interviews. These frequencies were adjusted to reflect the demographic distribution of the Bavarian population, considering both gender and age groupings spanning five or ten years. Results Data from 1,133 participants aged 70-95 (45.1% women) were available for analysis. Physician-diagnosed AD was reported by 3.3 % of participants (2.4% from men, 4.3% from women) and 5.6% (95%-CI: 4.3-7.1%) reported physician-diagnosed psoriasis (6.6% in men, 4.3% in women). Age- and gender-standardized frequency estimates for AD were 3.4% (95%-CI: 2.4-4.6, 2.6% in men, 4.3% in women) and 5.3% for psoriasis (95%-CI: 4.1-6.8, 6.3% in men and 4.1% in women). Conclusion This study indicates a lower than previously reported lifetime-prevalence of AD (3.4% vs. 8-10%) and a higher one regarding psoriasis (5.3% vs. 2-4%) in highly aged individuals. More epidemiological research in elderly populations using validated physician diagnoses are desirable.

The Frequency of Atopic Dermatitis and Other Skin Manifestations in Infants with Cow’s Milk Proteın Allergy in Karabük, Turkey

Background Atopic dermatitis (AD) is the most common skin disease in childhood, and Cow's milk protein allergy (CMPA) is the most common cause of food allergies in infancy and may be characterized by atopic dermatitis with skin involvement as the first finding. The aim of this study is to determine the serum eosinophil cationic protein (sECP) levels, eosinophil counts and the frequency of AD and other skin manifestation among infants with CMPA. Materials and Methods: This cross-sectional study was conducted in Karabuk province, Turkey. Eighty-three infants who were diagnosed with CMPA and followed at the Karabuk Training Hospital Pediatric outpatient clinic. The first group consisted of 52 infants presenting with skin manifestations. The second group consisted of 31 infants who were not presenting skin manifestations. The sECP level of infants in both groups was measured using an Immulite 2000 XPi analyzer Immunoassay System (Germany). Results: Of 83 infants with CMPA, 62.6% (n=52) were detected skin involvement as the first finding. The proportions of atopic dermatitis and urticaria in CMPA infants with skin involvement were 90.4% and 9.6% respectively. The median sECP level and eosinophil counts (56.5 ng/mL vs 470/mm3, p-value=0.001), in skin manifestations with CMPA group were significantly higher than that in the CMPA group without skin manifestations (33.1 ng/mL vs. 270/mm3, p-value=0.006). Conclusion This study revealed that AD is the most common skin manifestation of CMPA and also found higher sECP levels in infants with skin involvement. The frequency of both diseases, which are easily treated with elimination diet, is increasing day by day.

Dermatoses in children in the Republic of Palau

The spectrum of dermatoses in the pediatric population of the Republic of Palau is unknown and largely unmentioned in publication. All Palauan pediatric patients who consulted the Shin Kong Medical Assistant Program to Palau dermatology services at Belau National Hospital (BNH) and local dispensaries from 2015 to 2018 were analyzed. The results were classified according to age and sex and also analyzed by region. This population included a total of 155 patients, with 92 girls and 63 boys. Eczema (52.9%), superficial fungal infection (21.93%), and bacterial infection (16.77%) were the most frequent conditions. More than 20% of the patients presented with more than one concurrent skin disease. Among the disease spectrum, the frequency of atopic dermatitis was comparable: 29.1% in girls and 28.6% in boys. Superficial fungal infections were more common in boys, with a frequency of 31.7% as opposed to 15.2% in girls. The results were also analyzed according to region: 123 patients were seen at BNH and 32 patients were seen at the local dispensaries. Bacterial infection was more common at the local dispensaries (37.5%) than at BNH (11.4%). Hereby, we describe the pattern of skin diseases in Palauan children.

Frequency of Asthma and Atopic Diseases in Inflammatory Bowel Disease and Celiac Disease.

To compare the frequency of asthma and allergic diseases in patients with inflammatory bowel disease and Celiac disease using international study of asthma and allergies in childhood questionnaire. Cross-sectional, descriptive study. Pediatric gastroenterology outpatient clinics and pediatric pulmonology outpatient clinics, from May 2015 to August 2015. Patients aged between 6 and 18 years with the diagnoses of celiac and inflammatory bowel disease were included in the study. After recording the socio-demographic characteristics of all patients, the International study of asthma and allergies in childhood questionnaire was applied and required information collected. Eighty-three patients (31 males, 52 females) diagnosed with celiac, 42 patients (24 males, 18 females) diagnosed with ulcerative colitis, and 28 patients (11 females, 17 males) diagnosed with Crohn's disease were included. No significant difference was found between the groups in terms of the frequency of wheezing, wheezing in the last year, lifelong allergic rhinitis, long-term use of nasal steroids, and history of eczema (p >0.05). The frequency of atopic dermatitis was significantly higher in the celiac disease group than the other groups. The frequencies of asthma and atopy are similar in patients with celiac disease and inflammatory bowel disease.

A study of skin disease spectrum occurring in Angola phototype V-VI population in Luanda.

Prevalence of skin diseases in Luanda (Angola) is unknown, and publications are barely found in the literature. We aim to describe, for the first time, the frequency of skin disease spectrum in phototype V-VI Angolan population in Luanda City. We included Fitzpatrick phototype V-VI Angolan patients who consulted the Dermatology Unit in Luanda Medical Center during a 1-year period. Medical information was recovered from the electronic database, and diagnoses were based on ICD-10. Only the main complaint was registered, and the results were classified according to age and sex. Criteria exclusion consisted of incomplete clinical records, Fitzpatrick phototype I-IV Angolan, or foreign patients from the study. From a total of 3938 patients, 3554 met the inclusion criteria, of which 2742 were adults 13 years or older. In this group, acne (23.6%), dermatophytosis (11.0%), and pityriasis versicolor (8.6%) were the main complaints. On the other hand, in the pediatric population (n = 812), atopic dermatitis (29.4%), tinea capitis (13.7%), and molluscum contagiosum (12.5%) were the most frequent disorders. In adult females, acne (31.3%) was the main condition, while in adult males, dermatophytosis (13.5%). In children, the frequency of atopic dermatitis was comparable: 29.1% and 28.6% in girls and boys, respectively. We published for the first time the frequency of the skin disease spectrum in Fitzpatrick phototype V-VI Angolan population in Luanda City, highlighting the prevalence of acne, dermatophytosis, and atopic dermatitis.

Evaluation of efficacy and safety of Lactobacillus rhamnosus in children aged 4-48months with atopic dermatitis: An 8-week, double-blind, randomized, placebo-controlled study.

The main objective of this study was to evaluate the efficacy and safety of Lactobacillus rhamnosus in children aged 4-48months with atopic dermatitis. The design of this study was a two-center, double-blind, randomized, and placebo-controlled study with two parallel groups to evaluate the efficacy and safety profile of L. rhamnosus in children aged 4-48months with atopic dermatitis diagnosed using Hanifin and Rajka criteria and with a Scoring of Atopic Dermatitis (SCORAD)≥15 at enrollment. The duration of this study was 8weeks with a total of five visits. The enrolled patients were allocated into either a treatment group (one ComProbi capsule containing L. rhamnosus a day) or a control group (one capsule of placebo a day) at a ratio of 1:1. The primary endpoint was to compare the mean change from baseline in SCORAD after 8weeks of treatment. The other secondary end points were to compare the following: the mean changes from baseline in SCORAD at postbaseline visits, the frequency and total amount of the use of corticosteroids during the 8-week treatment, the frequency of atopic dermatitis and the symptom-free duration, the mean changes from baseline in Infant Dermatitis Quality of Life Questionnaire at Week 4 and Week 8, and the mean changes from baseline in the Dermatitis Family Impact Questionnaire at Week 4 and Week 8. The mean changes in SCORAD from baseline at Week 8 was -21.69±16.56 in the L. rhamnosus group and -12.35±12.82 in the placebo group for the intent-to-treat population (p=0.014). For the per-protocol population, the mean change of SCORAD from baseline was -23.20±15.24 in the L. rhamnosus group and -12.35±12.82 in the placebo group (p=0.003). Significant differences were demonstrated between groups at Week 8 in intensity in the intent-to-treat population and per-protocol population. Throughout the period, the amount of topical corticosteroids used showed no difference between groups. No significant difference was noted in the overall symptom-free durations compared with the placebo group. Infant Dermatitis Quality of Life Questionnaires and Dermatitis Family Impact Questionnaires scores improved significantly at Week 4 and Week 8 but did not reach statistical significance. Adverse events were documented in 14/33 patients in the L. rhamnosus group (42.42%, 35 events) and in 15/33 placebo patients (45.45%, 37 events). The results of this study indicated that L. rhamnosus was effective in decreasing symptoms of atopic dermatitis after an 8-week treatment by comparing the mean change of SCORAD from baseline with a placebo (p<0.05). The reduction in SCORAD resulted from a consistent decrease in all components of SCORAD. Patients who took L. rhamnosus for 8weeks expressed less SCORAD in the three components: area of affected skin, intensity of atopic dermatitis, and patient symptoms, with a significant decrease in the mean change of intensity from baseline compared with placebo.

Prevalencia de las enfermedades alérgicas y su asociación con la lactancia materna y el inicio de la alimentación complementaria en niños de edad escolar de Ciudad Guzmán, México

The effect that breastfeeding and complementary feeding practices have on the prevalence of allergic diseases has shown inconsistent results. To assess the effect of breastfeeding and the initiation of complementary feeding on the prevalence of allergic disease. Analytical, crosssectional population-based study conducted in 6-12 year old children attending primary school and selected through a multistage sampling technique. A structured questionnaire was administered to parents or tutors to identify allergic diseases (asthma, allergic rhinitis, or atopic dermatitis), a history of prolonged breastfeeding and age at initiation of complementary feeding. A logistic regression analysis was used to establish associations among variables. A total of 740 children were included. The frequency of breastfeeding for >6 months was 73.4%, and of complementary feeding at <4 months old was 31.9%. Prolonged breastfeeding showed no effect on the prevalence of allergic diseases. A protective effect was observed on the frequency of atopic dermatitis when complementary feeding was initiated late, adjusted OR= 0.36, 95% confidence interval (CI): 0.1-0.8 (p 0.019). The protective effect of breastfeeding against the prevalence of allergic diseases has not been demonstrated. There is a reduction in the prevalence of atopic dermatitis when complementary feeding is started late.

858 Analysis of the Incidence of Giardiasis in Children with Atopic Dermatitis

Atopic dermatitis holds the first place among children’s allergic diseases. One of its proven ethiopathogenetic factors is parasitosis, affecting the course of dermatoses and leading to frequent recurrences and chronization...

Probiotics and prevention of allergic disease

Over the past few decades, public reports have shown increasing enthusiasm for the potential health effects of probiotics. Therefore, the purpose of this review is to focus on studies, which have addressed the use of probiotics for primary prevention of atopic diseases. The Finnish study of Kalliomaki was the first report to describe that the frequency of atopic dermatitis in neonates treated with Lactobacillus rhamnosus GG (LGG) was half that of the placebo. Recently, these results have been questioned by two trials, which reported no difference in the development of atopic dermatitis in neonates supplemented with LGG and L. acidophilus, respectively. In contrast, an unexpected increase in respiratory side-effects was observed in some studies in children who received the probiotics. Up to now no data have been released which report a positive effect of probiotics for the prevention of allergic rhinitis or asthma. Moreover, an allergen-preventive effect of probiotics for the development of atopic dermatitis could not be consistently established. In conclusion, probiotics cannot be generally recommended for primary prevention of atopic disease. Further studies should clarify if any susceptible subgroups exist and how these subgroups benefit from supplementation with certain probiotic strains. Moreover, the selection of the most beneficial probiotic strain or the composition of different probiotics and/or prebiotics, the dose and the timing of supplementation still need to be determined.

Prevalence of Atopic Dermatitis in Italian Schoolchildren: Factors Affecting its Variation

The frequency of atopic dermatitis in Italian children and its relationship with selected variables were analysed in a large survey of skin health conducted in Italy. In 1997 we conducted a survey on schoolchildren aged 12-17 years from 13 areas of northern, central and southern Italy. For the present analyses, 3179 Caucasian children (1618 males, 1561 females) were considered. A diagnosis of atopic dermatitis was reported in 224 cases (7.0%). The frequency of reported atopic dermatitis was significantly higher in children with asthma (rate ratio (RR) 4.5; 95% confidence interval (CI) 3.1-6.5). The lifetime prevalence of a diagnosis of atopic dermatitis was higher among schoolchildren reporting a diagnosis of psoriasis (RR 5.5, 95% CI 3.0-10.1) and vitiligo (RR 16.1, 95% CI 6.5-39.5). This study gives estimates of the lifetime prevalence of atopic dermatitis in adolescents in Italy and emphasizes the direct association between the condition and other immune-related skin diseases.

Epidemiology of Atopic Dermatitis in Primary Schoolchildren in Turkey

The present study aimed to investigate the prevalence of atopic dermatitis in primary schoolchildren in Denizli, Turkey, and to determine the possible risk factors for atopic dermatitis in home environment. A self-administered questionnaire was handled to the parents of 2,100 children aged 7 to 15 years, from three randomized primary schools and 1,644 (78.9%) completed and returned the questionnaire. The questionnaire included the United Kingdom Working Party diagnostic criteria and asked about conditions that could affect the course of atopic dermatitis. The prevalence of atopic dermatitis and coexisting factors that may affect the course of the disease were evaluated in 1,644 children (825 girls and 819 boys). The prevalence of atopic dermatitis was detected as 4.9%. Passive smoking, heating systems either in the house or in the child's bedroom, and the number of people living in the house had no significant effect (p > 0.005). The difference in prevalence of atopic dermatitis between developed and developing countries is striking. The determination of the factors that have an influence in this issue will probably enable us to change the course and frequency of atopic dermatitis.

Role of Eosinophil Cationic Protein as a Predictor for Atopic Dermatitis Flare-ups

RASHONALE: To report the results of a study that investigate the relation between serum Eosinophilic Cation protein (ECP) and frequency of Atopic dermatitis (AD) flare- ups. METHODS: A cohort of 36 patients with atopic dermatitis was followed up for 1 year. Study subjects were evaluated for frequency of AD flare-ups (based on use of rescue medications, sick visits for flare-ups). Study subjects were divided into Group A and B. Group A comprised of patients with 3 or less flare-ups /yr and in group B subjects had flare-ups >4 /yr. Serum ECP levels were obtained and divided into four categories (Level I 10-20 mcg/L, Level II 21-40mcg/L, Level III .41-60mcg/L and Level IV ECP >60mcg/L). RESULTS: i) 14 patients had ECP level in category I, 10 in category II, 6 in category III and 6 patients were placed in category IV. ii) 23 patients had 3 or less flare ups/yr (Group A) and 13 had 4 or more flare-ups /yr (Group B). iii)In Group A 14 subjects had ECP level in category I, 6 in category II,2 in category III and one patient had ECP in category IV. iv) Out of 13 subjects in Group B, 4 had ECP in category I, 6 in category II, 2 in category III and 1 was in category IV. CONCLUSIONS: Although ECP may be helpful in monitoring disease activity in AD, however it may not be a good indicator to predict atopic dermatitis flare ups especially in children with moderate to severe elevation of ECP.

P78 Frequency and development of atopic dermatitis in Norway

Investigations in several western countries, especially european, have shown an increase in the frequency of atopic disease. To investigate these trends in Norway, the following procedure was followed.Using four standardized interview‐reports the development and the frequency of atopic dermatitis was determined.The questionnaires were conducted in the years 1968, 1975, 1985 and 1995. The results were registred electronically, and made available on the Statistical Package for the Social Sciences (SPSS) in Windows version.In 1968 420 out of 11101 persons suffered from a skin disease.The diagnosis atopic dermatitis was not recorded in 1968, in 1975 0.7% of all skin disease considered atopic dermatitis, in 1985 1.3% and in 1995 10.1%.The results show an increased incidence of atopic dermatitis in Norway, comparable to other western countries.Connections to air pollution, indoor environment, especially smoking are at present under investigation.

P77 Incidence of psoriasis in Norway

Investigations in several western countries, especially european, have shown an increase in the frequency of psoriasis. To investigate these trends in Norway, the following procedure was followed.Using four standardized interview‐reports the development and the frequency of atopic dermatitis was determined.The questionnaires were conducted in the years 1968, 1975, 1985 and 1995. The results were registred electronically, and made available on the Statistical Package for the Social Sciences (SPSS) in Windows version.In 1968 420 out of 11101 persons suffered from a skin disease, in 1975 the number had increased to 690 out of 11014 persons. These numbers still increased; in 1985 1136 out of 10576 and in 1995 1026 out of 10248 said to suffer from a skin disease.The diagnosis psoriasis was reported by 34 persons in 1968 (8% of all skin disease), increased to 97 in 1975 (14.1%), to 149 in 1985 (13.1%), and finally to 284 in 1995 (26.7%).In all, the infectious skin diseases decreased in number, whereas inflammatory skin diseases, such as psoriasis but also atopic dermatitis increased.Connections to air pollution, indoor environment, especially smoking are at present under investigation.These results indicate that psoriasis is among the most frequent skin diseases in Norway, comparable to other western industrialized countries.

Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: A randomized, controlled trial

Background There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of allergic disease. Objective We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants. Methods In a randomized, controlled trial 98 atopic, pregnant women received fish oil (3.7 g n-3 PUFAs per day) or placebo from 20 weeks' gestation until delivery. Neonatal PUFA levels and immunologic response to allergens were measured at birth. Results Eighty-three women completed the study. Fish oil supplementation (n = 40) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes (mean ± SD, 17.75% ± 1.85% as a percentage of total fatty acids) compared with the control group (n = 43, 13.69% ± 1.22%, P < .001). All neonatal cytokine (IL-5, IL-13, IL-10, and IFN-γ) responses (to all allergens) tended to be lower in the fish oil group (statistically significant only for IL-10 in response to cat). Although this study was not designed to examine clinical effects, we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (odds ratio, 0.34; 95% confidence interval, 0.11 to 1.02; P = .055). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had significantly less severe disease (odds ratio, 0.09; 95% confidence interval, 0.01 to 0.94; P = .045). Conclusions These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation. More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children.

Incidence and predictors of atopic dermatitis in an open birth cohort in Sisimiut, Greenland.

The frequency of atopic dermatitis (AD) is unknown among children in Greenland. To determine the incidence of AD and to identify risk factors for onset of AD within the first 2 y of life among Greenlandic children an open cohort of 143 children aged 0-2 y in Sisimiut, West Greenland, was followed for a median of 335 d. The children were visited on a weekly basis, where clinical examinations revealed any cases of AD. In total, 24 of the 143 children developed AD. The incidence rate of AD was 177 cases per 1000 child years at risk, corresponding to a cumulative risk of 16% per year. Maternal history of AD [hazard ratio (HR) 2.6, 95% confidence interval (CI) 1.03-6.57], high social class of the family (HR 6.18, CI 2.19-17.41) and living in a detached house compared with living in a terraced house or an apartment (HR 2.81, CI 1.16-6.28) were associated with increased risks of AD. In a multivariate model these risk factors all remained significant. The findings confirm that AD represents a health problem among Greenlandic infants and that the pattern of predictive risk factors associated with the development of AD is comparable to that found in northern European countries.

The occurrence of atopic dermatitis in North Europe: An international questionnaire study

Background: Atopic dermatitis is a common multifactorial disease that seems to be increasing in frequency. Objective: Our purpose was to determine the increased prevalence of atopic dermatitis in North Europe. Methods: Approximately 3000 7-year-old school children in Denmark, Germany, and Sweden were enrolled in a cross-sectional questionnaire study that was conducted in the autumn of 1992 with common protocols and standardized procedures. Results: The response rate was 90%. The frequency of atopic dermatitis was calculated to be 15.6% (95% confidence interval 14.2% to 17%) with some regional differences. Girls more often had flexural eczema and outnumbered boys in a ratio of 1.3:1.0. Boys more often had a personal history of asthma, whereas girls more often had a family history of asthma. Conclusion: The increasing prevalence of atopic dermatitis has been confirmed. This simple questionnaire model works well, is cost effective, and is sufficiently sensitive and specific to conduct large-scale epidemiologic investigations in school children.

An epidemiological study of hand eczema. III. Characterization of hairdressers with and without hand eczema, regarding demographic factors and medical histories

The aim of this study was to compare, by stratification, subgroups of hairdressers. Three groups were considered: Group I (102 persons) consisted of hairdressers reporting skin affection at the time of completing an earlier mailed questionnaire (point prevalence). Group II reported exanthema prior to completing, while group III reported not having had exanthema at all (51 and 50 persons, respectively). No significant difference was found between these groups with regard to age and duration in work. The mean number of months since start of disease was significantly higher for group I (64 (range: 0.5-552)) than group II (7 (range: 0.6-38)). The frequency of atopic dermatitis was 12.7% (C.I: 6.3-19.2) in group I, compared with 3.9% (C.I: 0.0-9.2) in group II and none in group III. This difference between groups was significant. A significantly higher extent of sick leave was found in group I, compared to group II.

Atopic dermatitis: A genetic-epidemiologic study in a population-based twin sample

Atopic dermatitis is a common multifactorial disease that seems to be increasing in frequency. Our purpose was to evaluate and expand previous findings on the incidence of atopic dermatitis and its concordance rates in twins. A mailed questionnaire study was conducted. It involved 812 twin pairs living in Fyn County, Denmark, as of Jan. 1, 1987 and born between 1965 and 1979. Zygosity was determined by the similarity method. The response rate was 92%. The cumulative incidence rate (up to 7 years) of atopic dermatitis increased significantly from 0.06 for the birth cohort 1965-1969 to 0.12 for the birth cohort 1975-1979. The pairwise concordance rate was 0.72 in monozygotic and 0.23 in dizygotic twin pairs. The frequency of atopic dermatitis is still increasing but not as rapidly as in the 1960s. The magnitude of the concordance rates indicates that genetic factors are decisive in the development of atopic dermatitis. It is suggested that widespread environmental factors are operating in genetically susceptible persons.

Secular change in the occurrence of atopic dermatitis.

Atopic dermatitis is a common disease, and population-based studies indicate that the frequency of atopic dermatitis has increased substantially during recent decades. It has been generally accepted that disease onset occurs before 7 years of age in 80-90% of the cases, and consequently the epidemiology of atopic dermatitis has been studied mostly in children on admission of first grade school. Before 1960 about 2-3% of children suffered from atopic dermatitis. In the 1960s, some 4-8% was recorded in several studies, and for those born after 1970 most researchers found that 9-12% developed atopic dermatitis during childhood. The diagnostic criteria of Hanifin and Rajka are cumbersome for population studies not designed specifically for children. In order to compare epidemiologic data from varying times and locations, a framework for questionnaire studies in atopic dermatitis is proposed.