Evaluation of Patients with Atopic Dermatitis

INTRODUCTION: Infants with Atopic Dermatitis (AD) are predisposed to develop allergic rhinitis (AR) and/or asthma later in childhood. We aimed to investigate clinical features, accompaning allergic diseases and laboratory findings of AD in childhood and analyze the risk factors for recurrent wheeze (RW) and other allergic diseases among these children.
METHODS: We have retrospectively evaluated medical records of 298 patients who had been followed-up for AD between 2006-2010 in Pediatric Allergy Clinic.
RESULTS: We studied 298 patients (108 female, 190 male) with a mean age at referral of 18.1±21.5 months. Atopic sensitization was detected in 148 children (51.6%). A hundred and four children (34.9%) had RW episodes and 13.1% AR. The leading site of initial involvement was face (60.4%), followed by arm (32%), trunk (9.4%) and leg (6.5%). A positive history of maternalatopy was 34.2% and
paternal atopy 28.5%. Risk factors associated with RW included recurrent respiratory infections, history of hospitalization, environmental tobacco smoke (ETS) and gastroesophageal reflux (GER). We detected no association between RW and breast-feeding, gender, high Ig E level, site of involvement or family history of atopy. Meanwhile, presence of atopy was associated with paternal atopy, recurrent infections, history of hospitalization and inhaled corticosteroid (ICS) use.
DISCUSSION AND CONCLUSION: Among a group of children with AD 51.6% were found to be atopic and 35% had RW. Risk factors for recurrence of wheeze included recurrent respiratory infections, history of hospitalization, ETS and GER. These risk factors should be considered in the management of children with AD who present with wheezing episodes.